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Sample records for health organization criteria

  1. Setting priorities in health care organizations: criteria, processes, and parameters of success.

    Science.gov (United States)

    Gibson, Jennifer L; Martin, Douglas K; Singer, Peter A

    2004-09-08

    Hospitals and regional health authorities must set priorities in the face of resource constraints. Decision-makers seek practical ways to set priorities fairly in strategic planning, but find limited guidance from the literature. Very little has been reported from the perspective of Board members and senior managers about what criteria, processes and parameters of success they would use to set priorities fairly. We facilitated workshops for board members and senior leadership at three health care organizations to assist them in developing a strategy for fair priority setting. Workshop participants identified 8 priority setting criteria, 10 key priority setting process elements, and 6 parameters of success that they would use to set priorities in their organizations. Decision-makers in other organizations can draw lessons from these findings to enhance the fairness of their priority setting decision-making. Lessons learned in three workshops fill an important gap in the literature about what criteria, processes, and parameters of success Board members and senior managers would use to set priorities fairly.

  2. Setting priorities in health care organizations: criteria, processes, and parameters of success

    Directory of Open Access Journals (Sweden)

    Martin Douglas K

    2004-09-01

    Full Text Available Abstract Background Hospitals and regional health authorities must set priorities in the face of resource constraints. Decision-makers seek practical ways to set priorities fairly in strategic planning, but find limited guidance from the literature. Very little has been reported from the perspective of Board members and senior managers about what criteria, processes and parameters of success they would use to set priorities fairly. Discussion We facilitated workshops for board members and senior leadership at three health care organizations to assist them in developing a strategy for fair priority setting. Workshop participants identified 8 priority setting criteria, 10 key priority setting process elements, and 6 parameters of success that they would use to set priorities in their organizations. Decision-makers in other organizations can draw lessons from these findings to enhance the fairness of their priority setting decision-making. Summary Lessons learned in three workshops fill an important gap in the literature about what criteria, processes, and parameters of success Board members and senior managers would use to set priorities fairly.

  3. The 1997 American Diabetes Association criteria versus the 1985 World Health Organization criteria for the diagnosis of abnormal glucose tolerance : poor agreement in the Hoorn Study

    NARCIS (Netherlands)

    de Vegt, F; Dekker, J M; Stehouwer, C D; Nijpels, G; Bouter, L M; Heine, R J

    1998-01-01

    OBJECTIVE: Recently, the American Diabetes Association (ADA) introduced new diagnostic criteria. These new criteria are based on fasting plasma glucose levels, avoiding the burdensome oral glucose tolerance test (OGTT). We compared the 1997 ADA criteria with the 1985 World Health Organization (WHO)

  4. Reproducibility of the World Health Organization 2008 criteria for myelodysplastic syndromes.

    Science.gov (United States)

    Senent, Leonor; Arenillas, Leonor; Luño, Elisa; Ruiz, Juan C; Sanz, Guillermo; Florensa, Lourdes

    2013-04-01

    The reproducibility of the World Health Organization 2008 classification for myelodysplastic syndromes is uncertain and its assessment was the major aim of this study. The different peripheral blood and bone marrow variables required for an adequate morphological classification were blindly evaluated by four cytomorphologists in samples from 50 patients with myelodysplastic syndromes. The degree of agreement among observers was calculated using intraclass correlation coefficient and the generalized kappa statistic for multiple raters. The degree of agreement for the percentages of blasts in bone marrow and peripheral blood, ring sideroblasts in bone marrow, and erythroid, granulocytic and megakaryocytic dysplastic cells was strong (P<0.001 in all instances). After stratifying the percentages according to the categories required for the assignment of World Health Organization subtypes, the degree of agreement was not statistically significant for cases with 5-9% blasts in bone marrow (P=0.07), 0.1-1% blasts in peripheral blood (P=0.47), or percentage of erythroid dysplastic cells (P=0.49). Finally, the interobserver concordance for World Health Organization-defined subtypes showed a moderate overall agreement (P<0.001), the reproducibility being lower for cases with refractory anemia with excess of blasts type 1 (P=0.05) and refractory anemia with ring sideroblasts (P=0.09). In conclusion, the reproducibility of the World Health Organization 2008 classification for myelodysplastic syndromes is acceptable but the defining criteria for blast cells and features of erythroid dysplasia need to be refined.

  5. Diagnosis of Tuberculosis Following World Health Organization-Recommended Criteria in Severely Malnourished Children Presenting With Pneumonia.

    Science.gov (United States)

    Chisti, Mohammod Jobayer; Salam, Mohammed Abdus; Shahid, Abu S M S B; Shahunja, K M; Das, Sumon Kumar; Faruque, Abu Syed Golam; Bardhan, Pradip Kumar; Ahmed, Tahmeed

    2017-01-01

    Evidences on diagnosis of tuberculosis (TB) following the World Health Organization (WHO) criteria in children with severe acute malnutrition (SAM) are lacking. We sought to evaluate the WHO criteria for the diagnosis of TB in such children. In this prospective study, we enrolled SAM children aged <5 with radiological pneumonia. We collected induced sputum and gastric lavage for smear microscopy, mycobacterial culture, and Xpert MTB/RIF. Using the last 2 methods as the gold standard, we determined sensitivity, specificity, and positive and negative predictive values of WHO criteria (n = 388). However, Xpert MTB/RIF was performed on the last 214 children. Compared to mycobacterial culture-confirmed TB, sensitivity and specificity (95% confidence interval) of WHO criteria were 40 (14% to 73%) and 84 (80% to 87%), respectively. Compared to culture- and/or Xpert MTB/RIF-confirmed TB, the values were 22% (9% to 43%) and 83 (79% to 87%), respectively. Thus, the good specificity of the WHO criteria may help minimize overtreatment with anti-TB therapy in SAM children, especially in resource-limited settings.

  6. WHO environmental health criteria for oxides of nitrogen

    Energy Technology Data Exchange (ETDEWEB)

    1977-01-01

    A report in preparation by the World Health Organization (WHO), Geneva, on the Environmental Health Criteria for Oxides of Nitrogen is summarized. This report will be published under the joint sponsorship of the United Nations Environment Program (UNEP) and WHO. Chemistry and analytical methods, sources of oxides of nitrogen, environmental levels and exposures, effects on experimental animals, effects on man, and evaluation of health risks are discussed. Further research on the reaction of sensitive biological systems to nitrogen dioxide and oxidants, on the biological effects of nitric acid and nitrates, on the possibility of delayed effects, on epidemiological studies of occupational and community groups, and on asthmatic subjects and persons with cardiopulmonary disease was recommended.

  7. Towards an evaluation framework for information quality management (IQM) practices for health information systems--evaluation criteria for effective IQM practices.

    Science.gov (United States)

    Mohammed, Siti Asma; Yusof, Maryati Mohd

    2013-04-01

    Poor information quality (IQ) must be understood as a business problem rather than systems problem. In health care organization, what is required is an effective quality management that continuously manages and reviews the factors influencing IQ in health information systems (HIS) so as to achieve the desired outcomes. Hence, in order to understand the issues of information quality management (IQM) practices in health care organizations, a more holistic evaluation study should be undertaken to investigate the IQM practices in health care organizations. It is the aim of this paper to identify the significant evaluation criteria that influence the production of good IQ in HIS. Six selected frameworks and best practices both from health informatics and information systems literature have been reviewed to identify the evaluation criteria from the perspective of human, organizational and technological factors. From the review, it was found that human and organization factors are of greater significance in influencing HIS IQ. Our review depicts that there is still shortage in finding a comprehensive IQM evaluation framework. Thus, the criteria from the frameworks reviewed can be used in combination for more comprehensive evaluation criteria. Integrated IQM evaluation criteria for HIS are then proposed in this study. Poor IQ is the result of complex interdependency within sociotechnical factors in health care organization and lack of formal and structured IQM practices. Thus, a feedback mechanism such as evaluation is needed to understand the issues in depth in the future. © 2012 Blackwell Publishing Ltd.

  8. First International Public Health Film Competition 2016-reflections on the development and use of competition judging criteria.

    Science.gov (United States)

    Hoang, U; Luna, P; Russell, P; Bergonzi-King, L; Ashton, J; McCarthy, C; Donovan, H; Inman, P; Seminog, O; Botchway, S

    2018-03-01

    Film competitions can be a helpful method to understand issues of quality in health films. In this paper, we describe the development and use of explicit quality criteria to identify the 'best' films for the first ever international public health film competition. A film selection committee encompassing a range of stakeholders was compiled. The committee drew up 10 explicit quality criteria to judge films drawing upon other film festival's selection criteria. These criteria were then applied to a broad range of health-related films entered into a film competition to select the 'best' film to screen. Eighty-four films from 20 different countries were submitted to the public health film competition. The originality of the subject covered by the film, the public health importance of the issue and story-telling approach in the film were found to be the most discriminatory criteria to select films. Selection of health films for festivals can be undertaken using explicit quality criteria. There are a number of advantages to such an approach; however, explicit selection involves a large commitment of resources from film festival organizers and there is further research required to test the validity of the quality criteria applied to health-related films.

  9. Environmental assessment in health care organizations.

    Science.gov (United States)

    Romero, Isabel; Carnero, María Carmen

    2017-12-22

    The aim of this research is to design a multi-criteria model for environmental assessment of health care organizations. This is a model which guarantees the objectivity of the results obtained, is easy to apply, and incorporates a series of criteria, and their corresponding descriptors, relevant to the internal environmental auditing processes of the hospital. Furthermore, judgments were given by three experts from the areas of health, the environment, and multi-criteria decision techniques. From the values assigned, geometric means were calculated, giving weightings for the criteria of the model. This innovative model is intended for application within a continuous improvement process. A practical case from a Spanish hospital is included at the end. Information contained in the sustainability report provided the data needed to apply the model. The example contains all the criteria previously defined in the model. The results obtained show that the best-satisfied criteria are those related to energy consumption, generation of hazardous waste, legal matters, environmental sensitivity of staff, patients and others, and the environmental management of suppliers. On the other hand, those areas returning poor results are control of atmospheric emissions, increase in consumption of renewable energies, and the logistics of waste produced. It is recommended that steps be taken to correct these deficiencies, thus leading to an acceptable increase in the sustainability of the hospital.

  10. Organic farming and multi-criteria decisions

    DEFF Research Database (Denmark)

    Christensen, Tove; Olsen, Søren Bøye; Dubgaard, Alex

    of the many different Multi-Criteria Analysis (MCA) techniques available and their relative advantages and disadvantages. In addition, theoretical and practical problems related to the use of Cost-Benefit Analysis (CBA) and MCA respectively are briefly discussed. We then review the MCA literature on case...... studies on organic farming. Based on this review we provide directional markers for future research where MCA may possibly be applied and adapted in order to provide useful knowledge and support for decision makers in the context of organic farming....

  11. The impact of inclusion criteria in health economic assessments.

    Science.gov (United States)

    Richter, Anke; Thieda, Patricia; Thaler, Kylie; Gartlehner, Gerald

    2011-05-01

    The debate surrounding whether the findings of efficacy studies are applicable to real-world treatment situations is ongoing. The issue of lack of applicability due to a lack of clinical heterogeneity could be addressed by employing less restrictive inclusion criteria. Given that health economic assessments based on cost-effectiveness measures are required by many governments and insurance providers, the impact of this choice may be far reaching. The objective of this article was to explore the use of a pilot study to examine the impact of inclusion criteria on cost-effectiveness results and clinical heterogeneity. A health economic assessment was conducted using QRISK®2 and simulation modelling of different population groups within the pilot study in Lower Austria. Patients were referred by their family physicians to 'Active Prevention' (Vorsorge Aktiv), a community-based lifestyle intervention focused on exercise and nutritional programmes. Cardiovascular risk factors were recorded before and after the intervention and translated to cardiovascular events. As expected, enforcing restrictive inclusion criteria produced stronger and more irrefutable computations - in the expected number of events, the number of deaths, the incremental cost per life-year saved and in the 95% confidence interval. These findings provide insight into the issues surrounding clinical heterogeneity and the need for restrictive inclusion criteria. This is not a full health economic assessment of the intervention. While inclusion criteria provide stronger results by limiting populations to those who would benefit the most, they must be enforced, both within and outside the clinical trial setting. Enforcement has costs, both monetary and arising from unintended negative consequences of enforcement mechanisms. All these considerations will affect the results realized by the payer organization. A pilot study can reveal whether an intervention may be cost effective 'enough' without restrictive

  12. Overview criteria for the environmental, safety and health evaluation of remedial action project planning

    International Nuclear Information System (INIS)

    Stenner, R.D.; Denham, D.H.

    1984-10-01

    Overview criteria (i.e., subject areas requiring review) for evaluating remedial action project plans with respect to environmental, safety and health issues were developed as part of a Department of Energy, Office of Operational Safety, technical support project. Nineteen elements were identified as criteria that should be addressed during the planning process of a remedial action (decontamination and decommissioning) project. The scope was interpreted broadly enough to include such environmental, safety and health issues as public image, legal obligation and quality assurance, as well as more obvious concerns such as those involving the direct protection of public and worker health. The nineteen elements are discussed along with suggested ways to use a data management software system to organize and report results

  13. Comparison of the world health organization and the International association of diabetes and pregnancy study groups criteria in diagnosing gestational diabetes mellitus in South Indians

    Directory of Open Access Journals (Sweden)

    Sivagnanam Nallaperumal

    2013-01-01

    Full Text Available Aim: We aimed to compare the International Association of Diabetes and Pregnancy Study Groups (IADPSG and the World Health Organization (WHO criteria to diagnose gestational diabetes mellitus (GDM in Chennai, India. Materials and Methods: We reviewed the retrospective data of 1351 pregnant women who underwent screening for GDM at four selected diabetes centers at Chennai (three private and one government. All women underwent an oral glucose tolerance test using 75g glucose load and fasting, 1-h, and 2-h samples were collected. The IADPSG and WHO criteria were compared for diagnosis of GDM. Results: A total of 839 women had GDM by either the IADPSG or the WHO criteria, of whom the IADPSG criteria identified 699 and the WHO criteria also identified 699 women as having GDM. However, only 599/839 women (66.6% were identified by both criteria. Thus, 140/839 women (16.7% were missed by both the IADPSG and the WHO criteria. 687/699 (98.2% of the women with GDM were identified by the WHO criteria. In contrast, each value of IADPSG criteria i.e., fasting, 1 h, and 2 h identified only 12.5%, 14%, and 22%, respectively. Conclusions: A single WHO cut-point of 2 h > 140 mg/dl appears to be suitable for large-scale screening for GDM in India and other developing countries.

  14. Adopting the new World Health Organization diagnostic criteria for gestational diabetes: How the prevalence changes in a high-risk region in Australia.

    Science.gov (United States)

    Wong, Vincent W; Lin, Andrew; Russell, Hamish

    2017-07-01

    In this study, we assessed changes in prevalence of gestational diabetes mellitus (GDM) in a region with diverse cultural backgrounds in Australia under the new World Health Organization (WHO) diagnostic criteria, with reference to the woman's ethnicity, age and pre-pregnant body mass index (BMI). We recorded results of all 75-gram oral glucose tolerance tests (OGTTs) performed on pregnant women between February and December 2015 together with their demographic details, and determined the prevalence of GDM based on the old Australian Diabetes in Pregnancy Society (ADIPS) and the new WHO criteria respectively. Over that period, 2140 OGTTs were performed in 1725 pregnant women. The prevalence of GDM was 14.8% (255/1725 women) under old ADIPS criteria, but went up to 29.6% (510/1725) when using WHO criteria. An increase in prevalence was observed in all ethnic groups. Women from East/South-East Asia had the lowest increment (from 19.2 to 22.3%) while those from South Asia had the highest (from 22.0 to 44.4%). Prevalence of GDM was 45.9% amongst women with BMI>30kg/m 2 . For women from South Asia with BMI>30kg/m 2 , 70.0% would have GDM. Birth outcomes were similar between women who would have GDM under WHO but not the old ADIPS criteria (untreated), and those who were treated for GDM under old criteria. In parts of Australia, adoption of WHO diagnostic criteria could result in doubling of the prevalence of GDM, depending on the women's demographic characteristics. Women from South Asia or those with obesity should be targeted for pre-pregnant lifestyle intervention. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. Detecting cardiometabolic syndrome using World Health Organization public health action points for Asians and Pacific Islanders.

    Science.gov (United States)

    Grandinetti, Andrew; Kaholokula, Joseph K; Mau, Marjorie K; Chow, Dominic C

    2010-01-01

    To assess the screening characteristics of World Health Organization (WHO) body mass index action points for cardiometabolic syndrome (CMS) in Native Hawaiians and people of Asian ancestry (ie, Filipino and Japanese). Cross-sectional data were collected from 1,452 residents of a rural community of Hawai'i between 1997 and 2000, of which 1,198 were analyzed in this study. Ethnic ancestry was determined by self-report. Metabolic status was assessed using National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATPIII) criteria. Screening characteristics of WHO criteria for overweight and obesity were compared to WHO public health action points or to WHO West Pacific Regional Office (WPRO) cut-points. Among Asian-ancestry participants, WHO public health action points improved both sensitivity and specificity for detecting CMS. However, similar improvements were not observed for WPRO criteria for Native Hawaiians. Moreover, predictive values were high regardless of which criteria were utilized due to high CMS prevalence. WHO public health actions points for Asians provide a significant improvement in sensitivity in detection of CMS. However, predictive value, which varies greatly with disease prevalence, should be considered when deciding which criteria to apply.

  16. Assessment of Environmental Sustainability in Health Care Organizations

    Directory of Open Access Journals (Sweden)

    María Carmen Carnero

    2015-06-01

    Full Text Available Healthcare organizations should set a standard in corporate social responsibility and encourage environmental sustainability, since protection of the environment implies the development of preventive measures in healthcare. Environmental concern has traditionally focused on manufacturing plants. However, a Health Care Organization (HCO is the only type of company which generates all existing classes of waste, and 20% is dangerous, being infectious, toxic or radioactive in nature. Despite the extensive literature analysing environmental matters, there is no objective model for assessing the environmental sustainability of HCOs in such a way that the results may be compared over time for an organization, and between different organizations, to give a comparison or benchmarking tool for HCOs. This paper presents a Multi-Criteria Decision Analysis model integrating a Fuzzy Analytic Hierarchy Process and utility theory, to evaluate environmental sustainability in HCOs. The model uses criteria assessed as a function of the number of annual treatments undertaken. The model has been tested in two HCOs of very different sizes.

  17. Generic Assessment Criteria for human health risk assessment of potentially contaminated land in China.

    Science.gov (United States)

    Cheng, Yuanyuan; Nathanail, Paul C

    2009-12-20

    Generic Assessment Criteria (GAC) are derived using widely applicable assumptions about the characteristics and behaviour of contaminant sources, pathways and receptors. GAC provide nationally consistent guidance, thereby saving money and time. Currently, there are no human health based Generic Assessment Criteria (GAC) for contaminated sites in China. Protection of human health is therefore difficult to ensure and demonstrate; and the lack of GAC makes it difficult to tell if there is potential significant risk to human health unless site-specific criteria are derived. This paper derived Chinese GAC (GAC) for five inorganic and eight organic substances for three regions in China for three land uses: urban residential without plant uptake, Chinese cultivated land, and commercial/industrial using the SNIFFER model. The SNIFFER model has been further implemented with a dermal absorption algorithm and the model default input values have been changed to reflect the Chinese exposure scenarios. It is envisaged that the modified SNIFFER model could be used to derive GAC for more contaminants, more Regions, and more land uses. Further research to enhance the reliability and acceptability of the GAC is needed in regional/national surveys in diet and working patterns.

  18. Clinical relevance of routine semen analysis and controversies surrounding the 2010 World Health Organization criteria for semen examination

    Directory of Open Access Journals (Sweden)

    Sandro C. Esteves

    2014-08-01

    Full Text Available Semen analysis is the corner stone of infertility evaluation as it provides information on the functional status of the seminiferous tubules, epididymis and accessory sex glands. The methods on how the human semen should be evaluated are provided by the World Health Organization, which periodically releases manuals that include specific protocols and reference standards. In 2010, the WHO published new criteria for human semen characteristics that were markedly lower than those previously reported. In this review initially it is discussed the limitations of semen analysis as a surrogate measure of a man’s ability to father a pregnancy. Secondly, it is analyzed methodology issues that could explain why the newly released reference values were different from those earlier reported. Thirdly, it is speculated on the likely effects of the 2010 WHO criteria in the management of male infertility. Due to the several inherent limitations of semen analysis as a surrogate marker of male infertility, physicians should exercise caution when interpreting results. A template for semen analysis reports that incorporates the distribution of the semen characteristics of recent fathers in centiles rather than solely the minimum thresholds could aid clinicians to better understand how a given patient results compare with the reference population. Importantly, a male infertility evaluation must go far beyond a simple semen analysis, as it has to be complemented with a proper physical examination, a comprehensive history taking, and relevant endocrine, genetic, and other investigations.

  19. Definition of ACLF and inclusion criteria for extra-hepatic organ failure.

    Science.gov (United States)

    Wang, Xiaojing; Sarin, Shiv Kumar; Ning, Qin

    2015-07-01

    A prominent characteristic of ACLF is rapid hepatic disease progression with subsequent extra-hepatic organ failure, manifesting as either hepatic coma or hepatorenal syndrome, which is associated with a high mortality rate in a short time. The APASL definition mainly emphasizes recognizing patients with hepatic failure. These patients may subsequently develop extra-hepatic multisystem organ failure leading to high mortality. It is therefore worthwhile to identify the short interim period between the development of liver failure and the onset of extra-hepatic organ failure, the potential therapeutic 'golden window.' Interventions during this period may prevent the development of complications and eventually change the course of the illness. Organ failure is suggested to be a central component of ACLF and may behave differently from chronic decompensated liver disease. Clear and practical criteria for the inclusion of organ failure are urgently needed so that patients with these life-threatening complications can be treated in a timely and appropriate manner. Recent studies suggested that the scoring systems evaluating organ failure [acute physiology, age and chronic health evaluation (APACHE) and sequential organ failure assessment (SOFA) scores] work better than those addressing the severity of liver disease [Child-Pugh and model of end-stage liver disease (MELD) scores] in ACLF. However, a key problem remains that the former scoring systems are reflective of organ failure and not predictive, thus limiting their value as an early indication for intervention.

  20. Does diabetes disease management save money and improve outcomes? A report of simultaneous short-term savings and quality improvement associated with a health maintenance organization-sponsored disease management program among patients fulfilling health employer data and information set criteria.

    Science.gov (United States)

    Sidorov, Jaan; Shull, Robert; Tomcavage, Janet; Girolami, Sabrina; Lawton, Nadine; Harris, Ronald

    2002-04-01

    Little is known about the impact of disease management programs on medical costs for patients with diabetes. This study compared health care costs for patients who fulfilled health employer data and information set (HEDIS) criteria for diabetes and were in a health maintenance organization (HMO)-sponsored disease management program with costs for those not in disease management. We retrospectively examined paid health care claims and other measures of health care use over 2 years among 6,799 continuously enrolled Geisinger Health Plan patients who fulfilled HEDIS criteria for diabetes. Two groups were compared: those who were enrolled in an opt-in disease management program and those who were not enrolled. We also compared HEDIS data on HbA(1c) testing, percent not in control, lipid testing, diabetic eye screening, and kidney disease screening. All HEDIS measures were based on a hybrid method of claims and chart audits, except for percent not in control, which was based on chart audits only. Of 6,799 patients fulfilling HEDIS criteria for the diagnosis of diabetes, 3,118 (45.9%) patients were enrolled in a disease management program (program), and 3,681 (54.1%) were not enrolled (nonprogram). Both groups had similar male-to-female ratios, and the program patients were 1.4 years younger than the nonprogram patients. Per member per month paid claims averaged 394.62 dollars for program patients compared with 502.48 dollars for nonprogram patients (P 9.5%, as compared with 79 of 548 (14.4%) nonprogram patients. In this HMO, an opt-in disease management program appeared to be associated with a significant reduction in health care costs and other measures of health care use. There was also a simultaneous improvement in HEDIS measures of quality care. These data suggest that disease management may result in savings for sponsored managed care organizations and that improvements in HEDIS measures are not necessarily associated with increased medical costs.

  1. Design Criteria for Achieving Low Radon Concentration Indoors

    DEFF Research Database (Denmark)

    Rasmussen, Torben Valdbjørn

    2016-01-01

    Design criteria for achieving low radon concentration indoors are presented in this paper. The paper suggests three design criteria. These criteria have to be considered at the early stage of the building design phase to meet the latest recommendations from the World Health Organization in most...... countries. The three design criteria are; first, establishing a radon barrier facing the ground; second, lowering the air pressure in the lower zone of the slab on ground facing downwards; third, diluting the indoor air with outdoor air. Three criteria when used can prevent radon infiltration and lower...... the radon concentration in the indoor air. In addition, a cheap and reliable method for measuring the radon concentration in the air indoors is described. The provision on radon in the Danish Building Regulations complies with the latest recommendations from the World Health Organization. Radon can cause...

  2. A new approach to criteria for health risk assessment

    International Nuclear Information System (INIS)

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

    2012-01-01

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

  3. Mapping of multiple criteria for priority setting of health interventions: an aid for decision makers

    Directory of Open Access Journals (Sweden)

    Tromp Noor

    2012-12-01

    Full Text Available Abstract Background In rationing decisions in health, many criteria like costs, effectiveness, equity and feasibility concerns play a role. These criteria stem from different disciplines that all aim to inform health care rationing decisions, but a single underlying concept that incorporates all criteria does not yet exist. Therefore, we aim to develop a conceptual mapping of criteria, based on the World Health Organization’s Health Systems Performance and Health Systems Building Blocks frameworks. This map can be an aid to decision makers to identify the relevant criteria for priority setting in their specific context. Methods We made an inventory of all possible criteria for priority setting on the basis of literature review. We categorized the criteria according to both health system frameworks that spell out a country’s health system goals and input. We reason that the criteria that decision makers use in priority setting exercises are a direct manifestation of this. Results Our map includes thirty-one criteria that are distributed among five categories that reflect the goals of a health system (i.e. to improve level of health, fair distribution of health, responsiveness, social & financial risk protection and efficiency and leadership/governance one category that reflects feasibiliy based on the health system building blocks (i.e. service delivery, health care workforce , information, medical products, vaccines & technologies, financing and. Conclusions This conceptual mapping of criteria, based on well-established health system frameworks, will further develop the field of priority setting by assisting decision makers in the identification of multiple criteria for selection of health interventions.

  4. Quality criteria for micronutrient powder products: report of a meeting organized by the World Food Programme and Sprinkles Global Health Initiative.

    Science.gov (United States)

    de Pee, Saskia; Kraemer, Klaus; van den Briel, Tina; Boy, Erick; Grasset, Christopher; Moench-Pfanner, Regina; Zlotkin, Stanley; Bloem, Martin W

    2008-09-01

    Distribution of micronutrient powder (MNP), also known as Sprinkles", is becoming a preferred strategy for addressing micronutrient deficiencies. In response, different formulations are being developed, different producers manufacture MNP and several organizations coordinate distribution. However, as yet, the supply of MNP as well as experience with large-scale MNP programs is limited. To facilitate expansion of MNP use such that acceptability and compliance are high and effectiveness maintained, product quality, of both powder and packaging, good advocacy among decision makers, and providing good information to the target population are crucial. A meeting was organized in Toronto by the Sprinkles Global Health Initiative and the World Food Programme to review and reach consensus on quality criteria for composition, manufacturing, packaging, and labeling of MNP propose guidelines for wide-scale production, and discuss MNP program experience. It was recognized that the durability of some of the more sensitive micronutrients in their powdered form in the harsh climatic conditions of many countries has implications for formulation, packaging, storage, and handling of the MNP product. A question-and-answer manual would greatly facilitate program design and implementation. It was agreed to form an interim Technical Advisory Group to prepare for formation of a Technical Advisory Group with agreed-upon tasks and responsibilities. The MNP manufacturing manual of the Sprinkles Global Health Initiative can continue to be used, with reference to the recommendations from the Toronto Meeting outlined in this paper. Meanwhile, the Sprinkles Global Health Initiative will not place any encumbrances on production using its manual; however, the brand name Sprinkles" will stay protected under various trademark laws.

  5. Application of scientific criteria to food allergens of public health importance.

    Science.gov (United States)

    Chung, Y J; Ronsmans, S; Crevel, R W R; Houben, G F; Rona, R J; Ward, R; Baka, A

    2012-11-01

    Scientific criteria for identifying allergenic foods of public health importance (Björkstén, B., Crevel, R., Hischenhuber, C., Løvik, M., Samuels, F., Strobel, S., Taylor, S.L., Wal, J.-M., Ward, R., 2008. Criteria for identifying allergenic foods of public health importance. Regulatory Toxicology and Pharmacology 51(1), 42-52) have been further refined to incorporate an assessment of the strength of available scientific evidence (van Bilsen, J.H., Ronsmans, S., Crevel, R.W., Rona, R.J., Przyrembel, H., Penninks, A.H., Contor, L., Houben, G.F., 2011. Evaluation of scientific criteria for identifying allergenic food of public health importance. Regulatory Toxicology and Pharmacology 60, 281-289). A multi-disciplinary group was invited to critically test the refined approach. They independently evaluated selected publications on coconut, soy and/or peanut allergy, scored them using the newly developed level of evidence criteria, and debated proposed approaches for combining and utilising the scores to measure the overall impact of an allergen in public health impact assessments. The evaluation of selected publications using the modified criteria produced a relatively consistent result across the experts. These refined criteria were judged to be a way forward for the identification of allergenic foods of public health importance, and for prioritisation of allergen risk management and future data gathering. The debate to combine available evidence when assessing whether an allergenic food is of sufficient public health importance to warrant active management led to proposals on how to weight and combine evidence on allergen severity, potency and prevalence. The refined criteria facilitate a debate to find a meaningful sequence of steps to summarise the available information in relation to a food allergen. Copyright © 2012 ILSI Europe. Published by Elsevier Inc. All rights reserved.

  6. Priority setting of health interventions: the need for multi-criteria decision analysis

    Directory of Open Access Journals (Sweden)

    Baltussen Rob

    2006-08-01

    Full Text Available Abstract Priority setting of health interventions is often ad-hoc and resources are not used to an optimal extent. Underlying problem is that multiple criteria play a role and decisions are complex. Interventions may be chosen to maximize general population health, to reduce health inequalities of disadvantaged or vulnerable groups, ad/or to respond to life-threatening situations, all with respect to practical and budgetary constraints. This is the type of problem that policy makers are typically bad at solving rationally, unaided. They tend to use heuristic or intuitive approaches to simplify complexity, and in the process, important information is ignored. Next, policy makers may select interventions for only political motives. This indicates the need for rational and transparent approaches to priority setting. Over the past decades, a number of approaches have been developed, including evidence-based medicine, burden of disease analyses, cost-effectiveness analyses, and equity analyses. However, these approaches concentrate on single criteria only, whereas in reality, policy makers need to make choices taking into account multiple criteria simultaneously. Moreover, they do not cover all criteria that are relevant to policy makers. Therefore, the development of a multi-criteria approach to priority setting is necessary, and this has indeed recently been identified as one of the most important issues in health system research. In other scientific disciplines, multi-criteria decision analysis is well developed, has gained widespread acceptance and is routinely used. This paper presents the main principles of multi-criteria decision analysis. There are only a very few applications to guide resource allocation decisions in health. We call for a shift away from present priority setting tools in health – that tend to focus on single criteria – towards transparent and systematic approaches that take into account all relevant criteria

  7. Weighting of Criteria for Disease Prioritization Using Conjoint Analysis and Based on Health Professional and Student Opinion.

    Directory of Open Access Journals (Sweden)

    Nadine Stebler

    Full Text Available Disease prioritization exercises have been used by several organizations to inform surveillance and control measures. Though most methodologies for disease prioritization are based on expert opinion, it is becoming more common to include different stakeholders in the prioritization exercise. This study was performed to compare the weighting of disease criteria, and the consequent prioritization of zoonoses, by both health professionals and students in Switzerland using a Conjoint Analysis questionnaire. The health professionals comprised public health and food safety experts, cantonal physicians and cantonal veterinarians, while the student group comprised first-year veterinary and agronomy students. Eight criteria were selected for this prioritization based on expert elicitation and literature review. These criteria, described on a 3-tiered scale, were evaluated through a choice-based Conjoint Analysis questionnaire with 25 choice tasks. Questionnaire results were analyzed to obtain importance scores (for each criterion and mean utility values (for each criterion level, and the latter were then used to rank 16 zoonoses. While the most important criterion for both groups was "Severity of the disease in humans", the second ranked criteria by the health professionals and students were "Economy" and "Treatment in humans", respectively. Regarding the criterion "Control and Prevention", health professionals tended to prioritize a disease when the control and preventive measures were described to be 95% effective, while students prioritized a disease if there were almost no control and preventive measures available. Bovine Spongiform Encephalopathy was the top-ranked disease by both groups. Health professionals and students agreed on the weighting of certain criteria such as "Severity" and "Treatment of disease in humans", but disagreed on others such as "Economy" or "Control and Prevention". Nonetheless, the overall disease ranking lists were similar

  8. Multi-criteria approach to support strategically sustainable decisions in organizations

    Directory of Open Access Journals (Sweden)

    Victor Diogho Heuer de Carvalho

    2015-09-01

    Full Text Available Keeping the social and environmental conditions in a favorable conservation status for allowing the society to develop itself without restrictions is the central idea which underpins the sustainability concept. Different spheres such as media, academia and business organizations started to give more importance to the study of sustainability, once it directly affects aspects that influence the economy in the world. Organizationally, the use of sustainable strategies can bring returns in favor of a healthy development and a conscious culture about the waste as well as reflecting how organizations connect with society and the environment. The objective of this work is to propose a model for prioritizing strategies to support the creation of an environment and a culture based on sustainability in organizations. This model has four steps, beginning with the problem structuring, including the definition of criteria and alternatives, the application of a multi-criteria method for prioritization, and finally, the implementation of the alternatives according to the decision maker opinion as well as on prioritization results.

  9. Pre-validation of the WHO organ dysfunction based criteria for identification of maternal near miss

    Directory of Open Access Journals (Sweden)

    Parpinelli Mary A

    2011-08-01

    Full Text Available Abstract Background To evaluate the performance of the WHO criteria for defining maternal near miss and identifying deaths among cases of severe maternal morbidity (SMM admitted for intensive care. Method Between October 2002 and September 2007, 673 women with SMM were admitted, and among them 18 died. Variables used for the definition of maternal near miss according to WHO criteria and for the SOFA score were retrospectively evaluated. The identification of at least one of the WHO criteria in women who did not die defined the case as a near miss. Organ failure was evaluated through the maximum SOFA score above 2 for each one of the six components of the score, being considered the gold standard for the diagnosis of maternal near miss. The aggregated score (Total Maximum SOFA score was calculated using the worst result of the maximum SOFA score. Sensitivity, specificity, positive and negative predictive values of these WHO criteria for predicting maternal death and also for identifying cases of organ failure were estimated. Results The WHO criteria identified 194 cases of maternal near miss and all the 18 deaths. The most prevalent criteria among cases of maternal deaths were the use of vasoactive drug and the use of mechanical ventilation (≥1 h. For the prediction of maternal deaths, sensitivity was 100% and specificity 70.4%. These criteria identified 119 of the 120 cases of organ failure by the maximum SOFA score (Sensitivity 99.2% among 194 case of maternal near miss (61.34%. There was disagreement in 76 cases, one organ failure without any WHO criteria and 75 cases with no failure but with WHO criteria. The Total Maximum SOFA score had a good performance (area under the curve of 0.897 for prediction of cases of maternal near miss according to the WHO criteria. Conclusions The WHO criteria for maternal near miss showed to be able to identify all cases of death and almost all cases of organ failure. Therefore they allow evaluation of the

  10. Criteria for Drug Reimbursement Decision-Making: An Emerging Public Health Challenge in Bulgaria

    Directory of Open Access Journals (Sweden)

    Georgi Iskrov

    2016-02-01

    Full Text Available Background: During times of fiscal austerity, means of reimbursement decision-making are of particular interest for public health theory and practice. Introduction of advanced health technologies, growing health expenditures and increased public scrutiny over drug reimbursement decisions have pushed governments to consider mechanisms that promote the use of effective health technologies, while constraining costs. Aims: The study’s aim was to explore the current rationale of the drug reimbursement decision-making framework in Bulgaria. Our pilot research focused on one particular component of this process – the criteria used – because of the critical role that criteria are known to have in setting budgets and priorities in the field of public health. The analysis pursued two objectives: to identify important criteria relevant to drug reimbursement decision-making and to unveil relationships between theory and practice. Study Design: Cross-sectional study. Methods: The study was realized through a closed-ended survey on reimbursement criteria among four major public health stakeholders – medical professionals, patients, health authorities, and industry. Empirical outcomes were then cross-compared with the theoretical framework, as defined by current Bulgarian public health legislation. Analysis outlined what is done and what needs to be done in the field of public health reimbursement decision-making. Results: Bulgarian public health stakeholders agreed on 15 criteria to form a tentative optimal framework for drug reimbursement decision-making. The most apparent gap between the empirically found preferences and the official legislation is the lack of consideration for the strength of evidence in reimbursement decisions. Conclusion: Bulgarian policy makers need to address specific gaps, such as formal consideration for strength of evidence, explicit role of efficiency criteria, and means to effectively empower patient and citizen

  11. Setting standards for CSR : a comparative case study on criteria-formulating organizations

    NARCIS (Netherlands)

    Ingenbleek, P.T.M.; Binnekamp, M.H.A.; Goddijn, S.T.

    2007-01-01

    Though criteria-formulating organizations (CFOs) ¿ organizations in which business and community stakeholders cooperate to formulate standards for ethical issues ¿ play an important role in the relationship between firms and society, they receive scant attention from CSR researchers. Adopting an

  12. Occupational safety and health criteria for responsible development of nanotechnology

    Science.gov (United States)

    Schulte, P. A.; Geraci, C. L.; Murashov, V.; Kuempel, E. D.; Zumwalde, R. D.; Castranova, V.; Hoover, M. D.; Hodson, L.; Martinez, K. F.

    2014-01-01

    Organizations around the world have called for the responsible development of nanotechnology. The goals of this approach are to emphasize the importance of considering and controlling the potential adverse impacts of nanotechnology in order to develop its capabilities and benefits. A primary area of concern is the potential adverse impact on workers, since they are the first people in society who are exposed to the potential hazards of nanotechnology. Occupational safety and health criteria for defining what constitutes responsible development of nanotechnology are needed. This article presents five criterion actions that should be practiced by decision-makers at the business and societal levels—if nanotechnology is to be developed responsibly. These include (1) anticipate, identify, and track potentially hazardous nanomaterials in the workplace; (2) assess workers' exposures to nanomaterials; (3) assess and communicate hazards and risks to workers; (4) manage occupational safety and health risks; and (5) foster the safe development of nanotechnology and realization of its societal and commercial benefits. All these criteria are necessary for responsible development to occur. Since it is early in the commercialization of nanotechnology, there are still many unknowns and concerns about nanomaterials. Therefore, it is prudent to treat them as potentially hazardous until sufficient toxicology, and exposure data are gathered for nanomaterial-specific hazard and risk assessments. In this emergent period, it is necessary to be clear about the extent of uncertainty and the need for prudent actions.

  13. Gender Incongruence of Childhood: Clinical Utility and Stakeholder Agreement with the World Health Organization's Proposed ICD-11 Criteria.

    Directory of Open Access Journals (Sweden)

    Titia F Beek

    Full Text Available The World Health Organization (WHO is revising the tenth version of the International Classification of Diseases and Related Health Problems (ICD-10. This includes a reconceptualization of the definition and positioning of Gender Incongruence of Childhood (GIC. This study aimed to: 1 collect the views of transgender individuals and professionals regarding the retention of the diagnosis; 2 see if the proposed GIC criteria were acceptable to transgender individuals and health care providers; 3 compare results between two countries with two different healthcare systems to see if these differences influence opinions regarding the GIC diagnosis; and 4 determine whether healthcare providers from high-income countries feel that the proposed criteria are clinically useful and easy to use. A total of 628 participants were included in the study: 284 from the Netherlands (NL; 45.2%, 8 from Flanders (Belgium; 1.3%, and 336 (53.5% from the United Kingdom (UK. Most participants were transgender people (or their partners/relatives; TG (n = 522, 89 participants were healthcare providers (HCPs and 17 were both HCP and TG individuals. Participants completed an online survey developed for this study. Overall, the majority response from transgender participants (42.9% was that if the diagnosis would be removed from the mental health chapter it should also be removed from the ICD-11 completely, while 33.6% thought it should remain in the ICD-11. Participants were generally satisfied with other aspects of the proposed ICD-11 GIC diagnosis: most TG participants (58.4% thought the term Gender Identity Disorder should change, and most thought Gender Incongruence was an improvement (63.0%. Furthermore, most participants (76.1% did not consider GIC to be a psychiatric disorder and placement in a separate chapter dealing with Gender and Sexual Health (the majority response in the NL and selected by 37.5% of the TG participants overall or as a Z-code (the majority response

  14. Health system professionals, attitude towards necessary criteria for hospitals managers, performance assessment

    Directory of Open Access Journals (Sweden)

    ali janati

    2012-09-01

    Materials and Methods: This study was a qualitative research with thematic analysis method. By using semi structured questionnaire with 2 health system experts interview was conducted and 20 experts participated in focus group discussion. After each interview and group discussion withdrawals were checked with participants. The initial interviews were analyzed by two faculty members and then were combined. Results: 7 main themes about necessary criteria for hospital managers, performance assessment were obtained from experts, views. These themes are: skills related to planning, organization and staff performance management, leadership, information management, clinical governance and performance indicators. Conclusion: All participants in the study had a history of hospital management therefore their comments will be an effective step in identifying the criteria for making hospital managers, performance assessment tool. In addition to Professionals, perspectives and studies done in other countries, in order to design this kind of tools, it is necessary to adjust the obtained findings according to the local hospital conditions.

  15. Diagnosis of Tuberculosis Following World Health Organization–Recommended Criteria in Severely Malnourished Children Presenting With Pneumonia

    Science.gov (United States)

    Chisti, Mohammod Jobayer; Salam, Mohammed Abdus; Shahid, Abu S. M. S. B.; Shahunja, K. M.; Das, Sumon Kumar; Faruque, Abu Syed Golam; Bardhan, Pradip Kumar; Ahmed, Tahmeed

    2017-01-01

    Evidences on diagnosis of tuberculosis (TB) following the World Health Organization (WHO) criteria in children with severe acute malnutrition (SAM) are lacking. We sought to evaluate the WHO criteria for the diagnosis of TB in such children. In this prospective study, we enrolled SAM children aged <5 with radiological pneumonia. We collected induced sputum and gastric lavage for smear microscopy, mycobacterial culture, and Xpert MTB/RIF. Using the last 2 methods as the gold standard, we determined sensitivity, specificity, and positive and negative predictive values of WHO criteria (n = 388). However, Xpert MTB/RIF was performed on the last 214 children. Compared to mycobacterial culture–confirmed TB, sensitivity and specificity (95% confidence interval) of WHO criteria were 40 (14% to 73%) and 84 (80% to 87%), respectively. Compared to culture- and/or Xpert MTB/RIF-confirmed TB, the values were 22% (9% to 43%) and 83 (79% to 87%), respectively. Thus, the good specificity of the WHO criteria may help minimize overtreatment with anti-TB therapy in SAM children, especially in resource-limited settings. PMID:28229100

  16. Diagnosis of Tuberculosis Following World Health Organization–Recommended Criteria in Severely Malnourished Children Presenting With Pneumonia

    Directory of Open Access Journals (Sweden)

    Mohammod Jobayer Chisti MBBS, MMed, PhD

    2017-01-01

    Full Text Available Evidences on diagnosis of tuberculosis (TB following the World Health Organization (WHO criteria in children with severe acute malnutrition (SAM are lacking. We sought to evaluate the WHO criteria for the diagnosis of TB in such children. In this prospective study, we enrolled SAM children aged <5 with radiological pneumonia. We collected induced sputum and gastric lavage for smear microscopy, mycobacterial culture, and Xpert MTB/RIF. Using the last 2 methods as the gold standard, we determined sensitivity, specificity, and positive and negative predictive values of WHO criteria (n = 388. However, Xpert MTB/RIF was performed on the last 214 children. Compared to mycobacterial culture–confirmed TB, sensitivity and specificity (95% confidence interval of WHO criteria were 40 (14% to 73% and 84 (80% to 87%, respectively. Compared to culture- and/or Xpert MTB/RIF-confirmed TB, the values were 22% (9% to 43% and 83 (79% to 87%, respectively. Thus, the good specificity of the WHO criteria may help minimize overtreatment with anti-TB therapy in SAM children, especially in resource-limited settings.

  17. A survey-based benchmarking approach for health care using the Baldrige quality criteria.

    Science.gov (United States)

    Jennings, K; Westfall, F

    1994-09-01

    Since 1988, manufacturing and service industries have been using the Malcolm Baldrige National Quality Award to assess their management processes (for example, leadership, information, and analysis) against critical performance criteria. Recognizing that the typical Baldrige assessment is time intensive and dependent on intensive training, The Pacer Group, a consulting firm in Dayton, Ohio, developed a self-assessment tool based on the Baldrige criteria which provides a snapshot assessment of an organization's management practices. The survey was administered at 25 hospitals within a health care system. Hospitals were able to compare their scores with other hospitals in the system, as well as the scores of a Baldrige award winner. Results were also analyzed on a systemwide basis to identify strengths and weaknesses across the system. For all 25 hospitals, the following areas were identified as strengths: management of process quality, leadership, and customer focus and satisfaction. Weaknesses included lack of employee involvement in the quality planning process, poor design of quality systems, and lack of cross-departmental cooperation. One of the surveyed hospitals launched improvement initiatives in knowledge of improvement tools and methods and in a patient satisfaction focus. A team was formed to improve the human resource management system. Also, a new unit was designed using patient-centered care principles. A team re-evaluated every operation that affected patients on the unit. A survey modeled after the Baldrige Award criteria can be useful in benchmarking an organization's quality improvement practices.

  18. Transportation of Organs by Air: Safety, Quality, and Sustainability Criteria.

    Science.gov (United States)

    Mantecchini, L; Paganelli, F; Morabito, V; Ricci, A; Peritore, D; Trapani, S; Montemurro, A; Rizzo, A; Del Sordo, E; Gaeta, A; Rizzato, L; Nanni Costa, A

    2016-03-01

    The outcomes of organ transplantation activities are greatly affected by the ability to haul organs and medical teams quickly and safely. Organ allocation and usage criteria have greatly improved over time, whereas the same result has not been achieved so far from the transport point of view. Safety and the highest level of service and efficiency must be reached to grant transplant recipients the healthiest outcome. The Italian National Transplant Centre (CNT), in partnership with the regions and the University of Bologna, has promoted a thorough analysis of all stages of organ transportation logistics chains to produce homogeneous and shared guidelines throughout the national territory, capable of ensuring safety, reliability, and sustainability at the highest levels. The mapping of all 44 transplant centers and the pertaining airport network has been implemented. An analysis of technical requirements among organ shipping agents at both national and international level has been promoted. A national campaign of real-time monitoring of organ transport activities at all stages of the supply chain has been implemented. Parameters investigated have been hospital and region of both origin and destination, number and type of organs involved, transport type (with or without medical team), stations of arrival and departure, and shipping agents, as well as actual times of activities involved. National guidelines have been issued to select organ storage units and shipping agents on the basis of evaluation of efficiency, reliability, and equipment with reference to organ type and ischemia time. Guidelines provide EU-level standards on technical equipment of aircrafts, professional requirements of shipping agencies and cabin crew, and requirements on service provision, including pricing criteria. The introduction in the Italian legislation of guidelines issuing minimum requirements on topics such as the medical team, packaging, labeling, safety and integrity, identification

  19. Towards quality criteria for regional public health reporting: concept mapping with Dutch experts.

    Science.gov (United States)

    van Bon-Martens, Marja J H; Achterberg, Peter W; van de Goor, Ien A M; van Oers, Hans A M

    2012-06-01

    In the Netherlands, municipal health assessments are carried out by 28 Regional Health Services, serving 418 municipalities. In the absence of guidelines, regional public health reports were developed in two pilot regions on the basis of the model and experience of national health reporting. Though they were well received and positively evaluated, it was not clear which specific characteristics determined 'good public health reporting'. Therefore, this study was set up to develop a theoretical framework for the quality of regional public health reporting in The Netherlands. Using concept mapping as a standardized tool for conceptualization, 35 relevant reporting experts formulated short statements in two different brainstorming sessions, describing specific quality criteria of regional public health reports. After the removal of duplicates, the list was supplemented with international criteria, and the statements were sent to each participant for rating and sorting. The results were processed statistically and represented graphically. The output was discussed and interpreted, leading to the final concept map. The final concept map consisted of 97 criteria, grouped into 13 clusters, and plotted in two dimensions: a 'product' dimension, ranging from 'production' to 'content', and a 'context' dimension, ranging from 'science' to 'policy'. The three most important clusters were: (i) 'solution orientation', (ii) 'policy relevance' and (iii) 'policy impact'. This study provided a theoretical framework for the quality of regional public health reporting, indicating relevant domains and criteria. Further work should translate domains and criteria into operational indicators for evaluating regional public health reports.

  20. Organizational climate and employee mental health outcomes: A systematic review of studies in health care organizations.

    Science.gov (United States)

    Bronkhorst, Babette; Tummers, Lars; Steijn, Bram; Vijverberg, Dominique

    2015-01-01

    In recent years, the high prevalence of mental health problems among health care workers has given rise to great concern. The academic literature suggests that employees' perceptions of their work environment can play a role in explaining mental health outcomes. We conducted a systematic review of the literature in order to answer the following two research questions: (1) how does organizational climate relate to mental health outcomes among employees working in health care organizations and (2) which organizational climate dimension is most strongly related to mental health outcomes among employees working in health care organizations? Four search strategies plus inclusion and quality assessment criteria were applied to identify and select eligible studies. As a result, 21 studies were included in the review. Data were extracted from the studies to create a findings database. The contents of the studies were analyzed and categorized according to common characteristics. Perceptions of a good organizational climate were significantly associated with positive employee mental health outcomes such as lower levels of burnout, depression, and anxiety. More specifically, our findings indicate that group relationships between coworkers are very important in explaining the mental health of health care workers. There is also evidence that aspects of leadership and supervision affect mental health outcomes. Relationships between communication, or participation, and mental health outcomes were less clear. If health care organizations want to address mental health issues among their staff, our findings suggest that organizations will benefit from incorporating organizational climate factors in their health and safety policies. Stimulating a supportive atmosphere among coworkers and developing relationship-oriented leadership styles would seem to be steps in the right direction.

  1. World Health Organization-defined classification of myeloproliferative neoplasms

    DEFF Research Database (Denmark)

    Madelung, Ann Brinch; Bondo, Henrik; Stamp, Inger

    2013-01-01

    marrow biopsies including 43 controls. Diagnoses were determined according to the 2008 criteria of the World Health Organization (WHO). The participants were blinded to all clinical data except patient age. After initial evaluation all hematopathologists participated in a 3-day meeting with a leading...... clinician chaired by an expert hematopathologists. In cases with lack of consensus on fiber grading (n = 57), a new evaluation was performed. In cases with discordance on morphological diagnosis (n = 129), an additional nonblinded evaluation taking clinical data into consideration was carried out...

  2. A risk-based approach to health criteria for radon indoors -report on a WHO initiative

    International Nuclear Information System (INIS)

    Steinhaeusler, F.

    1994-01-01

    The World Health Organization (WHO), Regional Office for Europe, organised a meeting of a working group on indoor air quality in Eilat, Israel, from 28 March to 4 April 1993. The aim was to develop a risk-based approach to health criteria for radon indoors. The Group reviewed the latest epidemiological data from occupational and non-occupational radon exposure, animal experiments and dosimetry. The Group issued 14 conclusions and 23 recommendations on radon related risk to health, on risk management and risk communication. In summary, radon was confirmed as a human carcinogen. Indoor radon exposures resulting in individual risks exceeding 10 -3 per year are to be considered as severe and risk reduction programmes implemented. Guidance on risk management and communication is offered to national authorities. (author)

  3. What criteria do consumer health librarians use to develop library collections? a phenomenological study.

    Science.gov (United States)

    Papadakos, Janet; Trang, Aileen; Wiljer, David; Cipolat Mis, Chiara; Cyr, Alaina; Friedman, Audrey Jusko; Mazzocut, Mauro; Snow, Michelle; Raivich, Valeria; Catton, Pamela

    2014-04-01

    The criteria for determining whether resources are included in consumer health library collections are summarized in institutional collection development policies (CDPs). Evidence suggests that CDPs do not adequately capture all of these criteria. The aim of this study was to describe the resource review experience of librarians and compare it to what is described in CDPs. A phenomenological approach was used to explore and describe the process. Four consumer health librarians independently evaluated cancer-related consumer health resources and described their review process during a semi-structured telephone interview. Afterward, these librarians completed online questionnaires about their approaches to collection development. CDPs from participating libraries, interview transcripts, and questionnaire data were analyzed. Researchers summarized the findings, and participating librarians reviewed results for validation. Librarians all utilized similar criteria, as documented in their CDPs; however, of thirteen criteria described in the study, only four were documented in CDPs. CDPs for consumer health libraries may be missing important criteria that are considered integral parts of the collection development process. A better understanding of the criteria and contextual factors involved in the collection development process can assist with establishing high-quality consumer health library collections.

  4. What criteria do consumer health librarians use to develop library collections? a phenomenological study*

    Science.gov (United States)

    Papadakos, Janet; Trang, Aileen; Wiljer, David; Mis, Chiara Cipolat; Cyr, Alaina; Friedman, Audrey Jusko; Mazzocut, Mauro; Snow, Michelle; Raivich, Valeria; Catton, Pamela

    2014-01-01

    Objectives: The criteria for determining whether resources are included in consumer health library collections are summarized in institutional collection development policies (CDPs). Evidence suggests that CDPs do not adequately capture all of these criteria. The aim of this study was to describe the resource review experience of librarians and compare it to what is described in CDPs. Methods: A phenomenological approach was used to explore and describe the process. Four consumer health librarians independently evaluated cancer-related consumer health resources and described their review process during a semi-structured telephone interview. Afterward, these librarians completed online questionnaires about their approaches to collection development. CDPs from participating libraries, interview transcripts, and questionnaire data were analyzed. Researchers summarized the findings, and participating librarians reviewed results for validation. Results: Librarians all utilized similar criteria, as documented in their CDPs; however, of thirteen criteria described in the study, only four were documented in CDPs. Conclusions: CDPs for consumer health libraries may be missing important criteria that are considered integral parts of the collection development process. Implications: A better understanding of the criteria and contextual factors involved in the collection development process can assist with establishing high-quality consumer health library collections. PMID:24860261

  5. Interim criteria for Organic Watch List tanks at the Hanford Site

    International Nuclear Information System (INIS)

    Babad, S.; Turner, D.A.

    1993-09-01

    This document establishes interim criteria for identifying single-shell radioactive waste storage tanks at the Hanford Site that contain organic chemicals mixed with nitrate/nitrite salts in potentially hazardous concentrations. These tanks are designated as ''organic Watch List tanks.'' Watch List tanks are radioactive waste storage tanks that have the potential for release of high-level waste as a result of uncontrolled increases in temperature or pressure. Organic Watch List tanks are those Watch List tanks that contain relatively high concentrations of organic chemicals. Because of the potential for release of high-level waste resulting from uncontrolled increases in temperature or pressure, the organic Watch List tanks (collectively) constitute a Hanford Site radioactive waste storage tank ''safety issue.''

  6. Criteria for social media-based scholarship in health professions education.

    Science.gov (United States)

    Sherbino, Jonathan; Arora, Vineet M; Van Melle, Elaine; Rogers, Robert; Frank, Jason R; Holmboe, Eric S

    2015-10-01

    Social media are increasingly used in health professions education. How can innovations and research that incorporate social media applications be adjudicated as scholarship? To define the criteria for social media-based scholarship in health professions education. In 2014 the International Conference on Residency Education hosted a consensus conference of health professions educators with expertise in social media. An expert working group drafted consensus statements based on a literature review. Draft consensus statements were posted on an open interactive online platform 2 weeks prior to the conference. In-person and virtual (via Twitter) participants modified, added or deleted draft consensus statements in an iterative fashion during a facilitated 2 h session. Final consensus statements were unanimously endorsed. A review of the literature demonstrated no existing criteria for social media-based scholarship. The consensus of 52 health professions educators from 20 organisations in four countries defined four key features of social media-based scholarship. It must (1) be original; (2) advance the field of health professions education by building on theory, research or best practice; (3) be archived and disseminated; and (4) provide the health professions education community with the ability to comment on and provide feedback in a transparent fashion that informs wider discussion. Not all social media activities meet the standard of education scholarship. This paper clarifies the criteria, championing social media-based scholarship as a legitimate academic activity in health professions education. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  7. The criteria for metabolic syndrome and the national health screening and education system in Japan

    Directory of Open Access Journals (Sweden)

    Kazumasa Yamagishi

    2017-01-01

    Full Text Available Two major definitions of metabolic syndrome have been proposed. One focuses on the accumulation of risk factors, a measure used by the American Heart Association (AHA and the National Heart, Lung, and Blood Institute (NHLBI; the other focuses on abdominal obesity, a measure used by the International Diabetes Federation (IDF and the Japanese government. The latter definition takes waist circumference (WC into consideration as an obligatory component, whereas the former does not. In 2009, the IDF, NHLBI, AHA, and other organizations attempted to unify these criteria; as a result, WC is no longer an obligatory component of those systems, while it remains obligatory in the Japanese criteria. In 2008, a new Japanese cardiovascular screening and education system focused on metabolic syndrome was launched. People undergoing screening are classified into three groups according to the presence of abdominal obesity and the number of metabolic risk factors, and receive health educational support from insurers. This system has yielded several beneficial outcomes: the visibility of metabolic syndrome at the population level has drastically improved; preventive measures have been directed toward metabolic syndrome, which is expected to become more prevalent in future generations; and a post-screening education system has been established. However, several problems with the current system have been identified and are under debate. In this review, we discuss topics related to metabolic syndrome, including (1 the Japanese criteria for metabolic syndrome; (2 metabolic syndrome and the universal health screening and education system; and (3 recent debates about Japanese criteria for metabolic syndrome.

  8. Preliminary safety criteria for organic watch list tanks at the Hanford site

    International Nuclear Information System (INIS)

    Webb, A.B.; Stewart, J.L.; Turner, O.A.; Plys, M.G.; Malinovic, B.; Grigsby, J.M.; Camaioni, D.M.; Heasler, P.G.; Samuels, W.O.; Toth, J.J.

    1995-11-01

    Condensed-phase, rapid reactions of organic salts with nitrates/nitrites in Hanford High Level Radioactive Waste single-shell tanks could lead to structural failure of the tanks resulting in significant releases of radionuclides and toxic materials. This report establishes appropriate preliminary safety criteria to ensure that tank wastes will be maintained safe. These criteria show that if actual dry wastes contain less than 1.2 MJ/kg of reactants reaction energy or less 4.5 wt % of total organic carbon, then the waste will be safe and will not propagate if ignited. Waste moisture helps to retard reactions; when waste moisture exceeds 20 wt %, rapid reactions are prevented, regardless of organic carbon concentrations. Aging and degradation of waste materials has been considered to predict the types and amounts to organic compounds present in the waste. Using measurements of 3 waste phases (liquid, salt cake, and sludge) obtained from tank waste samples analyzed in the laboratory, analysis of variance (ANOVA) models were used to estimate waste states for unmeasured tanks. The preliminary safety criteria are based upon calorimetry and propagation testing of likely organic compounds which represent actual tank wastes. These included sodium salts of citrate, formate, acetate and hydroxyethylethylenediaminetricetate (HEDTA). Hot cell tests of actual tank wastes are planned for the future to confirm propagation tests performed in the laboratory. The effects of draining liquids from the tanks which would remove liquids and moisture were considered because reactive waste which is too dry may propagate. Evaporation effects which could remove moisture from the tanks were also calculated. The various ways that the waste could be heated or ignited by equipment failures or tank operations activities were considered and appropriate monitoring and controls were recommended

  9. Preliminary safety criteria for organic watch list tanks at the Hanford site

    Energy Technology Data Exchange (ETDEWEB)

    Webb, A.B.; Stewart, J.L.; Turner, O.A. [Westinghouse Hanford Co., Richland, WA (United States); Plys, M.G.; Malinovic, B. [Fauske and Associates, Inc., Burr Ridge, IL (United States); Grigsby, J.M. [G & P Consulting, Inc. (United States); Camaioni, D.M.; Heasler, P.G.; Samuels, W.O.; Toth, J.J. [Pacific Northwest Lab., Portland, OR (United States)

    1995-11-01

    Condensed-phase, rapid reactions of organic salts with nitrates/nitrites in Hanford High Level Radioactive Waste single-shell tanks could lead to structural failure of the tanks resulting in significant releases of radionuclides and toxic materials. This report establishes appropriate preliminary safety criteria to ensure that tank wastes will be maintained safe. These criteria show that if actual dry wastes contain less than 1.2 MJ/kg of reactants reaction energy or less 4.5 wt % of total organic carbon, then the waste will be safe and will not propagate if ignited. Waste moisture helps to retard reactions; when waste moisture exceeds 20 wt %, rapid reactions are prevented, regardless of organic carbon concentrations. Aging and degradation of waste materials has been considered to predict the types and amounts to organic compounds present in the waste. Using measurements of 3 waste phases (liquid, salt cake, and sludge) obtained from tank waste samples analyzed in the laboratory, analysis of variance (ANOVA) models were used to estimate waste states for unmeasured tanks. The preliminary safety criteria are based upon calorimetry and propagation testing of likely organic compounds which represent actual tank wastes. These included sodium salts of citrate, formate, acetate and hydroxyethylethylenediaminetricetate (HEDTA). Hot cell tests of actual tank wastes are planned for the future to confirm propagation tests performed in the laboratory. The effects of draining liquids from the tanks which would remove liquids and moisture were considered because reactive waste which is too dry may propagate. Evaporation effects which could remove moisture from the tanks were also calculated. The various ways that the waste could be heated or ignited by equipment failures or tank operations activities were considered and appropriate monitoring and controls were recommended.

  10. Current approach to the diagnosis of IgG4-related disease - Combination of comprehensive diagnostic and organ-specific criteria.

    Science.gov (United States)

    Umehara, Hisanori; Okazaki, Kazuichi; Nakamura, Takuji; Satoh-Nakamura, Tomomi; Nakajima, Akio; Kawano, Mitsuhiro; Mimori, Tsuneyo; Chiba, Tsutomu

    2017-05-01

    IgG4-related disease (IgG4-RD) is a fascinating clinical entity proposed by Japanese investigators, and includes a wide variety of diseases, formerly diagnosed as Mikulicz's disease (MD), autoimmune pancreatitis (AIP), interstitial nephritis, prostatitis, retroperitoneal fibrosis, etc. Although all clinicians in every field of medicine may encounter this new disease, a unifying diagnostic criterion has not been established. In 2011, the Japanese IgG4 team, organized by the Ministry of Health, Labor and Welfare (MHLW) of Japan, published comprehensive diagnostic criteria for IgG4-RD. Several problems with these criteria have arisen in clinical practice, however, including the difficulty obtaining biopsy samples from some patients, and the sensitivity and the specificity of techniques used to measure serum IgG4 concentrations. Although serum IgG4 concentration is an important clinical marker for IgG4-RD, its diagnostic utility in differentiating IgG4-RD from other diseases, called IgG4-RD mimickers, remains unclear. This review describes the current optimal approach for the diagnosis of IgG4-RD, based on both comprehensive and organ-specific diagnostic criteria, in patients with diseases such as IgG4-related pancreatitis (AIP), sclerosing cholangitis, and renal, lung and orbital diseases.

  11. Dengue disease severity in Indonesian children: An evaluation of the World Health Organization classification system

    NARCIS (Netherlands)

    T.E. Setiati (Tatty); A.T.A. Mairuhu; P. Koraka (Penelope); M. Supriatna (Mohamad); M.R. Mac Gillavry (Melvin); D.P.M. Brandjes (Dees); A.D.M.E. Osterhaus (Albert); J.W.M. van der Meer (Jos); E.C.M. van Gorp (Eric); A. Soemantri (Augustinus)

    2007-01-01

    textabstractBackground: Dengue disease severity is usually classified using criteria set up by the World Health Organization (WHO). We aimed to assess the diagnostic accuracy of the WHO classification system and modifications to this system, and evaluated their potential practical usefulness.

  12. Multi-criteria decision making--an approach to setting priorities in health care.

    Science.gov (United States)

    Nobre, F F; Trotta, L T; Gomes, L F

    1999-12-15

    The objective of this paper is to present a multi-criteria decision making (MCDM) approach to support public health decision making that takes into consideration the fuzziness of the decision goals and the behavioural aspect of the decision maker. The approach is used to analyse the process of health technology procurement in a University Hospital in Rio de Janeiro, Brazil. The method, known as TODIM, relies on evaluating alternatives with a set of decision criteria assessed using an ordinal scale. Fuzziness in generating criteria scores and weights or conflicts caused by dealing with different viewpoints of a group of decision makers (DMs) are solved using fuzzy set aggregation rules. The results suggested that MCDM models, incorporating fuzzy set approaches, should form a set of tools for public health decision making analysis, particularly when there are polarized opinions and conflicting objectives from the DM group. Copyright 1999 John Wiley & Sons, Ltd.

  13. Water Quality Criteria for Human Health and Aquatic Life

    Science.gov (United States)

    Collaborative effort with the Office of Water to provide science in support of the development and implementation of new or revised ambient water quality criteria for microbial and chemical contaminants for human health and aquatic life. The research also addresses implementation...

  14. Some criteria for landscape quality applied on an organic goat farm in Gelderland, the Netherlands.

    NARCIS (Netherlands)

    Hendriks, K.; Stobbelaar, D.J.; Mansvelt, van J.D.

    1997-01-01

    Within the framework of the concerted action 'The landscape and nature production capacity of organic/sustainable types of agriculture', the authors visited the organic goat farm Caprica to test some criteria on farm level

  15. Organizational health in health organizations: towards a conceptualization.

    Science.gov (United States)

    Orvik, Arne; Axelsson, Runo

    2012-12-01

    This article is introducing a new concept of organizational health and discussing its possible implications for health organizations and health management. The concept is developed against the background of New Public Management, which has coincided with increasing workplace health problems in health organizations. It is based on research mainly in health promotion and health management. Organizational health is defined in terms of how an organization is able to deal with the tensions of diverse and competing values. This requires a dialectical perspective, integration as well as disintegration, and a tricultural approach to value tensions. The concept of organizational health is pointing towards an inverse value pyramid and a hybrid- and value-based form of management in health organizations. An application of this concept may clarify competing values and help managers to deal with the value tensions underlying workplace health problems on an organizational as well as an individual and group level. More empirical research is required, however, to link more closely the different aspects of organizational health in health organizations. © 2012 The Authors. Scandinavian Journal of Caring Sciences © 2012 Nordic College of Caring Science.

  16. Selecting the Acceptance Criteria of Medicines in the Reimbursement List of Public Health Insurance of Iran, Using the "Borda" Method: a Pilot Study.

    Science.gov (United States)

    Viyanchi, Amir; Rasekh, Hamid Reza; Rajabzadeh Ghatari, Ali; SafiKhani, Hamid Reza

    2015-01-01

    Decision-making for medicines to be accepted in Iran's public health insurance reimbursement list is a complex process and involves factors, which should be considered in applying a coverage for medicine costs. These processes and factors are not wholly assessed, while assessment of these factors is an essential need for getting a transparent and evidence-based approach toward medicine reimbursement in Iran. This paper aims to show an evidence-based approach toward medicine selection criteria to inform the medical reimbursement decision makers in Iranian health insurance organizations. To explore an adaptable decision-making framework while incorporating a method called "Borda" in medicine reimbursement assessment, we used the help of an expert group including decision makers and clinical researchers who are also policy makers to appraise the five chief criteria that have three sub criteria (Precision, Interpretability, and Cost). Also software "Math-lab"7, "SPSS" 17 and Excel 2007 were used in this study. "Borda" estimates the amount of perceived values from different criteria and creates a range from one to five while providing a comprehensive measurement of a large spectrum of criteria. Participants reported that the framework provided an efficient approach to systematic consideration in a pragmatic format consisting of many parts to guide decision-makings, including criteria and value (a model with the core of Borda) and evidences (medicine reimbursement based on criteria). The most important criterion for medicine acceptance in health insurance companies, in Iran, is the "life-threatening" factor and "evidence quality" is accounted as the fifth important factor. This pilot study showed the usefulness of incorporating Borda in medicine reimbursement decisions to support a transparent and systematic appraisal of health insurance companies' deeds. Further research is needed to advance Borda-based approaches that are effective on health insurance decision making.

  17. Organizing Rural Health Care

    DEFF Research Database (Denmark)

    Bunkenborg, Mikkel

    2012-01-01

    to organize rural health care is more regulatory and distanced in its emphasis on nudging patients and doctors towards the right decisions through economic incentives. This bureaucratic approach to organizing health individually offers a sharp contrast to the religious collectivities that form around health...

  18. Assessing health status and quality-of-life instruments: attributes and review criteria.

    Science.gov (United States)

    Aaronson, Neil; Alonso, Jordi; Burnam, Audrey; Lohr, Kathleen N; Patrick, Donald L; Perrin, Edward; Stein, Ruth E

    2002-05-01

    The field of health status and quality of life (QoL) measurement - as a formal discipline with a cohesive theoretical framework, accepted methods, and diverse applications--has been evolving for the better part of 30 years. To identify health status and QoL instruments and review them against rigorous criteria as a precursor to creating an instrument library for later dissemination, the Medical Outcomes Trust in 1994 created an independently functioning Scientific Advisory Committee (SAC). In the mid-1990s, the SAC defined a set of attributes and criteria to carry out instrument assessments; 5 years later, it updated and revised these materials to take account of the expanding theories and technologies upon which such instruments were being developed. This paper offers the SAC's current conceptualization of eight key attributes of health status and QoL instruments (i.e., conceptual and measurement model; reliability; validity; responsiveness; interpretability; respondent and administrative burden; alternate forms; and cultural and language adaptations) and the criteria by which instruments would be reviewed on each of those attributes. These are suggested guidelines for the field to consider and debate; as measurement techniques become both more familiar and more sophisticated, we expect that experts will wish to update and refine these criteria accordingly.

  19. Selection criteria for oxidation method in total organic carbon measurement.

    Science.gov (United States)

    Yoon, GeunSeok; Park, Sang-Min; Yang, Heuiwon; Tsang, Daniel C W; Alessi, Daniel S; Baek, Kitae

    2018-05-01

    During the measurement of total organic carbon (TOC), dissolved organic carbon is converted into CO 2 by using high temperature combustion (HTC) or wet chemical oxidation (WCO). However, the criteria for selecting the oxidation methods are not clear. In this study, the chemical structures of organic material were considered as a key factor to select the oxidation method used. Most non-degradable organic compounds showed a similar oxidation efficiency in both methods, including natural organic compounds, dyes, and pharmaceuticals, and thus both methods are appropriate to measure TOC in waters containing these compounds. However, only a fraction of the carbon in the halogenated compounds (perfluorooctanoic acid and trifluoroacetic acid) were oxidized using WCO, resulting in measured TOC values that are considerably lower than those determined by HTC. This result is likely due to the electronegativity of halogen elements which inhibits the approach of electron-rich sulfate radicals in the WCO, and the higher bond strength of carbon-halogen pairs as compared to carbon-hydrogen bonds, which results in a lower degree of oxidation of the compounds. Our results indicate that WCO could be used to oxidize most organic compounds, but may not be appropriate to quantify TOC in organic carbon pools that contain certain halogenated compounds. Copyright © 2018 Elsevier Ltd. All rights reserved.

  20. Priority setting of health interventions: the need for multi-criteria decision analysis.

    NARCIS (Netherlands)

    Baltussen, R.M.P.M.; Niessen, L.

    2006-01-01

    ABSTRACT: Priority setting of health interventions is often ad-hoc and resources are not used to an optimal extent. Underlying problem is that multiple criteria play a role and decisions are complex. Interventions may be chosen to maximize general population health, to reduce health inequalities of

  1. The Criteria People Use in Relevance Decisions on Health Information: An Analysis of User Eye Movements When Browsing a Health Discussion Forum.

    Science.gov (United States)

    Pian, Wenjing; Khoo, Christopher Sg; Chang, Yun-Ke

    2016-06-20

    People are increasingly accessing health-related social media sites, such as health discussion forums, to post and read user-generated health information. It is important to know what criteria people use when deciding the relevance of information found on health social media websites, in different situations. The study attempted to identify the relevance criteria that people use when browsing a health discussion forum, in 3 types of use contexts: when seeking information for their own health issue, when seeking for other people's health issue, and when browsing without a particular health issue in mind. A total of 58 study participants were self-assigned to 1 of the 3 use contexts or information needs and were asked to browse a health discussion forum, HealthBoards.com. In the analysis, browsing a discussion forum was divided into 2 stages: scanning a set of post surrogates (mainly post titles) in the summary result screen and reading a detailed post content (including comments by other users). An eye tracker system was used to capture participants' eye movement behavior and the text they skim over and focus (ie, fixate) on during browsing. By analyzing the text that people's eyes fixated on, the types of health information used in the relevance judgment were determined. Post-experiment interviews elicited participants' comments on the relevance of the information and criteria used. It was found that participants seeking health information for their own health issue focused significantly more on the poster's symptoms, personal history of the disease, and description of the disease (P=.01, .001, and .02). Participants seeking for other people's health issue focused significantly more on cause of disease, disease terminology, and description of treatments and procedures (P=.01, .01, and .02). In contrast, participants browsing with no particular issue in mind focused significantly more on general health topics, hot topics, and rare health issues (P=.01, .01, and .01

  2. The Criteria People Use in Relevance Decisions on Health Information: An Analysis of User Eye Movements When Browsing a Health Discussion Forum

    Science.gov (United States)

    Khoo, Christopher SG; Chang, Yun-Ke

    2016-01-01

    Background People are increasingly accessing health-related social media sites, such as health discussion forums, to post and read user-generated health information. It is important to know what criteria people use when deciding the relevance of information found on health social media websites, in different situations. Objective The study attempted to identify the relevance criteria that people use when browsing a health discussion forum, in 3 types of use contexts: when seeking information for their own health issue, when seeking for other people’s health issue, and when browsing without a particular health issue in mind. Methods A total of 58 study participants were self-assigned to 1 of the 3 use contexts or information needs and were asked to browse a health discussion forum, HealthBoards.com. In the analysis, browsing a discussion forum was divided into 2 stages: scanning a set of post surrogates (mainly post titles) in the summary result screen and reading a detailed post content (including comments by other users). An eye tracker system was used to capture participants’ eye movement behavior and the text they skim over and focus (ie, fixate) on during browsing. By analyzing the text that people’s eyes fixated on, the types of health information used in the relevance judgment were determined. Post-experiment interviews elicited participants’ comments on the relevance of the information and criteria used. Results It was found that participants seeking health information for their own health issue focused significantly more on the poster’s symptoms, personal history of the disease, and description of the disease (P=.01, .001, and .02). Participants seeking for other people’s health issue focused significantly more on cause of disease, disease terminology, and description of treatments and procedures (P=.01, .01, and .02). In contrast, participants browsing with no particular issue in mind focused significantly more on general health topics, hot

  3. Analyzing health organizations' use of Twitter for promoting health literacy.

    Science.gov (United States)

    Park, Hyojung; Rodgers, Shelly; Stemmle, Jon

    2013-01-01

    This study explored health-related organizations' use of Twitter in delivering health literacy messages. A content analysis of 571 tweets from health-related organizations revealed that the organizations' tweets were often quoted or retweeted by other Twitter users. Nonprofit organizations and community groups had more tweets about health literacy than did other types of health-related organizations examined, including health business corporations, educational institutions, and government agencies. Tweets on health literacy topics focused predominantly on using simple language rather than complicated language. The results suggest that health organizations need a more strategic approach to managing positive organizational self-presentations in order to create an optimal level of exposure on social networking sites.

  4. Design Criteria for Achieving Acceptable Indoor Radon Concentration

    DEFF Research Database (Denmark)

    Rasmussen, Torben Valdbjørn

    2016-01-01

    Design criteria for achieving an acceptable indoor radon concentration are presented in this paper. The paper suggests three design criteria. These criteria have to be considered at the early stage of the building design phase to meet the latest recommendations from the World Health Organization...... in most countries. The three design criteria are; first, establishing a radon barrier facing the ground; second, lowering the air pressure in the lower zone of the slab on ground facing downwards; third, diluting the indoor air with outdoor air. The first two criteria can prevent radon from infiltrating...... from the ground, and the third criteria can dilute the indoor air. By combining these three criteria, the indoor radon concentration can be lowered achieving an acceptable level. In addition, a cheap and reliable method for measuring the radon concentration in the indoor air is described. The provision...

  5. Towards Sustainable Health Care Organizations

    Directory of Open Access Journals (Sweden)

    Mauro ROMANELLI

    2017-09-01

    Full Text Available Health care organizations have to develop a sustainable path for creating public value by seeking legitimacy for building and maintaining public trust with patients as social and economic institutions creating value and sustaining both health and wealth for people and communities within society. Health care organizations having at disposal decreasing resources and meeting increasing demands of citizens are following an unsustainable path. Designing sustainable health care systems and organizations is emerging as a strategic goal for developing the wealth of people and communities over time. Building sustainable organizations relies on valuing human resources, designing efficient and effective processes, using technology for better managing the relationships within and outside organizations. Sustainable health care organizations tend to rediscover the importance of human resource management and policies for effectively improving communication with patients and building trust-based relationships. While processes of accreditation contribute to legitimizing effectiveness and quality of health care services and efficient processes, introducing and using new information and communication technologies (ICTs and informatics helps communication leading to restore trust-based relationships between health care institutions and patients for value creation within society.

  6. Quality improvement using the Baldrige Criteria for Organizational Performance Excellence.

    Science.gov (United States)

    DeJong, Douglas J

    2009-06-01

    The criteria needed to achieve the Malcolm Baldrige National Quality Award (MBNQA) are described. The MBNQA was created in 1987 to recognize quality and performance and to encourage excellence in American companies. In 2003, Saint Luke's Hospital, the largest hospital in the Saint Luke's Health System, received the MBNQA. In the years since, the hospital has continued to use the Baldrige approach and has pursued the award on the health-system level. The Baldrige Criteria for Organizational Performance Excellence provide a framework that focuses on obtaining the highest levels of organizational excellence. These criteria consist of seven categories-leadership; strategic planning; focus on patients, customers, and markets; measurement, analysis, and knowledge management; work-force focus; process management; and results. At Saint Luke's Hospital, a category leader was designated for each of the seven categories in order to fully apply the criteria to the organization. Pharmacy leaders worked closely with each category leader to ensure that the appropriate format was being followed and to contribute positively to the written application and the site visit conducted by MBNQA examiners. The MBNQA involves its own vernacular and pattern. Effort should be made to fully understand and embrace the path that the organization's leaders have chosen. Departmental activities should be placed in front of an individual's leadership so that he or she can play an active part in demonstrating quality-improvement success stories. The criteria for the MBNQA are structured around seven categories that form a framework by which any organization or department can structure its own pursuit of quality and excellence. Pharmacy leaders can play an important role in the successful pursuit of quality within their organization.

  7. 2015 Edition Health Information Technology (Health IT) Certification Criteria, 2015 Edition Base Electronic Health Record (EHR) Definition, and ONC Health IT Certification Program Modifications. Final rule.

    Science.gov (United States)

    2015-10-16

    This final rule finalizes a new edition of certification criteria (the 2015 Edition health IT certification criteria or "2015 Edition'') and a new 2015 Edition Base Electronic Health Record (EHR) definition, while also modifying the ONC Health IT Certification Program to make it open and accessible to more types of health IT and health IT that supports various care and practice settings. The 2015 Edition establishes the capabilities and specifies the related standards and implementation specifications that Certified Electronic Health Record Technology (CEHRT) would need to include to, at a minimum, support the achievement of meaningful use by eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) under the Medicare and Medicaid EHR Incentive Programs (EHR Incentive Programs) when such edition is required for use under these programs.

  8. Using matrix organization to manage health care delivery organizations.

    Science.gov (United States)

    Allcorn, S

    1990-01-01

    Matrix organization can provide health care organization managers enhanced information processing, faster response times, and more flexibility to cope with greater organization complexity and rapidly changing operating environments. A review of the literature informed by work experience reveals that the use of matrix organization creates hard-to-manage ambiguity and balances of power in addition to providing positive benefits for health care organization managers. Solutions to matrix operating problems generally rely on the use of superior information and decision support systems and extensive staff training to develop attitudes and behavior consistent with the more collegial matrix organization culture. Further improvement in understanding the suitability of matrix organization for managing health care delivery organizations will involve appreciating the impact of partial implementation of matrix organization, temporary versus permanent uses of matrix organization, and the impact of the ambiguity created by dual lines of authority upon the exercise of power and authority.

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

    Science.gov (United States)

    Khoshnood, Zohreh; Rayyani, Masoud; Tirgari, Batool

    2018-01-13

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

  10. Assessment of American Heart Association's Ideal Cardiovascular Health Metrics Among Employees of a Large Healthcare Organization: The Baptist Health South Florida Employee Study.

    Science.gov (United States)

    Ogunmoroti, Oluseye; Younus, Adnan; Rouseff, Maribeth; Spatz, Erica S; Das, Sankalp; Parris, Don; Aneni, Ehimen; Holzwarth, Leah; Guzman, Henry; Tran, Thinh; Roberson, Lara; Ali, Shozab S; Agatston, Arthur; Maziak, Wasim; Feldman, Theodore; Veledar, Emir; Nasir, Khurram

    2015-07-01

    Healthcare organizations and their employees are critical role models for healthy living in their communities. The American Heart Association (AHA) 2020 impact goal provides a national framework that can be used to track the success of employee wellness programs with a focus on improving cardiovascular (CV) health. This study aimed to assess the CV health of the employees of Baptist Health South Florida (BHSF), a large nonprofit healthcare organization. HRAs and wellness examinations can be used to measure the cardiovascular health status of an employee population. The AHA's 7 CV health metrics (diet, physical activity, smoking, body mass index, blood pressure, total cholesterol, and blood glucose) categorized as ideal, intermediate, or poor were estimated among employees of BHSF participating voluntarily in an annual health risk assessment (HRA) and wellness fair. Age and gender differences were analyzed using χ(2) test. The sample consisted of 9364 employees who participated in the 2014 annual HRA and wellness fair (mean age [standard deviation], 43 [12] years, 74% women). Sixty (1%) individuals met the AHA's definition of ideal CV health. Women were more likely than men to meet the ideal criteria for more than 5 CV health metrics. The proportion of participants meeting the ideal criteria for more than 5 CV health metrics decreased with age. A combination of HRAs and wellness examinations can provide useful insights into the cardiovascular health status of an employee population. Future tracking of the CV health metrics will provide critical feedback on the impact of system wide wellness efforts as well as identifying proactive programs to assist in making substantial progress toward the AHA 2020 Impact Goal. © 2015 Wiley Periodicals, Inc.

  11. Budget- and Priority-Setting Criteria at State Health Agencies in Times of Austerity: A Mixed-Methods Study

    Science.gov (United States)

    Resnick, Beth; Kass, Nancy; Sellers, Katie; Young, Jessica; Bernet, Patrick; Jarris, Paul

    2014-01-01

    Objectives. We examined critical budget and priority criteria for state health agencies to identify likely decision-making factors, pressures, and opportunities in times of austerity. Methods. We have presented findings from a 2-stage, mixed-methods study with state public health leaders regarding public health budget- and priority-setting processes. In stage 1, we conducted hour-long interviews in 2011 with 45 health agency executive and division or bureau leaders from 6 states. Stage 2 was an online survey of 207 executive and division or bureau leaders from all state health agencies (66% response rate). Results. Respondents identified 5 key criteria: whether a program was viewed as “mission critical,” the seriousness of the consequences of not funding the program, financing considerations, external directives and mandates, and the magnitude of the problem the program addressed. Conclusions. We have presented empirical findings on criteria used in state health agency budgetary decision-making. These criteria suggested a focus and interest on core public health and the largest public health problems with the most serious ramifications. PMID:24825212

  12. Reliability, Resilience, and Vulnerability criteria for the evaluation of Human Health Risks

    Science.gov (United States)

    Rodak, C. M.; Silliman, S. E.; Bolster, D.

    2011-12-01

    Understanding the impact of water quality on the health of a general population is challenging due high degrees of uncertainty and variability in hydrological, toxicological and human aspects of the system. Assessment of the impact of changes in water quality of a public water supply is critical to management of that water supply. We propose the use of three different system evaluation criteria: Reliability, Resilience and Vulnerability (RRV) as a tool for assessing the impact of uncertainty in the arrival of contaminant mass through time with respect to human health risks on a variable population. These criteria were first introduced to the water resources community by Hashimoto et al (1982). Most simply one can understand these criteria as the following: Reliability is the likelihood of the system being in a state of success; Resilience is the probability that the system will return to a state of success at t+1 if it is in failure at time step t, and Vulnerability is the severity of failure, which here is defined as the maximum health risk. These concepts are applied to a theoretical example where the water quality at a water supply well varies over time: health impact is considered based on sliding, 30-year windows of exposure to water derived from the well. We apply the methodology, in terms of uncertainty in water quality deviations, to eight simulated breakthrough curves of a contaminant at the well: each curve represents equal mass of contaminant arriving at the well over a 70-year lifetime of the well, but different mass distributions over time. These curves are used to investigate the impact of uncertainty in the distribution through time of the contaminant mass at the well, as well as the initial arrival of the contaminant over the 70-year lifetime of the well. In addition to extending the health risk through time with uncertainty in mass distribution, we incorporate variability in the human population to examine the evolution of the three criteria within

  13. Criteria for intraventricular conduction disturbances and pre-excitation

    NARCIS (Netherlands)

    Willems, J.L.; Robles de Medina, E.O.; Bernard, R.; Coumel, Ph.; Fisch, Ch.; Mazur, N.A.; Meijler, F.L.; Mogensen, L.; Moret, P.; Pisa, Z.; Rautaharju, P.M.; Surawicz, B.; Watanabe, Y.; Wellens, H.J.J.; WHO/ISFC Task Force ad hoc

    1985-01-01

    In an effort to standardize terminology and criteria for clinical electrocardiography, and as a follow-up of its work on definitions of terms related to cardiac rhythm, an Ad Hoc Working Group established by the World Health Organization and the International Society and Federation of Cardiology

  14. Ecological radiation protection criteria for nuclear power

    International Nuclear Information System (INIS)

    Kryshev, I.I.

    1993-01-01

    By now a large quantity of radioactive hazards of all sizes and shapes has accumulated in Russia. They include RBMK, VVER, and BN (fast-neutron) nuclear power plants, nuclear fuel processing plants, radioactive waste dumps, ships with nuclear power units, etc. In order to evaluate the radioecological situation correctly, the characteristics of the radioactive contamination must be compiled in these areas with some system of criteria which will provide an acceptable level of ecological safety. Currently health criteria for radiation protection are, which are oriented to man's radiation protection, predominate. Here the concept of a thresholdless linear dose-response dependence, which has been confirmed experimentally only at rather high doses (above 1 Gy), is taken as the theoretical basis for evaluating and normalizing radiation effects. According to one opinion, protecting people against radiation is sufficient to protect other types of organisms, although they are not necessarily of the same species. However, from the viewpoint of ecology, this approach is incorrect, because it does not consider radiation dose differences between man and other living organisms. The article discusses dose-response dependences for various organisms, biological effects of ionizing radiation, and appropriate radiation protection criteria

  15. IMPORTANCE OF MULTIPLE CRITERIA FOR PRIORITY SETTING OF HIV/AIDS INTERVENTIONS.

    Science.gov (United States)

    Tromp, Noor; Prawiranegara, Rozar; Siregar, Adiatma; Sunjaya, Deni; Baltussen, Rob

    2015-01-01

    This study describes the views of various stakeholders on the importance of different criteria for priority setting of HIV/AIDS interventions in Indonesia. Based on a general list of criteria and a focus group discussion with stakeholders (n = 6), a list was developed of thirty-two criteria that play a role in priority setting in HIV/AIDS control in West-Java province. Criteria were categorized according to the World Health Organization's health system goals and building block frameworks. People living with HIV/AIDS (n = 49), healthcare workers (HCW) (n = 41), the general population (n = 43), and policy makers (n = 22) rated the importance of thirty-two criteria on a 5-point Likert-scale. Thereafter, respondents ranked the highest rated criteria to express more detailed preferences. Stakeholders valued the following criteria as most important for the priority setting of HIV/AIDS interventions: an intervention's impact on the HIV/AIDS epidemic, reduction of stigma, quality of care, effectiveness on individual level, and feasibility in terms of current capacity of the health system (i.e., HCW, product, information, and service requirements), financial sustainability, and acceptance by donors. Overall, stakeholders' preferences for the importance of criteria are similar. Our study design outlines an approach for other settings to identify which criteria are important for priority setting of health interventions. For Indonesia, these study results may be used in priority setting processes for HIV/AIDS control and may contribute to more transparent and systematic allocation of resources.

  16. Health Literacy and Communication Quality in Health Care Organizations

    Science.gov (United States)

    Wynia, Matthew K.; Osborn, Chandra Y.

    2011-01-01

    The relationship between limited health literacy and poor health may be due to poor communication quality within health care delivery organizations. We explored the relationship between health literacy status and receiving patient-centered communication in clinics and hospitals serving communication-vulnerable patient populations. Thirteen health care organizations nationwide distributed a survey to 5,929 patients. All patients completed seven items assessing patient-centered communication. One third also completed three items assessing health literacy. The majority of patients had self-reported health literacy challenges, reporting problems learning about their medical condition because of difficulty understanding written information (53%), a lack of confidence in completing medical forms by themselves (61%), and needing someone to help them read hospital/clinic materials (57%). Logistic regression models showed that, after adjustment for patient demographic characteristics and health care organization type, patients with limited health literacy were 28–79% less likely than those with adequate health literacy to report their health care organization “always” provides patient-centered communication across seven communication items. Using a scaled composite of these items, limited health literacy remained associated with lower reported communication quality. These results suggest that improving communication quality in health care organizations might help to address the challenges facing patients with limited health literacy. They also highlight that efforts to address the needs of patients with limited health literacy should be sensitive to the range of communication challenges confronting these patients and their caregivers. PMID:20845197

  17. Learn More about EPA’s Plans to Establish Voluntary Criteria for Radon Credentialing Organizations

    Science.gov (United States)

    This page will provide the public with information on a Federal Register Notice of Intent to Establish Voluntary Criteria for Radon Credentialing Organizations.Topics covered include background and information on how to review and provide comments.

  18. Reconsidering Evaluation Criteria for Scientific Adequacy in Health Care Research: An Integrative Framework of Quantitative and Qualitative Criteria

    Directory of Open Access Journals (Sweden)

    Hiroaki Miyata PhD

    2009-03-01

    Full Text Available It is important to reconsider evaluation criteria regarding scientific adequacy in health care research. In this article the authors review the four pairs of quantitative/qualitative paradigms. They discuss the use of evaluation criteria based on a pragmatic perspective after examining the epistemological issues behind the criteria. Validity/credibility is concerned with research framework, whereas reliability/dependability refers to the range of stability in observations, objectivity/ confirmability reflects influences between observers and subjects, and generalizability/transferability has epistemological differences in the way findings are applied. Qualitative studies should not always choose qualitative paradigms, and vice versa. If stability can be assumed to some extent in a qualitative study, it is better to use a quantitative paradigm. Regardless of whether it is quantitative or qualitative research, it is important to recognize the four epistemological axes.

  19. Criteria for quantitative and qualitative data integration: mixed-methods research methodology.

    Science.gov (United States)

    Lee, Seonah; Smith, Carrol A M

    2012-05-01

    Many studies have emphasized the need and importance of a mixed-methods approach for evaluation of clinical information systems. However, those studies had no criteria to guide integration of multiple data sets. Integrating different data sets serves to actualize the paradigm that a mixed-methods approach argues; thus, we require criteria that provide the right direction to integrate quantitative and qualitative data. The first author used a set of criteria organized from a literature search for integration of multiple data sets from mixed-methods research. The purpose of this article was to reorganize the identified criteria. Through critical appraisal of the reasons for designing mixed-methods research, three criteria resulted: validation, complementarity, and discrepancy. In applying the criteria to empirical data of a previous mixed methods study, integration of quantitative and qualitative data was achieved in a systematic manner. It helped us obtain a better organized understanding of the results. The criteria of this article offer the potential to produce insightful analyses of mixed-methods evaluations of health information systems.

  20. Integrating Community Health Workers (CHWs) into Health Care Organizations.

    Science.gov (United States)

    Payne, Julianne; Razi, Sima; Emery, Kyle; Quattrone, Westleigh; Tardif-Douglin, Miriam

    2017-10-01

    Health care organizations increasingly employ community health workers (CHWs) to help address growing provider shortages, improve patient outcomes, and increase access to culturally sensitive care among traditionally inaccessible or disenfranchised patient populations. Scholarly interest in CHWs has grown in recent decades, but researchers tend to focus on how CHWs affect patient outcomes rather than whether and how CHWs fit into the existing health care workforce. This paper focuses on the factors that facilitate and impede the integration of the CHWs into health care organizations, and strategies that organizations and their staff develop to overcome barriers to CHW integration. We use qualitative evaluation data from 13 awardees that received Health Care Innovation Awards from the Centers of Medicare and Medicaid Innovation to enhance the quality of health care, improve health outcomes, and reduce the cost of care using programs involving CHWs. We find that organizational capacity, support for CHWs, clarity about health care roles, and clinical workflow drive CHW integration. We conclude with practical recommendations for health care organizations interested in employing CHWs.

  1. Evaluation of the Quality of Occupational Health and Safety Management Systems Based on Key Performance Indicators in Certified Organizations

    OpenAIRE

    Iraj Mohammadfam; Mojtaba Kamalinia; Mansour Momeni; Rostam Golmohammadi; Yadollah Hamidi; Alireza Soltanian

    2017-01-01

    Background: Occupational Health and Safety Management Systems are becoming more widespread in organizations. Consequently, their effectiveness has become a core topic for researchers. This paper evaluates the performance of the Occupational Health and Safety Assessment Series 18001 specification in certified companies in Iran. Methods: The evaluation is based on a comparison of specific criteria and indictors related to occupational health and safety management practices in three certified...

  2. Early declaration of death by neurologic criteria results in greater organ donor potential.

    Science.gov (United States)

    Resnick, Shelby; Seamon, Mark J; Holena, Daniel; Pascual, Jose; Reilly, Patrick M; Martin, Niels D

    2017-10-01

    Aggressive management of patients prior to and after determination of death by neurologic criteria (DNC) is necessary to optimize organ recovery, transplantation, and increase the number of organs transplanted per donor (OTPD). The effects of time management are understudied but potentially pivotal component. The objective of this study was to analyze specific time points (time to DNC, time to procurement) and the time intervals between them to better characterize the optimal timeline of organ donation. Using data over a 5-year time period (2011-2015) from the largest US OPO, all patients with catastrophic brain injury and donated transplantable organs were retrospectively reviewed. Active smokers were excluded. Maximum donor potential was seven organs (heart, lungs [2], kidneys [2], liver, and pancreas). Time from admission to declaration of DNC and donation was calculated. Mean time points stratified by specific organ procurement rates and overall OTPD were compared using unpaired t-test. Of 1719 Declaration of Death by Neurologic Criteria organ donors, 381 were secondary to head trauma. Smokers and organs recovered but not transplanted were excluded leaving 297 patients. Males comprised 78.8%, the mean age was 36.0 (±16.8) years, and 87.6% were treated at a trauma center. Higher donor potential (>4 OTPD) was associated with shorter average times from admission to brain death; 66.6 versus 82.2 hours, P = 0.04. Lung donors were also associated with shorter average times from admission to brain death; 61.6 versus 83.6 hours, P = 0.004. The time interval from DNC to donation varied minimally among groups and did not affect donation rates. A shorter time interval between admission and declaration of DNC was associated with increased OTPD, especially lungs. Further research to identify what role timing plays in the management of the potential organ donor and how that relates to donor management goals is needed. Copyright © 2017 Elsevier Inc. All rights

  3. 75 FR 6673 - Expert Meeting on Measurement Criteria for Children's Health Insurance Program; Reauthorization...

    Science.gov (United States)

    2010-02-10

    ... on Measurement Criteria for Children's Health Insurance Program; Reauthorization Act Pediatric... enacted in the Children's Health Insurance Program Reauthorization Act (CHIPRA). DATES: The meeting will...) reauthorized the Child Health Insurance Program (CHIP) originally established in 1997, and in Title IV of the...

  4. Performance Against WELCOA's Worksite Health Promotion Benchmarks Across Years Among Selected US Organizations.

    Science.gov (United States)

    Weaver, GracieLee M; Mendenhall, Brandon N; Hunnicutt, David; Picarella, Ryan; Leffelman, Brittanie; Perko, Michael; Bibeau, Daniel L

    2018-05-01

    The purpose of this study was to quantify the performance of organizations' worksite health promotion (WHP) activities against the benchmarking criteria included in the Well Workplace Checklist (WWC). The Wellness Council of America (WELCOA) developed a tool to assess WHP with its 100-item WWC, which represents WELCOA's 7 performance benchmarks. Workplaces. This study includes a convenience sample of organizations who completed the checklist from 2008 to 2015. The sample size was 4643 entries from US organizations. The WWC includes demographic questions, general questions about WHP programs, and scales to measure the performance against the WELCOA 7 benchmarks. Descriptive analyses of WWC items were completed separately for each year of the study period. The majority of the organizations represented each year were multisite, multishift, medium- to large-sized companies mostly in the services industry. Despite yearly changes in participating organizations, results across the WELCOA 7 benchmark scores were consistent year to year. Across all years, benchmarks that organizations performed the lowest were senior-level support, data collection, and programming; wellness teams and supportive environments were the highest scoring benchmarks. In an era marked with economic swings and health-care reform, it appears that organizations are staying consistent in their performance across these benchmarks. The WWC could be useful for organizations, practitioners, and researchers in assessing the quality of WHP programs.

  5. Basic principles and criteria for public health protection in the event of a nuclear accident

    International Nuclear Information System (INIS)

    Kiradzhiev, G.

    1992-01-01

    Decision making criteria for population protection in nuclear accidents are discussed, and in particular the three basic principles: 1) excluding the appearance of nonstostochastic effects that occur in the case of high individual doses; 2) weighing the risks of radiation damage if such measures are not taken; 3) optimization based on comparison of benefit and costs, using the same measures for costs of health injury to affected populations and of the protected measures to be taken. The decision making criteria developed in Bulgaria are based on international recommendations with lowered upper limit of the range for evacuation and specified doses for vulnerable groups, children and pregnant women. The organization and the specific problems of the following individual types of protective measures are described: sheltering; protection of respiratory organs; iodine prophylaxis; evacuation of the public. One major condition for ensuring protection is to provide the public with timely information on the actual situation and the necessary countermeasures. Such information should be released in a manner that allows for understanding the expediency and significance of actions to be taken. An important aspect of emergency planning consists in taking into consideration the conditions actually prevailing in the country. This is well illustrated in the principle designated as 'national level of challenge' taking into account a country's capabilities for introducing intervention levels and permissible dose levels. In the case of Bulgaria this still remains to be done in protective planning for accidents. (author)

  6. Value judgment of health interventions from different perspectives : arguments and criteria

    NARCIS (Netherlands)

    Vermeulen, Karin M; Krabbe, Paul F M

    Background: The healthcare sector is evolving while life expectancy is increasing. These trends put greater pressure on healthcare resources, prompt healthcare reforms, and demand transparent arguments and criteria to assess the overall value of health interventions. There is no consensus on the

  7. Human health implications of organic food and organic agriculture

    DEFF Research Database (Denmark)

    Mie, Axel; Andersen, Helle Raun; Gunnarsson, Stefan

    2017-01-01

    . Organic food consumption may reduce the risk of allergic disease and of overweight and obesity, but the evidence is not conclusive due to likely residual confounding, as consumers of organic food tend to have healthier lifestyles overall. However, animal experiments suggest that identically composed feed...... benefits associated with organic food production, and application of such production methods is likely to be beneficial within conventional agriculture, e.g., in integrated pest management.......This review summarises existing evidence on the impact of organic food on human health. It compares organic vs. conventional food production with respect to parameters important to human health and discusses the potential impact of organic management practices with an emphasis on EU conditions...

  8. Multiple criteria decision analysis for health technology assessment.

    Science.gov (United States)

    Thokala, Praveen; Duenas, Alejandra

    2012-12-01

    Multicriteria decision analysis (MCDA) has been suggested by some researchers as a method to capture the benefits beyond quality adjusted life-years in a transparent and consistent manner. The objectives of this article were to analyze the possible application of MCDA approaches in health technology assessment and to describe their relative advantages and disadvantages. This article begins with an introduction to the most common types of MCDA models and a critical review of state-of-the-art methods for incorporating multiple criteria in health technology assessment. An overview of MCDA is provided and is compared against the current UK National Institute for Health and Clinical Excellence health technology appraisal process. A generic MCDA modeling approach is described, and the different MCDA modeling approaches are applied to a hypothetical case study. A comparison of the different MCDA approaches is provided, and the generic issues that need consideration before the application of MCDA in health technology assessment are examined. There are general practical issues that might arise from using an MCDA approach, and it is suggested that appropriate care be taken to ensure the success of MCDA techniques in the appraisal process. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  9. [Consensus on the legibility criteria of health education leaflets].

    Science.gov (United States)

    Barrio-Cantalejo, I; Simón-Lorda, P; Jiménez, M Melguizo; Ruiz, A Molina

    2011-01-01

    To identify the most relevant aspects that guarantee the readability, clarity and simplicity of written health education materials. Delphi methodology in order to reach a state of consensus among health education experts on criteria of legibility in the design and publication of informative material and literature. Seventeen experts reached agreement on the principal recommendations for ensuring the legibility of health education materials. They were as follows: a) text content and layout: to structure the text using a title or subtitle, message explanation and conclusion; b) text construction: to use simple and concise sentences, diagrams and examples, and graphically highlighting the principal ideas; c) lexical comprehension: to use simple words and avoid technical language and abbreviations; d) typography: to use an easy-to-read font. There is a high degree of consensus regarding the way health education materials should be drawn up. This list of recommendations could be used as an instrument for reviewing and improving the design of health education materials. In general, it is recommended to identify the users of the leaflets and involve them in the writing and design.

  10. Who Shall Not Be Treated: Public Attitudes on Setting Health Care Priorities by Person-Based Criteria in 28 Nations.

    Science.gov (United States)

    Rogge, Jana; Kittel, Bernhard

    2016-01-01

    The principle of distributing health care according to medical need is being challenged by increasing costs. As a result, many countries have initiated a debate on the introduction of explicit priority regulations based on medical, economic and person-based criteria, or have already established such regulations. Previous research on individual attitudes towards setting health care priorities based on medical and economic criteria has revealed consistent results, whereas studies on the use of person-based criteria have generated controversial findings. This paper examines citizens' attitudes towards three person-based priority criteria, patients' smoking habits, age and being the parent of a young child. Using data from the ISSP Health Module (2011) in 28 countries, logistic regression analysis demonstrates that self-interest as well as socio-demographic predictors significantly influence respondents' attitudes towards the use of person-based criteria for health care prioritization. This study contributes to resolving the controversial findings on person-based criteria by using a larger country sample and by controlling for country-level differences with fixed effects models.

  11. Who Shall Not Be Treated: Public Attitudes on Setting Health Care Priorities by Person-Based Criteria in 28 Nations.

    Directory of Open Access Journals (Sweden)

    Jana Rogge

    Full Text Available The principle of distributing health care according to medical need is being challenged by increasing costs. As a result, many countries have initiated a debate on the introduction of explicit priority regulations based on medical, economic and person-based criteria, or have already established such regulations. Previous research on individual attitudes towards setting health care priorities based on medical and economic criteria has revealed consistent results, whereas studies on the use of person-based criteria have generated controversial findings. This paper examines citizens' attitudes towards three person-based priority criteria, patients' smoking habits, age and being the parent of a young child. Using data from the ISSP Health Module (2011 in 28 countries, logistic regression analysis demonstrates that self-interest as well as socio-demographic predictors significantly influence respondents' attitudes towards the use of person-based criteria for health care prioritization. This study contributes to resolving the controversial findings on person-based criteria by using a larger country sample and by controlling for country-level differences with fixed effects models.

  12. Criteria for the Evaluation of Quality Improvement Programs and the Use of Quality Improvement Data

    Science.gov (United States)

    American Psychologist, 2009

    2009-01-01

    This document provides a set of criteria to be used by psychologists in evaluating quality improvement programs (QIPs) that have been promulgated by health care organizations, government agencies, professional associations, or other entities. These criteria also address the privacy and confidentiality issues evoked by the intended use of patient…

  13. Health and welfare of organic livestock

    NARCIS (Netherlands)

    Sukkel, W.; Hommes, M.

    2009-01-01

    Animal health and welfare are important principles of organic animal husbandry. In the Netherlands organic animal husbandry has proven to perform better than the conventional sector on many aspects of animal welfare. The Dutch organic animal husbandry sector has recognised animal health and welfare

  14. Criteria for the prioritization of public health interventions for climate-sensitive vector-borne diseases in Quebec.

    Directory of Open Access Journals (Sweden)

    Valerie Hongoh

    Full Text Available Prioritizing resources for optimal responses to an ever growing list of existing and emerging infectious diseases represents an important challenge to public health. In the context of climate change, there is increasing anticipated variability in the occurrence of infectious diseases, notably climate-sensitive vector-borne diseases. An essential step in prioritizing efforts is to identify what considerations and concerns to take into account to guide decisions and thus set disease priorities. This study was designed to perform a comprehensive review of criteria for vector-borne disease prioritization, assess their applicability in a context of climate change with a diverse cross-section of stakeholders in order to produce a baseline list of considerations to use in this decision-making context. Differences in stakeholder choices were examined with regards to prioritization of these criteria for research, surveillance and disease prevention and control objectives. A preliminary list of criteria was identified following a review of the literature. Discussions with stakeholders were held to consolidate and validate this list of criteria and examine their effects on disease prioritization. After this validation phase, a total of 21 criteria were retained. A pilot vector-borne disease prioritization exercise was conducted using PROMETHEE to examine the effects of the retained criteria on prioritization in different intervention domains. Overall, concerns expressed by stakeholders for prioritization were well aligned with categories of criteria identified in previous prioritization studies. Weighting by category was consistent between stakeholders overall, though some significant differences were found between public health and non-public health stakeholders. From this exercise, a general model for climate-sensitive vector-borne disease prioritization has been developed that can be used as a starting point for further public health prioritization

  15. Criteria for the prioritization of public health interventions for climate-sensitive vector-borne diseases in Quebec.

    Science.gov (United States)

    Hongoh, Valerie; Gosselin, Pierre; Michel, Pascal; Ravel, André; Waaub, Jean-Philippe; Campagna, Céline; Samoura, Karim

    2017-01-01

    Prioritizing resources for optimal responses to an ever growing list of existing and emerging infectious diseases represents an important challenge to public health. In the context of climate change, there is increasing anticipated variability in the occurrence of infectious diseases, notably climate-sensitive vector-borne diseases. An essential step in prioritizing efforts is to identify what considerations and concerns to take into account to guide decisions and thus set disease priorities. This study was designed to perform a comprehensive review of criteria for vector-borne disease prioritization, assess their applicability in a context of climate change with a diverse cross-section of stakeholders in order to produce a baseline list of considerations to use in this decision-making context. Differences in stakeholder choices were examined with regards to prioritization of these criteria for research, surveillance and disease prevention and control objectives. A preliminary list of criteria was identified following a review of the literature. Discussions with stakeholders were held to consolidate and validate this list of criteria and examine their effects on disease prioritization. After this validation phase, a total of 21 criteria were retained. A pilot vector-borne disease prioritization exercise was conducted using PROMETHEE to examine the effects of the retained criteria on prioritization in different intervention domains. Overall, concerns expressed by stakeholders for prioritization were well aligned with categories of criteria identified in previous prioritization studies. Weighting by category was consistent between stakeholders overall, though some significant differences were found between public health and non-public health stakeholders. From this exercise, a general model for climate-sensitive vector-borne disease prioritization has been developed that can be used as a starting point for further public health prioritization exercises relating to

  16. Developing priority criteria for magnetic resonance imaging: results from the Western Canada Waiting List project

    International Nuclear Information System (INIS)

    Hadorn, D.C.

    2002-01-01

    The Western Canada Waiting List (WCWL) Project is a federally funded partnership of 19 organizations, including medical associations, health authorities, ministries of health and research organizations, that was created to develop tools to assist in assessing the relative urgency and priority of patients on waiting lists. The WCWL panel on magnetic resonance imaging (MRI) was 1 of 5 panels constituted under this project. The panel developed and tested a set of standardized clinical criteria for setting priorities among patients awaiting MRI. The criteria were applied to 407 patients in the 4 western provinces. Regression analysis was used to determine the set of criteria weights that collectively best predicted clinicians' overall ratings of patients' urgency for MRI. Reliability was assessed using clinicians' ratings of 6 hypothetical paper cases. The resulting weighted criteria accounted for about two-fifths of the observed variance in overall urgency ratings (R 2 = 39.9%). The panel then modified the criteria on the basis of regression results and clinical judgment. Most of the revised criteria items showed poor inter-rater reliability, but test-retest reliability (over a 2-month interval) was relatively good. Criteria items requiring probability judgments were a challenge for clinicians. Further development and testing of the tool appears warranted, although considerable question remains concerning the utility of priority criteria for MRI and other diagnostic services. (author)

  17. International organizations and migrant health in Europe.

    Science.gov (United States)

    Kentikelenis, Alexander E; Shriwise, Amanda

    International organizations have defined and managed different aspects of migrant health issues for decades, yet we lack a systematic understanding of how they reach decisions and what they do on the ground. The present article seeks to clarify the state of knowledge on the relationship between international organizations and migrant health in Europe. To do so, we review the operations of six organizations widely recognized as key actors in the field of migrant health: the European Commission, the Regional Office for Europe of the World Health Organization, the International Organization on Migration, Médecins du Monde, Médecins Sans Frontières, and the Open Society Foundation. We find that international organizations operate in a complementary fashion, with each taking on a unique role in migrant health provision. States often rely on international organizations as policy advisors or sub-contractors for interventions, especially in the case of emergencies. These linkages yield a complex web of relationships, which can vary depending on the country under consideration or the health policy issue in question.

  18. 42 CFR Appendix to Subpart G of... - Interim Procedures and Criteria for Review by Health Systems Agencies of Applications Under...

    Science.gov (United States)

    2010-10-01

    ... Health Systems Agencies of Applications Under Section 1625 of the Public Health Service Act Appendix to..., App. Appendix to Subpart G of Part 124—Interim Procedures and Criteria for Review by Health Systems... section 1625 of the Act, health systems agencies shall use the procedures and criteria stated below. A...

  19. Health Disparities Research Among Small Tribal Populations: Describing Appropriate Criteria for Aggregating Tribal Health Data.

    Science.gov (United States)

    Van Dyke, Emily R; Blacksher, Erika; Echo-Hawk, Abigail L; Bassett, Deborah; Harris, Raymond M; Buchwald, Dedra S

    2016-07-01

    In response to community concerns, we used the Tribal Participatory Research framework in collaboration with 5 American-Indian communities in Washington, Idaho, and Montana to identify the appropriate criteria for aggregating health data on small tribes. Across tribal sites, 10 key informant interviews and 10 focus groups (n = 39) were conducted between July 2012 and April 2013. Using thematic analysis of focus group content, we identified 5 guiding criteria for aggregating tribal health data: geographic proximity, community type, environmental exposures, access to resources and services, and economic development. Preliminary findings were presented to focus group participants for validation at each site, and a culminating workshop with representatives from all 5 tribes verified our final results. Using this approach requires critical assessment of research questions and study designs by investigators and tribal leaders to determine when aggregation or stratification is appropriate and how to group data to yield robust results relevant to local concerns. At project inception, tribal leaders should be consulted regarding the validity of proposed groupings. After regular project updates, they should be consulted again to confirm that findings are appropriately contextualized for dissemination. © 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.

  20. Trends in Ideal Cardiovascular Health Metrics Among Employees of a Large Healthcare Organization (from the Baptist Health South Florida Employee Study).

    Science.gov (United States)

    Ogunmoroti, Oluseye; Utuama, Ovie; Spatz, Erica S; Rouseff, Maribeth; Parris, Don; Das, Sankalp; Younus, Adnan; Guzman, Henry; Tran, Thinh; Agatston, Arthur; Feldman, Theodore; Virani, Salim S; Maziak, Wasim; Veledar, Emir; Nasir, Khurram

    2016-03-01

    The American Heart Association (AHA)'s 2020 goal is to improve the cardiovascular health (CVH) of people living in the United States (US) by 20% and reduce mortality from cardiovascular diseases and stroke by 20%. Given that 155 million adults are in the US workforce, and >60% have employee-based insurance, workplace studies provide an important opportunity to assess and potentially advance CVH through the use of comprehensive workplace wellness programs. Among a cohort of employees of the Baptist Health System, CVH was assessed annually during voluntary health fairs and health risk assessments (HRA) from 2011 to 2014 using the AHA's 7 CVH metrics: smoking, body mass index (BMI), physical activity, diet, blood pressure, total cholesterol, and blood glucose. Each metric was categorized as ideal, intermediate, or poor according to the AHA criteria. Cochrane-Armitage test was used to detect trends in CVH by year. Ideal CVH, defined as meeting ideal criteria for all 7 metrics, was assessed and compared across years. The overall cohort was 34,746 with 4,895 employees in 2011, 10,724 in 2012, 9,763 in 2013, and 9,364 in 2014. Mean age (SD) was between 43 (±12) and 46 years (±12). Female to male ratio was 3:1. The prevalence of study participants who met the ideal criteria for diet, physical activity, and blood pressure increased significantly from 2011 to 2014 but for BMI, total cholesterol, and blood glucose, a significant decrease was noticed. In addition, the prevalence of study participants in ideal CVH although low, increased significantly over time (0.3% to 0.6%, p health care organization. The positive findings noted for the metrics of smoking, physical activity, total cholesterol, and blood glucose should be reinforced. However, the metrics of diet, BMI, and blood pressure need more attention. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Criteria for risk acceptance: a health physicist's view

    International Nuclear Information System (INIS)

    Hull, A. P.

    1977-01-01

    While energy need (or demand) and the risks of energy production and use may be objectively quantified, risk acceptance embodies a subjective element of preferences and values. Yet, as demonstrated by the nuclear controversy in the United States, public acceptance is essential to the beneficial uses of radiation. The statement of the objectives and purposes of the Health Physics Society and our application of it are proposed as offering useful criteria for risk acceptance. The principle of comparing risk with a number of those regularly accepted in everyday life is emphasized. On this basis, it is concluded that the expenditures to attain currently applicable or proposed 'as low as practicable' (or 'as low as readily achievable') levels for the nuclear fuel cycle are disproportionate to those addressed to other sources of general public exposure to radiation. They are also disproportionate compared to those addressed to a variety of public health risks. It is suggested that sensible priorities for radiation and public health protection might be achieved by the application of a de minimus negligible (but nonzero) level of probable risk. (Research supported by the U.S. Energy Research and Development Administration.)

  2. Gender Incongruence of Adolescence and Adulthood: Acceptability and Clinical Utility of the World Health Organization's Proposed ICD-11 Criteria.

    Directory of Open Access Journals (Sweden)

    Titia F Beek

    Full Text Available The World Health Organization (WHO is currently updating the tenth version of their diagnostic tool, the International Classification of Diseases (ICD, WHO, 1992. Changes have been proposed for the diagnosis of Transsexualism (ICD-10 with regard to terminology, placement and content. The aim of this study was to gather the opinions of transgender individuals (and their relatives/partners and clinicians in the Netherlands, Flanders (Belgium and the United Kingdom regarding the proposed changes and the clinical applicability and utility of the ICD-11 criteria of 'Gender Incongruence of Adolescence and Adulthood' (GIAA. A total of 628 participants were included in the study: 284 from the Netherlands (45.2%, 8 from Flanders (Belgium (1.3%, and 336 (53.5% from the UK. Most participants were transgender people (or their partners/relatives (n = 522, 89 participants were healthcare providers (HCPs and 17 were both healthcare providers and (partners/relatives of transgender people. Participants completed an online survey developed for this study. Most participants were in favor of the proposed diagnostic term of 'Gender Incongruence' and thought that this was an improvement on the ICD-10 diagnostic term of 'Transsexualism'. Placement in a separate chapter dealing with Sexual- and Gender-related Health or as a Z-code was preferred by many and only a small number of participants stated that this diagnosis should be excluded from the ICD-11. In the UK, most transgender participants thought there should be a diagnosis related to being trans. However, if it were to be removed from the chapter on "psychiatric disorders", many transgender respondents indicated that they would prefer it to be removed from the ICD in its entirety. There were no large differences between the responses of the transgender participants (or their partners and relatives and HCPs. HCPs were generally positive about the GIAA diagnosis; most thought the diagnosis was clearly defined and

  3. Improved exposure estimation in soil screening and cleanup criteria for volatile organic chemicals.

    Science.gov (United States)

    DeVaull, George E

    2017-09-01

    Soil cleanup criteria define acceptable concentrations of organic chemical constituents for exposed humans. These criteria sum the estimated soil exposure over multiple pathways. Assumptions for ingestion, dermal contact, and dust exposure generally presume a chemical persists in surface soils at a constant concentration level for the entire exposure duration. For volatile chemicals, this is an unrealistic assumption. A calculation method is presented for surficial soil criteria that include volatile depletion of chemical for these uptake pathways. The depletion estimates compare favorably with measured concentration profiles and with field measurements of soil concentration. Corresponding volatilization estimates compare favorably with measured data for a wide range of volatile and semivolatile chemicals, including instances with and without the presence of a mixed-chemical residual phase. Selected examples show application of the revised factors in estimating screening levels for benzene in surficial soils. Integr Environ Assess Manag 2017;13:861-869. © 2017 The Authors. Integrated Environmental Assessment and Management published by Wiley Periodicals, Inc. on behalf of Society of Environmental Toxicology & Chemistry (SETAC). © 2017 The Authors. Integrated Environmental Assessment and Management published by Wiley Periodicals, Inc. on behalf of Society of Environmental Toxicology & Chemistry (SETAC).

  4. Study-design selection criteria in systematic reviews of effectiveness of health systems interventions and reforms: A meta-review.

    Science.gov (United States)

    Rockers, Peter C; Feigl, Andrea B; Røttingen, John-Arne; Fretheim, Atle; de Ferranti, David; Lavis, John N; Melberg, Hans Olav; Bärnighausen, Till

    2012-03-01

    At present, there exists no widely agreed upon set of study-design selection criteria for systematic reviews of health systems research, except for those proposed by the Cochrane Collaboration's Effective Practice and Organisation of Care (EPOC) review group (which comprises randomized controlled trials, controlled clinical trials, controlled before-after studies, and interrupted time series). We conducted a meta-review of the study-design selection criteria used in systematic reviews available in the McMaster University's Health Systems Evidence or the EPOC database. Of 414 systematic reviews, 13% did not indicate any study-design selection criteria. Of the 359 studies that described such criteria, 50% limited their synthesis to controlled trials and 68% to some or all of the designs defined by the EPOC criteria. Seven out of eight reviews identified at least one controlled trial that was relevant for the review topic. Seven percent of the reviews included either no or only one relevant primary study. Our meta-review reveals reviewers' preferences for restricting synthesis to controlled experiments or study designs that comply with the EPOC criteria. We discuss the advantages and disadvantages of the current practices regarding study-design selection in systematic reviews of health systems research as well as alternative approaches. Copyright © 2012. Published by Elsevier Ireland Ltd.

  5. The World Health Organization and Global Health Governance: post-1990.

    Science.gov (United States)

    Lidén, J

    2014-02-01

    This article takes a historical perspective on the changing position of WHO in the global health architecture over the past two decades. From the early 1990s a number of weaknesses within the structure and governance of the World Health Organization were becoming apparent, as a rapidly changing post Cold War world placed more complex demands on the international organizations generally, but significantly so in the field of global health. Towards the end of that decade and during the first half of the next, WHO revitalized and played a crucial role in setting global health priorities. However, over the past decade, the organization has to some extent been bypassed for funding, and it lost some of its authority and its ability to set a global health agenda. The reasons for this decline are complex and multifaceted. Some of the main factors include WHO's inability to reform its core structure, the growing influence of non-governmental actors, a lack of coherence in the positions, priorities and funding decisions between the health ministries and the ministries overseeing development assistance in several donor member states, and the lack of strong leadership of the organization. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  6. Global mental health and the National Institute of Mental Health Research Domain Criteria.

    Science.gov (United States)

    Weine, Stevan Merill; Langenecker, Scott; Arenliu, Aliriza

    2018-05-01

    The National Institute of Mental Health (NIMH) Research Domain Criteria (RDoC) project presents innovative ways of investigating mental illness based on behavioral and neurobiological measures of dimensional processes. Although cultural psychiatrists have critiqued RDoC's implications and limitations for its under-developed focus on context and experience, RDoC presents opportunities for synergies with global mental health. It can capture aspects of clinical or sub-clinical behavior which are less dependent upon Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) and perhaps better elucidate the role of culture in disease expression and resilience. Aim/Results: This article uses the example of migration to describe several starting points for new research: (1) providing components for building an investigable conceptual framework to understand individual's mental health, resilience and adjustment to migration challenges or social adversities in low- and middle-income countries (LMICs) and (2) identifying measurable factors which determine resilience or vulnerability, to guide development and evaluation of targeted prevention, treatment and recovery strategies for mental health in LMICs. In such ways, RDoC frameworks could help put the new cutting edge neurobiological dimensional scientific advances in a position to contribute to addressing mental health problems amid social adversities in LMICs. However, this would require a much-expanded commitment by both RDoC and global mental health researchers to address contextual and experiential dimensions.

  7. The Journey to Become a Health Literate Organization: A Snapshot of Health System Improvement.

    Science.gov (United States)

    Brach, Cindy

    2017-01-01

    A health literate health care organization is one that makes it easy for people to navigate, understand, and use information and services to take care of their health. This chapter explores the journey that a growing number of organizations are taking to become health literate. Health literacy improvement has increasingly been viewed as a systems issue, one that moves beyond siloed efforts by recognizing that action is required on multiple levels. To help operationalize the shift to a systems perspective, members of the U.S. National Academies of Sciences, Engineering, Medicine Roundtable on Health Literacy defined ten attributes of health literate health care organizations. External factors, such as payment reform in the U.S., have buoyed health literacy as an organizational priority. Health care organizations often begin their journey to become health literate by conducting health literacy organizational assessments, focusing on written and spoken communication, and addressing difficulties in navigating facilities and complex systems. As organizations' efforts mature, health literacy quality improvement efforts give way to transformational activities. These include: the highest levels of the organization embracing health literacy, making strategic plans for initiating and spreading health literate practices, establishing a health literacy workforce and supporting structures, raising health literacy awareness and training staff system-wide, expanding patient and family input, establishing policies, leveraging information technology, monitoring policy compliance, addressing population health, and shifting the culture of the organization. The penultimate section of this chapter highlights the experiences of three organizations that have explicitly set a goal to become health literate: Carolinas Healthcare System (CHS), Intermountain Healthcare, and Northwell Health. These organizations are pioneers that approached health literacy in a systematic fashion, each

  8. Health Maintenance Organization (HMO) Plan

    Science.gov (United States)

    ... Find & compare doctors, hospitals, & other providers Health Maintenance Organization (HMO) Plan In most HMO Plans, you generally ... certain service when needed. Related Resources Preferred Provider Organization (PPO) Private Fee-for-Service (PFFS) Special Needs ...

  9. Between worst and best: developing criteria to identify promising practices in health promotion and disease prevention for the Canadian Best Practices Portal.

    Science.gov (United States)

    Fazal, Nadia; Jackson, Suzanne F; Wong, Katy; Yessis, Jennifer; Jetha, Nina

    2017-11-01

    In health promotion and chronic disease prevention, both best and promising practices can provide critical insights into what works for enhancing the healthrelated outcomes of individuals and communities, and how/why these practices work in different situations and contexts. The promising practices criteria were developed using the Public Health Agency of Canada's (PHAC's) existing best practices criteria as the foundation. They were modified and pilot tested (three rounds) using published interventions. Theoretical and methodological issues and challenges were resolved via consultation and in-depth discussions with a working group. The team established a set of promising practices criteria, which differentiated from the best practices criteria via six specific measures. While a number of complex challenges emerged in the development of these criteria, they were thoroughly discussed, debated and resolved. The Canadian Best Practices Portal's screening criteria allow one to screen for both best and promising practices in the fields of public health, health promotion, chronic disease prevention, and potentially beyond.

  10. Resource utilization associated with procurement of transplantable organs from donors that do not meet OPTN eligible death criteria.

    Science.gov (United States)

    DuBay, Derek A; Redden, David T; Bryant, Mary K; Dorn, David P; Fouad, Mona N; Gray, Stephen H; White, Jared A; Locke, Jayme E; Meeks, Christopher B; Taylor, Garry C; Kilgore, Meredith L; Eckhoff, Devin E

    2014-05-27

    The strategy of evaluating every donation opportunity warrants an investigation into the financial feasibility of this practice. The purpose of this investigation is to measure resource utilization required for procurement of transplantable organs in an organ procurement organization (OPO). Donors were stratified into those that met OPTN-defined eligible death criteria (ED donors, n=589) and those that did not (NED donors, n=703). Variable direct costs and time utilization by OPO staff for organ procurement were measured and amortized per organ transplanted using permutation methods and statistical bootstrapping/resampling approaches. More organs per donor were procured (3.66±1.2 vs. 2.34±0.8, Pdonors compared with NED donors. The variable direct costs were significantly lower in the NED donors ($29,879.4±11590.1 vs. $19,019.6±7599.60, Porgan transplanted were significantly higher in the NED donors ($8,414.5±138.29 vs. $9,272.04±344.56, Pdonors where thoracic organ procurement occurred were 67% more expensive than in abdominal-only organ procurement. The total time allocated per donor was significantly shorter in the NED donors (91.2±44.9 hr vs. 86.8±78.6 hr, P=0.01). In contrast, the amortized time per organ transplanted was significantly longer in the NED donors (23.1±0.8 hr vs. 36.9±3.2 hr, Porgan transplanted is significantly higher in donors that do not meet the eligible death criteria.

  11. The Journey to Become a Health Literate Organization: A Snapshot of Health System Improvement

    Science.gov (United States)

    BRACH, Cindy

    2017-01-01

    A health literate health care organization is one that makes it easy for people to navigate, understand, and use information and services to take care of their health. This chapter explores the journey that a growing number of organizations are taking to become health literate. Health literacy improvement has increasingly been viewed as a systems issue, one that moves beyond siloed efforts by recognizing that action is required on multiple levels. To help operationalize the shift to a systems perspective, members of the National Academies Roundtable on Health Literacy defined ten attributes of health literate health care organizations. External factors, such as payment reform in the U.S., have buoyed health literacy as an organizational priority. Health care organizations often begin their journey to become health literate by conducting health literacy organizational assessments, focusing on written and spoken communication, and addressing difficulties in navigating facilities and complex systems. As organizations’ efforts mature, health literacy quality improvement efforts give way to transformational activities. These include: the highest levels of the organization embracing health literacy, making strategic plans for initiating and spreading health literate practices, establishing a health literacy workforce and supporting structures, raising health literacy awareness and training staff system-wide, expanding patient and family input, establishing policies, leveraging information technology, monitoring policy compliance, addressing population health, and shifting the culture of the organization. The penultimate section of this chapter highlights the experiences of three organizations that have explicitly set a goal to become health literate: Carolinas Healthcare System (CHS), Intermountain Healthcare, and Northwell Health. These organizations are pioneers that approached health literacy in a systematic fashion, each exemplifying different routes an

  12. 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...

  13. [Priority setting of health interventions. Review of criteria, approaches and role of assessment agencies].

    Science.gov (United States)

    Varela-Lema, Leonor; Atienza-Merino, Gerardo; López-García, Marisa

    This study was carried out to develop an explicit health priority setting methodology to support decision-making regarding the technologies to be assessed for inclusion in the National Health Service service portfolio. The primary objective is to identify and analyse the criteria, approaches and conceptual frameworks used for national/international priority setting. An exhaustive review of the literature was carried out. For this purpose, a search of the main biomedical databases was performed and assessment agency websites were reviewed, among other sources. In general terms, it was found that there are no standardised criteria for priority setting, although some consensus and common trends have been identified regarding key elements (criteria, models and strategies, key actors, etc.). Globally, 8 key domains were identified: 1) need for intervention; 2) health outcomes; 3) type of benefit of the intervention; 4) economic consequences; 5) existing knowledge on the intervention/quality of and uncertainties regarding the evidence; 6) implementation and complexity of the intervention/feasibility; 7) priority, justice and ethics; and 8) overall context. The review provides a thorough analysis of the relevant issues and offers key recommendations regarding considerations for developing a national prioritisation framework. Findings are envisioned to be useful for different public organisations that are aiming to establish healthcare priorities. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  14. Tweeting as Health Communication: Health Organizations' Use of Twitter for Health Promotion and Public Engagement.

    Science.gov (United States)

    Park, Hyojung; Reber, Bryan H; Chon, Myoung-Gi

    2016-01-01

    This study examined how major health organizations use Twitter for disseminating health information, building relationships, and encouraging actions to improve health. The sampled organizations were the American Heart Association, American Cancer Society, and American Diabetes Association. A content analysis was conducted on 1,583 tweets to examine these organizations' use of Twitter's interactive features and to understand the message functions and topics of their tweets. The numbers of retweets and favorites were also measured as engagement indicators and compared by different message functions. The results revealed that all of the organizations posted original tweets most, but they differed in the degree to which they used the retweet and reply functions. Hashtags and hyperlinks were the most frequently used interactive tools. The majority of the tweets were about organization-related topics, whereas personal health-related tweets represented a relatively small portion of the sample. Followers were most likely to like and retweet personal health action-based messages.

  15. Between worst and best: developing criteria to identify promising practices in health promotion and disease prevention for the Canadian Best Practices Portal

    Directory of Open Access Journals (Sweden)

    Nadia Fazal

    2017-11-01

    Full Text Available Introduction: In health promotion and chronic disease prevention, both best and promising practices can provide critical insights into what works for enhancing the healthrelated outcomes of individuals and communities, and how/why these practices work in different situations and contexts. Methods: The promising practices criteria were developed using the Public Health Agency of Canada’s (PHAC’s existing best practices criteria as the foundation. They were modified and pilot tested (three rounds using published interventions. Theoretical and methodological issues and challenges were resolved via consultation and in-depth discussions with a working group. Results: The team established a set of promising practices criteria, which differentiated from the best practices criteria via six specific measures. Conclusion: While a number of complex challenges emerged in the development of these criteria, they were thoroughly discussed, debated and resolved. The Canadian Best Practices Portal’s screening criteria allow one to screen for both best and promising practices in the fields of public health, health promotion, chronic disease prevention, and potentially beyond.

  16. Risk assessment of soil contamination criteria

    International Nuclear Information System (INIS)

    King, C.M.; Marter, W.L.; Montaque, D.F.; Holton, G.A.

    1987-06-01

    Criteria have been developed to select radioactive and nonradioactive contaminants at waste sites detailed analysis and risk assessment. These criteria were based on soil and water quality guidelines developed by various government agencies to determine if the criteria were appropriate. We performed a risk assessment of a hypothetical site which contained radioactive and nonradioactive contaminants at levels equal to the criteria values. Risks to the public from atmospheric, surface water, and groundwater exposure pathways were examined. Health risks to the public from atmospheric releases of radioactive and nonradioactive materials from a waste at soil criteria contamination levels are low. Health risks to the maximally exposed individual to chemical carcinogens are considerably below traditional EPA action levels. And health risks to the maximally exposed individual to atmospherically released radioactive contaminants is 1.88 x 10 -7 , more than a factor of 5 less than 10 -6 . Based on our atmospheric exposure pathways analysis and risk assessment, the applied soil criteria are appropriate for screening out unimportant risk contributors to human health from atmospheric exposure pathways. 13 refs., 3 figs., 7 tabs

  17. Combining the IADPSG criteria with the WHO diagnostic criteria for ...

    African Journals Online (AJOL)

    The International Association of Diabetes in Pregnancy Study Group (IADPSG) and World Health ... Macrosomia or at least one adverse outcome were more likely in GDM patients who ... criteria for GDM in the ADA's more recent position statement.[18] .... at risk for postpartum type 2 DM;[27] the IADPSG criteria on the other ...

  18. The DSM-5: Classification and criteria changes.

    Science.gov (United States)

    Regier, Darrel A; Kuhl, Emily A; Kupfer, David J

    2013-06-01

    The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) marks the first significant revision of the publication since the DSM-IV in 1994. Changes to the DSM were largely informed by advancements in neuroscience, clinical and public health need, and identified problems with the classification system and criteria put forth in the DSM-IV. Much of the decision-making was also driven by a desire to ensure better alignment with the International Classification of Diseases and its upcoming 11th edition (ICD-11). In this paper, we describe select revisions in the DSM-5, with an emphasis on changes projected to have the greatest clinical impact and those that demonstrate efforts to enhance international compatibility, including integration of cultural context with diagnostic criteria and changes that facilitate DSM-ICD harmonization. It is anticipated that this collaborative spirit between the American Psychiatric Association (APA) and the World Health Organization (WHO) will continue as the DSM-5 is updated further, bringing the field of psychiatry even closer to a singular, cohesive nosology. Copyright © 2013 World Psychiatric Association.

  19. [Social and ethical criteria for prioritizing patients: a survey of students and health professionals in Portugal].

    Science.gov (United States)

    Pinho, Micaela Moreira

    2016-12-01

    This qualitative/quantitative study examines the ethical dilemma of microallocation of health resources. It seeks to identify and compare the opinion of two groups in Portuguese society - students and health professionals - on the importance of personal characteristics of patients at the moment of prioritizing them and if the choices can be explained by bioethical references of a utilitarian or deontological nature. Data were collected by means of a questionnaire administered to a sample of 180 students and 60 health professionals. Faced with hypothetical emergency scenarios, the respondents had to choose between two patients (distinguished by: age, gender, social responsibility, economic and employment situation, harmful health behaviors and criminal record), duly selecting who to treat and then justifying their choice. The results suggest the existence of differences in choices between the two groups, with health professionals revealing they are less prepared to accept the use of social criteria in a context of scarce resources and co-existence of utilitarian and deontological criteria, with a predominance of efficiency on the part of health professionals and equity on the part of students.

  20. The health maintenance organization strategy: a corporate takeover of health services delivery.

    Science.gov (United States)

    Salmon, J W

    1975-01-01

    This paper presents a political economic framework for viewing the social organization of the delivery of health care servies and predicting a qualitatively different institutional configuration involving the health maintenance organization. The principal forces impacting American capitalism today are leading to a fundamental restructuring for increased social efficiency of the entire social welfare sector, including the health services industry. The method to achieve this restructuring involves health policy directed at raising the contribution to the social surplus from the delivery of health care services and eventual corporate domination. The health maintenance organization conceptualization is examined with suggestions as to how the HMO strategy promoted by the state leads to this corporate takeover. The mechanism and extent of the present corporate involvement are examined and implications of health services as a social control mechanism are presented.

  1. Health technology prioritization: which criteria for prioritizing new technologies and what are their relative weights?

    Science.gov (United States)

    Golan, Ofra; Hansen, Paul; Kaplan, Giora; Tal, Orna

    2011-10-01

    To review the criteria and 'other' considerations used internationally for prioritizing new health technologies, and to demonstrate a conjoint-analysis methodology (also known as discrete choice experiments) for deriving relative weights for the criteria. We searched the literature for criteria and other considerations for prioritizing new technologies. A convenience sample of 74 respondents completed a conjoint-analysis survey involving criteria related to technologies' 'benefits'. Encompassing 11 countries and the US state of Oregon, we were able to distinguish three main groups of criteria: (a) Need, appropriateness and clinical benefits; (b) Efficiency (including cost-effectiveness); and (c) Equality, solidarity and other ethical or social values. For several countries, the quality of the clinical and economic evidence and factors related to strategic issues and procedural justice respectively are also considered. The criteria and their weights from the conjoint-analysis survey are: 'Lives saved'=0.343, 'Life-prolongation benefits'=0.243, 'Quality-of-life gains'=0.217, a criterion representing the availability of alternative treatments=0.107, and 'Other important social/ethical benefits'=0.087. The criteria represent a pluralistic combination of needs-based, maximizing and egalitarian principles, and we demonstrated a methodology for deriving the weights for criteria related to technologies' 'benefits'. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  2. Health and Welfare in Organic Poultry Production

    Directory of Open Access Journals (Sweden)

    Berg C

    2002-03-01

    Full Text Available This review paper deals with the major health and welfare aspects of organic poultry production. The differences between organic and conventional egg and poultry meat production are discussed, with the main emphasis on housing and management requirements, feed composition and the use of veterinary prophylactic and therapeutic drugs. The effects of the legislation and statutes for organic farming on the health and welfare of the birds are also discussed, especially in relation to the biosecurity problems associated with free-range systems, the occurrence of behavioural disturbances in loose housed flocks and the use of veterinary drugs and vaccinations in general. The results from a questionnaire sent out to all Swedish organic egg producers, where questions about the farmer's perception of the birds' health status were included, are presented at the end of the paper. It is concluded that most of the health and welfare problems seen in conventional poultry systems for loose housed or free ranging birds can also been found on organic poultry farms. It is also concluded that there is a need for information about biosecurity, disease detection and disease prevention on organic poultry farms.

  3. Influencing organizations to promote health: applying stakeholder theory.

    Science.gov (United States)

    Kok, Gerjo; Gurabardhi, Zamira; Gottlieb, Nell H; Zijlstra, Fred R H

    2015-04-01

    Stakeholder theory may help health promoters to make changes at the organizational and policy level to promote health. A stakeholder is any individual, group, or organization that can influence an organization. The organization that is the focus for influence attempts is called the focal organization. The more salient a stakeholder is and the more central in the network, the stronger the influence. As stakeholders, health promoters may use communicative, compromise, deinstitutionalization, or coercive methods through an ally or a coalition. A hypothetical case study, involving adolescent use of harmful legal products, illustrates the process of applying stakeholder theory to strategic decision making. © 2015 Society for Public Health Education.

  4. Quality of laboratory studies assessing effects of Bt-proteins on non-target organisms: minimal criteria for acceptability.

    Science.gov (United States)

    De Schrijver, Adinda; Devos, Yann; De Clercq, Patrick; Gathmann, Achim; Romeis, Jörg

    2016-08-01

    The potential risks that genetically modified plants may pose to non-target organisms and the ecosystem services they contribute to are assessed as part of pre-market risk assessments. This paper reviews the early tier studies testing the hypothesis whether exposure to plant-produced Cry34/35Ab1 proteins as a result of cultivation of maize 59122 is harmful to valued non-target organisms, in particular Arthropoda and Annelida. The available studies were assessed for their scientific quality by considering a set of criteria determining their relevance and reliability. As a case-study, this exercise revealed that when not all quality criteria are met, weighing the robustness of the study and its relevance for risk assessment is not obvious. Applying a worst-case expected environmental concentration of bioactive toxins equivalent to that present in the transgenic crop, confirming exposure of the test species to the test substance, and the use of a negative control were identified as minimum criteria to be met to guarantee sufficiently reliable data. This exercise stresses the importance of conducting studies meeting certain quality standards as this minimises the probability of erroneous or inconclusive results and increases confidence in the results and adds certainty to the conclusions drawn.

  5. Influencing Organizations to Promote Health: Applying Stakeholder Theory

    Science.gov (United States)

    Kok, Gerjo; Gurabardhi, Zamira; Gottlieb, Nell H.; Zijlstra, Fred R. H.

    2015-01-01

    Stakeholder theory may help health promoters to make changes at the organizational and policy level to promote health. A stakeholder is any individual, group, or organization that can influence an organization. The organization that is the focus for influence attempts is called the focal organization. The more salient a stakeholder is and the more…

  6. Managing mechanistic and organic structure in health care organizations.

    Science.gov (United States)

    Olden, Peter C

    2012-01-01

    Managers at all levels in a health care organization must organize work to achieve the organization's mission and goals. This requires managers to decide the organization structure, which involves dividing the work among jobs and departments and then coordinating them all toward the common purpose. Organization structure, which is reflected in an organization chart, may range on a continuum from very mechanistic to very organic. Managers must decide how mechanistic versus how organic to make the entire organization and each of its departments. To do this, managers should carefully consider 5 factors for the organization and for each individual department: external environment, goals, work production, size, and culture. Some factors may push toward more mechanistic structure, whereas others may push in the opposite direction toward more organic structure. Practical advice can help managers at all levels design appropriate structure for their departments and organization.

  7. Multi-criteria decision analysis for assessment and appraisal of orphan drugs

    Directory of Open Access Journals (Sweden)

    Georgi Iskrov

    2016-09-01

    Full Text Available Background: Limited resources and expanding expectations push all countries and types of health systems to adopt new approaches in priority setting and resources allocation. Despite best efforts, it is difficult to reconcile all competing interests and trade-offs are inevitable. This is why multi-criteria decision analysis (MCDA has played a major role in recent uptake of value-based reimbursement. MCDA framework enables exploration of stakeholders’ preferences, as well as explicit organization of broad range of criteria on which real-world decisions are made.Assessment and appraisal of orphan drugs tend to be one of the most complicated health technology assessment (HTA tasks. Access to market approved orphan therapies remains an issue. Early constructive dialogue among rare disease stakeholders and elaboration of orphan drug-tailored decision support tools could set the scene for ongoing accumulation of evidence, as well as for proper reimbursement decision-making.Objective: The objective of this study was to create a MCDA value measurement model to assess and appraise orphan drugs. This was achieved by exploring the preferences on decision criteria’s weights and performance scores through a stakeholder-representative survey and a focus group discussion that were both organized in Bulgaria.Results/Conclusions: Decision criteria that describe the health technology’s characteristics were unanimously agreed as the most important group of reimbursement considerations. This outcome, combined with the high individual weight of disease severity and disease burden criteria underlined some of the fundamental principles of healthcare – equity and fairness. Our study proved that strength of evidence may be a key criterion in orphan drug assessment and appraisal. Evidence is not only used to shape reimbursement decision-making, but also to lend legitimacy to policies pursued. The need for real-world data on orphan drugs was largely stressed

  8. Extending World Health Organization weight-for-age reference curves to older children.

    Science.gov (United States)

    Rodd, Celia; Metzger, Daniel L; Sharma, Atul

    2014-02-03

    For ages 5-19 years, the World Health Organization (WHO) publishes reference charts based on 'core data' from the US National Center for Health Statistics (NCHS), collected from 1963-75 on 22,917 US children. To promote the use of body mass index in older children, weight-for-age was omitted after age 10. Health providers have subsequently expressed concerns about this omission and the selection of centiles. We therefore sought to extend weight-for-age reference curves from 10 to 19 years by applying WHO exclusion criteria and curve fitting methods to the core NCHS data and to revise the choice of displayed centiles. WHO analysts first excluded ~ 3% of their reference population in order to achieve a "non-obese sample with equal height". Based on these exclusion criteria, 314 girls and 304 boys were first omitted for 'unhealthy' weights-for-height. By applying WHO global deviance and information criteria, optimal Box-Cox power exponential models were used to fit smoothed weight-for-age centiles. Bootstrap resampling was used to assess the precision of centile estimates. For all charts, additional centiles were included in the healthy range (3 to 97%), and the more extreme WHO centiles 0.1 and 99.9% were dropped. In addition to weight-for-age beyond 10 years, our charts provide more granularity in the centiles in the healthy range -2 to +2 SD (3-97%). For both weight and BMI, the bootstrap confidence intervals for the 99.9th centile were at least an order of magnitude wider than the corresponding 50th centile values. These charts complement existing WHO charts by allowing weight-for-age to be plotted concurrently with height in older children. All modifications followed strict WHO methodology and utilized the same core data from the US NCHS. The additional centiles permit a more precise assessment of normal growth and earlier detection of aberrant growth as it crosses centiles. Elimination of extreme centiles reduces the risk of misclassification. A complete set of

  9. How Turkey Meets MPOWER Criteria?

    Directory of Open Access Journals (Sweden)

    Nazmi Bilir

    2013-02-01

    Full Text Available In 2003 World Health Assembly adopted an international treaty on tobacco control; FCTC, Framework Convention on Tobacco Control. Five year later World Health Organization (WHO declared the six effective approach for tobacco control, under the name of MPOWER. In the following years, WHO evaluated the level of implementation of MPOWER criteria in the countries. In this article, how Turkey implemented these six criteria will be discussed. Monitor tobacco use and prevention policies: Monitoring of tobacco use prevalence has been successfully monitored in Turkey through Global Adult Tobacco Survey, Global Youth Tobacco Survey and Health Professionals Tobacco Use Survey. Nevertheless, monitoring of tobacco industry activities was not successfully implemented. Protect people from tobacco smoke: Smoking was banned in most of the indoor public places in Turkey since 1996, and Turkey became a complete smoke-free country by the exposion of smoke-free places including the hospitality workplaces in 2008. Offer help to quit tobacco use: Although smoking cessation services has been a bit late in Turkey, availability of smoking cessation drugs and the establishment of free quitline services made Turkey successful in this regard. Warn about the dangers of tobacco: Since 1996, all TV channels have a duty of broadcasting programs on harms of tobacco use, not less than 90 minutes in a month and it has been implemented successfully. Additionally written messages indicating harms of tobacco has been printed on the packs since 1988 and pictures was added in 2010. But since the average surface area covered by the messages in less than 50% of the total surface of the pack, Turkey was not regarded as to meet the requirement. Enforce bans on tobacco advertising, promotion and sponsorship: All kinds of tobacco advertisement and promotion was banned by the Law in 1996. But the tobacco products was not in closed boxes at the sales points. Turkey was not found as successful

  10. Addressing the disconnect between public health science and personalised health care: the potential role of cluster analysis in combination with multi-criteria decision analysis

    DEFF Research Database (Denmark)

    Kaltoft, Mette Kjer; Dowie, Jack; Turner, Robin

    2013-01-01

    Background: Public health promotion and person-centred health care are being pursued simultaneously, with little attempt to resolve the conflict between them. One necessary step is to accept that health-care decisions involve multiple criteria and hence are preference sensitive. A second...... is to arrive at the necessary compromise between an individualised public policy (using each individual's preferences) and a deindividualised policy (using mean population preferences) in a more rigorous and transparent way. We show how cluster analysis can be combined with multi-criteria decision analysis...... (MCDA) to facilitate progression from variable-centred to person-centred public health, albeit at a subgroup level. Methods: Cluster analysis encompasses various techniques designed to detect patterns in the characteristics of individuals to establish the basis for policy decisions targeted at subgroups...

  11. Integrated Science Assessment (ISA) for Sulfur Oxides – Health Criteria (Final Report, Sep 2008)

    Science.gov (United States)

    EPA announced the availability of the final report, Integrated Science Assessment (ISA) for Sulfur Oxides – Health Criteria final assessment. This report represents a concise synthesis and evaluation of the most policy-relevant science and will ultimately provide the scien...

  12. Contribution of Organically Grown Crops to Human Health

    Directory of Open Access Journals (Sweden)

    Eva Johansson

    2014-04-01

    Full Text Available An increasing interest in organic agriculture for food production is seen throughout the world and one key reason for this interest is the assumption that organic food consumption is beneficial to public health. The present paper focuses on the background of organic agriculture, important public health related compounds from crop food and variations in the amount of health related compounds in crops. In addition, influence of organic farming on health related compounds, on pesticide residues and heavy metals in crops, and relations between organic food and health biomarkers as well as in vitro studies are also the focus of the present paper. Nutritionally beneficial compounds of highest relevance for public health were micronutrients, especially Fe and Zn, and bioactive compounds such as carotenoids (including pro-vitamin A compounds, tocopherols (including vitamin E and phenolic compounds. Extremely large variations in the contents of these compounds were seen, depending on genotype, climate, environment, farming conditions, harvest time, and part of the crop. Highest amounts seen were related to the choice of genotype and were also increased by genetic modification of the crop. Organic cultivation did not influence the content of most of the nutritional beneficial compounds, except the phenolic compounds that were increased with the amounts of pathogens. However, higher amounts of pesticide residues and in many cases also of heavy metals were seen in the conventionally produced crops compared to the organic ones. Animal studies as well as in vitro studies showed a clear indication of a beneficial effect of organic food/extracts as compared to conventional ones. Thus, consumption of organic food seems to be positive from a public health point of view, although the reasons are unclear, and synergistic effects between various constituents within the food are likely.

  13. 76 FR 67437 - Draft Aquatic Life Ambient Water Quality Criteria for Carbaryl-2011

    Science.gov (United States)

    2011-11-01

    ... ENVIRONMENTAL PROTECTION AGENCY [EPA-HQ-OW-2011-0787; FRL-9483-8] Draft Aquatic Life Ambient Water... National Water Quality Criteria for the Protection of Aquatic Organisms and Their Uses (1985), (EPA/R-85... authorized Tribes in adopting water quality standards for protecting aquatic life and human health. These...

  14. Stakeholders responses on health maintenance organizations ...

    African Journals Online (AJOL)

    National Health Insurance Scheme uses the services of Health Maintenance Organizations to run the scheme. This model of administering a national health insurance scheme is different from how so many other national health insurance programs are run in other parts of the world. The designing of the NHIS to include the ...

  15. 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.

  16. Evaluation of the Quality of Occupational Health and Safety Management Systems Based on Key Performance Indicators in Certified Organizations.

    Science.gov (United States)

    Mohammadfam, Iraj; Kamalinia, Mojtaba; Momeni, Mansour; Golmohammadi, Rostam; Hamidi, Yadollah; Soltanian, Alireza

    2017-06-01

    Occupational Health and Safety Management Systems are becoming more widespread in organizations. Consequently, their effectiveness has become a core topic for researchers. This paper evaluates the performance of the Occupational Health and Safety Assessment Series 18001 specification in certified companies in Iran. The evaluation is based on a comparison of specific criteria and indictors related to occupational health and safety management practices in three certified and three noncertified companies. Findings indicate that the performance of certified companies with respect to occupational health and safety management practices is significantly better than that of noncertified companies. Occupational Health and Safety Assessment Series 18001-certified companies have a better level of occupational health and safety; this supports the argument that Occupational Health and Safety Management Systems play an important strategic role in health and safety in the workplace.

  17. Great Lakes water quality initiative technical support document for human health criteria and values (January 1993 draft)

    International Nuclear Information System (INIS)

    1993-01-01

    The goal of the human health criteria and values for the Great Lakes is the protection of humans from unacceptable exposure to toxicants from consumption of contaminated fish, drinking water and water related to recreational activities. Emphasis is on the protection of the individual in evaluating toxicity information and its application in the derivation of criteria and values

  18. The World Health Organization?s Health Promoting Schools framework: a Cochrane systematic review and meta-analysis

    OpenAIRE

    Langford, Rebecca; Bonell, Christopher; Jones, Hayley; Pouliou, Theodora; Murphy, Simon; Waters, Elizabeth; Komro, Kelli; Gibbs, Lisa; Magnus, Daniel; Campbell, Rona

    2015-01-01

    BACKGROUND: Healthy children achieve better educational outcomes which, in turn, are associated with improved health later in life. The World Health Organization's Health Promoting Schools (HPS) framework is a holistic approach to promoting health and educational attainment in school. The effectiveness of this approach has not yet been rigorously reviewed. METHODS: We searched 20 health, education and social science databases, and trials registries and relevant websites in 2011 and 2013. We i...

  19. The Judicialization of Health in Brazil: Guiding Principles, Organization as the Law 8.080/90, Possibilities and Limites of Jurisdiction in Actions of Free Medicine Provision

    OpenAIRE

    Anna Christina Zenkner; Natal dos Reis Carvalho Junior

    2016-01-01

    The theme of this paper deals with the increasing movement of judicialization of the right to health, characterized by the excess of judicial demands aiming at the obtaining of health treatments and medicines. A study was made on the right to health, its principles and health organization in Brazil in light of Law 8.080 / 90. It analyzed parameters for rationalization of the judicialization in the supply of medicines. He noted the need to adapt procedures and criteria, both administrative and...

  20. Assessment of Clinical Criteria for Sepsis

    Science.gov (United States)

    Seymour, Christopher W.; Liu, Vincent X.; Iwashyna, Theodore J.; Brunkhorst, Frank M.; Rea, Thomas D.; Scherag, André; Rubenfeld, Gordon; Kahn, Jeremy M.; Shankar-Hari, Manu; Singer, Mervyn; Deutschman, Clifford S.; Escobar, Gabriel J.; Angus, Derek C.

    2016-01-01

    IMPORTANCE The Third International Consensus Definitions Task Force defined sepsis as “life-threatening organ dysfunction due to a dysregulated host response to infection.” The performance of clinical criteria for this sepsis definition is unknown. OBJECTIVE To evaluate the validity of clinical criteria to identify patients with suspected infection who are at risk of sepsis. DESIGN, SETTINGS, AND POPULATION Among 1.3 million electronic health record encounters from January 1, 2010, to December 31, 2012, at 12 hospitals in southwestern Pennsylvania, we identified those with suspected infection in whom to compare criteria. Confirmatory analyses were performed in 4 data sets of 706 399 out-of-hospital and hospital encounters at 165 US and non-US hospitals ranging from January 1, 2008, until December 31, 2013. EXPOSURES Sequential [Sepsis-related] Organ Failure Assessment (SOFA) score, systemic inflammatory response syndrome (SIRS) criteria, Logistic Organ Dysfunction System (LODS) score, and a new model derived using multivariable logistic regression in a split sample, the quick Sequential [Sepsis-related] Organ Failure Assessment (qSOFA) score (range, 0–3 points, with 1 point each for systolic hypotension [≤100 mm Hg], tachypnea [≥22/min], or altered mentation). MAIN OUTCOMES AND MEASURES For construct validity, pairwise agreement was assessed. For predictive validity, the discrimination for outcomes (primary: in-hospital mortality; secondary: in-hospital mortality or intensive care unit [ICU] length of stay ≥3 days) more common in sepsis than uncomplicated infection was determined. Results were expressed as the fold change in outcome over deciles of baseline risk of death and area under the receiver operating characteristic curve (AUROC). RESULTS In the primary cohort, 148 907 encounters had suspected infection (n = 74 453 derivation; n = 74 454 validation), of whom 6347 (4%) died. Among ICU encounters in the validation cohort (n = 7932 with suspected

  1. National Recommended Water Quality Criteria

    Data.gov (United States)

    U.S. Environmental Protection Agency — The National Recommended Water Quality Criteria is a compilation of national recommended water quality criteria for the protection of aquatic life and human health...

  2. Core competencies of the entrepreneurial leader in health care organizations.

    Science.gov (United States)

    Guo, Kristina L

    2009-01-01

    The purpose of this article is to discuss core competencies that entrepreneurial health care leaders should acquire to ensure the survival and growth of US health care organizations. Three overlapping areas of core competencies are described: (1) health care system and environment competencies, (2) organization competencies, and (3) interpersonal competencies. This study offers insight into the relationship between leaders and entrepreneurship in health care organizations and establishes the foundation for more in-depth studies on leadership competencies in health care settings. The approach for identifying core competencies and designing a competency model is useful for practitioners in leadership positions in complex health care organizations, so that through the understanding and practice of these 3 areas of core competencies, they can enhance their entrepreneurial leadership skills to become more effective health care entrepreneurial leaders. This study can also be used as a tool by health care organizations to better understand leadership performance, and competencies can be used to further the organization's strategic vision and for individual improvement purposes.

  3. Green Supplier Selection Criteria

    DEFF Research Database (Denmark)

    Nielsen, Izabela Ewa; Banaeian, Narges; Golinska, Paulina

    2014-01-01

    Green supplier selection (GSS) criteria arise from an organization inclination to respond to any existing trends in environmental issues related to business management and processes, so GSS is integrating environmental thinking into conventional supplier selection. This research is designed...... to determine prevalent general and environmental supplier selection criteria and develop a framework which can help decision makers to determine and prioritize suitable green supplier selection criteria (general and environmental). In this research we considered several parameters (evaluation objectives......) to establish suitable criteria for GSS such as their production type, requirements, policy and objectives instead of applying common criteria. At first a comprehensive and deep review on prevalent and green supplier selection literatures performed. Then several evaluation objectives defined to assess the green...

  4. Ensuring right to organic food in public health system.

    Science.gov (United States)

    Pashkov, Vitalii; Batyhina, Olena; Leiba, Liudmyla

    2018-01-01

    Introduction: Human health directly depends on safety and quality of food. In turn, quality and safety of food directly depend on its production conditions and methods. There are two main food production methods: traditional and organic. Organic food production is considered safer and more beneficial for human health. Aim: to determine whether the organic food production method affects human health. Materials and methods: international acts, data of international organizations and conclusions of scientists have been examined and used in the study. The article also summarizes information from scientific journals and monographs from a medical and legal point of view with scientific methods. This article is based on dialectical, comparative, analytic, synthetic and comprehensive research methods. The problems of effects of food production methods and conditions on human health have been analyzed within the framework of the system approach. Conclusions: Food production methods and conditions ultimately affect the state and level of human health. The organic method of production activity has a positive effect on human health.

  5. A framework for cultural competence in health care organizations.

    Science.gov (United States)

    Castillo, Richard J; Guo, Kristina L

    2011-01-01

    Increased racial and ethnic diversity in the United States brings challenges and opportunities for health care organizations to provide culturally competent services that effectively meet the needs of diverse populations. The need to provide more culturally competent care is essential to reducing and eliminating health disparities among minorities. By removing barriers to cultural competence and placing a stronger emphasis on culture in health care, health care organizations will be better able to address the unique health care needs of minorities. Organizations should assess cultural differences, gain greater cultural knowledge, and provide cultural competence training to deliver high-quality services. This article develops a framework to guide health care organizations as they focus on establishing culturally competent strategies and implementing best practices aimed to improve quality of care and achieve better outcomes for minority populations.

  6. Gut Health of Pigs: Challenge Models and Response Criteria with a Critical Analysis of the Effectiveness of Selected Feed Additives - A Review.

    Science.gov (United States)

    Adewole, D I; Kim, I H; Nyachoti, C M

    2016-07-01

    The gut is the largest organ that helps with the immune function. Gut health, especially in young pigs has a significant benefit to health and performance. In an attempt to maintain and enhance intestinal health in pigs and improve productivity in the absence of in-feed antibiotics, researchers have evaluated a wide range of feed additives. Some of these additives such as zinc oxide, copper sulphate, egg yolk antibodies, mannan-oligosaccharides and spray dried porcine plasma and their effectiveness are discussed in this review. One approach to evaluate the effectiveness of these additives in vivo is to use an appropriate disease challenge model. Over the years, researchers have used a number of challenge models which include the use of specific strains of enterotoxigenic Escherichia coli, bacteria lipopolysaccharide challenge, oral challenge with Salmonella enteric serotype Typhimurium, sanitation challenge, and Lawsonia intercellularis challenge. These challenge models together with the criteria used to evaluate the responses of the animals to them are also discussed in this review.

  7. Human health implications of organic food and organic agriculture: a comprehensive review.

    Science.gov (United States)

    Mie, Axel; Andersen, Helle Raun; Gunnarsson, Stefan; Kahl, Johannes; Kesse-Guyot, Emmanuelle; Rembiałkowska, Ewa; Quaglio, Gianluca; Grandjean, Philippe

    2017-10-27

    This review summarises existing evidence on the impact of organic food on human health. It compares organic vs. conventional food production with respect to parameters important to human health and discusses the potential impact of organic management practices with an emphasis on EU conditions. Organic food consumption may reduce the risk of allergic disease and of overweight and obesity, but the evidence is not conclusive due to likely residual confounding, as consumers of organic food tend to have healthier lifestyles overall. However, animal experiments suggest that identically composed feed from organic or conventional production impacts in different ways on growth and development. In organic agriculture, the use of pesticides is restricted, while residues in conventional fruits and vegetables constitute the main source of human pesticide exposures. Epidemiological studies have reported adverse effects of certain pesticides on children's cognitive development at current levels of exposure, but these data have so far not been applied in formal risk assessments of individual pesticides. Differences in the composition between organic and conventional crops are limited, such as a modestly higher content of phenolic compounds in organic fruit and vegetables, and likely also a lower content of cadmium in organic cereal crops. Organic dairy products, and perhaps also meats, have a higher content of omega-3 fatty acids compared to conventional products. However, these differences are likely of marginal nutritional significance. Of greater concern is the prevalent use of antibiotics in conventional animal production as a key driver of antibiotic resistance in society; antibiotic use is less intensive in organic production. Overall, this review emphasises several documented and likely human health benefits associated with organic food production, and application of such production methods is likely to be beneficial within conventional agriculture, e.g., in integrated

  8. EVALUATION CRITERIA OF INNOVATIVE SOCIAL INVESTMENT PROJECTS IN HEALTH CARE

    Directory of Open Access Journals (Sweden)

    Vadim Aleksandrovich Lomazov

    2013-11-01

    Full Text Available Purpose: analysis of key indicators and creation of evaluation criteria of innovative socio-economic investment projects in healthcare, implemented on the basis of public-private partnerships.Methodology: there has been performed comprehensive assessment of specialized socio-economic projects in health sector taking into consideration interests of participants in the project (public and private, main aspects (medical, social, economic, scientific and innovative, and assessment components (presumable effectiveness or risk during implementation of the project. The degree of relative importance of the factors considered in each level, and the levels themselves are determined by experts with the help of paired comparisons method. The values of the project indicators are estimated against nonuniform grading scale, both the results of direct measurements and expert information being used.Results: There has been suggested an approach and a procedure for evaluating projects based on the allocation of interests, issues and evaluation components of the project as sub-criteria levels of the hierarchy analysis method; there has been developed research prototype of information analysis system for assessment of projects on the basis of the proposed approach.DOI: http://dx.doi.org/10.12731/2218-7405-2013-8-48

  9. Are Classification Criteria for IgG4-RD Now Possible? The Concept of IgG4-Related Disease and Proposal of Comprehensive Diagnostic Criteria in Japan

    Directory of Open Access Journals (Sweden)

    Kazuichi Okazaki

    2012-01-01

    Full Text Available Recent studies suggest simultaneous or metachronous lesions in multiorgans characterized by elevated serum levels of IgG4 and abundant infiltration of IgG4-positive plasma cells with various degrees of fibrosis. Two Japanese research committees for IgG4-RD, one from fibrosclerosis (Okazaki team and the other from lymph proliferation (Umehara team supported by the “Research Program for Intractable Disease” of the Ministry of Health, Labor, and Welfare of Japan, have agreed with the unified nomenclature as “IgG4-RD” and proposed the comprehensive diagnostic criteria (CDC for IgG4-RD. Validation of the CDC demonstrated satisfactory sensitivity for the practical use of general physicians and nonspecialists but low sensitivity in the organs to be difficult in taking biopsy specimens such as type1 autoimmune pancreatitis (IgG4-related AIP, compared with IgG4-related sialadenitis/dacryoadenitis (Mikulicz's disease and IgG4-related kidney disease. Although the diagnostic criteria covering all IgG4-RD are hard to be established, combination with the CDC and organ-specific diagnostic criteria should improve sensitivity.

  10. [Need of specific criteria for psychotherapy referral in the public health system: A proposal].

    Science.gov (United States)

    García-Haro, J; Fernández-Briz, N

    2015-01-01

    This study discusses the need of specific criteria for psychotherapy referral in the public services. the use of psychotherapy as a supplement to traditional medication, and its comparison with informal methods of support, has been questioned. This study proposes the establishment of basic criteria for the integration of psychotherapy, based on an analysis of the conditions that allow it to function. It thus aims to contribute to improving the reputation and the practice conditions of psychotherapy in the public health system. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  11. Health politics meets post-modernism: its meaning and implications for community health organizing.

    Science.gov (United States)

    Rosenau, P V

    1994-01-01

    In this article, post-modern theory is described and applied to health politics with examples from community health organizing, social movements, and health promotion. Post-modernism questions conventional assumptions about concepts such as representation, participation, empowerment, community, identity, causality, accountability, responsibility, authority, and roles in community health promotion (those of expert, leader, and organizer). I compare post-modern social movements with their modern counterparts: the organizational forms, leadership styles, and substantive intellectual orientations of the two differ. I explain the social planning, community development, and social action models of community health organizing, comparing them with the priorities of post-modern social movements, and show the similarities and differences between them as to structural preferences, process, and strategies. Finally, and most importantly, I present the implicit lessons that post-modernism offers to health politics and outline the strengths and weaknesses of this approach to health politics.

  12. Profiling health-care accreditation organizations: an international survey.

    Science.gov (United States)

    Shaw, Charles D; Braithwaite, Jeffrey; Moldovan, Max; Nicklin, Wendy; Grgic, Ileana; Fortune, Triona; Whittaker, Stuart

    2013-07-01

    To describe global patterns among health-care accreditation organizations (AOs) and to identify determinants of sustainability and opportunities for improvement. Web-based questionnaire survey. Organizations offering accreditation services nationally or internationally to health-care provider institutions or networks at primary, secondary or tertiary level in 2010. s) External relationships, scope and activity public information. Forty-four AOs submitted data, compared with 33 in a survey 10 years earlier. Of the 30 AOs that reported survey activity in 2000 and 2010, 16 are still active and stable or growing. New and old programmes are increasingly linked to public funding and regulation. While the number of health-care AOs continues to grow, many fail to thrive. Successful organizations tend to complement mechanisms of regulation, health-care funding or governmental commitment to quality and health-care improvement that offer a supportive environment. Principal challenges include unstable business (e.g. limited market, low uptake) and unstable politics. Many organizations make only limited information available to patients and the public about standards, procedures or results.

  13. [Organization of workplace first aid in health care facilities].

    Science.gov (United States)

    Ciavarella, M; Sacco, A; Bosco, Maria Giuseppina; Chinni, V; De Santis, A; Pagnanelli, A

    2007-01-01

    Laws D.Lgs. 626/94 and D.I. 388/03 attach particular importance to the organization of first aid in the workplace. Like every other enterprise, also hospitals and health care facilities have the obligation, as foreseen by the relevant legislation, to organize and manage first aid in the workplace. To discuss the topic in the light of the guidelines contained in the literature. We used the references contained in the relevant literature and in the regulations concerning organization of first aid in health care facilities. The regulations require the general manager of health care facilities to organize the primary intervention in case of emergencies in all health care facilities (health care or administrative, territorial and hospitals). In health care facilities the particular occupational risks, the general access of the public and the presence of patients who are already assumed to have altered states of health, should be the reason for particular care in guaranteeing the best possible management of a health emergency in the shortest time possible.

  14. Organic Food in the Diet: Exposure and Health Implications.

    Science.gov (United States)

    Brantsæter, Anne Lise; Ydersbond, Trond A; Hoppin, Jane A; Haugen, Margaretha; Meltzer, Helle Margrete

    2017-03-20

    The market for organic food products is growing rapidly worldwide. Such foods meet certified organic standards for production, handling, processing, and marketing. Most notably, the use of synthetic fertilizers, pesticides, and genetic modification is not allowed. One major reason for the increased demand is the perception that organic food is more environmentally friendly and healthier than conventionally produced food. This review provides an update on market data and consumer preferences for organic food and summarizes the scientific evidence for compositional differences and health benefits of organic compared with conventionally produced food. Studies indicate some differences in favor of organic food, including indications of beneficial health effects. Organic foods convey lower pesticide residue exposure than do conventionally produced foods, but the impact of this on human health is not clear. Comparisons are complicated by organic food consumption being strongly correlated with several indicators of a healthy lifestyle and by conventional agriculture "best practices" often being quite close to those of organic.

  15. 'Learning Organizations': a clinician's primer.

    Science.gov (United States)

    O'Connor, Nick; Kotze, Beth

    2008-06-01

    Most clinicians are poorly informed in relation to the key concepts of organizational learning. Yet the paradigm may offer clinicians a powerful method for using their knowledge and skills to respond to the demands of a changing environment through experimentation and learning. The concept is critically examined. Organizational learning principles are presented, including a conceptual framework for assessing health services as Learning Organizations. Barriers to organizational learning and strategies to overcome these are discussed. The seminal works of Argyris and Senge are reviewed and a framework for assessing organizational learning in health services is proposed. Current area health service actions are evaluated against the 'diagnostic' framework for a Learning Organization. Although critical examination reveals a poor empirical basis for the concept, the metaphor of the Learning Organization provides a useful conceptual framework and tools for individuals and organizations to apply in developing knowledge and effecting change. The Clinical Practice Improvement and Root Cause Analysis programs being conducted across NSW area health services meet the criteria for effective organizational learning. Key concepts from organizational learning theory provide a diagnostic framework for evaluating area health services as Learning Organizations and support two current strategies for overcoming barriers to organizational learning.

  16. Gut Health of Pigs: Challenge Models and Response Criteria with a Critical Analysis of the Effectiveness of Selected Feed Additives — A Review

    Science.gov (United States)

    Adewole, D. I.; Kim, I. H.; Nyachoti, C. M.

    2016-01-01

    The gut is the largest organ that helps with the immune function. Gut health, especially in young pigs has a significant benefit to health and performance. In an attempt to maintain and enhance intestinal health in pigs and improve productivity in the absence of in-feed antibiotics, researchers have evaluated a wide range of feed additives. Some of these additives such as zinc oxide, copper sulphate, egg yolk antibodies, mannan-oligosaccharides and spray dried porcine plasma and their effectiveness are discussed in this review. One approach to evaluate the effectiveness of these additives in vivo is to use an appropriate disease challenge model. Over the years, researchers have used a number of challenge models which include the use of specific strains of enterotoxigenic Escherichia coli, bacteria lipopolysaccharide challenge, oral challenge with Salmonella enteric serotype Typhimurium, sanitation challenge, and Lawsonia intercellularis challenge. These challenge models together with the criteria used to evaluate the responses of the animals to them are also discussed in this review. PMID:26954144

  17. The Charter on Professionalism for Health Care Organizations.

    Science.gov (United States)

    Egener, Barry E; Mason, Diana J; McDonald, Walter J; Okun, Sally; Gaines, Martha E; Fleming, David A; Rosof, Bernie M; Gullen, David; Andresen, May-Lynn

    2017-08-01

    In 2002, the Physician Charter on Medical Professionalism was published to provide physicians with guidance for decision making in a rapidly changing environment. Feedback from physicians indicated that they were unable to fully live up to the principles in the 2002 charter partly because of their employing or affiliated health care organizations. A multistakeholder group has developed a Charter on Professionalism for Health Care Organizations, which may provide more guidance than charters for individual disciplines, given the current structure of health care delivery systems.This article contains the Charter on Professionalism for Health Care Organizations, as well as the process and rationale for its development. For hospitals and hospital systems to effectively care for patients, maintain a healthy workforce, and improve the health of populations, they must attend to the four domains addressed by the Charter: patient partnerships, organizational culture, community partnerships, and operations and business practices. Impacting the social determinants of health will require collaboration among health care organizations, government, and communities.Transitioning to the model hospital described by the Charter will challenge historical roles and assumptions of both its leadership and staff. While the Charter is aspirational, it also outlines specific institutional behaviors that will benefit both patients and workers. Lastly, this article considers obstacles to implementing the Charter and explores avenues to facilitate its dissemination.

  18. Validation of organ procurement and transplant network (OPTN)/united network for organ sharing (UNOS) criteria for imaging diagnosis of hepatocellular carcinoma.

    Science.gov (United States)

    Fowler, Kathryn J; Karimova, E Jane; Arauz, Anthony R; Saad, Nael E; Brunt, Elizabeth M; Chapman, William C; Heiken, Jay P

    2013-06-27

    Imaging diagnosis of hepatocellular carcinoma (HCC) presents an important pathway for transplant exception points and priority for cirrhotic patients. The purpose of this retrospective study is to evaluate the validity of the new Organ Procurement and Transplant Network (OPTN) classification system on patients undergoing transplantation for HCC. One hundred twenty-nine patients underwent transplantation for HCC from April 14, 2006 to April 18, 2011; a total of 263 lesions were reported as suspicious for HCC on pretransplantation magnetic resonance imaging. Magnetic resonance imaging examinations were reviewed independently by two experienced radiologists, blinded to final pathology. Reviewers identified major imaging features and an OPTN classification was assigned to each lesion. Final proof of diagnosis was pathology on explant or necrosis along with imaging findings of ablation after transarterial chemoembolization. Application of OPTN imaging criteria in our population resulted in high specificity for the diagnosis of HCC. Sensitivity in diagnosis of small lesions (≥1 and based on preoperative imaging but would not have met criteria under the new system. Eleven percent of the patients not meeting OPTN criteria were found to have T2 stage tumor burden on pathology. The OPTN imaging policy introduces a high level of specificity for HCC but may decrease sensitivity for small lesions. Management may be impacted in a number of patients, potentially requiring longer surveillance periods or biopsy to confirm diagnosis.

  19. Health and wellbeing boards: public health decision making bodies or political pawns?

    Science.gov (United States)

    Greaves, Z; McCafferty, S

    2017-02-01

    Health and Wellbeing boards in England are uniquely constituted; embedded in the local authorities with membership drawn from a range of stakeholders and partner organizations. This raises the question of how decision making functions of the boards reflects wider public health decision making, if criteria are applied to decision making, and what prioritization processes, if any, are used. Qualitative research methods were employed and five local boards were approached, interview dyads were conducted with the boards Chair and Director of Public Health across four of these (n = 4). Three questions were addressed: how are decisions made? What are the criteria applied to decision making? And how are criteria then prioritized? A thematic approach was used to analyse data identifying codes and extracting key themes. Equity, effectiveness and consistency with strategies of board and partners were most consistently identified by participants as criteria influencing decisions. Prioritization was described as an engaged and collaborative process, but criteria were not explicitly referenced in the decision making of the boards which instead made unstructured prioritization of population sub-groups or interventions agreed by consensus. Criteria identified are broadly consistent with those used in wider public health practice but additionally incorporated criteria which recognizes the political siting of the boards. The study explored the variety in different board's approaches to prioritization and identified a lack of clarity and rigour in the identification and use of criteria in prioritization processes. Decision making may benefit from the explicit inclusion of criteria in the prioritization process. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  20. Improving the quality of health services organization structure by reengineering: circular design and clinical case impact in an academic medical center.

    Science.gov (United States)

    Lartin-Drake, J M; Curran, C; Gillis-Donovan, J; Kruger, N R; Ziegenfuss, J T; Ostrem, J; Zanotti, M

    1996-01-01

    Innovation to improve the quality of structure and process in health care organization is reported in this case example of change in an academic medical center. Interactive planning and the circular organization design concept were the driving principles and methods. This report presents the needs for and initial obstructions to change, planning and project design work, a description of the change process, and illustrative accomplishments to date--two cases, one of conscious sedation policy and one of nuisance pages. Evaluative criteria for judging the progress and lessons of the project regarding key design characteristics also are included.

  1. Appropriate drinking water treatment processes for organic micropollutants removal based on experimental and model studies - A multi-criteria analysis study

    KAUST Repository

    Sudhakaran, Sairam

    2013-01-01

    The presence of organic micropollutants (OMPs), pharmaceuticals and personal care products (PPCPs) in potable water is of great environmental and public health concern. OMPs are included in the priority list of contaminants in United States EPA and European framework directives. Advanced treatment processes such as reverse osmosis, nanofiltration, ozonation and adsorption are the usual industry-recommended processes for OMPs removal, however, natural systems, e.g., riverbank filtration and constructed wetlands, are also potentially efficient options for OMPs removal. In this study, a decision support system (DSS) based on multi-criteria analysis (MCA) was created to compare processes for OMPs removal under various criteria. Multi-criteria analysis (MCA), a transparent and reliable procedure, was adopted. Models were built for both experimental and predicted percent-removals for a range of OMPs reflecting different physicochemical properties. The experimental percent-removals for several processes (riverbank filtration (RBF), ozonation, advanced oxidation, adsorption, reverse osmosis, and nanofiltration) were considered. The predicted percent-removals were taken from validated quantitative structure activity relationship (QSAR) models. Analytical methods to detect OMPs in water are very laborious, thus a modeling approach such as QSAR is an attractive option.A survey among two groups of participants including academics (PhD students and post-doctoral research associates) and industry (managers and operators) representatives was conducted to assign weights for the following criteria: treatability, costs, technical considerations, sustainability and time. The process rankings varied depending on the contaminant species and personal preferences (weights). The results indicated that RBF and oxidation were preferable over adsorption and membranes processes. The results also suggest that the use of a hybrid treatment process, e.g., combining a natural system with an

  2. Microbiological criteria for good manufacturing practice (GMP)

    Energy Technology Data Exchange (ETDEWEB)

    Farkas, J [Inst. of Preservation and Livestock Products Technology, Univ. of Horticulture and Food Industry, Budapest (Hungary); Zukal, E [Inst. of Preservation and Livestock Products Technology, Univ. of Horticulture and Food Industry, Budapest (Hungary)

    1992-01-01

    Good manufacturing practice (GMP) consist of an effective manufacturing operation and an effective application of food control. GMP is best supported by the Hazard Analysis Critical Control Point system (HACCP) of the preventive quality assurance, which requires that food irradiation as any food processing technology should be used only with foods of an acceptable quality and adequate handling and storage procedures should precede and follow the processing. The paper concentrates on the first element of the HACCP system for an irradiation plant: the incoming product control, i.e. whether GMP of foods to be irradiated can be assessed by establishing microbiological criteria for their previous good manufacturing practice. In this regard, it summarizes considerations and findings of a ''Consultation on Microbiological Criteria for Foods to be Further Processed Including by Irradiation'' held in 1989 by the International Consultative Group on Food irradiation at the Headquarters of the World Health Organization, Geneva. Difficulties in establishing reference values and defining good manufacturing practices will be pointed out. (orig.)

  3. Microbiological criteria for good manufacturing practice (GMP)

    International Nuclear Information System (INIS)

    Farkas, J.; Zukal, E.

    1992-01-01

    Good manufacturing practice (GMP) consist of an effective manufacturing operation and an effective application of food control. GMP is best supported by the Hazard Analysis Critical Control Point system (HACCP) of the preventive quality assurance, which requires that food irradiation as any food processing technology should be used only with foods of an acceptable quality and adequate handling and storage procedures should precede and follow the processing. The paper concentrates on the first element of the HACCP system for an irradiation plant: the incoming product control, i.e. whether GMP of foods to be irradiated can be assessed by establishing microbiological criteria for their previous good manufacturing practice. In this regard, it summarizes considerations and findings of a ''Consultation on Microbiological Criteria for Foods to be Further Processed Including by Irradiation'' held in 1989 by the International Consultative Group on Food irradiation at the Headquarters of the World Health Organization, Geneva. Difficulties in establishing reference values and defining good manufacturing practices will be pointed out. (orig.) [de

  4. The role of risk assessment in the work of the World Health Organization in Europe

    International Nuclear Information System (INIS)

    Heijden, Kees A. van der; Stern, Richard M.

    1992-01-01

    The World Health Organization, through its Headquarters in Geneva (WHO/HQ), and its Regional Office for Europe (WHO/EURO) in Copenhagen, has the responsibility for providing national governments with advice on formulation and implementation of public health policy globally and in Europe, respectively. Globally, the major areas for health related risk assessment/management is the provision of adequate and safe drinking water and food and control of vector borne and parasitic disease. In the industrialized countries of Europe, a wide number of issues are dealt with which require the development and application of risk assessment and risk management tools and strategies. Primary areas of application are in monitoring trends and status of public health, harmonization of issues of chemical safety, development of criteria documents for environmental pollutants, and providing decision support and technical cooperation, especially in the area of development policies and environment management and their potential health impact. An emerging concern is the need for the introduction of these methodologies in the Countries of Central and Eastern Europe, and harmonization of approaches used by international and intergovernmental organizations and the Member States. One of the first steps towards the management of the environment as a resource for health in Europe, the mandate given WHO/EURO by the European Charter for Environment and Health (Frankfurt, 1989), has been the creation of the European Centre for Environment and Health (ECEH) with support from the Netherlands and Italian Governments. The initial task of EDEH is a description of the current state of the environment and the current state of public health in the European Region, using harmonized methodologies for information gathering. The production of this report, 'Concern for Europe's tomorrow', provides the basic elements of a unified region wide approach to priority setting for the risk assessment and risk

  5. The role of risk assessment in the work of the World Health Organization in Europe

    Energy Technology Data Exchange (ETDEWEB)

    Heijden, Kees A. van der; Stern, Richard M [World Health Organization Regional Office for Europe, European Centre for Environment and Health, Bilthoven Division, Copenhagen (Denmark)

    1992-07-01

    The World Health Organization, through its Headquarters in Geneva (WHO/HQ), and its Regional Office for Europe (WHO/EURO) in Copenhagen, has the responsibility for providing national governments with advice on formulation and implementation of public health policy globally and in Europe, respectively. Globally, the major areas for health related risk assessment/management is the provision of adequate and safe drinking water and food and control of vector borne and parasitic disease. In the industrialized countries of Europe, a wide number of issues are dealt with which require the development and application of risk assessment and risk management tools and strategies. Primary areas of application are in monitoring trends and status of public health, harmonization of issues of chemical safety, development of criteria documents for environmental pollutants, and providing decision support and technical cooperation, especially in the area of development policies and environment management and their potential health impact. An emerging concern is the need for the introduction of these methodologies in the Countries of Central and Eastern Europe, and harmonization of approaches used by international and intergovernmental organizations and the Member States. One of the first steps towards the management of the environment as a resource for health in Europe, the mandate given WHO/EURO by the European Charter for Environment and Health (Frankfurt, 1989), has been the creation of the European Centre for Environment and Health (ECEH) with support from the Netherlands and Italian Governments. The initial task of EDEH is a description of the current state of the environment and the current state of public health in the European Region, using harmonized methodologies for information gathering. The production of this report, 'Concern for Europe's tomorrow', provides the basic elements of a unified region wide approach to priority setting for the risk assessment and risk

  6. The evolving role of health care organizations in research.

    Science.gov (United States)

    Tuttle, W C; Piland, N F; Smith, H L

    1988-01-01

    Many hospitals and health care organizations are contending with fierce financial and competitive pressures. Consequently, programs that do not make an immediate contribution to master strategy are often overlooked in the strategic management process. Research programs are a case in point. Basic science, clinical, and health services research programs may help to create a comprehensive and fundamentally sound master strategy. This article discusses the evolving role of health care organizations in research relative to strategy formulation. The primary costs and benefits from participating in research programs are examined. An agenda of questions is presented to help health care organizations determine whether they should incorporate health-related research as a key element in their strategy.

  7. The Judicialization of Health in Brazil: Guiding Principles, Organization as the Law 8.080/90, Possibilities and Limites of Jurisdiction in Actions of Free Medicine Provision

    Directory of Open Access Journals (Sweden)

    Anna Christina Zenkner

    2016-12-01

    Full Text Available The theme of this paper deals with the increasing movement of judicialization of the right to health, characterized by the excess of judicial demands aiming at the obtaining of health treatments and medicines. A study was made on the right to health, its principles and health organization in Brazil in light of Law 8.080 / 90. It analyzed parameters for rationalization of the judicialization in the supply of medicines. He noted the need to adapt procedures and criteria, both administrative and judicial, to make public policies feasible in order to achieve satisfaction of the right to health.

  8. Developmentally Sensitive Diagnostic Criteria for Mental Health Disorders in Early Childhood: The Diagnostic and Statistical Manual of Mental Disorders-IV, the Research Diagnostic Criteria-Preschool Age, and the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood-Revised

    Science.gov (United States)

    Egger, Helen L.; Emde, Robert N.

    2011-01-01

    As the infant mental health field has turned its focus to the presentation, course, and treatment of clinically significant mental health disorders, the need for reliable and valid criteria for identifying and assessing mental health symptoms and disorders in early childhood has become urgent. In this article we offer a critical perspective on…

  9. Organic foods for children: health or hype.

    Science.gov (United States)

    Batra, Prerna; Sharma, Nisha; Gupta, Piyush

    2014-05-01

    Organic foods are promoted as superior and safer options for today's health-conscious consumer. Manufacturers of organic food claim it to be pesticide-free and better in terms of micronutrients. Consumers have to pay heavily for these products--and they are willing to--provided they are assured of the claimed advantages. Scientific data proving the health benefits of organic foods, especially in children, are lacking. Indian Government has developed strict guidelines and certification procedures to keep a check on manufacturers in this financially attractive market. American Academy of Pediatrics, in its recently issued guidelines, did not recommend organic foods over conventional food for children. Indian Academy of Pediatrics has not opined on this issue till date. In this perspective, we present a critical review of production and marketing of organic foods, and scientific evidence pertaining to their merits and demerits, with special reference to pediatric population.

  10. Policies and procedures in the workplace: how health care organizations compare.

    Science.gov (United States)

    Loo, R

    1993-01-01

    Many organizations are implementing programs and services to manage the human and economic costs of stress. A mail survey was conducted of 500 randomly selected Canadian organizations having at least 500 employees. The survey tapped four major areas: organizational policies and procedures for managing stress; programs and services offered; perceived benefits and constraints for the organization; and projected future directions in this area. Analyses of returns from 210 organizations-43 health and 167 non-health-revealed various findings. For example, over half of health care organizations have policies and procedures as opposed to less than half of non-health care organizations. Also, health care organizations place greater emphasis on smoking cessation, weight control programs and on stress management training. Although some Canadian organizations are addressing stress, much more could and should be done, especially by organizations that do not yet recognize the impact of stress on employees and their work performance.

  11. Implications of DSM-5 for Health Care Organizations and Mental Health Policy.

    Science.gov (United States)

    Castillo, Richard J; Guo, Kristina L

    2016-01-01

    The American Psychiatric Association (APA) has made major changes in the way mental illness is conceptualized, assessed, and diagnosed in its new diagnostic manual, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), published in 2013, and has far reaching implications for health care organizations and mental health policy. This paper reviews the four new principles in DSM-5: 1) A spectrum (also called "dimensional") approach to the definition of mental illness; 2) recognition of the role played by environmental risk factors related to stress and trauma in predisposing, precipitating, and perpetuating mental illness; 3) cultural relativism in diagnosis and treatment of mental illness; and 4) recognizing the adverse effects of psychiatric medications on patients. Each of these four principles will be addressed in detail. In addition, four major implications for health care organizations and mental health policy are identified as: 1) prevention; 2) client-centered psychiatry; 3) mental health workers retraining; and 4) medical insurance reform. We conclude that DSM- 5's new approach to diagnosis and treatment of mental illness will have profound implications for health care organizations and mental health policy, indicating a greater emphasis on prevention and cure rather than long-term management of symptoms.

  12. Failure criteria for low-temperature irradiated organic composite insulation systems

    International Nuclear Information System (INIS)

    Schutz, J.B.; Fabian, P.E.

    1997-01-01

    Composite insulation systems in fusion magnet applications are often subjected to conditions of combined through thickness compression and shear at varying stress ratios. Characterization of insulation system strength under these conditions requires unidirectional shear and compression tests, as well as biaxial shear/compression testing to define the systems failure envelope. An appropriate failure criteria would reduce the number of tests required to define this envelope, and would give designers a better estimate of material strengths at intermediate stress ratios. Biaxial shear/compression testing requires the use of metallic sandwich specimens, which are susceptible to activation during irradiation. A reliable failure criteria which eliminates the need for biaxial characterization would also reduce the difficulty and expense involved in radiation effects characterization while still providing a complete failure envelope. Several generalized failure criteria, taken from classical composites analysis, were reformulated for application in the shear/compression quadrant. The maximum stress and Tsai-Hill criteria were found to be inadequate to represent the biaxial failure envelope. The generalized Tsai-Wu tensor quadratic failure criterion was also examined. Application of this criterion requires through thickness tensile strength data. Through thickness tensile strengths of insulation systems have not been routinely characterized, but limited data are available. Utilizing unidirectional through thickness tension, compression, and interlaminar shear strength data, the Tsai-Wu failure criteria was found to agree well with biaxial shear/compression test data

  13. Issues in researching leadership in health care organizations.

    Science.gov (United States)

    Simons, Tony; Leroy, Hannes

    2013-01-01

    We provide a review of the research in this volume and suggest avenues for future research. Review of the research in this volume and unstructured interviews with health care executives. We identified the three central themes: (1) trust in leadership, (2) leading by example, and (3) multi-level leadership. For each of these themes, we highlight the shared concerns and findings, and provide commentary about the contribution to the literature on leadership. While relation-oriented leadership is important in health care, there is a danger of too much emphasis on relations in an already caring profession. Moreover, in most health care organizations, leadership is distributed and scholars need to adopt the appropriate methods to investigate these multi-level phenomena. In health care organizations, hands-on leadership, through role modeling, may be necessary to promote change. However, practicing what you preach is not as easy as it may seem. We provide a framework for understanding current research on leadership in health care organizations.

  14. [The ethics of health care organization].

    Science.gov (United States)

    Goic, Alejandro

    2004-03-01

    Health care organization is not only a technical issue. Ethics gives meaning to the medical profession's declared intent of preserving the health and life of the people while honoring their intelligence, dignity and intimacy. It also induces physicians to apply their knowledge, intellect and skills for the benefit of the patient. In a health care system, it is important that people have insurance coverage for health contingencies and that the quality of the services provided be satisfactory. People tend to judge the medical profession according to the experience they have in their personal encounter with physicians, health care workers, hospitals and clinics. Society and its political leaders must decide upon the particular model that will ensure the right of citizens to a satisfactory health care. Any health care organization not founded on humanitarian and ethical values is doomed tofailure. The strict adherence of physicians to Hippocratic values and to the norms of good clinical practice as well as to an altruistic cooperative attitude will improve the efficiency of the health care sector and reduce its costs. It is incumbent upon society to generate the conditions where by the ethical roots of medical care can be brought to bear upon the workings of the health care system. Every country must strive to provide not only technically efficient medical services, but also the social mechanisms that make possible a humanitarian interaction between professionals and patients where kindness and respect prevail.

  15. Organizational Learning in Health Care Organizations

    Directory of Open Access Journals (Sweden)

    Savithiri Ratnapalan

    2014-02-01

    Full Text Available The process of collective education in an organization that has the capacity to impact an organization’s operations, performance and outcomes is called organizational learning. In health care organizations, patient care is provided through one or more visible and invisible teams. These teams are composed of experts and novices from diverse backgrounds working together to provide coordinated care. The number of teams involved in providing care and the possibility of breakdowns in communication and coordinated care increases in direct proportion to sophisticated technology and treatment strategies of complex disease processes. Safe patient care is facilitated by individual professional learning; inter-professional team learning and system based organizational learning, which encompass modified context specific learning by multiple teams and team members in a health care organization. Organizational learning in health care systems is central to managing the learning requirements in complex interconnected dynamic systems where all have to know common background knowledge along with shared meta-knowledge of roles and responsibilities to execute their assigned functions, communicate and transfer the flow of pertinent information and collectively provide safe patient care. Organizational learning in health care is not a onetime intervention, but a continuing organizational phenomenon that occurs through formal and informal learning which has reciprocal association with organizational change. As such, organizational changes elicit organizational learning and organizational learning implements new knowledge and practices to create organizational changes.

  16. Organic food and the impact on human health.

    Science.gov (United States)

    Hurtado-Barroso, Sara; Tresserra-Rimbau, Anna; Vallverdú-Queralt, Anna; Lamuela-Raventós, Rosa María

    2017-11-30

    In the last decade, the production and consumption of organic food have increased steadily worldwide, despite the lower productivity of organic crops. Indeed, the population attributes healthier properties to organic food. Although scientific evidence is still scarce, organic agriculture seems to contribute to maintaining an optimal health status and decreases the risk of developing chronic diseases. This may be due to the higher content of bioactive compounds and lower content of unhealthy substances such as cadmium and synthetic fertilizers and pesticides in organic foods of plant origin compared to conventional agricultural products. Thus, large long-term intervention studies are needed to determine whether an organic diet is healthier than a diet including conventionally grown food products. This review provides an update of the present knowledge of the impact of an organic versus a conventional food diet on health.

  17. Knowledge and Attitudes Toward Organ Donation in Health Care Undergraduate Students in Italy.

    Science.gov (United States)

    Fontana, F; Massari, M; Giovannini, L; Alfano, G; Cappelli, G

    2017-11-01

    The number of organ donors in Italy is increasing, but with still disappointing living donation activity and relatively frequent objection by potential deceased donors' relatives to organ recovery. Few studies have assessed health care students' knowledge and attitude on donation. We administered a questionnaire to medical (MS) and nursing students (NS) at University of Modena and Reggio Emilia, Italy, and 749 students (406 MS and 343 NS) completed the questionnaire. Although 95% of students were in favor of donation, only 21.9% of NS and 24.9% of MS were registered as donors. One quarter of students reported family disagreement. MS appeared more confident with personnel involved in donation. Overall, 60% of students knew the term donation after brain death but only 40% were aware of the criteria used to define it. Barely 27.1% of NS and 15.3% of MS believed they had received sufficient information in lessons. Backward logistic regression demonstrated that students whose families agree with them and who knew the definition of donation after brain death were more likely to express the disposition of registering, and those who showed distrust in the declaration of brain death were half as likely to register as donors. Students expressed a lack of knowledge, controversial attitudes on donation, and strong need for education; increased awareness may help increase donation rates. The majority of educational institutions in Italy do not directly address training on organ donation and transplantation for health care students; an integrated curriculum favoring interpersonal discussion including practical aspects is urgently required. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Organ Procurement Organizations and the Electronic Health Record.

    Science.gov (United States)

    Howard, R J; Cochran, L D; Cornell, D L

    2015-10-01

    The adoption of electronic health records (EHRs) has adversely affected the ability of organ procurement organizations (OPOs) to perform their federally mandated function of honoring the donation decisions of families and donors who have signed the registry. The difficulties gaining access to potential donor medical record has meant that assessment, evaluation, and management of brain dead organ donors has become much more difficult. Delays can occur that can lead to potential recipients not receiving life-saving organs. For over 40 years, OPO personnel have had ready access to paper medical records. But the widespread adoption of EHRs has greatly limited the ability of OPO coordinators to readily gain access to patient medical records and to manage brain dead donors. Proposed solutions include the following: (1) hospitals could provide limited access to OPO personnel so that they could see only the potential donor's medical record; (2) OPOs could join with other transplant organizations to inform regulators of the problem; and (3) hospital organizations could be approached to work with Center for Medicare and Medicaid Services (CMS) to revise the Hospital Conditions of Participation to require OPOs be given access to donor medical records. © Copyright 2015 The American Society of Transplantation and the American Society of Transplant Surgeons.

  19. Development of a business plan for women's health services, using Malcolm Baldrige Performance Excellence Criteria.

    Science.gov (United States)

    Caramanica, L; Maxwell, S; Curry, S

    2000-06-01

    A new process for business planning at Hartford Hospital was needed to achieve critical business results. This article describes the Hospital's use of the Malcolm Baldrige Performance Excellence Criteria as a way to standardize and improve business planning. Women's Health Services is one of Hartford Hospital's "centers for excellence" and one of the first to use these criteria to improve its service. Staff learned how to build their business plan upon a set of core values and concepts such as customer-driven quality, leadership that sets high expectations, continuous improvement and learning, valuing employees, faster response to market demands, management by fact, and a long-range view of the future.

  20. Education Criteria for Performance Excellence, 2002.

    Science.gov (United States)

    National Inst. of Standards and Technology, Gaithersburg, MD.

    The education criteria presented in this guide are designed to help organizations use an integrated approach to organizational performance management that results in delivery of ever-improving value to students and stakeholders. Implementation of the criteria will contribute to improvement of education quality, improvement of overall…

  1. Effect of ranking criteria on development goals in capital and manpower-limited oil and gas organizations

    International Nuclear Information System (INIS)

    Starzer, M.R.

    1991-01-01

    This paper summarizes a study to determine the effect of financial ranking criteria on development goals of oil and gas organizations. Economic analysis and ranking was applied to one hundred projects representing oil and gas investment opportunities available to an organization. Each project's after tax cash flows were subjected to four financial analysis methods for ranking. The four analysis methods used were net present value to investment ratio (NPVI), internal rate of return (IRR), payback period and profit to investment ratio (P/I). After ranking, the projects were totaled according to a particular organizational objective. Totaling of projects by ranking would continue until a limiting resource to the organization was exhausted. This study demonstrates the insensitivity of financial analysis methods for ranking whether the organization is limited by capital or manpower. It concludes that the only requirement for a ranking criterion to properly allocate resources is that the criterion quantifies the organizational goal to some degree. Decision makers charged with selecting the most attractive growth portfolio of investment opportunities will do well with any profit measuring criterion for ranking

  2. Water Quality Criteria

    Science.gov (United States)

    EPA develops water quality criteria based on the latest scientific knowledge to protect human health and aquatic life. This information serves as guidance to states and tribes in adopting water quality standards.

  3. Integrated Science Assessment (ISA) for Sulfur Oxides – Health Criteria (First External Review Draft, Sep 2007)

    Science.gov (United States)

    EPA has announced that the First External Review Draft of the Integrated Science Assessment (ISA) for Sulfur Oxides – Health Criteria has been made available for independent peer review and public review. This draft ISA document represents a concise synthesis and evaluatio...

  4. Organizing the health sector for response to disasters

    Directory of Open Access Journals (Sweden)

    Kimberley Shoaf

    2014-09-01

    Full Text Available Each year millions of people around the world are affected by natural and manmade disasters. The consequences of natural disasters in terms of health are complex. Disasters directly impact the health of the population resulting in physical trauma, acute disease, and emotional trauma. Furthermore, disasters may increase the morbidity and mortality associated with chronic and infectious diseases due to the impact on the health system. The health sector must be organized for adequate preparedness, mitigation, response and recuperation from a plethora of potential disasters. This paper examines the various potential impacts of disasters on health, the components of the health sector and their roles in emergency medical care and disaster situations, as well as the coordination and organization necessary within the system to best meet the health needs of a population in the aftermath of a disaster.

  5. [Dental loss in a rural population and the goals established for the World Health Organization].

    Science.gov (United States)

    Saliba, Nemre Adas; Moimaz, Suzely Adas Saliba; Saliba, Orlando; Tiano, Ana Valéria Pagliari

    2010-06-01

    This study aimed to report the dental loss in a rural population, evaluating the contribution of socioeconomic and behavioral variables and comparing the results with the goals of the World Health Organization (WHO) for 2000 and 2010. A total of 473 residents had been examined using the methodology, codes and criteria according to WHO guidelines. The results were processed using the Epibuco program and the chi-square test (ppopulation, the dental loss advanced considerably with the age, being the situation much distant of the goals established by WHO for 2010. Chi-square test revealed statistically significant differences among the number of teeth lost by the interviewed with 35 years-old or more in relation to education level, housing and self-perception of the speak quality. The development of oral health attention programs becomes necessary, in order to reduce the actual damages and to prevent the continuity of this trend of mutilation.

  6. Marketing for health-care organizations: an introduction to network management.

    Science.gov (United States)

    Boonekamp, L C

    1994-01-01

    The introduction of regulated competition in health care in several Western countries confronts health care providing organizations with changing relationships, with their environment and a need for knowledge and skills to analyse and improve their market position. Marketing receives more and more attention, as recent developments in this field of study provide a specific perspective on the relationships between an organization and external and internal parties. In doing so, a basis is offered for network management. A problem is that the existing marketing literature is not entirely appropriate for the specific characteristics of health care. After a description of the developments in marketing and its most recent key concepts, the applicability of these concepts in health-care organizations is discussed. States that for the health-care sector, dominated by complex networks of interorganizational relationships, the strategic marketing vision on relationships can be very useful. At the same time however, the operationalization of these concepts requires special attention and a distinct role of the management of health-care organizations, because of the characteristics of such organizations and the specific type of their service delivery.

  7. Evidence for current diagnostic criteria of diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    Ritesh; Kumar[1; Lakshmana; Perumal; Nandhini[1; Sadishkumar; Kamalanathan[1; Jayaprakash; Sahoo[1; Muthupillai; Vivekanadan[1

    2016-01-01

    Diabetes mellitus is a non-communicable metabolic derangement afflicting several millions of individuals globally. It is associated with several micro and macrovascular complications and is also a leading cause of mortality. The unresolved issue is that of definition of the diagnostic threshold for diabetes. The World Health Organization and the American Diabetes Association (ADA) have laid down several diagnostic criteria for diagnosing diabetes and prediabetes based on the accumulating body of evidence.This review has attempted to analyse the scientific evidence supporting the justification of these differing criteria. The evidence for diagnosing diabetes is strong, and there is a concordance between the two professional bodies.The controversy arises when describing the normal lower limit of fasting plasma glucose (FPG) with little evidence favouring the reduction of the FPG by the ADA. Several studies have also shown the development of complications specific for diabetes in patients with prediabetes as defined by the current criteria though there is a significant overlap of such prevalence in individuals with normoglycemia. Large multinational longitudinal prospective studies involving subjects without diabetes and retinopathy at baseline will ideally help identify the threshold of glycemic measurements for future development of diabetes and its complications.

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

    Science.gov (United States)

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

    2002-01-01

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

  9. Democratizing the world health organization.

    Science.gov (United States)

    van de Pas, R; van Schaik, L G

    2014-02-01

    A progressive erosion of the democratic space appears as one of the emerging challenges in global health today. Such delimitation of the political interplay has a particularly evident impact on the unique public interest function of the World Health Organization (WHO). This paper aims to identify some obstacles for a truly democratic functioning of the UN specialized agency for health. The development of civil society's engagement with the WHO, including in the current reform proposals, is described. The paper also analyses how today's financing of the WHO--primarily through multi-bi financing mechanisms--risks to choke the agency's role in global health. Democratizing the public debate on global health, and therefore the role of the WHO, requires a debate on its future role and engagement at the country level. This desirable process can only be linked to national debates on public health, and the re-definition of health as a primary political and societal concern. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  10. Criteria for selecting organ donors and recipients.

    Science.gov (United States)

    Michielsen, P

    1990-11-01

    As there is a world-wide shortage of organs for transplantation, the selection of the patients is more defined by the availability of transplantable organs than by the medical condition of the potential recipient. This shortage of cadaveric organs is mainly responsible for the use of living donors. With HLA identical sibling donors the results are better than with cadaveric organs, but the ethical problems are usually underestimated. For the parent-to-child donation, the HLA compatibility is less than what could be achieved with well-matched cadaveric donors. The use of genetically unrelated donors is unacceptable from the ethical as well as from the medical point of view. The short- and long-term risk of donation has been insufficiently documented. The experience with the introduction of an opting-out legislation in Belgium in 1987 demonstrates that the shortage of cadaveric organs can be overcome. Harmonization of the legislation is, however, necessary so as to achieve comparable organ retrieval rates between countries participating in organ-exchange organisations.

  11. A preferred provider organization (PPO) case study for mental health and substance abuse.

    Science.gov (United States)

    Gomillion, I; Self, D R

    1988-01-01

    The Preferred Provider Organization concept is quickly becoming more popular because of its relative cost-effectiveness and recent successes. Managed care through means of this mental health and substance abuse PPO may well serve as the prototype for the general health care cost containment efforts of the future for the self-insured insurance plans for Alabama state employees and teachers. The first year also revealed several problems in the original proposal especially with respect to the unintended attractiveness of inpatient/residential care. Consequently, copayment plans were added to dissuade unnecessary lengthy stays (see Table 2). Second, a new quality assurance mechanism has been added to further evaluate the need for admissions to facilities, as well as for the need for continued inpatient treatment. The Alabama Quality Assurance Foundation (AQAF) began on January 1, 1988, conducting the preadmission certification on all admissions based upon criteria established jointly by AQAF and the PPO providers. In addition, AQAF will conduct continuing stay reviews at predetermined time periods to ensure that continued treatment in an inpatient setting is indeed necessary.

  12. The World Health Organization Global Health Emergency Workforce: What Role Will the United States Play?

    Science.gov (United States)

    Burkle, Frederick M

    2016-08-01

    During the May 2016 World Health Assembly of 194 member states, the World Health Organization (WHO) announced the process of developing and launching emergency medical teams as a critical component of the global health workforce concept. Over 64 countries have either launched or are in the development stages of vetting accredited teams, both international and national, to provide surge support to national health systems through WHO Regional Organizations and the delivery of emergency clinical care to sudden-onset disasters and outbreak-affected populations. To date, the United States has not yet committed to adopting the emergency medical team concept in funding and registering an international field hospital level team. This article discusses future options available for health-related nongovernmental organizations and the required educational and training requirements for health care provider accreditation. (Disaster Med Public Health Preparedness. 2016;10:531-535).

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

    Science.gov (United States)

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

    2012-01-01

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

  14. The Contribution of Civil Society Organizations in Achieving Health ...

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

    Global gaps in health care The World Health Organization's Health for All ... Making the invisible visible: gender, data, and evidence for development ... Strengthening Governance in Health Systems for Reproductive Health and Rights in ...

  15. Are Public Health Organizations Tweeting to the Choir? Understanding Local Health Department Twitter Followership

    Science.gov (United States)

    Choucair, Bechara; Maier, Ryan C; Jolani, Nina; Bernhardt, Jay M

    2014-01-01

    Background One of the essential services provided by the US local health departments is informing and educating constituents about health. Communication with constituents about public health issues and health risks is among the standards required of local health departments for accreditation. Past research found that only 61% of local health departments met standards for informing and educating constituents, suggesting a considerable gap between current practices and best practice. Objective Social media platforms, such as Twitter, may aid local health departments in informing and educating their constituents by reaching large numbers of people with real-time messages at relatively low cost. Little is known about the followers of local health departments on Twitter. The aim of this study was to examine characteristics of local health department Twitter followers and the relationship between local health department characteristics and follower characteristics. Methods In 2013, we collected (using NodeXL) and analyzed a sample of 4779 Twitter followers from 59 randomly selected local health departments in the United States with Twitter accounts. We coded each Twitter follower for type (individual, organization), location, health focus, and industry (eg, media, government). Local health department characteristics were adopted from the 2010 National Association of City and County Health Officials Profile Study data. Results Local health department Twitter accounts were followed by more organizations than individual users. Organizations tended to be health-focused, located outside the state from the local health department being followed, and from the education, government, and non-profit sectors. Individuals were likely to be local and not health-focused. Having a public information officer on staff, serving a larger population, and “tweeting” more frequently were associated with having a higher percentage of local followers. Conclusions Social media has the

  16. Developing criteria to establish Trusted Digital Repositories

    Science.gov (United States)

    Faundeen, John L.

    2017-01-01

    This paper details the drivers, methods, and outcomes of the U.S. Geological Survey’s quest to establish criteria by which to judge its own digital preservation resources as Trusted Digital Repositories. Drivers included recent U.S. legislation focused on data and asset management conducted by federal agencies spending $100M USD or more annually on research activities. The methods entailed seeking existing evaluation criteria from national and international organizations such as International Standards Organization (ISO), U.S. Library of Congress, and Data Seal of Approval upon which to model USGS repository evaluations. Certification, complexity, cost, and usability of existing evaluation models were key considerations. The selected evaluation method was derived to allow the repository evaluation process to be transparent, understandable, and defensible; factors that are critical for judging competing, internal units. Implementing the chosen evaluation criteria involved establishing a cross-agency, multi-disciplinary team that interfaced across the organization

  17. Radiological protection criteria for waste management

    International Nuclear Information System (INIS)

    Hill, M.D.; Webb, G.A.M.

    1985-01-01

    In this Paper the progress being made by international organizations towards the development of a consensus on the radiological protection criteria to be applied to waste management, and in particular waste disposal, is reviewed. Against this background, work on the development of criteria for use in the UK is described. It is concluded that an international consensus is emerging and that the criteria being recommended for use in the UK are consistent with current international views. (author)

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

    Science.gov (United States)

    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

  19. Community-based organizations in the health sector: A scoping review

    Directory of Open Access Journals (Sweden)

    Wilson Michael G

    2012-11-01

    Full Text Available Abstract Community-based organizations are important health system stakeholders as they provide numerous, often highly valued programs and services to the members of their community. However, community-based organizations are described using diverse terminology and concepts from across a range of disciplines. To better understand the literature related to community-based organizations in the health sector (i.e., those working in health systems or more broadly to address population or public health issues, we conducted a scoping review by using an iterative process to identify existing literature, conceptually map it, and identify gaps and areas for future inquiry. We searched 18 databases and conducted citation searches using 15 articles to identify relevant literature. All search results were reviewed in duplicate and were included if they addressed the key characteristics of community-based organizations or networks of community-based organizations. We then coded all included articles based on the country focus, type of literature, source of literature, academic discipline, disease sector, terminology used to describe organizations and topics discussed. We identified 186 articles addressing topics related to the key characteristics of community-based organizations and/or networks of community-based organizations. The literature is largely focused on high-income countries and on mental health and addictions, HIV/AIDS or general/unspecified populations. A large number of different terms have been used in the literature to describe community-based organizations and the literature addresses a range of topics about them (mandate, structure, revenue sources and type and skills or skill mix of staff, the involvement of community members in organizations, how organizations contribute to community organizing and development and how they function in networks with each other and with government (e.g., in policy networks. Given the range of terms used to

  20. Path analysis and multi-criteria decision making: an approach for multivariate model selection and analysis in health.

    Science.gov (United States)

    Vasconcelos, A G; Almeida, R M; Nobre, F F

    2001-08-01

    This paper introduces an approach that includes non-quantitative factors for the selection and assessment of multivariate complex models in health. A goodness-of-fit based methodology combined with fuzzy multi-criteria decision-making approach is proposed for model selection. Models were obtained using the Path Analysis (PA) methodology in order to explain the interrelationship between health determinants and the post-neonatal component of infant mortality in 59 municipalities of Brazil in the year 1991. Socioeconomic and demographic factors were used as exogenous variables, and environmental, health service and agglomeration as endogenous variables. Five PA models were developed and accepted by statistical criteria of goodness-of fit. These models were then submitted to a group of experts, seeking to characterize their preferences, according to predefined criteria that tried to evaluate model relevance and plausibility. Fuzzy set techniques were used to rank the alternative models according to the number of times a model was superior to ("dominated") the others. The best-ranked model explained above 90% of the endogenous variables variation, and showed the favorable influences of income and education levels on post-neonatal mortality. It also showed the unfavorable effect on mortality of fast population growth, through precarious dwelling conditions and decreased access to sanitation. It was possible to aggregate expert opinions in model evaluation. The proposed procedure for model selection allowed the inclusion of subjective information in a clear and systematic manner.

  1. 29 CFR 1904.4 - Recording criteria.

    Science.gov (United States)

    2010-07-01

    ... criteria. (Needlestick and sharps injury cases, tuberculosis cases, hearing loss cases, medical removal... Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR RECORDING AND REPORTING OCCUPATIONAL INJURIES AND ILLNESSES Recordkeeping Forms and Recording Criteria § 1904.4...

  2. Improving exchange with consumers within mental health organizations: Recognizing mental ill health experience as a 'sneaky, special degree'.

    Science.gov (United States)

    Scholz, Brett; Bocking, Julia; Happell, Brenda

    2018-02-01

    Stigmatizing views towards consumers may be held even by those working within mental health organizations. Contemporary mental health policies require organizations to work collaboratively with consumers in producing and delivering services. Using social exchange theory, which emphasises mutual exchange to maximise benefits in partnership, the current study explores the perspectives of those working within organizations that have some level of consumer leadership. Interviews were conducted with 14 participants from a range of mental health organizations. Data were transcribed, and analyzed using thematic analytic and discursive psychological techniques. Findings suggest stigma is still prevalent even in organizations that have consumers in leadership positions, and consumers are often perceived as less able to work in mental health organizations than non-consumers. Several discourses challenged such a view - showing how consumers bring value to mental health organizations through their expertise in the mental health system, and their ability to provide safety and support to other consumers. Through a social exchange theory lens, the authors call for organizations to challenge stigma and promote the value that consumers can bring to maximize mutual benefits. © 2017 Australian College of Mental Health Nurses Inc.

  3. [Organization of health services and tuberculosis care management].

    Science.gov (United States)

    Barrêto, Anne Jaquelyne Roque; de Sá, Lenilde Duarte; Nogueira, Jordana de Almeida; Palha, Pedro Fredemir; Pinheiro, Patrícia Geórgia de Oliveira Diniz; de Farias, Nilma Maria Porto; Rodrigues, Débora Cezar de Souza; Villa, Tereza Cristina Scatena

    2012-07-01

    The scope of this study was to analyze the discourse of managers regarding the relationship between the organization of the health services and tuberculosis care management in a city in the metropolitan region of João Pessoa, State of Pernambuco. Using qualitative research in the analytical field of the French line of Discourse Analysis, 16 health workers who worked as members of the management teams took part in the study. The transcribed testimonials were organized using Atlas.ti version 6.0 software. After detailed reading of the empirical material, an attempt was made to identify the paraphrasic, polyssemic and metaphoric processes in the discourses, which enabled identification of the following discourse formation: Organization of the health services and the relation with TB care management: theory and practice. In the discourse of the managers the fragmentation of the actions of control of tuberculosis, the lack of articulation between the services and sectors, the compliance of the specific activities for TB, as well as the lack of strategic planning for management of care of the disease are clearly revealed. In this respect, for the organization of the health services to be effective, it is necessary that tuberculosis be considered a priority and acknowledged as a social problem in the management agenda.

  4. Becoming a health literate organization: Formative research results from healthcare organizations providing care for undeserved communities.

    Science.gov (United States)

    Adsul, Prajakta; Wray, Ricardo; Gautam, Kanak; Jupka, Keri; Weaver, Nancy; Wilson, Kristin

    2017-11-01

    Background Integrating health literacy into primary care institutional policy and practice is critical to effective, patient centered health care. While attributes of health literate organizations have been proposed, approaches for strengthening them in healthcare systems with limited resources have not been fully detailed. Methods We conducted key informant interviews with individuals from 11 low resourced health care organizations serving uninsured, underinsured, and government-insured patients across Missouri. The qualitative inquiry explored concepts of impetus to transform, leadership commitment, engaging staff, alignment to organization wide goals, and integration of health literacy with current practices. Findings Several health care organizations reported carrying out health literacy related activities including implementing patient portals, selecting easy to read patient materials, offering community education and outreach programs, and improving discharge and medication distribution processes. The need for change presented itself through data or anecdotal staff experience. For any change to be undertaken, administrators and medical directors had to be supportive; most often a champion facilitated these changes in the organization. Staff and providers were often resistant to change and worried they would be saddled with additional work. Lack of time and funding were the most common barriers reported for integration and sustainability. To overcome these barriers, managers supported changes by working one on one with staff, seeking external funding, utilizing existing resources, planning for stepwise implementation, including members from all staff levels and clear communication. Conclusion Even though barriers exist, resource scarce clinical settings can successfully plan, implement, and sustain organizational changes to support health literacy.

  5. Microbiological criteria for good manufacturing practice (GMP)

    Energy Technology Data Exchange (ETDEWEB)

    Farkas, J. (Inst. of Preservation and Livestock Products Technology, Univ. of Horticulture and Food Industry, Budapest (Hungary)); Zukal, E. (Inst. of Preservation and Livestock Products Technology, Univ. of Horticulture and Food Industry, Budapest (Hungary))

    1992-01-01

    Good manufacturing practice (GMP) consist of an effective manufacturing operation and an effective application of food control. GMP is best supported by the Hazard Analysis Critical Control Point system (HACCP) of the preventive quality assurance, which requires that food irradiation as any food processing technology should be used only with foods of an acceptable quality and adequate handling and storage procedures should precede and follow the processing. The paper concentrates on the first element of the HACCP system for an irradiation plant: the incoming product control, i.e. whether GMP of foods to be irradiated can be assessed by establishing microbiological criteria for their previous good manufacturing practice. In this regard, it summarizes considerations and findings of a ''Consultation on Microbiological Criteria for Foods to be Further Processed Including by Irradiation'' held in 1989 by the International Consultative Group on Food irradiation at the Headquarters of the World Health Organization, Geneva. Difficulties in establishing reference values and defining good manufacturing practices will be pointed out. (orig.)

  6. A summation of online recruiting practices for health care organizations.

    Science.gov (United States)

    Gautam, Kanak S

    2005-01-01

    Worker shortage is among the foremost challenges facing US health care today. Health care organizations are also confronted with rising costs of recruiting and compensating scarce workers in times of declining reimbursement. Many health care organizations are adopting online recruitment as a nontraditional, low-cost method for hiring staff. Online recruitment is the fastest growing method of recruitment today, and has advantages over traditional recruiting in terms of cost, reach, and time-saving. Several health care organizations have achieved great success in recruiting online. Yet awareness of online recruiting remains lower among health care managers than managers in other industries. Many health care organizations still search for job candidates within a 30-mile radius using traditional methods. This article describes the various aspects of online recruitment for health care organizations. It is meant to help health care managers currently recruiting online by answering frequently asked questions (eg, Should I be advertising on national job sites? Why is my Web site not attracting job seekers? Is my online ad effective?). It is also meant to educate health care managers not doing online recruiting so that they try recruiting online. The article discusses the salient aspects of online recruiting: (a) using commercial job boards; (b) building one's own career center; (c) building one's own job board; (d) collecting and storing resumes; (e) attracting job seekers to one's Web site; (f) creating online job ads; (g) screening and evaluating candidates online; and (h) building long-term relationships with candidates. Job seekers in health care are adopting the Internet faster than health care employers. To recruit successfully during the current labor shortage, it is imperative that employers adopt and expand online recruiting.

  7. A study on safety concept and criteria of site release of nuclear installation proposed by international organizations and adopted in decommissioning practices

    International Nuclear Information System (INIS)

    Enokido, Yuji; Miyasaka, Yasuhiko; Ishikawa, Hironori

    2008-01-01

    Regulatory systems and safety criteria of site release of nuclear installation proposed by international organizations such as IAEA and applied in decommissioning in domestic and foreign countries have been studied, in order to avail them to deliberate the relevant domestic regulation and guides. In addition, the applicability of the proposal and practices to domestic legislation have been discussed. Regarding the national safety criteria, the annual individual dose constraint is optimized between 10 μSv and 300 μSv after recommendation and/or guides of IAEA etc. Unconditional release should be achieved, but the conditional and/or partial site release are possible under the same safety criteria to make the selection flexible for licensees. (author)

  8. Management of mutual health organizations in Ghana.

    NARCIS (Netherlands)

    Baltussen, R.M.P.M.; Bruce, E.; Rhodes, G.; Narh-Bana, S.A.; Agyepong, I.

    2006-01-01

    OBJECTIVE: Mutual Health Organizations (MHO) emerged in Ghana in the mid-1990s. The organizational structure and financial management of private and public MHO hold important lessons for the development of national health insurance in Ghana, but there is little evidence to date on their features.

  9. World Trade Organization activity for health services.

    Science.gov (United States)

    Gros, Clémence

    2012-01-01

    Since the establishment of a multilateral trading system and the increasing mobility of professionals and consumers of health services, it seems strongly necessary that the World Trade Organization (WTO) undertakes negotiations within the General Agreement on Trade in Services (GATS), and that WTO's members attempt to reach commitments for health-related trade in services. How important is the GATS for health policy and how does the GATS refer to health services? What are the current negotiations and member's commitments?

  10. Health organizations providing and seeking social support: a Twitter-based content analysis.

    Science.gov (United States)

    Rui, Jian Raymond; Chen, Yixin; Damiano, Amanda

    2013-09-01

    Providing and seeking social support are important aspects of social exchange. New communication technologies, especially social network sites (SNSs), facilitate the process of support exchange. An increasing number of health organizations are using SNSs. However, how they provide and seek social support via SNSs has yet to garner academic attention. This study examined the types of social support provided and sought by health organizations on Twitter. A content analysis was conducted on 1,500 tweets sent by a random sample of 58 health organizations within 2 months. Findings indicate that providing informational and emotional support, as well as seeking instrumental support, were the main types of social support exchanged by health organizations through Twitter. This study provides a typology for studying social support exchanges by health organizations, and recommends strategies for health organizations regarding the effective use of Twitter.

  11. A marketing matrix for health care organizations.

    Science.gov (United States)

    Weaver, F J; Gombeski, W R; Fay, G W; Eversman, J J; Cowan-Gascoigne, C

    1986-06-01

    Irrespective of the formal marketing structure successful marketing for health care organizations requires the input on many people. Detailed here is the Marketing Matrix used at the Cleveland Clinic Foundation in Cleveland, Ohio. This Matrix is both a philosophy and a tool for clarifying and focusing the organization's marketing activities.

  12. Identifying Homelessness among Veterans Using VA Administrative Data: Opportunities to Expand Detection Criteria.

    Directory of Open Access Journals (Sweden)

    Rachel Peterson

    Full Text Available Researchers at the U.S. Department of Veterans Affairs (VA have used administrative criteria to identify homelessness among U.S. Veterans. Our objective was to explore the use of these codes in VA health care facilities. We examined VA health records (2002-2012 of Veterans recently separated from the military and identified as homeless using VA conventional identification criteria (ICD-9-CM code V60.0, VA specific codes for homeless services, plus closely allied V60 codes indicating housing instability. Logistic regression analyses examined differences between Veterans who received these codes. Health care services and co-morbidities were analyzed in the 90 days post-identification of homelessness. VA conventional criteria identified 21,021 homeless Veterans from Operations Enduring Freedom, Iraqi Freedom, and New Dawn (rate 2.5%. Adding allied V60 codes increased that to 31,260 (rate 3.3%. While certain demographic differences were noted, Veterans identified as homeless using conventional or allied codes were similar with regards to utilization of homeless, mental health, and substance abuse services, as well as co-morbidities. Differences were noted in the pattern of usage of homelessness-related diagnostic codes in VA facilities nation-wide. Creating an official VA case definition for homelessness, which would include additional ICD-9-CM and other administrative codes for VA homeless services, would likely allow improved identification of homeless and at-risk Veterans. This also presents an opportunity for encouraging uniformity in applying these codes in VA facilities nationwide as well as in other large health care organizations.

  13. Identifying Homelessness among Veterans Using VA Administrative Data: Opportunities to Expand Detection Criteria

    Science.gov (United States)

    Peterson, Rachel; Gundlapalli, Adi V.; Metraux, Stephen; Carter, Marjorie E.; Palmer, Miland; Redd, Andrew; Samore, Matthew H.; Fargo, Jamison D.

    2015-01-01

    Researchers at the U.S. Department of Veterans Affairs (VA) have used administrative criteria to identify homelessness among U.S. Veterans. Our objective was to explore the use of these codes in VA health care facilities. We examined VA health records (2002-2012) of Veterans recently separated from the military and identified as homeless using VA conventional identification criteria (ICD-9-CM code V60.0, VA specific codes for homeless services), plus closely allied V60 codes indicating housing instability. Logistic regression analyses examined differences between Veterans who received these codes. Health care services and co-morbidities were analyzed in the 90 days post-identification of homelessness. VA conventional criteria identified 21,021 homeless Veterans from Operations Enduring Freedom, Iraqi Freedom, and New Dawn (rate 2.5%). Adding allied V60 codes increased that to 31,260 (rate 3.3%). While certain demographic differences were noted, Veterans identified as homeless using conventional or allied codes were similar with regards to utilization of homeless, mental health, and substance abuse services, as well as co-morbidities. Differences were noted in the pattern of usage of homelessness-related diagnostic codes in VA facilities nation-wide. Creating an official VA case definition for homelessness, which would include additional ICD-9-CM and other administrative codes for VA homeless services, would likely allow improved identification of homeless and at-risk Veterans. This also presents an opportunity for encouraging uniformity in applying these codes in VA facilities nationwide as well as in other large health care organizations. PMID:26172386

  14. Development of a culture of sustainability in health care organizations.

    Science.gov (United States)

    Ramirez, Bernardo; West, Daniel J; Costell, Michael M

    2013-01-01

    This paper aims to examine the concept of sustainability in health care organizations and the key managerial competencies and change management strategies needed to implant a culture of sustainability. Competencies and management development strategies needed to engrain this corporate culture of sustainability are analyzed in this document. This paper draws on the experience of the authors as health care executives and educators developing managerial competencies with interdisciplinary and international groups of executives in the last 25 years, using direct observation, interviews, discussions and bibliographic evidence. With a holistic framework for sustainability, health care managers can implement strategies for multidisciplinary teams to respond to the constant change, fine-tune operations and successfully manage quality of care. Managers can mentor students and provide in-service learning experiences that integrate knowledge, skills, and abilities. Further empirical research needs to be conducted on these interrelated innovative topics. Health care organizations around the world are under stakeholders' pressure to provide high quality, cost-effective, accessible and sustainable services. Professional organizations and health care providers can collaborate with university graduate health management education programs to prepare competent managers in all the dimensions of sustainability. The newly designated accountable care organizations represent an opportunity for managers to address the need for sustainability. Sustainability of health care organizations with the holistic approach discussed in this paper is an innovative and practical approach to quality improvement that merits further development.

  15. [Financing of regional occupational health service centers: structure and financial criteria in years 2000-2001].

    Science.gov (United States)

    Rydlewska-Liszkowska, Izabela

    2003-01-01

    The rational planning and financing of occupational health services at the national level have to be based on an appropriate system of information about individual units and their financial status that could illustrate their financial administration. This is required not only in view of the internal needs of public money management, but also in view of the national health accounts. The major task in this regard is to assess the level and structure of financing to individual units and to check the soundness of criteria used in the process of supplying financial means. The results of such an analysis can be a valuable source of information for planning carried out also by the institutions which provide funds to cover the cost of tasks performed by individual units. The aim of the project implemented by the Nofer Institute of Occupational Medicine was to collect, process and analyze data on the level and structure of financing of provincial occupational medicine centers. In this paper, the objectives, methodology and analytical tools are discussed. The results and structural data on the level and structure of financing of regional occupational health services centers covering a two-year period are presented. At the same time, the criteria for allocating funds were identified, which made it possible to evaluate the situation and to propose new solutions.

  16. 76 FR 55928 - Food and Drug Administration Health Professional Organizations Conference

    Science.gov (United States)

    2011-09-09

    ...] Food and Drug Administration Health Professional Organizations Conference AGENCY: Food and Drug... conference for representatives of Health Professional Organizations. Dr. Margaret Hamburg, Commissioner of... person attending, the name of the organization, address, and telephone number. There is no registration...

  17. Clinical case review: A method to improve identification of true clinical and radiographic pneumonia in children meeting the World Health Organization definition for pneumonia

    OpenAIRE

    Puumalainen, Taneli; Quiambao, Beatriz; Abucejo-Ladesma, Erma; Lupisan, Socorro; Heiskanen-Kosma, Tarja; Ruutu, Petri; Lucero, Marilla G; Nohynek, Hanna; Simoes, Eric AF; Riley, Ian

    2008-01-01

    Abstract Background The World Health Organization's (WHO) case definition for childhood pneumonia, composed of simple clinical signs of cough, difficult breathing and fast breathing, is widely used in resource poor settings to guide management of acute respiratory infections. The definition is also commonly used as an entry criteria or endpoint in different intervention and disease burden studies. Methods A group of paediatricians conducted a retrospective review of clinical and laboratory da...

  18. Diagnostic criteria for adverse health effects in the environs of wind turbines.

    Science.gov (United States)

    McMurtry, Robert Y; Krogh, Carmen Me

    2014-10-01

    In an effort to address climate change, governments have pursued policies that seek to reduce greenhouse gases. Alternative energy, including wind power, has been proposed by some as the preferred approach. Few would debate the need to reduce air pollution, but the means of achieving this reduction is important not only for efficiency but also for health protection. The topic of adverse health effects in the environs of industrial wind turbines (AHE/IWT) has proven to be controversial and can present physicians with challenges regarding the management of an exposure to IWT. Rural physicians in particular must be aware of the possibility of people presenting to their practices with a variety of sometimes confusing complaints. An earlier version of the diagnostic criteria for AHE/IWT was published in August 2011. A revised case definition and a model for a study to establish a confirmed diagnosis is proposed.

  19. Understanding and managing change in health care organizations.

    Science.gov (United States)

    Nagaike, K

    1997-01-01

    Change impacts affected people and often causes difficulties. Health care organizations, locally and nationally, have undergone tremendous change to deliver quality services in a more effective and efficient manner in a competitive environment, with varying degrees of success. This article presents Robbins's categories of change and relates them to current changes in health care organizations. It discusses areas to consider to develop adaptable plans and to assist affected employees to better deal with these changes throughout the transition.

  20. World Health Organization's Mental Health Atlas 2005:implications for policy development

    Science.gov (United States)

    SAXENA, SHEKHAR; SHARAN, PRATAP; GARRIDO, MARCO; SARACENO, BENEDETTO

    2006-01-01

    In 2005, the World Health Organization (WHO) launched the second edition of the Mental Health Atlas, consisting of revised and updated information on mental health from countries. The sources of information included the mental health focal points in the Ministries of Health, published literature and unpublished reports available to WHO. The results show that global mental health resources remain low and grossly inadequate to respond to the high level of need. In addition, the revised Atlas shows that the improvements over the period 2001 to 2004 are very small. Imbalances across income groups of countries remain largely the same. Enhancement in resources devoted to mental health is urgently needed, especially in low- and middle-income countries. PMID:17139355

  1. The diagnosis and management of progressive dysfunction of health care organizations.

    Science.gov (United States)

    Chervenak, Frank A; McCullough, Laurence B

    2005-04-01

    This paper presents an ethically justified approach to the diagnosis and management of progressive dysfunction of health care organizational cultures. We explain the concept of professional integrity in terms of the ethical concept of the cofiduciary responsibility of physicians and health care organizations. We identify the ethical features of a healthy health care organization and the spectrum of progressive dysfunction of organizational cultures from cynical through wonderland and Kafkaesque to postmodern. Physicians should respond to cynical health care organizations by creating moral enclaves of professional integrity for the main purpose of confrontation and reform, to wonderland organizations by strengthening moral enclaves for the main purpose of resisting self-deception, to Kafkaesque organizations by strengthening moral enclaves still further for the main purpose of defending professional integrity (adopting a Machiavellian appearance of virtue as necessary), and to postmodern organizations by creating moral fortresses and, should these fail, quitting.

  2. Criteria for controlled atmosphere chambers

    International Nuclear Information System (INIS)

    Robinson, J.N.

    1980-03-01

    The criteria for design, construction, and operation of controlled atmosphere chambers intended for service at ORNL are presented. Classification of chambers, materials for construction, design criteria, design, controlled atmosphere chamber systems, and operating procedures are presented. ORNL Safety Manual Procedure 2.1; ORNL Health Physics Procedure Manual Appendix A-7; and Design of Viewing Windows are included in 3 appendices

  3. Current Approaches and Future Trends in Compost Quality Criteria for Agronomic, Environmental, and Human Health Benefits

    DEFF Research Database (Denmark)

    Bernal, Maria Pilar; Sommer, Sven G.; Chadwick, Dave

    2017-01-01

    destination, which includes agriculture, horticulture, and urban landscaping. The development of a market for compost greatly depends on the definition and adoption of quality standards. Several countries and public and private organizations have established quality standards for compost, where certain......Organic wastes are composted to stabilize organic matter, reduce the moisture content, increase the concentrations of plant nutrients, eliminate pathogens and weed seeds, develop disease suppressiveness, and reduce greenhouse gas emissions. The requirements for compost quality depend on its final...... properties are prioritized and different limits are established according to the end use. However, there is a need to harmonize such criteria at the international level. Also, if the process of composting is not managed properly, then it can result in excessive emissions of ammonia (NH3), nitrous oxide (N2O...

  4. Organ donation and transplantation in Mexico. A transplantation health professionals’ perspective

    Directory of Open Access Journals (Sweden)

    Luis Eduardo Hernández-Ibarra

    2017-01-01

    Full Text Available Objective. We aimed to explore organ donation and transplantation in Mexico from the point of view of transplantation health professionals. Materials and methods. A qualitative study was carried out. Twenty six organ transplantation health professionals from seven states of Mexico participated. Semi-structured face-to-face interviews were conducted mainly in hospital settings. Critical discourse analysis was performed. Results. According to participants, living organ transplantation offers benefits for recipients as well as for donors. Several factors influence the field of transplantation negatively, among them the scarcity of resources that impedes the incorporation of new health personnel, as well as conflicts between transplantation teams with diverse health professionals and authorities. Conclusion. Besides increasing economic resources, transplantation health personnel should be sensitized to find solutions in order to avoid conflicts with different health professionals. Studies on organ donation and transplants also should include other social actors’ viewpoint.

  5. Finnish NGOs promoting health equity in the context of welfare economy.

    Science.gov (United States)

    Rouvinen-Wilenius, Päivi; Ahokas, Jussi; Kiukas, Vertti; Aalto-Kallio, Mervi

    2018-04-05

    Health inequality is a national challenge in Finland. The WHO global strategy of Health for All implies that all people should have an equal opportunity to develop and maintain their health through fair and just access to health resources. This article examines the role of Finnish Non-Governmental Organizations (NGO) in strengthening the health equity. The article presents the strategy and specific criteria constructed by the NGOs to promote health equity in society. The health equity criteria and welfare economy strategy are combined to a framework which NGOs can utilize in their work to promote health equity. The welfare economy strategy describes the important issues that NGOs have to address when working towards a specific societal goal, in this case equity. The health equity criteria in turn are an instrument for the practical implementation of the preconditions of equity.

  6. Reliability, resilience and vulnerability criteria for the evaluation of time-dependent health risks: A hypothetical case study of wellhead protection

    Science.gov (United States)

    Rodak, C. M.; Silliman, S. E.; Bolster, D.

    2012-12-01

    A hypothetical case study of groundwater contaminant protection was carried out using time-dependent health risk calculations. The case study focuses on a hypothetical zoning project for parcels of land around a well field in northern Indiana, where the control of cancer risk relative to a mandated cancer risk threshold is of concern in the management strategy. Within our analysis, we include both uncertainty in the subsurface transport and variability in population behavior in the calculation of time-dependent health risks. From these results we introduce risk maps, a visual representation of the probability of an unacceptable health risk as a function of population behavior and the time at which exposure to the contaminant begins. We also evaluate the time-dependent risks with three criteria from water resource literature: reliability, resilience, and vulnerability (RRV). With respect to health risk from a groundwater well, the three criteria determine: the probability that a well produces safe water (reliability), the probability that a contaminated well returns to an uncontaminated state within a specified time interval (resilience), and the overall severity in terms of health impact of the contamination at a well head (vulnerability). The results demonstrate that the distributions of RRV values for each parcel of land are linked to the time-dependent concentration profile of the contaminant at the well, and the toxicological characteristics of the contaminant. The proposed time-dependent risk calculation expands on current techniques to include a continuous exposure start time, capable of reproducing the maximum risk while providing information on the severity and duration of health risks. Overall this study suggests that, especially in light of the inherent complexity of health-groundwater systems, RRV are viable criteria for relatively simple and effective evaluation of time-dependent health risk. It is argued that the RRV approach, as applied to

  7. World Health Organization global policy for improvement of oral health--World Health Assembly 2007

    DEFF Research Database (Denmark)

    Petersen, Poul Erik

    2008-01-01

    The World Health Organization (WHO) Global Oral Health Programme has worked hard over the past five years to increase the awareness of oral health worldwide as an important component of general health and quality of life. Meanwhile, oral disease is still a major public health problem in high income...... countries and the burden of oral disease is growing in many low- and middle income countries. In the World Oral Health Report 2003, the WHO Global Oral Health Programme formulated the policies and the necessary actions for the improvement of oral health. The strategy is that oral disease prevention...... and the promotion of oral health needs to be integrated with chronic disease prevention and general health promotion as the risks to health are linked. The World Health Assembly (WHA) and the Executive Board (EB) are supreme governance bodies of WHO and for the first time in 25 years oral health was subject...

  8. Phase angle and World Health Organization criteria for the assessment of nutritional status in children with osteogenesis imperfecta.

    Science.gov (United States)

    Pileggi, Vicky Nogueira; Scalize, Antonio Rodolpho Hakime; Camelo Junior, José Simon

    2016-12-01

    To compare the phase angle of patients with osteogenesis imperfecta treated at a tertiary university hospital with patients in a control group of healthy children, and to assess the nutritional status of these patients through the body mass index proposed by the World Health Organization. Cross-sectional study carried out in a university hospital that included seven patients with osteogenesis imperfecta and a control group of 17 healthy children of the same gender and age. Weight and height were measured and bioelectrical impedance was performed. Subsequently, the phase angle was calculated based on resistance and reactance values. The phase angle of the group of children with osteogenesis imperfecta was significantly lower than that of the control group (posteogenesis imperfecta have a nutritional risk detected by the phase angle, which is a useful tool for nutritional screening. The calculation result could help in the diet therapy of patients with osteogenesis imperfecta. Copyright © 2016 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

  9. Proceedings of the international symposium on radioactive waste disposal: Health and environmental criteria and standards

    International Nuclear Information System (INIS)

    Hultcrantz, K.

    1999-04-01

    The co-organisers of the International Symposium on Health and Environmental Criteria and Standards for Radioactive Waste Disposal are pleased to present these proceedings. This Symposium succeeded in bringing together a wide range of participants and perspectives in order to address in a common forum the technical and non-technical issues related to long-term storage of radioactive waste. The papers presented herein reflect both the diversity of the participants and the complexity of the issues addressed. The sessions, panels, and papers developed for the symposium focused on some of the daunting challenges posed by long-term isolation and storage of high level radioactive waste. Panel sessions addressed the basic principles of criteria and standards, the context of the risks involved, and an overview of relevant philosophical, social, and ethical issues. Paper sessions considered national laws, policies and experiences; criteria formulation; environmental protection; compliance; human intrusion; and fundamental philosophical, social, and ethical issues. The presentations stimulated lively discussion and debate, and the contributors received valuable feedback. The interplay between technical and social aspects reflected in some papers and in the discussion highlights the changing role of the public in radioactive waste issues. The average citizen has become more aware of and more involved in radioactive waste matters in recent years. Solutions that were previously analysed through a technological lens are now being viewed in a much broader perspective that better addresses the concerns of local communities as well as national and international interests. Public involvement must begin earlier, last longer, and improve in quality so as to create an ongoing dialogue and debate rather than cycles of dictates and discord. The symposium has offered suggestions as to how government, industry, and the public can foster a broader dialogue on the formulation and

  10. Sponsorship of National Health Organizations by Two Major Soda Companies.

    Science.gov (United States)

    Aaron, Daniel G; Siegel, Michael B

    2017-01-01

    Obesity is a pervasive public health problem in the U.S. Reducing soda consumption is important for stemming the obesity epidemic. However, several articles and one book suggest that soda companies are using their resources to impede public health interventions that might reduce soda consumption. Although corporate sponsorship by tobacco and alcohol companies has been studied extensively, there has been no systematic attempt to catalog sponsorship activities of soda companies. This study investigates the nature, extent, and implications of soda company sponsorship of U.S. health and medical organizations, as well as corporate lobbying expenditures on soda- or nutrition-related public health legislation from 2011 to 2015. Records of corporate philanthropy and lobbying expenditures on public health legislation by soda companies in the U.S. during 2011-2015 were found through Internet and database searches. From 2011 to 2015, the Coca-Cola Company and PepsiCo were found to sponsor a total of 95 national health organizations, including many medical and public health institutions whose specific missions include fighting the obesity epidemic. During the study period, these two soda companies lobbied against 29 public health bills intended to reduce soda consumption or improve nutrition. There is surprisingly pervasive sponsorship of national health and medical organizations by the nation's two largest soda companies. These companies lobbied against public health intervention in 97% of cases, calling into question a sincere commitment to improving the public's health. By accepting funding from these companies, health organizations are inadvertently participating in their marketing plans. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  11. Active offer of health services in French in Ontario: Analysis of reorganization and management strategies of health care organizations.

    Science.gov (United States)

    Farmanova, Elina; Bonneville, Luc; Bouchard, Louise

    2018-01-01

    The availability of health services in French is not only weak but also inexistent in some regions in Canada. As a result, estimated 78% of more than a million of Francophones living in a minority situation in Canada experience difficulties accessing health care in French. To promote the delivery of health services in French, publicly funded organizations are encouraged to take measures to ensure that French-language services are clearly visible, available, easily accessible, and equivalent to the quality of services offered in English. This study examines the reorganization and management strategies taken by health care organizations in Ontario that provide health services in French. Review and analysis of designation plans of a sample of health care organizations. Few health care organizations providing services in French have concrete strategies to guarantee availability, visibility, and accessibility of French-language services. Implementation of the active offer of French-language services is likely to be difficult and slow. The Ontario government must strengthen collaboration with health care organizations, Francophone communities, and other key actors participating in the designation process to help health care organizations build capacities for the effective offer of French-language services. Copyright © 2017 John Wiley & Sons, Ltd.

  12. Can eHealth tools enable health organizations to reach their target audience?

    Science.gov (United States)

    Zbib, Ahmad; Hodgson, Corinne; Calderwood, Sarah

    2011-01-01

    Data from the health risk assessment operated by the Heart and Stroke Foundation found users were more likely to be female; married; have completed post secondary education; and report hypertension, stroke, or being overweight or obese. In developing and operating eHealth tools for health promotion, organizations should compare users to their target population(s). eHealth tools may not be optimal for reaching some higher-risk sub-groups, and a range of social marketing approaches may be required.

  13. Philosophy of organ donation: Review of ethical facets.

    Science.gov (United States)

    Dalal, Aparna R

    2015-06-24

    Transplantation ethics is a philosophy that incorporates systematizing, defending and advocating concepts of right and wrong conduct related to organ donation. As the demand for organs increases, it is essential to ensure that new and innovative laws, policies and strategies of increasing organ supply are bioethical and are founded on the principles of altruism and utilitarianism. In the field of organ transplantation, role of altruism and medical ethics values are significant to the welfare of the society. This article reviews several fundamental ethical principles, prevailing organ donation consent laws, incentives and policies related to the field of transplantation. The Ethical and Policy Considerations in Organ Donation after Circulatory Determination of Death outline criteria for death and organ retrieval. Presumed consent laws prevalent mostly in European countries maintain that the default choice of an individual would be to donate organs unless opted otherwise. Explicit consent laws require organ donation to be proactively affirmed with state registries. The Declaration of Istanbul outlines principles against organ trafficking and transplant tourism. World Health Organization's Guiding Principles on Human Cell, Tissue and Organ Transplantation aim at ensuring transparency in organ procurement and allocation. The ethics of financial incentives and non-financial incentives such as incorporation of non-medical criteria in organ priority allocation have also been reviewed in detail.

  14. Analysis and implementation of a World Health Organization health report: methodological concepts and strategies.

    Science.gov (United States)

    von Groote, Per Maximilian; Giustini, Alessandro; Bickenbach, Jerome Edmond

    2014-01-01

    A long-standing scientific discourse on the use of health research evidence to inform policy has come to produce multiple implementation theories, frameworks, models, and strategies. It is from this extensive body of research that the authors extract and present essential components of an implementation process in the health domain, gaining valuable guidance on how to successfully meet the challenges of implementation. Furthermore, this article describes how implementation content can be analyzed and reorganized, with a special focus on implementation at different policy, systems and services, and individual levels using existing frameworks and tools. In doing so, the authors aim to contribute to the establishment and testing of an implementation framework for reports such as the World Health Organization World Report on Disability, the World Health Organization International Perspectives on Spinal Cord Injury, and other health policy reports or technical health guidelines.

  15. Misidentification of mental health symptoms in presence of organic diseases and delirium during psychiatric liaison consulting.

    Science.gov (United States)

    Otani, Victor Henrique Oyamada; Otani, Thaís Zélia Dos Santos; Freirias, Andrea; Calfat, Elie Leal de Barros; Aoki, Patricia Satiko; Cordeiro, Quirino; Kanaan, Richard A A; Cross, Sean; Liersch-Sumskis, Susan; Uchida, Ricardo Riyoiti

    2017-09-01

    To identify predictors of misidentification of organic mental disorders and delirium in patients undergoing psychiatric liaison consultation. Data were collected at Santa Casa de São Paulo between July of 2009 and March of 2013. We included in our analysis all inpatients for whom the requesting service judged that a psychiatric consultation was required for a possible mental health condition. Outcomes of interest were the instances of misidentification where a condition was initially deemed to be of a psychiatric nature, whereas the final diagnosis by the liaison psychiatric team was of an organic disease or delirium. Our predictors were the clinical specialty of the requesting service, requester and patient characteristics. A series of generalised linear models were used to evaluate misidentification risks. A total of 947 subjects met our inclusion criteria, 14.6% having a final liaison diagnosis of organic mental disorder and 8.1% of delirium. Older patients were significantly associated with increased risk of misidentification for both organic conditions (OR 3.01 - 95% CI 2.01, 4.5) and delirium (OR 3.92 - 2.4, 6.39). Educational interventions in general hospitals focused on preventing psychiatric misdiagnosis should target in-hospital services where patients tend to be older.

  16. Professionalism: good for patients and health care organizations.

    Science.gov (United States)

    Brennan, Michael D; Monson, Verna

    2014-05-01

    Professionalism is an indispensable element in the compact between the medical profession and society that is based on trust and putting the needs of patients above all other considerations. The resurgence of interest in professionalism dates back to the 1980s when health maintenance organizations were formed and proprietary influences in health care increased. Since then, a rich and comprehensive literature has emerged in defining professionalism, including desirable individual attributes and behaviors and how they may be taught, promoted, and assessed. More recently, scholarship has shifted from individual to organizational professionalism. This literature addresses the role that health care organizations can play to establish environments that are conducive to the consistent expression of professionalism by individuals and health care teams. We reviewed interdisciplinary empirical studies from health care effectiveness and outcomes, organizational sciences, positive psychology, and social psychology, finding evidence that organizational and individual professionalism is associated with a wide range of benefits to patients and the organization. We identify actionable organizational strategies and approaches that, if adopted, can foster and promote combined organizational and individual professionalism. In doing so, trust in the medical profession and its institutions can be enhanced, which in turn will reconfirm a commitment to the social compact. Copyright © 2014 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  17. The Clinician-Educator Pathway in Radiology: An Analysis of Institutional Promotion Criteria.

    Science.gov (United States)

    Jhala, Khushboo; Kim, Jisoo; Chetlen, Alison; Nickerson, Joshua P; Lewis, Petra J

    2017-12-01

    To provide radiology departmental promotional committees and vice chairs of education with a more global perspective on the types of academic activity valued by institutions to aid in their faculty mentoring and standardizing of the Clinician-Educator (ClinEd) pathway. Ninety-two research schools were ranked into three tiers. Ranking was correlated with the presence of a ClinEd track. Thirty promotion documents (ten from each tier) were analyzed to identify common criteria. Differences in guidelines between tiers were assessed by the frequency distribution of criteria. Tier 1 had a significantly greater proportion of schools with a ClinEd track than tier 2 (73% versus 44%, p < 0.05). Thirty-nine criteria were identified and organized into four categories teaching (13), scholarship (12), service/clinical excellence (7), and research (7). The top five included meeting presentations, trainee evaluations, leadership in committees, development of teaching methodologies and materials, and publication of book chapters. First and second tier schools were most similar in frequency distribution. The criteria for the ClinEd promotion track still vary across institutions, though many commonalities exist. A handful of innovative criteria reflect the changing structure of modern health care systems, such as incorporation of online teaching modules and quality improvement efforts. As health care changes, guidelines and incentive structures for faculty should change as well. The information gathered may provide promotion committees with a more global perspective on the types of academic activity valued by modern-day institutions to aid in the national standardization of this pathway and to assist in faculty mentoring. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  18. Creating a New Learning Community: A Case Study of School Leaders' Perceptions of the Baldrige Criteria for Performance Excellence and Their Implementation in a Suburban School District

    Science.gov (United States)

    Adams, Denean

    2013-01-01

    The Baldrige Criteria for Performance Excellence (Baldrige categories) are increasingly being used throughout the health, education, and business sectors to drive continuous improvement in quality organizations. In each industry, specific categories are available to assist in identifying quality practices deployed throughout an organization. The…

  19. Organization of the population health follow-up

    International Nuclear Information System (INIS)

    Pirard, Ph.

    2010-01-01

    This document presents propositions for the organization of health supervision after a radiological accident of medium severity. It distinguishes short term medical care (psychological impacts, side effects of ingestion of iodine tablets, anthropo-radiometry when required, and prevention or taking into care of health problems due to massive grouping of people), and long term measures. The author indicates and discusses what health supervision will have to do: to identify health problems to be treated in priority, to assess the impact of the accident, to give elements on the application and efficiency of management actions. He also discusses and comments the various tools which health supervision will use: a health control and alert system, existing health supervision data, an adapted epidemiological investigation

  20. Basic principles of information technology organization in health care institutions.

    Science.gov (United States)

    Mitchell, J A

    1997-01-01

    This paper focuses on the basic principles of information technology (IT) organization within health sciences centers. The paper considers the placement of the leader of the IT effort within the health sciences administrative structure and the organization of the IT unit. A case study of the University of Missouri-Columbia Health Sciences Center demonstrates how a role-based organizational model for IT support can be effective for determining the boundary between centralized and decentralized organizations. The conclusions are that the IT leader needs to be positioned with other institutional leaders who are making strategic decisions, and that the internal IT structure needs to be a role-based hybrid of centralized and decentralized units. The IT leader needs to understand the mission of the organization and actively use change-management techniques.

  1. Organic food processing

    DEFF Research Database (Denmark)

    Kahl, Johannes; Alborzi, Farnaz; Beck, Alexander

    2014-01-01

    In 2007 EU Regulation (EC) 834/2007 introduced principles and criteria for organic food processing. These regulations have been analysed and discussed in several scientific publications and research project reports. Recently, organic food quality was described by principles, aspects and criteria....... These principles from organic agriculture were verified and adapted for organic food processing. Different levels for evaluation were suggested. In another document, underlying paradigms and consumer perception of organic food were reviewed against functional food, resulting in identifying integral product...... identity as the underlying paradigm and a holistic quality view connected to naturalness as consumers' perception of organic food quality. In a European study, the quality concept was applied to the organic food chain, resulting in a problem, namely that clear principles and related criteria were missing...

  2. Research Needs Assessment in the Health Insurance Organization: Level of Health Care Provider

    Directory of Open Access Journals (Sweden)

    Mohammadkarim Bahadori

    2011-12-01

    Full Text Available Objective: Setting research priorities in the research management cycle is a key. It is important to set the research priorities to make optimal use of scarce resources. The aim of this research was to determine the research needs of Health Insurance Organization based on its health care centers research needs.Methods: This is a qualitative, descriptive and cross-sectional study that was conducted in 2011. A purposeful sample of 60 participants from 14 hospitals, seven dispensaries, five dental clinics, two rehabilitation centers, four radiology centers, six medical diagnostic laboratories, 12 pharmacies, and 20 medical offices that were contracted with the Health Insurance Organization in Iran was interviewed. The framework analysis method (a qualitative research method was used for analysis of interviews. Atlas-Ti software was used to analyze quantitative data, respectively. The topics were prioritized using the Analytical Hierarchy Process (AHP method through Expert Choice software.Results: Based on the problems extracted in our qualitative study, 12 research topics were proposed by the experts. Among these “Design of standard treatment protocols,” “Designing model of ranking the health care centers under contract,” and “Pathology of payment system” took the priority ranks of 1 to 3, earning the scores of 0.44, 0.42, and 0.37, respectively.Conclusion: Considering limited resources and unlimited needs and to prevent research resource wasting, conducting research related to health care providers in the Health Insurance Organization can help it achieve its goals.

  3. Definition of design criteria of mechanical transfer: an interaction between engineering and health areas.

    Science.gov (United States)

    Luz, Taciana Ramos; Echternacht, Eliza Helena de Oliveira

    2012-01-01

    This study aims to analyze the factors that justify the low use of a mechanical transfer in the context of a long-term institution. It is a device intended for internal transportation of individuals who have mobility problems. The analysis involves researchers from the fields of health and engineering in order to generate design criteria that consider the needs of caregivers and patients of this institution. To understand the reality of this site and their specificities, was used Ergonomic Work Analysis.

  4. The Modified Risk Factors of Health Heads of the Medical Organizations

    Directory of Open Access Journals (Sweden)

    O. L. Zadvornaya

    2017-01-01

    Full Text Available Purpose: study and evaluation of modifiable potential risk factors of health of heads of medical organizations in terms of structural and technological modernization of the health system, the growing need for highly qualified management personnel. Efficiency of activity of medical associations largely due to the level of health managers, allowing to solve problems of activities of medical organizations in the modern fastchanging environmental conditions. Based on international experience and our own research the authors identified features of the state of health of heads of medical organizations, and the degree of exposure to risk factors for no communicable diseases; considered approaches to assess motivation and psychological readiness to promote the health and potential of managerial personnel in the formation of health-saving behavior. Methods: in the present study, the following methods were used: systemic approach, content analysis, methods of social diagnosis (questionnaires, interviews, comparative analysis, method of expert evaluations, and method of statistical processing of information. Results: reviewed and proposed approaches to use preventive measures prevention of risk factors of non-communicable diseases healthcare leaders, forming health-preserving behavior. Conclusions and Relevance: in modern scientific studies on the health of medical workers, including heads of medical institutions, defined the modern methodological approaches to formation of health-saving behavior and maintaining healthy lifestyle health care workers. Despite the high awareness of heads of medical organizations in the area of influence of risk factors on health, accessibility of medical care for the diagnosis and correction of risk factors of chronic no communicable diseases, risk factors of health among healthcare leaders have sufficient prevalence. Health-promoting behavior model is not a conscious lifestyle leader and formed as a reaction if you have

  5. Let's dance: Organization studies, medical sociology and health policy.

    Science.gov (United States)

    Currie, Graeme; Dingwall, Robert; Kitchener, Martin; Waring, Justin

    2012-02-01

    This Special Issue of Social Science & Medicine investigates the potential for positive inter-disciplinary interaction, a 'generative dance', between organization studies (OS), and two of the journal's traditional disciplinary foundations: health policy and medical sociology. This is both necessary and timely because of the extent to which organizations have become a neglected topic within medical sociology and health policy analysis. We argue there is need for further and more sustained theoretical and conceptual synergy between OS, medical sociology and health policy, which provides, on the one-hand a cutting-edge and thought-provoking basis for the analysis of contemporary health reforms, and on the other hand, enables the development and elaboration of theory. We emphasize that sociologists and policy analysts in healthcare have been leading contributors to our understanding of organizations in modern society, that OS enhances our understanding of medical settings, and that organizations remain one of the most influential actors of our time. As a starting point to discussion, we outline the genealogy of OS and its application to healthcare settings. We then consider how medical sociology and health policy converge or diverge with the concerns of OS in the study of healthcare settings. Following this, we focus upon the material environment, specifically the position of business schools, which frames the generative dance between OS, medical sociology and health policy. This sets the context for introducing the thirteen articles that constitute the Special Issue of Social Science & Medicine. Copyright © 2011 Elsevier Ltd. All rights reserved.

  6. The Evolution of World Health Organization's Initiatives for the Strengthening of Nursing and Midwifery.

    Science.gov (United States)

    Ventura, Carla Aparecida Arena; Mendes, Isabel Amélia Costa; Fumincelli, Laís; Trevizan, Maria Auxiliadora

    2015-09-01

    To describe the evolution in the resolutions approved by World Health Organization (WHO)'s World Health Assembly (WHA) to strengthen nursing and midwifery. Qualitative and descriptive study, undertaken through a search of resolutions presented by WHA, on the WHO website, regarding the theme "strengthening of nursing and midwifery." The resolutions on the theme "nursing and midwifery" were included, whose titles were available and whose full texts were accessed, excluding those on general health themes. The key words used were resolutions, strengthening, and nursing and midwifery. Among the 20 resolutions found, 12 were selected, adopted between 1948 and 2013, in accordance with the study inclusion criteria. The data were interpreted using thematic qualitative analysis, identifying and grouping the data in categories related to the study theme. Based on the content analysis of the 12 resolutions studied, three thematic categories were defined: "nursing and midwifery in primary health"; "role of nursing and midwifery in health for all"; and "nurses and midwives' professional training." Based on the categories, the evolution in the strengthening of nursing and midwifery was demonstrated through the initiatives and resolutions approved by WHA, highlighting the importance of nurses and midwives as multiprofessional health team members and their fundamental role in the improvements of the health system. Therefore, in accordance with the needs of each country, the member states can implement strategies presented by the WHA resolutions to strengthen nursing and midwifery services. This study has relevance for the development of health policies considering the relevant contributions of nurses and midwives to healthcare systems and services, based on the analysis of WHO resolutions involving these professions. © 2015 Sigma Theta Tau International.

  7. Adaptation and Evaluation of a Multi-Criteria Decision Analysis Model for Lyme Disease Prevention.

    Directory of Open Access Journals (Sweden)

    Cécile Aenishaenslin

    Full Text Available Designing preventive programs relevant to vector-borne diseases such as Lyme disease (LD can be complex given the need to include multiple issues and perspectives into prioritizing public health actions. A multi-criteria decision aid (MCDA model was previously used to rank interventions for LD prevention in Quebec, Canada, where the disease is emerging. The aim of the current study was to adapt and evaluate the decision model constructed in Quebec under a different epidemiological context, in Switzerland, where LD has been endemic for the last thirty years. The model adaptation was undertaken with a group of Swiss stakeholders using a participatory approach. The PROMETHEE method was used for multi-criteria analysis. Key elements and results of the MCDA model are described and contrasted with the Quebec model. All criteria and most interventions of the MCDA model developed for LD prevention in Quebec were directly transferable to the Swiss context. Four new decision criteria were added, and the list of proposed interventions was modified. Based on the overall group ranking, interventions targeting human populations were prioritized in the Swiss model, with the top ranked action being the implementation of a large communication campaign. The addition of criteria did not significantly alter the intervention rankings, but increased the capacity of the model to discriminate between highest and lowest ranked interventions. The current study suggests that beyond the specificity of the MCDA models developed for Quebec and Switzerland, their general structure captures the fundamental and common issues that characterize the complexity of vector-borne disease prevention. These results should encourage public health organizations to adapt, use and share MCDA models as an effective and functional approach to enable the integration of multiple perspectives and considerations in the prevention and control of complex public health issues such as Lyme disease or

  8. Adaptation and Evaluation of a Multi-Criteria Decision Analysis Model for Lyme Disease Prevention.

    Science.gov (United States)

    Aenishaenslin, Cécile; Gern, Lise; Michel, Pascal; Ravel, André; Hongoh, Valérie; Waaub, Jean-Philippe; Milord, François; Bélanger, Denise

    2015-01-01

    Designing preventive programs relevant to vector-borne diseases such as Lyme disease (LD) can be complex given the need to include multiple issues and perspectives into prioritizing public health actions. A multi-criteria decision aid (MCDA) model was previously used to rank interventions for LD prevention in Quebec, Canada, where the disease is emerging. The aim of the current study was to adapt and evaluate the decision model constructed in Quebec under a different epidemiological context, in Switzerland, where LD has been endemic for the last thirty years. The model adaptation was undertaken with a group of Swiss stakeholders using a participatory approach. The PROMETHEE method was used for multi-criteria analysis. Key elements and results of the MCDA model are described and contrasted with the Quebec model. All criteria and most interventions of the MCDA model developed for LD prevention in Quebec were directly transferable to the Swiss context. Four new decision criteria were added, and the list of proposed interventions was modified. Based on the overall group ranking, interventions targeting human populations were prioritized in the Swiss model, with the top ranked action being the implementation of a large communication campaign. The addition of criteria did not significantly alter the intervention rankings, but increased the capacity of the model to discriminate between highest and lowest ranked interventions. The current study suggests that beyond the specificity of the MCDA models developed for Quebec and Switzerland, their general structure captures the fundamental and common issues that characterize the complexity of vector-borne disease prevention. These results should encourage public health organizations to adapt, use and share MCDA models as an effective and functional approach to enable the integration of multiple perspectives and considerations in the prevention and control of complex public health issues such as Lyme disease or other vector

  9. Organizing workplace health literacy to reduce musculoskeletal pain and consequences

    DEFF Research Database (Denmark)

    Larsen, Anne Konring; Holtermann, Andreas; Mortensen, Ole Steen

    2015-01-01

    of the workplace as an arena for improving health literacy has developed emphasizing the organizational responsibility in facilitating and supporting that employees obtain basic knowledge and information needed to understand and take action on individual and occupational health concerns. The literature about...... workplace health literacy is very limited but points at the importance of educating employees to be able to access, appraise and apply health information and of organizing the infrastructure and communication in the organization. This study suggests a concrete operationalization of health literacy...... and effect of workplace health initiatives might be due to the fact that pain and the consequences of pain are affected by various individual, interpersonal and organizational factors in a complex interaction. Recent health literacy models pursue an integrated approach to understanding health behavior...

  10. Evaluating the Mental Health Training Needs of Community-based Organizations Serving Refugees

    Directory of Open Access Journals (Sweden)

    Jennifer Anne Simmelink

    2012-08-01

    Full Text Available This exploratory study examines the mental health knowledge and training needs of refugee-serving community based organizations in a Midwestern state. A survey was administered to 31 staff members at 27 community based organizations (CBOs to assess the ability of staff to recognize and screen for mental health symptoms that may interfere with successful resettlement. Of the 31 respondents 93.5% (n=29 see refugees with mental health issues and 48.4% (n=15 assess refugees for mental health symptoms – primarily through informal assessment. Mainstream organizations were more likely than ethnic organizations to have received training related to the mental health needs of refugees. Results indicate that while refugee led CBOs recognize mental health symptoms of refugees they may be less likely to assess mental health symptoms and refer for treatment. Policy recommendations for improving CBO services to refugees are offered.

  11. Organizational Health Index and Organizational Agility Maturity Criteria as Measurement Tools of Organizational Transformation Effectiveness

    Directory of Open Access Journals (Sweden)

    Swasti Sri Harjanti

    2017-04-01

    Full Text Available Abstract. As a response to negative growth in the mobile legacy projection - which supports 50% of Telkom revenue, and a positive high growth projection in the ICT and digital business revenue, Telkom decides to shift the business to digital. To be a successful digital company, Telkom has created strategic initiatives, including organizational transformation adopting Customer Facing Unit (CFU concept that has been done for several months but there still no evaluation method for the success. This paper purpose is to evaluate the implementation of one human capital management strategic initiatives - CFU transformation implementation success, through Organizational Health Index and Organizational Agility Maturity model and formulate a recommendation for Telkom to create a more healthy and agile organization. This research using 11 synthetized dimension of Organization Health Index and Organizational Agility Maturity Model method as tools. Questionnaire consist of 53 practices that represented by 55 questions that asks about respondents extent to which they agree (satisfaction and whether it meet respondents expectation. Survey result shows that Telkom already in a healthy condition and agile as an organization. This result concluded that by methods used in this research, the transformation could be stated as a success. However, according to the result, maintain and improvement of current health and agility still needed, especially improvement regarding innovation and learning. Keywords:Organization, organizational agility, organizational health index, telecommunication, transformation

  12. 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...

  13. Forest health monitoring: 2005 national technical report

    Science.gov (United States)

    Mark J. Ambrose; Barbara L. Conkling

    2007-01-01

    The Forest Health Monitoring program's annual national technical report presents results of forest health analyses from a national perspective using data from a variety of sources. The report is organized according to the Criteria and Indicators for the Conservation and Sustainable Management of Temperate and Boreal Forests of the Santiago Declaration. The results...

  14. Forest health monitoring: 2006 national technical report

    Science.gov (United States)

    Mark J. Ambrose; Barbara L. Conkling

    2009-01-01

    The Forest Health Monitoring Program’s annual national technical report presents results of forest health analyses from a national perspective using data from a variety of sources. The report is organized according to the Criteria and Indicators for the Conservation and Sustainable Management of Temperate and Boreal Forests of the...

  15. Health and research organization to meet complex needs of developing energy technologies

    International Nuclear Information System (INIS)

    Griffith, R.V.

    1980-01-01

    At the Lawrence Livermore Laboratory, a unique safety technology organization has been established that is especially geared to respond to interdisciplinary health and safety questions in response to rapidly growing energy technology problems. This concept can be adopted by smaller organizations at a more modest cost, and still maintains the efficiency, flexibility, and technical rigor that are needed more and more in support of any industry health and safety problem. The separation of the technology development role from the operation safety organization allows the operational safety specialists to spend more time upgrading the occupational health and safety program but yet provides the opportunity for interchange with health and safety technology development specialists. In fact, a personnel assignment flow between an operational health and safety organization and a special technology development organization provides a mechanism for upgrading the overall safety capability and program provided by a given industrial or major laboratory

  16. Accuracy of clinical diagnosis versus the World Health Organization case definition in the Amoy Garden SARS cohort.

    Science.gov (United States)

    Wong, W N; Sek, Antonio C H; Lau, Rick F L; Li, K M; Leung, Joe K S; Tse, M L; Ng, Andy H W; Stenstrom, Robert

    2003-11-01

    To compare the diagnostic accuracy of emergency department (ED) physicians with the World Health Organization (WHO) case definition in a large community-based SARS (severe acute respiratory syndrome) cohort. This was a cohort study of all patients from Hong Kong's Amoy Garden complex who presented to an ED SARS screening clinic during a 2-month outbreak. Clinical findings and WHO case definition criteria were recorded, along with ED diagnoses. Final diagnoses were established independently based on relevant diagnostic tests performed after the ED visit. Emergency physician diagnostic accuracy was compared with that of the WHO SARS case definition. Sensitivity, specificity, predictive values and likelihood ratios were calculated using standard formulae. During the study period, 818 patients presented with SARS-like symptoms, including 205 confirmed SARS, 35 undetermined SARS and 578 non-SARS. Sensitivity, specificity and accuracy were 91%, 96% and 94% for ED clinical diagnosis, versus 42%, 86% and 75% for the WHO case definition. Positive likelihood ratios (LR+) were 21.1 for physician judgement and 3.1 for the WHO criteria. Negative likelihood ratios (LR-) were 0.10 for physician judgement and 0.67 for the WHO criteria, indicating that clinician judgement was a much more powerful predictor than the WHO criteria. Physician clinical judgement was more accurate than the WHO case definition. Reliance on the WHO case definition as a SARS screening tool may lead to an unacceptable rate of misdiagnosis. The SARS case definition must be revised if it is to be used as a screening tool in emergency departments and primary care settings.

  17. Application of a Framework to Assess the Usefulness of Alternative Sepsis Criteria.

    Science.gov (United States)

    Seymour, Christopher W; Coopersmith, Craig M; Deutschman, Clifford S; Gesten, Foster; Klompas, Michael; Levy, Mitchell; Martin, Gregory S; Osborn, Tiffany M; Rhee, Chanu; Warren, David K; Watson, R Scott; Angus, Derek C

    2016-03-01

    The current definition of sepsis is life-threatening, acute organ dysfunction secondary to a dysregulated host response to infection. Criteria to operationalize this definition can be judged by six domains of usefulness (reliability, content, construct and criterion validity, measurement burden, and timeliness). The relative importance of these six domains depends on the intended purpose for the criteria (clinical care, basic and clinical research, surveillance, or quality improvement [QI] and audit). For example, criteria for clinical care should have high content and construct validity, timeliness, and low measurement burden to facilitate prompt care. Criteria for surveillance or QI/audit place greater emphasis on reliability across individuals and sites and lower emphasis on timeliness. Criteria for clinical trials require timeliness to ensure prompt enrollment and reasonable reliability but can tolerate high measurement burden. Basic research also tolerates high measurement burden and may not need stability over time. In an illustrative case study, we compared examples of criteria designed for clinical care, surveillance and QI/audit among 396,241 patients admitted to 12 academic and community hospitals in an integrated health system. Case rates differed four-fold and mortality three-fold. Predictably, clinical care criteria, which emphasized timeliness and low burden and therefore used vital signs and routine laboratory tests, had the greater case identification with lowest mortality. QI/audit criteria, which emphasized reliability and criterion validity, used discharge information and had the lowest case identification with highest mortality. Using this framework to identify the purpose and apply domains of usefulness can help with the evaluation of existing sepsis diagnostic criteria and provide a roadmap for future work.

  18. [The organization of health services: the comparison as contribution].

    Science.gov (United States)

    Conill, E M; Mendonça, M H; da Silva, R A; Gawryszewski, V

    1991-01-01

    This article discusses about a recent procedure in health care studies, the comparison as a methodology of analysis. The different analytical currents refer to a particular method of understanding health-disease process. They are: functionalism, the historical-materialism and the new currents. Their phylosophical and sociological basis, concepts, analysis instruments and purposes are showed here by a review of the principal works from representative authors as Navarro, Terris, Roemer, Fry, Illich, Capra and others. The paper suggests that comparative analysis can take two directions: the first is a operational approach for analysing the concrete situations of health's service organization, the second, a more conceptual one, aimed at identifying critical questions and international tendencies in health's systems. The recent discussion search for the overcoming of these dichotomies toward the progress of the production of knowledge and its effects in health's services organization.

  19. Criteria of estimation of positive health level in the long-term process of the health training of women of senior age.

    Directory of Open Access Journals (Sweden)

    Prusik Katerina

    2011-09-01

    Full Text Available In the article materials of the three-year looking are utillized after the state of positive health of group of women in age 50-80 years. The method of statistical ground of adequate control indexes is shown for the estimation of bodily condition of inspected. The use of high-quality criteria is offered for the estimation of efficiency of physical exercises on the Norwegian method of walking with sticks.

  20. Secure eHealth-Care Service on Self-Organizing Software Platform

    Directory of Open Access Journals (Sweden)

    Im Y. Jung

    2014-01-01

    Full Text Available There are several applications connected to IT health devices on the self-organizing software platform (SoSp that allow patients or elderly users to be cared for remotely by their family doctors under normal circumstances or during emergencies. An evaluation of the SoSp applied through PAAR watch/self-organizing software platform router was conducted targeting a simple user interface for aging users, without the existence of extrasettings based on patient movement. On the other hand, like normal medical records, the access to, and transmission of, health information via PAAR watch/self-organizing software platform requires privacy protection. This paper proposes a security framework for health information management of the SoSp. The proposed framework was designed to ensure easy detection of identification information for typical users. In addition, it provides powerful protection of the user’s health information.

  1. Feeding trials in organic food quality and health research

    DEFF Research Database (Denmark)

    Velimirov, Alberta; Huber, Machteld; Lauridsen, Charlotte

    2010-01-01

    Feeding experiments comparing organically and conventionally produced food are performed to assess the overall impact on the animals' health as a model for the effects experienced by the human consumers. These experiments are based on systems research and characterized by their focus on production...... research is not just about simple cause-effect chains, but rather about the pluralism of interactions in biological networks; therefore, the interpretation of the outcome of whole food experiments is difficult. Furthermore, the test diets of organic and conventional origin can be constituted in different...... methods, whole food testing and procedures in accordance with the terms of organic farming. A short review of such experiments shows that the majority of these tests revealed effects of the organically produced feed on health parameters such as reproductive performance and immune responses. Systems...

  2. Oral Health Care Delivery Within the Accountable Care Organization.

    Science.gov (United States)

    Blue, Christine; Riggs, Sheila

    2016-06-01

    The accountable care organization (ACO) provides an opportunity to strategically design a comprehensive health system in which oral health works within primary care. A dental hygienist/therapist within the ACO represents value-based health care in action. Inspired by health care reform efforts in Minnesota, a vision of an accountable care organization that integrates oral health into primary health care was developed. Dental hygienists and dental therapists can help accelerate the integration of oral health into primary care, particularly in light of the compelling evidence confirming the cost-effectiveness of care delivered by an allied workforce. A dental insurance Chief Operating Officer and a dental hygiene educator used their unique perspectives and experience to describe the potential of an interdisciplinary team-based approach to individual and population health, including oral health, via an accountable care community. The principles of the patient-centered medical home and the vision for accountable care communities present a paradigm shift from a curative system of care to a prevention-based system that encompasses the behavioral, social, nutritional, economic, and environmental factors that impact health and well-being. Oral health measures embedded in the spectrum of general health care have the potential to ensure a truly comprehensive healthcare system. Published by Elsevier Inc.

  3. The World Health Organization Quality of Live assessment (WHOQOL) : Position paper from the the World Health organization

    NARCIS (Netherlands)

    Kuyken, W.; Orley, J.; Power, M.; HERRMAN, H; Schofield, H.; Murphy, B.; Metelko, Z.; Szabo, S.; PIBERNIKOKANOVIC, M; Quemada, N.; Caria, A.; Rajkumar, S.; Kumar, S.; Saxena, S.; BARON, D; Amir, M.; TAZAKI, M; Noji, A.; VANHECK, G; DEVRIES, J; SUCRE, JA; PICARDAMI, L; KABANOV, M; LOMACHENKOV, A; BURKOVSKY, G; Lucas-Carrasco, R.; BODHARAMIK, Y; MEESAPYA, K; Skevington, S.M.; Patrick, D.L.; Martin-Jones, M.; WILD, D; ACUDA, W; MUTAMBIRWA, J; Aaronson, N.K.; BECH, P; BULLINGER, M; CHEN, HN; FOXRUSHBY, J; MOINPOUR, C; ROSSER, R; BUESCHING, D; BUCQUET, D; CHAMBERS, LW; JAMBON, B; JENKINS, CD; DELEO, D; FALLOWFIELD, L; GERIN, P; GRAHAM, P; GUREJE, O; KALUMBA, K; KERRCORREA,; MERCIER, C; OLIVER, J; Poortinga, Y.H.; TROTTER, R; VANDAM, F

    1995-01-01

    This paper describes the World Health Organization's project to develop a quality of life instrument (The WHOQOL). WHOQOL)It outlines the reasons that the project was undertaken, the thinking that underlies the project, the method that has been followed in its development and the current status of

  4. Faith and Health: Past and Present of Relations between Faith Communities and the World Health Organization

    Directory of Open Access Journals (Sweden)

    The Rev. Canon Ted Karpf

    2014-01-01

    Full Text Available Relationships between faith communities and international multi-lateral organizations can be complicated. While there is potential for synergy between the two, different values often characterize the approach of each. The history of these relationships is illustrative. This review describes collaboration between the World Health Organization (WHO and faith-based organizations (FBOs in the implementation of primary health care, the role of spirituality in health, community responses to the HIV pandemic, and definitions of Quality of Life containing spiritual dimensions. However, important gaps persist in the appreciation and measurement of the contribution of faith communities to health assets on the part of governments and the WHO. FBOs can still draw from the nine points developed in the 1960s as a time-tested viable agenda for current and future operations.

  5. 77 FR 57567 - Single Source Cooperative Agreement Award for World Health Organization

    Science.gov (United States)

    2012-09-18

    ... Organization AGENCY: Department of Health and Human Services (HHS), Assistant Secretary for Preparedness and... Organization for a grant titled: ``Smallpox Research Oversight Activities: WHO Advisory Committee on Variola... notification to World Health Organization (WHO) as soon as possible, and any confirmed smallpox case would...

  6. Building IT capability in health-care organizations.

    Science.gov (United States)

    Khatri, Naresh

    2006-05-01

    While computer technology has revolutionized industries such as banking and airlines, it has done little for health care so far. Most of the health-care organizations continue the early-computer-era practice of buying the latest technology without knowing how it might effectively be employed in achieving business goals. By investing merely in information technology (IT) rather than in IT capabilities they acquire IT components--primarily hardware, software, and vendor-provided services--which they do not understand and, as a result, are not capable of fully utilizing for achieving organizational objectives. In the absence of internal IT capabilities, health-care organizations have relied heavily on the fragmented IT vendor market in which vendors do not offer an open architecture, and are unwilling to offer electronic interfaces that would make their 'closed' systems compatible with those of other vendors. They are hamstrung as a result because they have implemented so many different technologies and databases that information stays in silos. Health systems can meet this challenge by developing internal IT capabilities that would allow them to seamlessly integrate clinical and business IT systems and develop innovative uses of IT. This paper develops a comprehensive conception of IT capability grounded in the resource-based theory of the firm as a remedy to the woes of IT investments in health care.

  7. Health Care Organizations and Policy Leadership: Perspectives on Nonsmoker-Only Hiring Policies.

    Science.gov (United States)

    McDaniel, Patricia A; Malone, Ruth E

    2018-02-01

    To explore employers' decisions to base hiring policies on tobacco or nicotine use and community perspectives on such policies, and analyze the implications for organizational identity, community engagement, and health promotion. From 2013 to 2016, 11 executives from six health care organizations and one non-health-care organization with nonsmoker-only hiring policies were interviewed about why and how their policies were created and implemented, concerns about the policies, and perceptions of employee and public reactions. Focus groups were conducted with community members (n = 51) who lived in or near cities where participating employers were based, exploring participants' opinions about why an employer would stop hiring smokers and their support (or not) for such a policy. Most employers excluded from employment those using all forms of nicotine. Several explained their adoption of the policy as a natural extension of a smoke-free campus and as consistent with their identity as health care organizations. They regarded the policy as promoting health. No employer mentioned engaging in a community dialogue before adopting the policy or reported efforts to track the policy's impact on rejected applicants. Community members understood the cost-saving appeal of such policies, but most opposed them. They made few exceptions for health care organizations. Policy decisions undertaken by health care organizations have influence beyond their immediate setting and may establish precedents that others follow. Nonsmoker-only hiring policies may fit with a health care organization's institutional identity but may not be congruent with community values or promote public health.

  8. [Organizational well-being in public health. Climate survey in a Piedmont public health organization].

    Science.gov (United States)

    Agnelli, Ileana; Saglietti, Daniele; Zotti, Anna Maria

    2010-01-01

    More and more Italian and European directives refers to organizational health promotion in work placements. As a matter of fact, organization well-being implies important benefits for individuals and improves business efficiency/efficacy. Improving factors involve listening tools aimed to analyze critical situations and needs, focus on working teams and communication development. In this respect, in a public health organization in Piedmont a research was devised for planning interventions of organizational health promotion and improvement, relying on climate analysis. The research process was supported by General Direction and involved the head of physicians and the departments CPSE (Coordinatore Professionale Sanitario Esperto: Professional Health Coordinator). The survey was carried out on the organizational population, focusing on teambuilding, which is the core of daily work life. Team Climate Inventory Questionnaire (TCI) was employed and administered on-line. Beyond the 5 original factorial scales, 6 item groups related to the individuals feeling in working team and consistent with the research interests were identified. 75.42% (n=1264) of employees answered the provided questionnaire. The data highlighted average scores--expressing organizational climate--over other public health organization data. The subjects also showed a good organizational climate perception. Elderly workers appeared more satisfied than the young ones. Furthermore, higher educated subjects took more advantage of technical and organizational supports.

  9. Validation of the Rome III criteria and alarm symptoms for recurrent abdominal pain in children

    NARCIS (Netherlands)

    Gijsbers, Carolien F. M.; Benninga, Marc A.; Schweizer, Joachim J.; Kneepkens, C. M. Frank; Vergouwe, Yvonne; Büller, Hans A.

    2014-01-01

    Rome criteria were formulated to define functional gastrointestinal disorders (Rome III criteria, 2006) excluding organic diagnoses when alarm symptoms were absent. The aims of the study were to validate the Rome III criteria as to their capacity to differentiate between organic and functional

  10. Comparison of rates of potentially inappropriate medication use according to the Zhan criteria for VA versus private sector medicare HMOs.

    Science.gov (United States)

    Barnett, Mitchell J; Perry, Paul J; Langstaff, Jodi D; Kaboli, Peter J

    2006-06-01

    Inappropriate prescribing in the elderly is common, but rates across different health care systems and the impact of formulary restrictions are not well described. To determine if rates of inappropriate medication use in the elderly differ between the Veterans Affairs (VA) health care system and the private sector Medicare health maintenance organization (HMO) patients. A cross-sectional study design compared administrative pharmacy claims from 10 distinct geographic regions in the United States in the VA health care system and 10 analogous regions for patients enrolled in Medicare HMOs. The cohorts included 123,633 VA and 157,517 Medicare HMO patients aged 65 years and older. Inappropriate medication use was identified using the Zhan modification of the Beers criteria, which categorizes 33 potentially inappropriate drugs into 3 major classifications: "always avoid," "rarely appropriate," and "some indications." Comparisons between the VA health care system and the private sector Medicare HMO were performed for overall differences and stratified by gender and age. The drug formulary status of the Zhan-criteria drugs was known for the VA health system but not for the Medicare HMO patients. Compared with private sector patients, VA patients were less likely to receive any inappropriate medication (21% vs. 29%, P private sector for males (21% vs. 24%, P private sector Medicare HMOs, elderly VA patients were less likely to receive medications defined by the Zhan criteria as potentially inappropriate. A restrictive formulary that excludes 12 of the 33 Zhan criteria drugs may be a factor in the reduction of undesired prescribing patterns in elderly populations.

  11. The case for the World Health Organization's Commission on Social Determinants of Health to address gender identity.

    Science.gov (United States)

    Pega, Frank; Veale, Jaimie F

    2015-03-01

    We analyzed the case of the World Health Organization's Commission on Social Determinants of Health, which did not address gender identity in their final report. We argue that gender identity is increasingly being recognized as an important social determinant of health (SDH) that results in health inequities. We identify right to health mechanisms, such as established human rights instruments, as suitable policy tools for addressing gender identity as an SDH to improve health equity. We urge the World Health Organization to add gender identity as an SDH in its conceptual framework for action on the SDHs and to develop and implement specific recommendations for addressing gender identity as an SDH.

  12. Objectivity applied to embodied subjects in health care and social security medicine: definition of a comprehensive concept of cognitive objectivity and criteria for its application.

    Science.gov (United States)

    Solli, Hans Magnus; Barbosa da Silva, António

    2018-03-02

    The article defines a comprehensive concept of cognitive objectivity (CCCO) applied to embodied subjects in health care. The aims of this study were: (1) to specify some necessary conditions for the definition of a CCCO that will allow objective descriptions and assessments in health care, (2) to formulate criteria for application of such a CCCO, and (3) to investigate the usefulness of the criteria in work disability assessments in medical certificates from health care provided for social security purposes. The study design was based on a philosophical conceptual analysis of objectivity and subjectivity, the phenomenological notions 'embodied subject', 'life-world', 'phenomenological object' and 'empathy', and an interpretation of certificates as texts. The study material consisted of 18 disability assessments from a total collection of 86 medical certificates provided for social security purposes, written in a Norwegian hospital-based mental health clinic. Four necessary conditions identified for defining a CCCO were: (A) acknowledging the patient's social context and life-world, (B) perceiving patients as cognitive objects providing a variety of meaningful data (clinical, psychometric, and behavioural data - i.e. activities and actions, meaningful expressions and self-reflection), (C) interpreting data in context, and (D) using general epistemological principles. The criteria corresponding to these conditions were: (a) describing the patient's social context and recognizing the patient's perspective, (b) taking into consideration a variety of quantitative and qualitative data drawn from the clinician's perceptions of the patient as embodied subject, (c) being aware of the need to interpret the data in context, and (d) applying epistemological principles (professional expertise, dialogical intersubjectivity, impartiality, accuracy and correctness). Genuine communication is presupposed. These criteria were tested in the work disability assessments of medical

  13. 76 FR 71345 - Patient Safety Organizations: Voluntary Relinquishment From Child Health Patient Safety...

    Science.gov (United States)

    2011-11-17

    ... Organizations: Voluntary Relinquishment From Child Health Patient Safety Organization, Inc. AGENCY: Agency for... notification of voluntary relinquishment from Child Health Patient Safety Organization, Inc. of its status as a Patient Safety Organization (PSO). The Patient Safety and Quality Improvement Act of 2005 (Patient Safety...

  14. Introduction to: The Forest Health monitoring program

    Science.gov (United States)

    Barbara L. Conkling

    2011-01-01

    The National Forest Health Monitoring (FHM) Program of the Forest Service, U.S. Department of Agriculture, produces an annual technical report on forest health as one of its products. The report is organized using the Criteria and Indicators for the Conservation and Sustainable Management of Temperate and Boreal Forests (Montréal Process Working Group 2007) as a...

  15. Animal health and welfare in production systems for organic fattening pigs

    DEFF Research Database (Denmark)

    Lindgren, Kristina; Bochicchio, Davide; Hegelund, Lene

    2014-01-01

    and conventional production. Conventional Danish herds consumed three times as much antibiotics (anthelmintics not included) as the organic herds, whilst there was no difference in mortality rate nor more pigs in need of treatment in the organic herds. Slaughter data indicated that organic pigs had fewer...... and aggression. Minimizing negative environmental impact may conflict with animal welfare, i.e. raising the pigs indoors may not only reduce plant nutrient losses but also reduce the pigs’ activity options. With an increasing number of specialized organic units, implementation of age-segregated production......With the aim to identify European health and welfare strategies in organic pig production, we summarized information about health and welfare status and potential hazards for organic fattening pigs. The results were primarily based on studies of organic production or comparisons between organic...

  16. Crew Transportation Technical Standards and Design Evaluation Criteria

    Science.gov (United States)

    Lueders, Kathryn L.; Thomas, Rayelle E. (Compiler)

    2015-01-01

    Crew Transportation Technical Standards and Design Evaluation Criteria contains descriptions of technical, safety, and crew health medical processes and specifications, and the criteria which will be used to evaluate the acceptability of the Commercial Providers' proposed processes and specifications.

  17. Organizational capacity for chronic disease prevention: a survey of Canadian public health organizations.

    Science.gov (United States)

    Hanusaik, Nancy; O'Loughlin, Jennifer L; Kishchuk, Natalie; Paradis, Gilles; Cameron, Roy

    2010-04-01

    There are no national data on levels of organizational capacity within the Canadian public health system to reduce the burden of chronic disease. Cross-sectional data were collected in a national survey (October 2004 to April 2005) of all 216 national, provincial and regional-level organizations engaged in chronic disease prevention through primary prevention or healthy lifestyle promotion. Levels of organizational capacity (defined as skills and resources to implement chronic disease prevention programmes), potential determinants of organizational capacity and involvement in chronic disease prevention programming were compared in western, central and eastern Canada and across three types of organizations (formal public health organizations, non-governmental organizations and grouped organizations). Forty percent of organizations were located in Central Canada. Approximately 50% were formal public health organizations. Levels of skill and involvement were highest for activities that addressed tobacco control and healthy eating; lowest for stress management, social determinants of health and programme evaluation. The few notable differences in skill levels by provincial grouping favoured Central Canada. Resource adequacy was rated low across the country; but was lowest in eastern Canada and among formal public health organizations. Determinants of organizational capacity (organizational supports and partnerships) were highest in central Canada and among grouped organizations. These data provide an evidence base to identify strengths and gaps in organizational capacity and involvement in chronic disease prevention programming in the organizations that comprise the Canadian public health system.

  18. World Health Organization Member States and Open Health Data: An Observational Study

    Directory of Open Access Journals (Sweden)

    Charles J Greenberg

    2016-09-01

    Full Text Available Background Open health data has implications for clinical care, research, public health, and health policy at regional, national, and global levels. No published attempts have been made to determine, collectively, whether WHO member states and governments have embraced the promise and effort required to officially share open health data. The observational study will provide evidence that World Health Organization (WHO member states individually and collectively have adopted open data recommended principles, providing access to open health data. Methods Using the WHO list of member states (n=194, the researchers identified the presence of open health data or initiatives. With each country, the following types of official government web pages were recorded: a Ministry of Health web page; a conspicuous link on a government web page to open health data; additional government health web sites; national government-sponsored open data repositories; unique attributes of national health data web sites; and adherence to the principles of open government data for health. A supplemental PDF file provides a representation of data used for analysis and observations. Our complete data is available at: https://goo.gl/Kwj7mb Observations and Discussion Open health data is easily discoverable in less than one-third of the WHO member states. 13 nations demonstrate the principle to provide comprehensive open data. Only 16 nations distribute primary, non-aggregated health data. 24 % of the WHO observed member states are providing some health data in a non-proprietary formats such as comma-separated values. The sixth, seventh, and eighth open government data principles for health, representing universal access, non-proprietary formats, and non-patent protection, are observed in about one-third of the WHO member states. While there are examples of organized national open health data, no more than a one-third minority of the world’s nations have portals set up to

  19. Addressing mental health through sport: a review of sporting organizations' websites.

    Science.gov (United States)

    Liddle, Sarah K; Deane, Frank P; Vella, Stewart A

    2017-04-01

    Mental health is a major concern among adolescents. Most mental illnesses have their onset during this period, and around 14% of all young people aged 12 to 17 years experience a mental illness in a 12-month period. However, only 65% of these adolescents access health services to address their mental health problems. Approximately 70% of all Australian adolescents participate in sport, and this presents an opportunity for mental health promotion. This paper reviewed current approaches by sporting organizations to mental health promotion, prevention and early intervention by searching peak body websites, as well as the wider Internet. Findings revealed many of the sport organizations reviewed acknowledged the importance of mental components of their sport to increase competitiveness, but few explicitly noted mental health problems or the potential of their sport to promote good mental health. Although some had participated in mental health promotion campaigns, there was no evaluation or reference to the evidence base for these campaigns. We describe a framework for integrating mental health promotion into sports organizations based on the MindMatters programme for schools. © 2016 John Wiley & Sons Australia, Ltd.

  20. American Mock World Health Organization: An Innovative Model for Student Engagement in Global Health Policy

    Science.gov (United States)

    Lei, Mia; Acharya, Neha; Kwok Man Lee, Edith; Catherine Holcomb, Emma; Kapoor, Veronica

    2017-01-01

    ABSTRACT The American Mock World Health Organization (AMWHO) is a model for experiential-based learning and student engagement in global health diplomacy. AMWHO was established in 2014 at the University of North Carolina at Chapel Hill with a mission to engage students in health policy by providing a simulation of the World Health Assembly (WHA), the policy-forming body of the World Health Organization that sets norms and transforms the global health agenda. AMWHO conferences are designed to allow students to take their knowledge of global health beyond the classroom and practice their skills in diplomacy by assuming the role of WHA delegates throughout a 3-day weekend. Through the process of developing resolutions like those formed in the WHA, students have the unique opportunity to understand the complexities behind the conflict and compromise that ensues through the lens of a stakeholder. This article describes the structure of the first 2 AMWHO international conferences, analyzes survey results from attendees, and discusses the expansion of the organization into a multi-campus national network. The AMWHO 2014 and 2015 post-conference survey results found that 98% and 90% of participants considered the conference "good" or "better," respectively, and survey responses showed that participants considered the conference "influential" in their careers and indicated that it "allowed a paradigm shift not possible in class." PMID:28351883

  1. Investigation on vibrational evaluation criteria for small-bore pipe

    International Nuclear Information System (INIS)

    Tsuji, Takashi; Maekawa, Akira; Takahashi, Tsuneo; Kato, Minoru; Torigoe, Yuichi

    2013-01-01

    The well-known organization such as API and SwRI in USA developed criteria for piping vibrational evaluation. These criteria are targeted for main pipes, but not branch pipes with small bore. In this study, applicability of criteria of API and SwRI to branch pipes was investigated. Vibration test using piping system with small bore branch pipe was conducted and amplitudes of vibrational stress and displacement were measured for various exciting force. In comparison of the measurements with the two criteria, though the criteria of API and SwRI were applicable to small bore branch pipe, they made too conservative evaluation. (author)

  2. Health care: a community concern? : developments in the organization of Canadian health services

    National Research Council Canada - National Science Library

    Crichton, Anne

    1997-01-01

    ... Canadian Health Care Organizational Policies 1967-86 IV Service Delivery Systems and Their Response to the Need for Change to a Collective Care Organization 9. Care in the Doctor's Office 10. Support Services for Physicians in General Practice 11. Medical Practice Organization: Alternative Medical Care Delivery Models 12. Evolution of Public H...

  3. Advancing the right to health through global organizations: The potential role of a Framework Convention on Global Health.

    Science.gov (United States)

    Friedman, Eric A; Gostin, Lawrence O; Buse, Kent

    2013-06-14

    Organizations, partnerships, and alliances form the building blocks of global governance. Global health organizations thus have the potential to play a formative role in determining the extent to which people are able to realize their right to health. This article examines how major global health organizations, such as WHO, the Global Fund to Fight AIDS, TB and Malaria, UNAIDS, and GAVI approach human rights concerns, including equality, accountability, and inclusive participation. We argue that organizational support for the right to health must transition from ad hoc and partial to permanent and comprehensive. Drawing on the literature and our knowledge of global health organizations, we offer good practices that point to ways in which such agencies can advance the right to health, covering nine areas: 1) participation and representation in governance processes; 2) leadership and organizational ethos; 3) internal policies; 4) norm-setting and promotion; 5) organizational leadership through advocacy and communication; 6) monitoring and accountability; 7) capacity building; 8) funding policies; and 9) partnerships and engagement. In each of these areas, we offer elements of a proposed Framework Convention on Global Health (FCGH), which would commit state parties to support these standards through their board membership and other interactions with these agencies. We also explain how the FCGH could incorporate these organizations into its overall financing framework, initiate a new forum where they collaborate with each other, as well as organizations in other regimes, to advance the right to health, and ensure sufficient funding for right to health capacity building. We urge major global health organizations to follow the leadership of the UN Secretary-General and UNAIDS to champion the FCGH. It is only through a rights-based approach, enshrined in a new Convention, that we can expect to achieve health for all in our lifetimes. Copyright © 2013 Friedman, Gostin

  4. Healthcare organization-education partnerships and career ladder programs for health care workers.

    Science.gov (United States)

    Dill, Janette S; Chuang, Emmeline; Morgan, Jennifer C

    2014-12-01

    Increasing concerns about quality of care and workforce shortages have motivated health care organizations and educational institutions to partner to create career ladders for frontline health care workers. Career ladders reward workers for gains in skills and knowledge and may reduce the costs associated with turnover, improve patient care, and/or address projected shortages of certain nursing and allied health professions. This study examines partnerships between health care and educational organizations in the United States during the design and implementation of career ladder training programs for low-skill workers in health care settings, referred to as frontline health care workers. Mixed methods data from 291 frontline health care workers and 347 key informants (e.g., administrators, instructors, managers) collected between 2007 and 2010 were analyzed using both regression and fuzzy-set qualitative comparative analysis (QCA). Results suggest that different combinations of partner characteristics, including having an education leader, employer leader, frontline management support, partnership history, community need, and educational policies, were necessary for high worker career self-efficacy and program satisfaction. Whether a worker received a wage increase, however, was primarily dependent on leadership within the health care organization, including having an employer leader and employer implementation policies. Findings suggest that strong partnerships between health care and educational organizations can contribute to the successful implementation of career ladder programs, but workers' ability to earn monetary rewards for program participation depends on the strength of leadership support within the health care organization. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. Recommended criteria for the evaluation of on-site nuclear power plant emergency plans, volume II: criteria

    International Nuclear Information System (INIS)

    1997-01-01

    A critical review of existing Canadian and international nuclear power plant (NPP) emergency plans, evaluation criteria, and approaches has been conducted to provide AECB staff with information which can be used to assess the adequacy of NPP on-site emergency response plans. The results of this work are published in two volumes. Volume I, Basis Document, provides the reasons why certain requirements are in place. It also gives comprehensive references to various standards.Volume II, Criteria, contains the criteria which relate to on-site actions and their integration with control room activities and the roles of off-site responsible organizations. The recommended criteria provide information on what is required, and not on how to accomplish the requirements. The licensees are given the latitude to decide on the methods and processes needed to meet the requirements. The documents do not address NPP off-site plans and response capability, or the control room emergency operating procedures and response capability. This report contains only Volume II: Criteria. 55 refs., 2 tabs., 1 fig

  6. Dismissal: Important criteria in managerial decision-making

    Directory of Open Access Journals (Sweden)

    Fabricio Stocker

    2018-04-01

    Full Text Available Knowledge about dismissal decision-making, particularly concerning the criteria used by managers in choosing who will be dismissed and why, is scarce. Considering the implications of such decisions for organizations and society, in this paper, we identify the seven most frequently used criteria in dismissal decisions and examine their importance for managers. We collected data through a survey among 385 managers and used the rational ranking and the multicriteria Analytic Hierarchy Process (AHP to analyze them. The results show that commitment, performance records, and trust have the greatest impact on the dismissal decision, whereas interpersonal relationship, growth potential, and professional experience are considered secondary criteria. These results contribute to extending our knowledge about dismissal decisions and showing the most relevant criteria in these choices and the relevance assigned to each of the criteria so that greater transparency can be achieved.

  7. Understanding the organization of public health delivery systems: an empirical typology.

    Science.gov (United States)

    Mays, Glen P; Scutchfield, F Douglas; Bhandari, Michelyn W; Smith, Sharla A

    2010-03-01

    Policy discussions about improving the U.S. health care system increasingly recognize the need to strengthen its capacities for delivering public health services. A better understanding of how public health delivery systems are organized across the United States is critical to improvement. To facilitate the development of such evidence, this article presents an empirical method of classifying and comparing public health delivery systems based on key elements of their organizational structure. This analysis uses data collected through a national longitudinal survey of local public health agencies serving communities with at least 100,000 residents. The survey measured the availability of twenty core public health activities in local communities and the types of organizations contributing to each activity. Cluster analysis differentiated local delivery systems based on the scope of activities delivered, the range of organizations contributing, and the distribution of effort within the system. Public health delivery systems varied widely in organizational structure, but the observed patterns of variation suggested that systems adhere to one of seven distinct configurations. Systems frequently migrated from one configuration to another over time, with an overall trend toward offering a broader scope of services and engaging a wider range of organizations. Public health delivery systems exhibit important structural differences that may influence their operations and outcomes. The typology developed through this analysis can facilitate comparative studies to identify which delivery system configurations perform best in which contexts.

  8. Latina Workers in North Carolina: Work Organization, Domestic Responsibilities, Health, and Family Life.

    Science.gov (United States)

    Rodriguez, Guadalupe; Trejo, Grisel; Schiemann, Elizabeth; Quandt, Sara A; Daniel, Stephanie S; Sandberg, Joanne C; Arcury, Thomas A

    2016-06-01

    This analysis describes the work organization and domestic work experienced by migrant Latinas, and explores the linkage between work and health. Twenty Latina workers in North Carolina with at least one child under age 12 completed in-depth interviews focused on their work organization, domestic responsibilities, work-family conflict, health, and family health. Using a systematic qualitative analysis, these women described a demanding work organization that is contingent and exploitative, with little control or support. They also described demanding domestic roles, with gendered and unequal division of household work. The resulting work-family conflict affects their mental and physical health, and has negative effects on the care and health of their families. The findings from this study highlight that work stressors from an unfavorable work organization create work-family conflict, and that work-family conflict in this population has a negative influence on workers' health and health behaviors.

  9. The World Health Organization: Is It Still Relevant?

    Science.gov (United States)

    Ferguson, Stephanie L

    2015-01-01

    The World Health Organization (WHO) is the United Nation's lead agency for directing and coordinating health. As leaders, nurse executives must advocate for a stronger nursing and midwifery health policy agenda at the global level and a seat at the table on WHO's technical advisory bodies and expert committees. There are no more borders as nurse executives; we are global citizens, leading global change. Nurse leaders hold the master key to shape the world's policies for sustainable global development.

  10. Assessment of health-care waste disposal methods using a VIKOR-based fuzzy multi-criteria decision making method.

    Science.gov (United States)

    Liu, Hu-Chen; Wu, Jing; Li, Ping

    2013-12-01

    Nowadays selection of the appropriate treatment method in health-care waste (HCW) management has become a challenge task for the municipal authorities especially in developing countries. Assessment of HCW disposal alternatives can be regarded as a complicated multi-criteria decision making (MCDM) problem which requires consideration of multiple alternative solutions and conflicting tangible and intangible criteria. The objective of this paper is to present a new MCDM technique based on fuzzy set theory and VIKOR method for evaluating HCW disposal methods. Linguistic variables are used by decision makers to assess the ratings and weights for the established criteria. The ordered weighted averaging (OWA) operator is utilized to aggregate individual opinions of decision makers into a group assessment. The computational procedure of the proposed framework is illustrated through a case study in Shanghai, one of the largest cities of China. The HCW treatment alternatives considered in this study include "incineration", "steam sterilization", "microwave" and "landfill". The results obtained using the proposed approach are analyzed in a comparative way. Copyright © 2013. Published by Elsevier Ltd.

  11. Environment Health & Safety Research Program. Organization and 1979-1980 Publications

    Energy Technology Data Exchange (ETDEWEB)

    None

    1981-01-01

    This document was prepared to assist readers in understanding the organization of Pacific Northwest Laboratory, and the organization and functions of the Environment, Health and Safety Research Program Office. Telephone numbers of the principal management staff are provided. Also included is a list of 1979 and 1980 publications reporting on work performed in the Environment, Health and Safety Research Program, as well as a list of papers submitted for publication.

  12. 7 CFR 3052.525 - Criteria for Federal program risk.

    Science.gov (United States)

    2010-01-01

    ... ORGANIZATIONS Auditors § 3052.525 Criteria for Federal program risk. (a) General. The auditor's determination... to the Federal program. The auditor shall use auditor judgment and consider criteria, such as... part of the risk analysis, the auditor may wish to discuss a particular Federal program with auditee...

  13. Animal Health and Welfare Planning in Organic Dairy Cattle Farms

    DEFF Research Database (Denmark)

    Vaarst, Mette; Winckler, Christoph; Roderick, Stephen

    2011-01-01

    Continuous development is needed within the farm to reach the goal of good animal health and welfare in organic livestock farming. The very different conditions between countries call for models that are relevant for different farming types and can be integrated into local practice and be relevant...... for each type of farming context. This article reviews frameworks, principles and practices for animal health and welfare planning which are relevant for organic livestock farming. This review is based on preliminary analyses carried out within a European project (acronym ANIPLAN) with participants from...... as well as animal health and welfare professionals (veterinarians and advisors) is paramount. This paper provides an overview of some current animal health and welfare planning initiatives and explains the principles of animal health and welfare planning which are being implemented in ANIPLAN partner...

  14. Consumption of organic and functional food. A matter of well-being and health?

    Science.gov (United States)

    Goetzke, Beate; Nitzko, Sina; Spiller, Achim

    2014-06-01

    Health is an important motivation for the consumption of both organic and functional foods. The aim of this study was to clarify to what extent the consumption of organic and functional foods are characterized by a healthier lifestyle and a higher level of well-being. Moreover, the influence of social desirability on the respondents' response behavior was of interest and was also analyzed. Well-being and health was measured in a sample of 555 German consumers at two levels: the cognitive-emotional and the behavioral level. The results show that although health is an important aspect for both functional food and organic food consumption, these two forms of consumption were influenced by different understandings of health: organic food consumption is influenced by an overall holistic healthy lifestyle including a healthy diet and sport, while functional food consumption is characterized by small "adjustments" to lifestyle to enhance health and to increase psychological well-being. An overlap between the consumption of organic and functional food was also observed. This study provides information which enables a better characterization of the consumption of functional food and organic food in terms of well-being and health. Copyright © 2014 Elsevier Ltd. All rights reserved.

  15. Assessing Capacity of Faith-Based Organizations for Health Promotion Activities.

    Science.gov (United States)

    Tagai, Erin Kelly; Scheirer, Mary Ann; Santos, Sherie Lou Z; Haider, Muhiuddin; Bowie, Janice; Slade, Jimmie; Whitehead, Tony L; Wang, Min Qi; Holt, Cheryl L

    2017-10-01

    Faith-based organizations (FBOs) are important venues for health promotion, particularly in medically underserved communities. These organizations vary considerably in their structural capacities, which may be linked to variability in implementation success for health promotion initiatives. Lacking an existing validated assessment of organizational capacity specific to FBOs, an initial prototype assessment was developed. The Faith-Based Organization Capacity Inventory (FBO-CI) assesses three structural areas of capacity: Staffing and Space, Health Promotion Experience, and External Collaboration. The multidisciplinary team, including FBO leaders, codeveloped the initial instrument. The initial reliability from a convenience sample of 34 African American churches including descriptions of FBOs representing three capacity levels is reported. The FBO-CI demonstrated feasibility of administration using an in-person interview format, and the three subscales had acceptable internal reliability (α ~ .70). Most churches had an established health ministry (n = 23) and had conducted activities across an average of seven health areas in the previous 2 years. This initial FBO-CI prototype is promising, and future work should consider validation with a larger sample of churches and domain expansion based on the conceptual model. The FBO-CI has a number of potential uses for researchers, FBO leaders, and practitioners working with FBOs in health promotion initiatives.

  16. How to achieve care coordination inside health care organizations

    DEFF Research Database (Denmark)

    Prætorius, Thim; C. Becker, Markus

    2015-01-01

    Understanding how health care organizations can achieve care coordination internally is essential because it is difficult to achieve, but essential for high quality and efficient health care delivery. This article offers an answer by providing a synthesis of knowledge about coordination from...

  17. Competition between health maintenance organizations and nonintegrated health insurance companies in health insurance markets.

    Science.gov (United States)

    Baranes, Edmond; Bardey, David

    2015-12-01

    This article examines a model of competition between two types of health insurer: Health Maintenance Organizations (HMOs) and nonintegrated insurers. HMOs vertically integrate health care providers and pay them at a competitive price, while nonintegrated health insurers work as indemnity plans and pay the health care providers freely chosen by policyholders at a wholesale price. Such difference is referred to as an input price effect which, at first glance, favors HMOs. Moreover, we assume that policyholders place a positive value on the provider diversity supplied by their health insurance plan and that this value increases with the probability of disease. Due to the restricted choice of health care providers in HMOs a risk segmentation occurs: policyholders who choose nonintegrated health insurers are characterized by higher risk, which also tends to favor HMOs. Our equilibrium analysis reveals that the equilibrium allocation only depends on the number of HMOs in the case of exclusivity contracts between HMOs and providers. Surprisingly, our model shows that the interplay between risk segmentation and input price effects may generate ambiguous results. More precisely, we reveal that vertical integration in health insurance markets may decrease health insurers' premiums.

  18. Multiple Criteria Decision Analysis for Health Care Decision Making--An Introduction: Report 1 of the ISPOR MCDA Emerging Good Practices Task Force.

    Science.gov (United States)

    Thokala, Praveen; Devlin, Nancy; Marsh, Kevin; Baltussen, Rob; Boysen, Meindert; Kalo, Zoltan; Longrenn, Thomas; Mussen, Filip; Peacock, Stuart; Watkins, John; Ijzerman, Maarten

    2016-01-01

    Health care decisions are complex and involve confronting trade-offs between multiple, often conflicting, objectives. Using structured, explicit approaches to decisions involving multiple criteria can improve the quality of decision making and a set of techniques, known under the collective heading multiple criteria decision analysis (MCDA), are useful for this purpose. MCDA methods are widely used in other sectors, and recently there has been an increase in health care applications. In 2014, ISPOR established an MCDA Emerging Good Practices Task Force. It was charged with establishing a common definition for MCDA in health care decision making and developing good practice guidelines for conducting MCDA to aid health care decision making. This initial ISPOR MCDA task force report provides an introduction to MCDA - it defines MCDA; provides examples of its use in different kinds of decision making in health care (including benefit risk analysis, health technology assessment, resource allocation, portfolio decision analysis, shared patient clinician decision making and prioritizing patients' access to services); provides an overview of the principal methods of MCDA; and describes the key steps involved. Upon reviewing this report, readers should have a solid overview of MCDA methods and their potential for supporting health care decision making. Copyright © 2016. Published by Elsevier Inc.

  19. Advocacy for mental health: roles for consumer and family organizations and governments.

    Science.gov (United States)

    Funk, Michelle; Minoletti, Alberto; Drew, Natalie; Taylor, Jacob; Saraceno, Benedetto

    2006-03-01

    The World Health Organization urges countries to become more active in advocacy efforts to put mental health on governments' agendas. Health policy makers, planners and managers, advocacy groups, consumer and family organizations, through their different roles and actions, can move the mental health agenda forward. This paper outlines the importance of the advocacy movement, describes some of the roles and functions of the different groups and identifies some specific actions that can be adopted by Ministries of Health. The mental health advocacy movement has developed over the last 30 years as a means of combating stigma and prejudice against people with mental disorders and improving services. Consumer and family organizations and related NGOs have been able to influence governments on mental health policies and laws and educating the public on social integration of people with mental disorders. Governments can promote the development of a strong mental health advocacy sector without compromising this sector's independence. For instance, they can publish and distribute a directory of mental health advocacy groups, include them in their mental health activities and help fledgling groups become more established. There are also some advocacy functions that government officials can, and indeed, should perform themselves. Officials in the ministry of health can persuade officials in other branches of government to make mental health more of a priority, support advocacy activities with both general health workers and mental health workers and carry out public information campaigns about mental disorders and how to maintain good mental health. In conclusion, the World Health Organization believes mental health advocacy is one of the pillars to improve mental health care and the human rights of people with mental disorders. It is hoped that the recommendations in this article will help government officials and activists to strengthen national advocacy movements.

  20. Behavioral health and health care reform models: patient-centered medical home, health home, and accountable care organization.

    Science.gov (United States)

    Bao, Yuhua; Casalino, Lawrence P; Pincus, Harold Alan

    2013-01-01

    Discussions of health care delivery and payment reforms have largely been silent about how behavioral health could be incorporated into reform initiatives. This paper draws attention to four patient populations defined by the severity of their behavioral health conditions and insurance status. It discusses the potentials and limitations of three prominent models promoted by the Affordable Care Act to serve populations with behavioral health conditions: the Patient-Centered Medical Home, the Health Home initiative within Medicaid, and the Accountable Care Organization. To incorporate behavioral health into health reform, policymakers and practitioners may consider embedding in the reform efforts explicit tools-accountability measures and payment designs-to improve access to and quality of care for patients with behavioral health needs.

  1. Prevalence of Metabolic Syndrome in Elderly and Agreement among Four Diagnostic Criteria

    International Nuclear Information System (INIS)

    Saad, Maria Auxiliadora Nogueira; Cardoso, Gilberto Perez; Martins, Wolney de Andrade; Velarde, Luis Guillermo Coca; Cruz, Rubens Antunes Filho da

    2014-01-01

    Metabolic syndrome (MS) is an aggregation of risk factors that increase the incidence of cardiovascular events and diabetes mellitus (DM). Population aging is accompanied by higher prevalence of MS, which varies depending on the population studied and the diagnostic criteria used. To determine prevalence of MS in the elderly using four diagnostic criteria and agreement between them. Cross-sectional study on 243 patients older than 60 years (180 women) in Niterói, RJ. They were evaluated by clinical examination, fasting glucose, fasting insulin, lipid profile and anthropometric measurements - weight, height, waist circumference and waist/hip ratio. Prevalence of MS was estimated by World Health Organization (WHO) modified, National Cholesterol Education Program - Adult Treatment Panel III (NCEP-ATP III), International Diabetes Federation (IDF) and Joint Interim Statement (JIS) criteria. Prevalence was high with the four criteria WHO (51.9%), NCEP-ATPIII (45.2%), IDF (64.1%) and JIS (69.1%), and agreement between criteria by kappa was moderate in almost all comparisons WHO vs. IDF (k = 0.47;95% confidence interval (CI), 0.35 to 0.58); WHO vs. NCEP-ATPIII (k = 0.51; 95% CI, 0.40 to 0.61); WHO vs. JIS (k = 0.45; 95% CI, 0.33 to 0.56); IDF vs. NCEP-ATPIII (k = 0.55; 95% CI, 0.45 to 0.65) and NCEP-ATPIII vs. JIS (k = 0.53; 95% CI, 0.43-0.64), except between IDF vs. JIS (K = 0.89;95% CI, 0.83 to 0.95), which was considered good. Prevalence of MS was high with the four diagnostic criteria, mainly by JIS. There was good agreement between JIS and IDF criteria and moderate among the others

  2. Prevalence of Metabolic Syndrome in Elderly and Agreement among Four Diagnostic Criteria

    Energy Technology Data Exchange (ETDEWEB)

    Saad, Maria Auxiliadora Nogueira, E-mail: auxiliadorasaad@yahoo.com.br [Fundação Municipal de Saúde de Niterói, Niterói, RJ (Brazil); Cardoso, Gilberto Perez; Martins, Wolney de Andrade; Velarde, Luis Guillermo Coca; Cruz, Rubens Antunes Filho da [Universidade Federal Fluminense, Niterói, RJ (Brazil)

    2014-03-15

    Metabolic syndrome (MS) is an aggregation of risk factors that increase the incidence of cardiovascular events and diabetes mellitus (DM). Population aging is accompanied by higher prevalence of MS, which varies depending on the population studied and the diagnostic criteria used. To determine prevalence of MS in the elderly using four diagnostic criteria and agreement between them. Cross-sectional study on 243 patients older than 60 years (180 women) in Niterói, RJ. They were evaluated by clinical examination, fasting glucose, fasting insulin, lipid profile and anthropometric measurements - weight, height, waist circumference and waist/hip ratio. Prevalence of MS was estimated by World Health Organization (WHO) modified, National Cholesterol Education Program - Adult Treatment Panel III (NCEP-ATP III), International Diabetes Federation (IDF) and Joint Interim Statement (JIS) criteria. Prevalence was high with the four criteria WHO (51.9%), NCEP-ATPIII (45.2%), IDF (64.1%) and JIS (69.1%), and agreement between criteria by kappa was moderate in almost all comparisons WHO vs. IDF (k = 0.47;95% confidence interval (CI), 0.35 to 0.58); WHO vs. NCEP-ATPIII (k = 0.51; 95% CI, 0.40 to 0.61); WHO vs. JIS (k = 0.45; 95% CI, 0.33 to 0.56); IDF vs. NCEP-ATPIII (k = 0.55; 95% CI, 0.45 to 0.65) and NCEP-ATPIII vs. JIS (k = 0.53; 95% CI, 0.43-0.64), except between IDF vs. JIS (K = 0.89;95% CI, 0.83 to 0.95), which was considered good. Prevalence of MS was high with the four diagnostic criteria, mainly by JIS. There was good agreement between JIS and IDF criteria and moderate among the others.

  3. Quantitative Analysis of Criteria in University Building Maintenance in Malaysia

    Directory of Open Access Journals (Sweden)

    Olanrewaju Ashola Abdul-Lateef

    2010-10-01

    Full Text Available University buildings are a significant part of university assets and considerable resources are committed to their design, construction and maintenance. The core of maintenance management is to optimize productivity and user satisfaction with optimum resources. An important segment in the maintenance management system is the analysis of criteria that influence building maintenance. Therefore, this paper aims to identify quantify, rank and discuss the criteria that influence maintenance costs, maintenance backlogs, productivity and user satisfaction in Malaysian university buildings. The paper reviews the related literature and presents the outcomes of a questionnaire survey. Questionnaires were administered on 50 university maintenance organizations. Thirty-one criteria were addressed to the university maintenance organizations to evaluate the degree to which each of the criteria influences building maintenance management. With a 66% response rate, it was concluded that the consideration of the criteria is critical to the university building maintenance management system. The quality of components and materials, budget constraints and the age of the building were found to be the most influential criteria but information on user performance satisfaction, problems associated with in-house workforce and shortage of materials and components were the least influential criteria. The paper also outlined that maintenance management is a strategic function in university administration.

  4. Assessment of health-care waste disposal methods using a VIKOR-based fuzzy multi-criteria decision making method

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Hu-Chen [School of Management, Hefei University of Technology, Hefei 230009 (China); Department of Industrial Engineering and Management, Tokyo Institute of Technology, Tokyo 152-8552 (Japan); Wu, Jing [Department of Public Management, Tongji University, Shanghai 200092 (China); Li, Ping, E-mail: yiwuchulp@126.com [Shanghai Pudong New Area Zhoupu Hospital, No. 135 Guanyue Road, Shanghai 201318 (China); East Hospital Affiliated to Tongji University, No. 150 Jimo Road, Shanghai 200120 (China)

    2013-12-15

    Highlights: • Propose a VIKOR-based fuzzy MCDM technique for evaluating HCW disposal methods. • Linguistic variables are used to assess the ratings and weights for the criteria. • The OWA operator is utilized to aggregate individual opinions of decision makers. • A case study is given to illustrate the procedure of the proposed framework. - Abstract: Nowadays selection of the appropriate treatment method in health-care waste (HCW) management has become a challenge task for the municipal authorities especially in developing countries. Assessment of HCW disposal alternatives can be regarded as a complicated multi-criteria decision making (MCDM) problem which requires consideration of multiple alternative solutions and conflicting tangible and intangible criteria. The objective of this paper is to present a new MCDM technique based on fuzzy set theory and VIKOR method for evaluating HCW disposal methods. Linguistic variables are used by decision makers to assess the ratings and weights for the established criteria. The ordered weighted averaging (OWA) operator is utilized to aggregate individual opinions of decision makers into a group assessment. The computational procedure of the proposed framework is illustrated through a case study in Shanghai, one of the largest cities of China. The HCW treatment alternatives considered in this study include “incineration”, “steam sterilization”, “microwave” and “landfill”. The results obtained using the proposed approach are analyzed in a comparative way.

  5. Assessment of health-care waste disposal methods using a VIKOR-based fuzzy multi-criteria decision making method

    International Nuclear Information System (INIS)

    Liu, Hu-Chen; Wu, Jing; Li, Ping

    2013-01-01

    Highlights: • Propose a VIKOR-based fuzzy MCDM technique for evaluating HCW disposal methods. • Linguistic variables are used to assess the ratings and weights for the criteria. • The OWA operator is utilized to aggregate individual opinions of decision makers. • A case study is given to illustrate the procedure of the proposed framework. - Abstract: Nowadays selection of the appropriate treatment method in health-care waste (HCW) management has become a challenge task for the municipal authorities especially in developing countries. Assessment of HCW disposal alternatives can be regarded as a complicated multi-criteria decision making (MCDM) problem which requires consideration of multiple alternative solutions and conflicting tangible and intangible criteria. The objective of this paper is to present a new MCDM technique based on fuzzy set theory and VIKOR method for evaluating HCW disposal methods. Linguistic variables are used by decision makers to assess the ratings and weights for the established criteria. The ordered weighted averaging (OWA) operator is utilized to aggregate individual opinions of decision makers into a group assessment. The computational procedure of the proposed framework is illustrated through a case study in Shanghai, one of the largest cities of China. The HCW treatment alternatives considered in this study include “incineration”, “steam sterilization”, “microwave” and “landfill”. The results obtained using the proposed approach are analyzed in a comparative way

  6. Globalization of health insecurity: the World Health Organization and the new International Health Regulations.

    Science.gov (United States)

    Aginam, Obijiofor

    2006-12-01

    The transnational spread of communicable and non-communicable diseases has opened new vistas in the discourse of global health security. Emerging and re-emerging pathogens, according to exponents of globalization of public health, disrespect the geo-political boundaries of nation-states. Despite the global ramifications of health insecurity in a globalizing world, contemporary international law still operates as a classic inter-state law within an international system exclusively founded on a coalition of nation-states. This article argues that the dynamic process of globalization has created an opportunity for the World Health Organization to develop effective synergy with a multiplicity of actors in the exercise of its legal powers. WHO's legal and regulatory strategies must transform from traditional international legal approaches to disease governance to a "post-Westphalian public health governance": the use of formal and informal sources from state and non-state actors, hard law (treaties and regulations) and soft law (recommendations and travel advisories) in global health governance. This article assesses the potential promise and problems of WHO's new International Health Regulations (IHR) as a regulatory strategy for global health governance and global health security.

  7. The representation of health professionals on governing boards of health care organizations in New York City.

    Science.gov (United States)

    Mason, Diana J; Keepnews, David; Holmberg, Jessica; Murray, Ellen

    2013-10-01

    The Representation of Health Professionals on Governing Boards of Health Care Organizations in New York City. The heightened importance of processes and outcomes of care-including their impact on health care organizations' (HCOs) financial health-translate into greater accountability for clinical performance on the part of HCO leaders, including their boards, during an era of health care reform. Quality and safety of care are now fiduciary responsibilities of HCO board members. The participation of health professionals on HCO governing bodies may be an asset to HCO governing boards because of their deep knowledge of clinical problems, best practices, quality indicators, and other issues related to the safety and quality of care. And yet, the sparse data that exist indicate that physicians comprise more than 20 % of the governing board members of hospitals while less than 5 % are nurses and no data exist on other health professionals. The purpose of this two-phased study is to examine health professionals' representations on HCOs-specifically hospitals, home care agencies, nursing homes, and federally qualified health centers-in New York City. Through a survey of these organizations, phase 1 of the study found that 93 % of hospitals had physicians on their governing boards, compared with 26 % with nurses, 7 % with dentists, and 4 % with social workers or psychologists. The overrepresentation of physicians declined with the other HCOs. Only 38 % of home care agencies had physicians on their governing boards, 29 % had nurses, and 24 % had social workers. Phase 2 focused on the barriers to the appointment of health professionals to governing boards of HCOs and the strategies to address these barriers. Sixteen health care leaders in the region were interviewed in this qualitative study. Barriers included invisibility of health professionals other than physicians; concerns about "special interests"; lack of financial resources for donations to the organization

  8. Ethical criteria for procuring and distributing organs for transplantation.

    Science.gov (United States)

    Childress, J F

    1989-01-01

    This article provides an ethical analysis and assessment of various actual and proposed policies of organ procurement and distribution in light of moral principles already embedded in U.S. institutions, laws, policies, and practices. Evaluating different methods of acquisition of human body parts--donation (express and presumed), sales, abandonment, and expropriation--the author argues for laws and policies, including required request, to maintain and facilitate express donation of organs by individuals and their families. Such laws and policies need adequate time for a determination of their effectiveness before society moves to other major alternatives, such as a market. In organ allocation and distribution, which have close moral connections with organ procurement, the author defends the judgment of the federal Task Force on Organ Transplantation that the community should have dispositional authority over donated organs, that professionals should be viewed as trustees and stewards of donated organs, and that the public should be heavily involved in the formation of policies of allocation and distribution. Concentrating on policies being developed in the United Network for Organ Sharing, the author examines the point system for cadaveric kidneys, the access of foreign nationals to organs donated in the U.S., and the multiple listings of patients seeking transplants. He concludes by identifying two major problems of equitable access to donated organs that will have to be addressed by social institutions other than UNOS: access to the waiting list for donated organs and the role of ability to pay in extrarenal transplants.

  9. Initial Readability Assessment of Clinical Trial Eligibility Criteria

    Science.gov (United States)

    Kang, Tian; Elhadad, Noémie; Weng, Chunhua

    2015-01-01

    Various search engines are available to clinical trial seekers. However, it remains unknown how comprehensible clinical trial eligibility criteria used for recruitment are to a lay audience. This study initially investigated this problem. Readability of eligibility criteria was assessed according to (i) shallow and lexical characteristics through the use of an established, generic readability metric; (ii) syntactic characteristics through natural language processing techniques; and (iii) health terminological characteristics through an automated comparison to technical and lay health texts. We further stratified clinical trials according to various study characteristics (e.g., source country or study type) to understand potential factors influencing readability. Mainly caused by frequent use of technical jargons, a college reading level was found to be necessary to understand eligibility criteria text, a level much higher than the average literacy level of the general American population. The use of technical jargons should be minimized to simplify eligibility criteria text. PMID:26958204

  10. 77 FR 11120 - Patient Safety Organizations: Voluntary Relinquishment From UAB Health System Patient Safety...

    Science.gov (United States)

    2012-02-24

    ... Organizations: Voluntary Relinquishment From UAB Health System Patient Safety Organization AGENCY: Agency for... notification of voluntary relinquishment from the UAB Health System Patient Safety Organization of its status as a Patient Safety Organization (PSO). The Patient Safety and Quality Improvement Act of 2005...

  11. Ambient volatile organic compounds (VOCs) in Calgary, Alberta: Sources and screening health risk assessment.

    Science.gov (United States)

    Bari, Md Aynul; Kindzierski, Warren B

    2018-08-01

    Exposure to ambient volatile organic compound (VOCs) in urban areas is of interest because of their potential chronic and acute adverse effects to public health. Limited information is available about VOC sources in urban areas in Canada. An investigation of ambient VOCs levels, their potential sources and associated risks to public health was undertaken for the urban core of Alberta's largest city (downtown Calgary) for the period 2010-2015. Twenty-four hour arithmetic and geometric mean concentrations of total VOCs were 42μg/m 3 and 39μg/m 3 , respectively and ranged from 16 to 160μg/m 3 , with winter levels about two-fold higher than summer. Alkanes (58%) were the most dominant compounds followed by halogenated VOCs (22%) and aromatics (11%). Mean and maximum 24h ambient concentrations of selected VOCs of public health concern were below chronic and acute health risk screening criteria of the United States regulatory agencies and a cancer screening benchmark used in Alberta equivalent to 1 in 100,000 lifetime risk. The Positive matrix factorization (PMF) model revealed nine VOC sources at downtown Calgary, where oil/natural gas extraction/combustion (26%), fuel combustion (20%), traffic sources including gasoline exhaust, diesel exhaust, mixed fugitive emissions (10-15%), and industrial coatings/solvents (12%) were predominant. Other sources included dry cleaning (3.3%), biogenic (3.5%) and a background source (18%). Source-specific health risk values were also estimated. Estimated cancer risks for all sources were below the Alberta cancer screening benchmark, and estimated non-cancer risks for all sources were well below a safe level. Copyright © 2018 Elsevier B.V. All rights reserved.

  12. Selection of bioaccumulation criteria for environmental emergency (E2) planning

    International Nuclear Information System (INIS)

    Ketcheson, K.; Hradecky, K.; Gagne, M.; St-Amant-Verret, M.

    2006-01-01

    Environment Canada's Environmental Emergency regulations require the evaluation of a substance by a Risk Evaluation Framework (REF). Bioaccumulation criteria are used within the environmental hazard ratings section of the REF to determine the risk of a substance to organisms and are obtained from 3 types of measurements depending on data reliability: (1) bioaccumulation factors (BAF); (2) bioconcentration factors (BCF); and (3) an octanol-water partition coefficient (log K ow ). This paper presented details of a study of international and regional bioaccumulation criteria conducted to aid in determining appropriate criteria for E2 regulations and plans, with specific reference to substances toxic to aquatic organisms. An E2 plan is required if a substance has a bioconcentration factor of more than 500 in conjunction with aquatic toxicity. Bioaccumulation criteria from several sources for 745 substances were obtained to aid in choosing the most important parameters. Various international and regional criteria were examined and corresponding sources were summarized, and different source criteria was compared with empirical chemical data. The criteria chosen included both log K ow values and BCF values, although it was suggested that BCF and BAF are more realistic measures of bioaccumulation than log K ow , as they are derived from animal studies. The chosen values agreed with the virtual elimination criteria set out by the Canadian Environmental Protection Act (CEPA) 1999 as well as United States Environmental Protection Agency (EPA) criteria. It was concluded that the bioaccumulation criteria for E2 planning will help Environment Canada ensure the protection of the environment from hazardous substances. 11 refs., 3 tabs., 5 figs

  13. Geography of community health information organization activity in the United States: Implications for the effectiveness of health information exchange.

    Science.gov (United States)

    Vest, Joshua R

    The United States has invested nearly a billion dollars in creating community health information organizations (HIOs) to foster health information exchange. Community HIOs provide exchange services to health care organizations within a distinct geographic area. While geography is a key organizing principle for community HIOs, it is unclear if geography is an effective method for organization or what challenges are created by a geography-based approach to health information exchange. This study describes the extent of reported community HIO coverage in the United States and explores the practical and policy implications of overlaps and gaps in HIO service areas. Furthermore, because self-reported service areas may not accurately reflect the true extent of HIOs activities, this study maps the actual markets for health services included in each HIO. An inventory of operational community HIOs that included self-reported geographic markets and participating organizations was face-validated using a crowd-sourcing approach. Aggregation of the participating hospitals' individual health care markets provided the total geographic market served by each community HIO. Mapping and overlay analyses using geographic information system methods described the extent of community HIO activity in the United States. Evidence suggests that community HIOs may be inefficiently distributed. Parts of the United States have multiple, overlapping HIOs, while others do not have any providing health information exchange services. In markets served by multiple community HIOs, 45% of hospitals were participants of only one HIO. The current geography of community HIO activity does not provide comprehensive patient information to providers, nor community-wide information for public health agencies. The discord between the self-reported and market geography of community HIOs raises concerns about the potential effectiveness of health information exchange, illustrates the limitations of geography as

  14. Procedures and Criteria for the regulation of innovative non-medicinal technologies into the benefit catalogue of solidly financed health care insurances

    Directory of Open Access Journals (Sweden)

    Hagen, Anja

    2007-01-01

    Full Text Available Because great interest in an efficient range of effective medicinal innovations and achievements has arisen, many countries have introduced procedures to regulate the adoption of innovative non-medicinal technologies into the benefit catalogue of solidly financed health care insurances. With this as a background, this report will describe procedures for the adoption of innovative non-medicinal technologies by solidly financed health care insurances in Germany, England, Australia and Switzerland. This report was commissioned by the German Agency for Health Technology Assessment at the German Institute for Medical Documentation and Information.In order to find the relevant literature and information, systematic literature research, a hand search and a written survey were carried out. All the selected documents (chosen according to defined criteria for inclusion and exclusion were qualitatively evaluated, summarized and presented on a chart using a framework developed for this purpose. All the countries in this report require that some innovative non-medicinal technologies undergo evaluation by a central governing body. This evaluation is a prerequisite for adoption into the benefit catalogue. The process of evaluation can differ (e. g. the people and institutions concerned, the division of the synthesis of evidence and overall evaluation, processing the evidence. Similarities do exist, such as the size and composition of the governing bodies or the overreaching criteria according to which institutions must make their recommendations. This is how all the countries examined in this report determine how the benefits and effectiveness of the innovations, as well as their cost-effectiveness, can be chosen as criteria for the evaluation. Furthermore, there are many criteria which differ from country to country (social and ethical aspects, possible effects on the health system, etc. and which are also relevant to an evaluation. The preferred types of

  15. Rates of Autism Spectrum Disorder Diagnosis Under the DSM-5 Criteria Compared to DSM-IV-TR Criteria in a Hospital-Based Clinic.

    Science.gov (United States)

    Hartley-McAndrew, Michelle; Mertz, Jana; Hoffman, Martin; Crawford, Donald

    2016-04-01

    We aimed to determine whether there was a decrease in the number of children diagnosed on the autism spectrum after the implementation of the new diagnostic criteria as outlined in the Diagnostic and Statistical Manual of Mental Health Disorders Fifth Edition published in May 2013. We reviewed 1552 charts of children evaluated at the Women and Children's Hospital of Buffalo, Autism Spectrum Disorders Clinic. A comparison was made of children diagnosed with autism spectrum disorder (autism, Asperger disorder, pervasive developmental disorder-not otherwise specified) from 2010 to May 2013 using the Diagnostic and Statistical Manual of Mental Health Disorders Fourth Edition, Text Revision criteria with children diagnosed from June 2013 through June 2015 under the Diagnostic and Statistical Manual of Mental Health Disorders Fifth Edition. Using χ(2) analysis, the 2013-2015 rate of autism spectrum disorder diagnosis (39%) was significantly lower (P disorder diagnosis was significantly lower under the recently implemented Diagnostic and Statistical Manual of Mental Health Disorders Fifth Edition criteria. Published by Elsevier Inc.

  16. Sediment quality criteria: A review with recommendations for developing criteria for the Hanford Site

    Energy Technology Data Exchange (ETDEWEB)

    Driver, C.J.

    1994-05-01

    Criteria for determining the quality of liver sediment are necessary to ensure that concentrations of contaminants in aquatic systems are within acceptable limits for the protection of aquatic and human life. Such criteria should facilitate decision-making about remediation, handling, and disposal of contaminants. Several approaches to the development of sediment quality criteria (SQC) have been described and include both descriptive and numerical methods. However, no single method measures all impacts at all times to all organisms (U.S. EPA 1992b). The U.S. EPA`s interest is primarily in establishing chemically based, numerical SQC that are applicable nation-wide (Shea 1988). Of the approaches proposed for SQC development, only three are being considered for numerical SQC on a national level. These approaches include an Equilibrium Partitioning Approach, a site-specific method using bioassays (the Apparent Effects Threshold Approach), and an approach similar to EPA`s water quality criteria (Pavlou and Weston 1984). Although national (or even regional) criteria address a number of political, litigative, and engineering needs, some researchers feel that protection of benthic communities require site-specific, biologically based criteria (Baudo et al. 1990). This is particularly true for areas where complex mixtures of contaminants are present in sediments. Other scientifically valid and accepted procedures for freshwater SQC include a background concentration approach, methods using field or spiked bioassays, a screening level concentration approach, the Apparent Effects Threshold Approach, the Sediment Quality Triad, the International Joint Commission Sediment Assessment Strategy, and the National Status and Trends Program Approach. The various sediment assessment approaches are evaluated for application to the Hanford Reach and recommendations for Hanford Site sediment quality criteria are discussed.

  17. [Organization development of the public health system].

    Science.gov (United States)

    Pfaff, Holger; Klein, Jürgen

    2002-05-15

    Changes in the German health care system require changes in health care institutions. Organizational development (OD) techniques can help them to cope successfully with their changing environment. OD is defined as a collective process of learning aiming to induce intended organizational change. OD is based on social science methods and conducted by process-oriented consultants. In contrast to techniques of organizational design, OD is characterized by employee participation. One of the most important elements of OD is the so-called "survey-feedback-technique". Five examples illustrate how the survey-feedback-technique can be used to facilitate organisational learning. OD technique supports necessary change in health care organizations. It should be used more frequently.

  18. Neuroendocrine tumors of colon and rectum: validation of clinical and prognostic values of the World Health Organization 2010 grading classifications and European Neuroendocrine Tumor Society staging systems.

    Science.gov (United States)

    Shen, Chaoyong; Yin, Yuan; Chen, Huijiao; Tang, Sumin; Yin, Xiaonan; Zhou, Zongguang; Zhang, Bo; Chen, Zhixin

    2017-03-28

    This study evaluated and compared the clinical and prognostic values of the grading criteria used by the World Health Organization (WHO) and the European Neuroendocrine Tumors Society (ENETS). Moreover, this work assessed the current best prognostic model for colorectal neuroendocrine tumors (CRNETs). The 2010 WHO classifications and the ENETS systems can both stratify the patients into prognostic groups, although the 2010 WHO criteria is more applicable to CRNET patients. Along with tumor location, the 2010 WHO criteria are important independent prognostic parameters for CRNETs in both univariate and multivariate analyses through Cox regression (P<0.05). Data from 192 consecutive patients histopathologically diagnosed with CRNETs and had undergone surgical resection from January 2009 to May 2016 in a single center were retrospectively analyzed. Findings suggest that the WHO classifications are superior over the ENETS classification system in predicting the prognosis of CRNETs. Additionally, the WHO classifications can be widely used in clinical practice.

  19. Organizing and managing care in a changing health system.

    Science.gov (United States)

    Kohn, L T

    2000-04-01

    To examine ways in which the management and organization of medical care is changing in response to the shifting incentives created by managed care. Site visits conducted in 12 randomly selected communities in 1996/ 1997. Approximately 35-60 interviews were conducted per site with key informants in healthcare and community organizations; about half were with providers. A standardized interview protocol was implemented across all sites, enabling cross-site comparisons. Multiple respondents were interviewed on each issue. A great deal of experimentation and apparent duplication exist in efforts to develop programs to influence physician practice patterns. Responsibility for managing care is being contested by health plans, medical groups and hospitals, as each seeks to accrue the savings that can result from the more efficient delivery of care. To manage the financial and clinical risk, providers are aggressively consolidating and reorganizing. Most significant was the rapid formation of intermediary organizations, such as independent practice arrangements (IPAs), physician-hospital organizations (PHOs), or management services organizations (MSOs), for contracting with managed care organizations. Managed care appears to have only a modest effect on how healthcare organizations deliver medical care, despite the profound effect that managed care has on how providers are organized. Rather than improving the efficiency of healthcare organizations, provider efforts to build large systems and become indispensable to health plans are exacerbating problems of excess capacity. It is not clear if new organizational arrangements will help providers manage the changing incentives they face, or if their intent is to blunt the effects of the incentives by forming larger organizations to improve their bargaining power and resist change.

  20. Evaluation of national health-care related infection criteria for epidemiological surveillance in neonatology.

    Science.gov (United States)

    Ferreira, Janita; Bouzada, Maria C F; Jesus, Lenize A de; Cortes, Maria da Conceição Werneck; Armond, Guilherme A; Clemente, Wanessa T; Anchieta, Lêni M; Romanelli, Roberta M C

    2014-01-01

    to assess the use of the Brazilian criteria for reporting of hospital-acquired infections (HAIs) in the neonatal unit and compare them with the criteria proposed by the National Healthcare Safety Network (NHSN). this was a cross-sectional study conducted from 2009 to 2011. It included neonates with HAI reporting by at least one of the criteria. Statistical analysis included calculation of incidence density of HAIs, distribution by weight, and by reporting criterion. Analysis of sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for the national criteria was performed considering the NHSN as the gold standard, with agreement assessed by kappa. a total of 882 newborns were followed, and 330 had at least one infection notified by at least one of the criteria. A total of 522 HAIs were reported, regardless of the criteria. An incidence density of 27.28 infections per 1,000 patient-days was observed, and the main topographies were sepsis (58.3%), candidiasis (15.1%), and conjunctivitis (6.5%). A total of 489 (93.7%) were notified by both criteria, eight infections were notified only by the national criteria (six cases of necrotizing enterocolitis and two cases of conjunctivitis), and 25 cases of clinical sepsis were reported by NHSN criteria only. The sensitivity, specificity, PPV, and NPV were 95.1%, 98.6%, 98.4%, and 95.7%, respectively, for all topographies, and were 91.8%, 100%, 100%, and 96.3% for the analysis of sepsis. Kappa analysis showed an agreement of 96.9%. there was a high rate of agreement between the criteria. The use of the national criteria facilitates the reporting of sepsis in newborns, and can help to improve the specificity and PPV. Copyright © 2014 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  1. Evaluation of national health-care related infection criteria for epidemiological surveillance in neonatology

    Directory of Open Access Journals (Sweden)

    Janita Ferreira

    2014-07-01

    Full Text Available OBJECTIVE: to assess the use of the Brazilian criteria for reporting of hospital-acquired infections (HAIs in the neonatal unit and compare them with the criteria proposed by the National Healthcare Safety Network (NHSN. METHODS: this was a cross-sectional study conducted from 2009 to 2011. It included neonates with HAI reporting by at least one of the criteria. Statistical analysis included calculation of incidence density of HAIs, distribution by weight, and by reporting criterion. Analysis of sensitivity, specificity, positive predictive value (PPV, and negative predictive value (NPV for the national criteria was performed considering the NHSN as the gold standard, with agreement assessed by kappa. RESULTS: a total of 882 newborns were followed, and 330 had at least one infection notified by at least one of the criteria. A total of 522 HAIs were reported, regardless of the criteria. An incidence density of 27.28 infections per 1,000 patient-days was observed, and the main topographies were sepsis (58.3%, candidiasis (15.1%, and conjunctivitis (6.5%. A total of 489 (93.7% were notified by both criteria, eight infections were notified only by the national criteria (six cases of necrotizing enterocolitis and two cases of conjunctivitis, and 25 cases of clinical sepsis were reported by NHSN criteria only. The sensitivity, specificity, PPV, and NPV were 95.1%, 98.6%, 98.4%, and 95.7%, respectively, for all topographies, and were 91.8%, 100%, 100%, and 96.3% for the analysis of sepsis. Kappa analysis showed an agreement of 96.9%. CONCLUSION: there was a high rate of agreement between the criteria. The use of the national criteria facilitates the reporting of sepsis in newborns, and can help to improve the specificity and PPV.

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

    Science.gov (United States)

    Macpherson, Cheryl C; Hill, Jonathan

    2017-12-01

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

  3. Community participation in international health: practical recommendations for donor and recipient organizations

    Directory of Open Access Journals (Sweden)

    Akukwe Chinua

    1999-01-01

    Full Text Available This article discusses the need for donor agencies and recipient organizations to involve target communities in the conceptualization, development, monitoring, and implementation of health services and programs in international health. This paper assumes that most donor organizations are based in industrialized countries. Given that resources are finite in both developing and developed countries, the article briefly reviews the current trend of declining public funds for health systems and an increasing role for privately funded health services worldwide. The article calls for community-based international health services that reflect the priorities of target populations, and it also discusses practi cal steps to involve local populations in community-based health planning and management in international health.

  4. Organization And Financing Models Of Health Service In Selected Countries

    Directory of Open Access Journals (Sweden)

    Branimir Marković

    2009-07-01

    Full Text Available The introductory part of the work gives a short theoretical presentation regarding possible financing models of health services in the world. In the applicative part of the work we shall present the basic practical models of financing health services in the countries that are the leaders of classic methods of health services financing, e. g. the USA, Great Britain, Germany and Croatia. Working out the applicative part of the work we gave the greatest significance to analysis of some macroeconomic indicators in health services (tendency of total health consumption in relation to GDP, average consumption per insured person etc., to structure analysis of health insurance and just to the scheme of health service organization and financing. We presume that each model of health service financing contains certain limitations that can cause problem (weak organization, increase of expenses etc.. This is the reason why we, in the applicative part of the work, paid a special attention to analysis of financial difficulties in the health sector and pointed to the needs and possibilities of solving them through possible reform measures. The end part of the work aims to point out to advantages and disadvantages of individual financing sources through the comparison method (budgetary – taxes or social health insurance – contributions.

  5. eHealth indicators

    DEFF Research Database (Denmark)

    HYPPÖNEN, Hannele; AMMENWERTH, Elske; Nøhr, Christian

    2012-01-01

    eHealth indicators are needed to measure defined aspects of national eHealth implementations. However, until now, eHealth indicators are ambiguous or unclear. Therefore, an expert workshop "Towards an International Minimum Dataset for Monitoring National Health Information System Implementations......" was organized. The objective was to develop ideas for a minimum eHealth indicator set. The proposed ideas for indicators were classified based on EUnetHTA and De-Lone & McClean, and classification was compared with health IT evaluation criteria classification by Ammenwerth & Keizer. Analysis of the workshop...... results emphasized the need for a common methodological framework for defining and classifying eHealth indicators. It also showed the importance of setting the indicators into context. The results will benefit policy makers, developers and researchers in pursuit of provision and use of evidence...

  6. Development of design Criteria for ITER In-vessel Components

    International Nuclear Information System (INIS)

    Sannazzaro, G.; Barabash, V.; Kang, S.C.; Fernandez, E.; Kalinin, G.; Obushev, A.; Martínez, V.J.; Vázquez, I.; Fernández, F.; Guirao, J.

    2013-01-01

    Absrtract: The components located inside the ITER vacuum chamber (in-vessel components – IC), due to their specific nature and the environments they are exposed to (neutron radiation, high heat fluxes, electromagnetic forces, etc.), have specific design criteria which are, in this paper, referred as Structural Design Criteria for In-vessel Components (SDC-IC). The development of these criteria started in the very early phase of the ITER design and followed closely the criteria of the RCC-MR code. Specific rules to include the effect of neutron irradiation were implemented. In 2008 the need of an update of the SDC-IC was identified to add missing specifications, to implement improvements, to modernise rules including recent evolutions in international codes and regulations (i.e. PED). Collaboration was set up between ITER Organization (IO), European (EUDA) and Russian Federation (RFDA) Domestic Agencies to generate a new version of SDC-IC. A Peer Review Group (PRG) composed by members of the ITER Organization and all ITER Domestic Agencies and code experts was set-up to review the proposed modifications, to provide comments, contributions and recommendations

  7. Health-safety and environmental risk assessment of power plants using multi criteria decision making method

    Directory of Open Access Journals (Sweden)

    Jozi Ali Seyed

    2011-01-01

    Full Text Available Growing importance of environmental issues at global and regional levels including pollution of water, air etc. as well as the outcomes such as global warming and climate change has led to being considered environmental aspects as effective factors for power generation. Study ahead, aims at examination of risks resulting from activities of Yazd Combined Cycle Power Plant located in Iran. Method applied in the research is analytical hierarchy process. After identification of factors causing risk, the analytical hierarchy structure of the power plant risks were designed and weight of the criteria and sub-criteria were calculated by intensity probability product using Eigenvector Method and EXPERT CHOICE Software as well. Results indicate that in technological, health-safety, biophysical and socio economic sections of the power plant, factors influenced by the power plant activities like fire and explosion, hearing loss, quantity of groundwater, power generation are among the most important factors causing risk in the power plant. The drop in underground water levels is the most important natural consequence influenced on Yazd Combined Cycle Power Plant.

  8. The radiation protection programme activities of the World Health Organization

    International Nuclear Information System (INIS)

    Komarov, E.; Suess, M.J.

    1980-01-01

    The radiation protection activities of the World Health Organization are reviewed. They include studies of radiation protection standards and guidelines, and public health aspects of nuclear power. WHO also provides member states with world data on radioactivity in air, water and food, and assessments of population exposure and health effects. (H.K.)

  9. Web-site evaluation tools: a case study in reproductive health information.

    Science.gov (United States)

    Aslani, Azam; Pournik, Omid; Abu-Hanna, Ameen; Eslami, Saeid

    2014-01-01

    Internet forms an opportunity to inform, teach, and connect professionals and patients. However, much information on Internet is incomplete, inaccurate, or misleading, and not only in the medical domain. Because of the potential for damage from misleading and inaccurate health information, many organizations and individuals have published or implemented scoring tools for evaluating the appropriateness or quality of these resources. The objective of this study is to identify and summarize scoring tools that have evaluated web-sites providing reproductive health information in order to compare them and recommend an overarching evaluation tool. We searched Ovid MEDLINE(R) (1946 to July 2013) and OVID Embase (1980 to July 2013); and included English language studies that have evaluated the quality of websites providing reproductive health information. Studies only assessing the content of websites were excluded. We identified 5 scoring tools: 1-The HON (health on the net) Code of Conduct for medical and health Web sites, 2-Silberg scores, 3-Hogne Sandvik scale, 4-Jim Kapoun's Criteria for Evaluating Web Pages, and 5-The Health Information Technology Institute (HITI) criteria. We have compared these scales and identified 14 criteria: authorship, ownership, currency, objectivity/content, transparency/source, interactivity, privacy/ethics, financial disclosure, navigability/links, complementarity, advertising policy, design, quantity, and accessibility. We integrated these criteria and introduced a new tool with 10 criteria. Website evaluation tools differ in their evaluation criteria and there is a lack of consensus about which to use; therefore, an integrated easy to use set of criteria is needed.

  10. Models and criteria for LLW disposal performance

    International Nuclear Information System (INIS)

    Smith, C.F.; Cohen, J.J.

    1980-12-01

    A primary objective of the Low Level Waste (LLW) Management Program is to assure that public health is protected. Predictive modeling, to some extent, will play a role in meeting this objective. This paper considers the requirements and limitations of predictive modeling in providing useful inputs to waste mangement decision making. In addition, criteria development needs and the relation between criteria and models are discussed

  11. Models and criteria for waste repository performance

    International Nuclear Information System (INIS)

    Smith, C.F.; Cohen, J.J.

    1981-03-01

    A primary objective of the Waste Management Program is to assure that public health is protected. Predictive modeling, to some extent, will play a role in assuring that this objective is met. This paper considers the requirements and limitations of predictive modeling in providing useful inputs to waste management decision making. Criteria development needs and the relation between criteria and models are also discussed

  12. Models and criteria for LLW disposal performance

    International Nuclear Information System (INIS)

    Smith, C.F.; Cohen, J.J.

    1980-01-01

    A primary objective of the Low Level Waste (LLW) Management Program is to assure that public health is protected. Predictive modeling, to some extent, will play a role in meeting this objective. This paper considers the requirements and limitations of predictive modeling in providing useful inputs to waste management decision making. In addition, criteria development needs and the relation between criteria and models are discussed

  13. Criteria for the definition of Pituitary Tumor Centers of Excellence (PTCOE): A Pituitary Society Statement.

    Science.gov (United States)

    Casanueva, Felipe F; Barkan, Ariel L; Buchfelder, Michael; Klibanski, Anne; Laws, Edward R; Loeffler, Jay S; Melmed, Shlomo; Mortini, Pietro; Wass, John; Giustina, Andrea

    2017-10-01

    With the goal of generate uniform criteria among centers dealing with pituitary tumors and to enhance patient care, the Pituitary Society decided to generate criteria for developing Pituitary Tumors Centers of Excellence (PTCOE). To develop that task, a group of ten experts served as a Task Force and through two years of iterative work an initial draft was elaborated. This draft was discussed, modified and finally approved by the Board of Directors of the Pituitary Society. Such document was presented and debated at a specific session of the Congress of the Pituitary Society, Orlando 2017, and suggestions were incorporated. Finally the document was distributed to a large group of global experts that introduced further modifications with final endorsement. After five years of iterative work a document with the ideal criteria for a PTCOE is presented. Acknowledging that very few centers in the world, if any, likely fulfill the requirements here presented, the document may be a tool to guide improvements of care delivery to patients with pituitary disorders. All these criteria must be accommodated to the regulations and organization of Health of a given country.

  14. Liver Transplantation: Evolving Patient Selection Criteria

    Directory of Open Access Journals (Sweden)

    Andy S Yu

    2001-01-01

    Full Text Available The widespread recognition of the success of liver transplantation as a treatment for most types of acute and chronic liver failure has led to increased referrals for transplantation in the setting of a relatively fixed supply of cadaver donor organs. These events have led to a marked lengthening of the waiting time for liver transplantation, resulting in increased deaths of those on the waiting list and sicker patients undergoing transplantation. Nearly 5000 liver transplantations were performed in the United States in 2000, while the waiting list grew to over 17,000 patients. The mounting disparity between the number of liver transplant candidates and the limited supply of donor organs has led to reassessment of the selection and listing criteria for liver transplantation, as well as revision of organ allocation and distribution policies for cadaver livers. The development of minimal listing criteria for patients with chronic liver disease based on a specific definition for decompensation of cirrhosis has facilitated the more uniform listing of patients at individual centres across the United States. The United Network for Organ Sharing, under pressure from transplant professionals, patient advocacy groups and the federal government, has continuously revised allocation and distribution policies based on the ethical principles of justice for the individual patient versus optimal utility of the limited organ supply available annually. Beginning in 2002, it is likely that the Model for End-stage Liver Disease (MELD score will be implemented to determine disease severity and direct donor organs to the sickest patients rather than to those with the longest waiting times.

  15. The organization of HIV and other health activities within urban religious congregations.

    Science.gov (United States)

    Palar, Kartika; Mendel, Peter; Derose, Kathryn Pitkin

    2013-10-01

    Most religious congregations in the USA are involved with some type of social service activity, including health activities. However, relatively few formally engage with people with HIV, and many have reported barriers to introducing HIV prevention activities. We conducted a qualitative case study of HIV involvement among 14 urban congregations in Los Angeles County in 2007. In-depth qualitative interviews of lay leaders and clergy were analyzed for themes related to HIV and other health activities, including types of health issues addressed, types of activities conducted, how activities were organized, and the relationship between HIV and other health activities. We identified three primary models representing how congregations organized HIV and other health activities: (1) embedded (n = 7), where HIV activities were contained within other health activities; (2) parallel (n = 5), where HIV and other health activities occurred side by side and were organizationally distinct; (3) overlap (n = 2), where HIV and non-HIV health efforts were conducted by distinct groups, but shared some members and organization. We discuss implications of each model for initiating and sustaining HIV activities within urban congregations over time.

  16. Identification of multi-criteria for supplier selection in IT project outsourcing

    Science.gov (United States)

    Fusiripong, Prashaya; Baharom, Fauziah; Yusof, Yuhanis

    2017-10-01

    In the increasing global business competitiveness, most organizations have attempted to determine the suitable external parties to support their core and non-core competency, particularly, in IT project outsourcing. The IT supplier selection is required to apply multi-criteria which comprised tangible criteria and intangible criteria in consider optimal IT supplier. Most researches attempted to identify optimal criteria for selecting IT supplier, however, the criteria cannot be the considered common criteria support the variety of IT outsourcing. Therefore, the study aimed to identify a common set of criteria being used in the various types of IT outsourcing. The common criteria are constructed by multi-criteria and success criteria, which were collected by literature review with comprehensive and comparative approach. Consequently, the researchers are able to identify a common set of criteria adopted in the variety of selection problem IT outsourcing supplier.

  17. Mapping of Health Communication and Education Strategies Addressing the Public Health Dangers of Illicit Online Pharmacies.

    Science.gov (United States)

    Anderson, Allison C; Mackey, Tim K; Attaran, Amir; Liang, Bryan A

    2016-01-01

    Illicit online pharmacies are a growing global public health concern. Stakeholders have started to engage in health promotion activities to educate the public, yet their scope and impact has not been examined. We wished to identify health promotion activities focused on consumer awareness regarding the risks of illicit online pharmacies. Organizations engaged on the issue were first identified using a set of engagement criteria. We then reviewed these organizations for health promotion programs, educational components, public service announcements, and social media engagement. Our review identified 13 organizations across a wide spectrum of stakeholders. Of these organizations, 69.2% (n = 9) had at least one type of health promotion activity targeting consumers. Although the vast majority of these organizations were active on Facebook or Twitter, many did not have dedicated content regarding online pharmacies (Facebook: 45.5%, Twitter: 58.3%). An online survey administered to 6 respondents employed by organizations identified in this study found that all organizations had dedicated programs on the issue, but only half had media planning strategies in place to measure the effectiveness of their programs. Overall, our results indicate that though some organizations are actively engaged on the issue, communication and education initiatives have had questionable effectiveness in reaching the public. We note that only a few organizations offered comprehensive and dedicated content to raise awareness on the issue and were effective in social media communications. In response, more robust collaborative efforts between stakeholders are needed to educate and protect the consumer about this public health and patient safety danger.

  18. 76 FR 58466 - Request for Comments on World Health Organization Pandemic Influenza Preparedness Framework

    Science.gov (United States)

    2011-09-21

    ... response, including implementation of the World Health Organization Pandemic Influenza Preparedness... INFORMATION: Written comments are sought in light of the approval of the World Health Organization (WHO... DEPARTMENT OF COMMERCE International Trade Administration Request for Comments on World Health...

  19. Effect of organic poultry purchase frequency on consumer attitudes toward organic poultry meat.

    Science.gov (United States)

    Van Loo, Ellen; Caputo, Vincenzina; Nayga, Rodolfo M; Meullenet, Jean-Francois; Crandall, Philip G; Ricke, Steven C

    2010-09-01

    Because of the growing consumers' interest in organic meat, consumers' (N = 976) attitude toward organic meat was evaluated. Most respondents (59%) occasionally purchased organic chicken. To determine the organic chicken consumer profile, the organic chicken consumption frequencies of different demographic groups were compared. The results show dependence on age (P= 0.039) and ethnicity (P = 0.015). Older respondents as well as respondents who identified themselves as Caucasians tended to buy organic chicken more frequently. However, many other socio-demographic factors were not correlated with organic chicken consumption: gender (P = 0.185), education (P = 0.235), household income (0.867), living with partner or not (P = 0.235), and number of children (P = 0.883). Taste was identified as the most important meat quality attribute (perceived as [very] important by 94% of the respondents). Other important meat quality criteria were: general appearance, overall health, price, nutritional value, and containing no medical residues. "Organically produced" appeared to not be that important compared with other criteria. When respondents bought organic chicken more often, the importance of most of the meat quality attributes shifted to higher levels of importance, except for the price where an adverse effect was shown. The main motivation factors to buy organic chicken were the perception that organic chicken has fewer residues (pesticides, hormones, antibiotics), is safer, and healthier. The high price for organic meats was the strongest limiting factor for organic meat purchases followed by poor availability. Approximately 41% of the non-buyers and 30% of the occasional buyers perceived organic meat as not or hardly likely to be available in their supermarket. This study obtained a better knowledge of consumers' attitudes and perception of organic chicken as well as the effect of various demographics on the likelihood of buying organic chicken. For marketing purposes of

  20. 42 CFR 420.303 - HHS criteria for requesting books, documents, and records.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false HHS criteria for requesting books, documents, and... HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM PROGRAM INTEGRITY: MEDICARE Access to Books, Documents, and Records of Subcontractors § 420.303 HHS criteria for requesting books, documents, and records...

  1. Work organization and health among immigrant women: Latina manual workers in North Carolina.

    Science.gov (United States)

    Arcury, Thomas A; Grzywacz, Joseph G; Chen, Haiying; Mora, Dana C; Quandt, Sara A

    2014-12-01

    We sought to describe work organization attributes for employed immigrant Latinas and determine associations of work organization with physical health, mental health, and health-related quality of life. We conducted a cross-sectional survey with 319 employed Latinas in western North Carolina (2009-2011). Measures included job demands (heavy load, awkward posture, psychological demand), decision latitude (skill variety, job control), support (supervisor control, safety climate), musculoskeletal symptoms, mental health (depressive symptoms), and mental (MCS) and physical component score (PCS) health-related quality of life. Three fifths reported musculoskeletal symptoms. Mean scores for depression, MCS, and PCS were 6.2 (SE = 0.2), 38.3 (SE = 0.5), and 42.8 (SE = 0.3), respectively. Greater job demands (heavy load, awkward posture, greater psychological demand) were associated with more musculoskeletal and depressive symptoms and worse MCS. Less decision latitude (lower skill variety, job control) was associated with more musculoskeletal and depressive symptoms. Greater support (supervisor's power and safety climate) was associated with fewer depressive symptoms and better MCS. Work organization should be considered to improve occupational health of vulnerable women workers. Additional research should delineate the links between work organization and health among vulnerable workers.

  2. Trade associations and labor organizations as intermediaries for disseminating workplace safety and health information.

    Science.gov (United States)

    Okun, Andrea H; Watkins, Janice P; Schulte, Paul A

    2017-09-01

    There has not been a systematic study of the nature and extent to which business and professional trade associations and labor organizations obtain and communicate workplace safety and health information to their members. These organizations can serve as important intermediaries and play a central role in transferring this information to their members. A sample of 2294 business and professional trade associations and labor organizations in eight industrial sectors identified by the National Occupational Research Agenda was surveyed via telephone. A small percent of these organizations (40.9% of labor organizations, 15.6% of business associations, and 9.6% of professional associations) were shown to distribute workplace safety and health information to their members. Large differences were also observed between industrial sectors with construction having the highest total percent of organizations disseminating workplace safety and health information. There appears to be significant potential to utilize trade and labor organizations as intermediaries for transferring workplace safety and health information to their members. Government agencies have a unique opportunity to partner with these organizations and to utilize their existing communication channels to address high risk workplace safety and health concerns. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

  3. Criteria for Radionuclide Activity Concentrations for Food and Drinking Water

    International Nuclear Information System (INIS)

    2016-04-01

    Requirements for the protection of people from the harmful consequences of exposure to ionizing radiation, for the safety of radiation sources and for the protection of the environment are established in IAEA Safety Standards Series No. GSR Part 3, Radiation Protection and Safety of Radiation Sources: International Basic Safety Standards. GSR Part 3 requires that the regulatory body or other relevant authority establish specific reference levels for exposure due to radionuclides in commodities, including food and drinking water. The reference level is based on an annual effective dose to the representative person that generally does not exceed a value of about 1 mSv. International standards have been developed by the Food and Agriculture Organization of the United Nations/World Health Organization (FAO/WHO) Codex Alimentarius Commission for levels of radionuclides contained in food traded internationally that contains, or could potentially contain, radioactive substances as a consequence of a nuclear or radiological emergency. International standards have also been developed by the WHO for radionuclides contained in drinking water, other than in a nuclear or radiological emergency. These international standards provide guidance and criteria in terms of levels of individual radiation dose, levels of activity concentration of specific radionuclides, or both. The criteria derived in terms of levels of activity concentration in the various international standards differ owing to a number of factors and assumptions underlying the common objective of protecting public health in different circumstances. This publication considers the various international standards to be applied at the national level for the assessment of levels of radionuclides in food and in drinking water in different circumstances for the purposes of control, other than in a nuclear or radiological emergency. It collates and provides an overview of the different criteria used in assessing and

  4. Asbestos and Asbestos-related Diseases in Vietnam: In reference to the International Labor Organization/World Health Organization National Asbestos Profile

    Directory of Open Access Journals (Sweden)

    Van Hai Pham

    2013-06-01

    Full Text Available This paper describes progress on formulating a national asbestos profile for the country of Vietnam. The Center of Asbestos Resource, Vietnam, formulated a National Profile on Asbestos-related Occupational Health, with due reference to the International Labor Organization/World Health Organization National Asbestos Profile. The Center of Asbestos Resource was established by the Vietnamese Health Environment Management Agency and the National Institute of Labor Protection, with the support of the Australian Agency for International Development, as a coordinating point for asbestos-related issues in Vietnam. Under the National Profile on Asbestos-related Occupational Health framework, the Center of Asbestos Resource succeeded in compiling relevant information for 15 of the 18 designated items outlined in the International Labor Organization/World Health Organization National Asbestos Profile, some overlaps of the information items notwithstanding. Today, Vietnam continues to import and use an average of more than 60,000 metric tons of raw asbestos per year. Information on asbestos-related diseases is limited, but the country has begun to diagnose mesothelioma cases, with the technical cooperation of Japan. As it stands, the National Profile on Asbestos-related Occupational Health needs further work and updating. However, we envisage that the National Profile on Asbestos-related Occupational Health will ultimately facilitate the smooth transition to an asbestos-free Vietnam.

  5. Power in health care organizations: contemplations from the first-line management perspective.

    Science.gov (United States)

    Isosaari, Ulla

    2011-01-01

    The aim of this paper is to examine health care organizations' power structures from the first-line management perspective. What liable power structures derive from the theoretical bases of bureaucratic, professional and result based organizations, and what power type do health care organizations represent, according to the empirical data? The paper seeks to perform an analysis using Mintzberg's power configurations of instrument, closed system, meritocracy and political arena. The empirical study was executed at the end of 2005 through a survey in ten Finnish hospital districts in both specialized and primary care. Respondents were all first-line managers in the area and a sample of staff members from internal disease, surgical and psychiatric units, as well as out-patient and primary care units. The number of respondents was 1,197 and the response percentage was 38. The data were analyzed statistically. As a result, it can be seen that a certain kind of organization structure supports the generation of a certain power type. A bureaucratic organization generates an instrument or closed system organization, a professional organization generates meritocracy and also political arena, and a result-based organization has a connection to political arena and meritocracy. First line managers regarded health care organizations as instruments when staff regarded them mainly as meritocracies having features of political arena. Managers felt their position to be limited by rules, whereas staff members regarded their position as having lots of space and influence potential. If the organizations seek innovative and active managers at the unit level, they should change the organizational structure and redistribute the work so that there could be more space for meaningful management. This research adds to the literature and gives helpful suggestions that will be of interest to those in the position of first-line management in health care.

  6. Great expectations for the World Health Organization: a Framework Convention on Global Health to achieve universal health coverage.

    Science.gov (United States)

    Ooms, G; Marten, R; Waris, A; Hammonds, R; Mulumba, M; Friedman, E A

    2014-02-01

    Establishing a reform agenda for the World Health Organization (WHO) requires understanding its role within the wider global health system and the purposes of that wider global health system. In this paper, the focus is on one particular purpose: achieving universal health coverage (UHC). The intention is to describe why achieving UHC requires something like a Framework Convention on Global Health (FCGH) that have been proposed elsewhere,(1) why WHO is in a unique position to usher in an FCGH, and what specific reforms would help enable WHO to assume this role. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  7. Systemic inflammatory response syndrome criteria in defining severe sepsis.

    Science.gov (United States)

    Kaukonen, Kirsi-Maija; Bailey, Michael; Pilcher, David; Cooper, D Jamie; Bellomo, Rinaldo

    2015-04-23

    The consensus definition of severe sepsis requires suspected or proven infection, organ failure, and signs that meet two or more criteria for the systemic inflammatory response syndrome (SIRS). We aimed to test the sensitivity, face validity, and construct validity of this approach. We studied data from patients from 172 intensive care units in Australia and New Zealand from 2000 through 2013. We identified patients with infection and organ failure and categorized them according to whether they had signs meeting two or more SIRS criteria (SIRS-positive severe sepsis) or less than two SIRS criteria (SIRS-negative severe sepsis). We compared their characteristics and outcomes and assessed them for the presence of a step increase in the risk of death at a threshold of two SIRS criteria. Of 1,171,797 patients, a total of 109,663 had infection and organ failure. Among these, 96,385 patients (87.9%) had SIRS-positive severe sepsis and 13,278 (12.1%) had SIRS-negative severe sepsis. Over a period of 14 years, these groups had similar characteristics and changes in mortality (SIRS-positive group: from 36.1% [829 of 2296 patients] to 18.3% [2037 of 11,119], P<0.001; SIRS-negative group: from 27.7% [100 of 361] to 9.3% [122 of 1315], P<0.001). Moreover, this pattern remained similar after adjustment for baseline characteristics (odds ratio in the SIRS-positive group, 0.96; 95% confidence interval [CI], 0.96 to 0.97; odds ratio in the SIRS-negative group, 0.96; 95% CI, 0.94 to 0.98; P=0.12 for between-group difference). In the adjusted analysis, mortality increased linearly with each additional SIRS criterion (odds ratio for each additional criterion, 1.13; 95% CI, 1.11 to 1.15; P<0.001) without any transitional increase in risk at a threshold of two SIRS criteria. The need for two or more SIRS criteria to define severe sepsis excluded one in eight otherwise similar patients with infection, organ failure, and substantial mortality and failed to define a transition point in

  8. Gossip and emotion in nursing and health-care organizations.

    Science.gov (United States)

    Waddington, Kathryn; Fletcher, Clive

    2005-01-01

    The purpose of this paper is to examine the relationship between gossip and emotion in health-care organizations. It draws on findings from empirical research exploring the characteristics and function of gossip which, to date, has been a relatively under-researched organizational phenomenon. A multidisciplinary approach was adopted, drawing on an eclectic range of discipline-based theories, skills, ideas and data. Methods included repertory grid technique, in-depth interviews and structured diary records of work-related gossip. The sample comprised 96 qualified nurses working in a range of practice areas and organizational settings in the UK. Template analysis was used to integrate findings across three phases of data collection. The findings revealed that gossip is used to express a range of emotions including care and concern about others, anger, annoyance and anxiety, with emotional outcomes that include feeling reassured and supported. It is the individual who gossips, while the organization provides the content, emotional context, triggers and opportunities. Nurses were chosen as an information-rich source of data, but the findings may simply reflect the professional culture and practice of nursing. Future research should take into account a wider range of health-care organizational roles and perspectives in order to capture the dynamics and detail of the emotions and relationships that initiate and sustain gossip. Because gossip makes people feel better it may serve to reinforce the "stress mask of professionalism", hiding issues of conflict, vulnerability and intense emotion. Managers need to consider what the emotions expressed through gossip might represent in terms of underlying issues relating to organizational health, communication and change. This paper makes a valuable contribution to the under-researched phenomenon of gossip in organizations and adds to the growing field of research into the role of emotion in health-care organizations and emotion

  9. Selection of response criteria for clinical trials of sarcoma treatment.

    Science.gov (United States)

    Schuetze, Scott M; Baker, Laurence H; Benjamin, Robert S; Canetta, Renzo

    2008-01-01

    Soft tissue sarcomas are a heterogeneous group of malignancies arising from mesenchymal tissues. A large number of new therapies are being evaluated in patients with sarcomas, and consensus criteria defining treatment responses are essential for comparison of results from studies completed by different research groups. The 1979 World Health Organization (WHO) handbook set forth operationally defined criteria for response evaluation in solid tumors that were updated in 2000 with the publication of the Response Evaluation Criteria in Solid Tumors (RECIST). There have been significant advances in tumor imaging, however, that are not reflected in the RECIST. For example, computed tomography (CT) slice thickness has been reduced from 10 mm to < or =2.5 mm, allowing for more reproducible and accurate measurement of smaller lesions. Combination of imaging techniques, such as positron emission tomography with fluorine-18-fluorodeoxyglucose (18FDG-PET) and CT can provide investigators and clinicians with both anatomical and functional information regarding tumors, and there is now a large body of evidence demonstrating the effectiveness of PET/CT and other newer imaging methods for the detection and staging of tumors as well as early determination of responses to therapy. The application of newer imaging methods has the potential to decrease both the sample sizes required for, and duration of, clinical trials by providing an early indication of therapeutic response that is well correlated with clinical outcomes, such as time to tumor progression or overall survival. The results summarized in this review support the conclusion that the RECIST and the WHO criteria for evaluation of response in solid tumors need to be modernized. In addition, there is a current need for prospective trials to compare new response criteria with established endpoints and to validate imaging-based response rates as surrogate endpoints for clinical trials of new agents for sarcoma and other solid

  10. Managing change in health care organizations.

    Science.gov (United States)

    Margulies, N

    1977-08-01

    The forces for change seem more potent today than ever before; increased technological advancement and rapid "societal upheavals" create a more critical need for change and a more significant need for skills to manage and channel change toward meaningful ends. The area of health care delivery is probably one of the fields most impinged upon and most affected by these turbulent times. Organizational development is presented herein as an approach to assist people in health care organizations with the problems of adaptation and change. A specific change strategy, action research, is discussed and a concrete case example is presented to illustrate the ways in which the action research model can be applied. Advantages and pitfalls are discussed in the concluding section.

  11. Working in the health sector: implementation of workplace health promotion

    Directory of Open Access Journals (Sweden)

    Eliana Castro S

    2011-11-01

    Full Text Available Objective: to discuss issues that are relevant to the implementation of workplace health promotion (whp in organization processes of the health sector as a strategic tool to manage health and safety at the workplace. Methods: after a conceptual review of whp in 2009, a qualitative case study on the development of this strategy in third level hospitals of Bogotá was carried out. This descriptive and cross-sectional study was approved by the Ethics Committee of the Faculty of Nursing at the National University of Colombia. Results: although there are occupational health programs that convey the spirit of whp in their content, its level of development is not consistently linked to it. The following criteria were analyzed: strategy and commitment, human resources and organization, social responsibility, planning, and development and results, all of which were not well valued by workers. Final considerations: the traditional approach to occupational health and the poor integration of the WHP principles into organizational processes are reflected in the actions taken and the expectations regarding the subject. Therefore, actions should be taken in terms of public policies to strengthen the institutional capacity to ensure the feasibility of whp in the health sector.

  12. The relationship between modifiable health risks and group-level health care expenditures. Health Enhancement Research Organization (HERO) Research Committee.

    Science.gov (United States)

    Anderson, D R; Whitmer, R W; Goetzel, R Z; Ozminkowski, R J; Dunn, R L; Wasserman, J; Serxner, S

    2000-01-01

    To assess the relationship between modifiable health risks and total health care expenditures for a large employee group. Risk data were collected through voluntary participation in health risk assessment (HRA) and worksite biometric screenings and were linked at the individual level to health care plan enrollment and expenditure data from employers' fee-for-service plans over the 6-year study period. The setting was worksite health promotion programs sponsored by six large private-sector and public-sector employers. Of the 50% of employees who completed the HRA, 46,026 (74.7%) met all inclusion criteria for the analysis. Eleven risk factors (exercise, alcohol use, eating, current and former tobacco use, depression, stress, blood pressure, cholesterol, weight, and blood glucose) were dichotomized into high-risk and lower-risk levels. The association between risks and expenditures was estimated using a two-part regression model, controlling for demographics and other confounders. Risk prevalence data were used to estimate group-level impact of risks on expenditures. Risk factors were associated with 25% of total expenditures. Stress was the most costly factor, with tobacco use, overweight, and lack of exercise also being linked to substantial expenditures. Modifiable risk factors contribute substantially to overall health care expenditures. Health promotion programs that reduce these risks may be beneficial for employers in controlling health care costs.

  13. Explanation of diagnosis criteria for radiation sickness from internal exposure

    International Nuclear Information System (INIS)

    Xing Zhiwei; Jiang Enhai; Du Jianying; Bai Guang

    2012-01-01

    A revised edition of the Diagnostic Criteria for Radiation Sickness from Internal Exposure has been approved and issued by the Ministry of Health. It is necessary to research the internal radiation sickness to adapt to the current serious anti-terrorism situation. This standard was enacted based on the extensive research of related literature, from which 12 cases with internal radiation sickness and screened out were involving 7 types of radionuclide. The Development of Emergency Response Standard Extension Framework: Midterm Evaluation Report is the main reference which approved by the International Atomic Energy Agency and World Health Organization. This amendment contains many new provisions such as internal radiation sickness effects models and threshold dose, and the appendix added threshold dose of serious deterministic effects induced by radionuclide intake and radiotoxicology parameters of some radionuclides. In order to understand and implement this standard, and to diagnose and treat the internal radiation sickness correctly, the contents of this standard were interpreted in this article. (authors)

  14. 45 CFR 1308.16 - Eligibility criteria: Traumatic brain injury.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Eligibility criteria: Traumatic brain injury. 1308... DISABILITIES Health Services Performance Standards § 1308.16 Eligibility criteria: Traumatic brain injury. A child is classified as having traumatic brain injury whose brain injuries are caused by an external...

  15. Validation of the Rome III criteria and alarm symptoms for recurrent abdominal pain in children.

    Science.gov (United States)

    Gijsbers, Carolien F M; Benninga, Marc A; Schweizer, Joachim J; Kneepkens, C M Frank; Vergouwe, Yvonne; Büller, Hans A

    2014-06-01

    Rome criteria were formulated to define functional gastrointestinal disorders (Rome III criteria, 2006) excluding organic diagnoses when alarm symptoms were absent. The aims of the study were to validate the Rome III criteria as to their capacity to differentiate between organic and functional abdominal pain and to assess the role of alarm symptoms in this differentiation. During 2 years all of the patients (ages 4-16 years) presenting with recurrent abdominal pain (Apley criteria) and referred to secondary care were included. Clinical diagnoses were based on protocolized evaluation and intervention with 6-month follow-up. Alarm symptoms were registered. Rome III criteria for functional pain syndromes were assigned independently. Descriptive statistical analyses were performed. In 200 patients (87 boys, mean age 8.8 years), organic (17%), functional (40%), combined organic and functional (9%), spontaneous recovery (27%), and other (8%) clinical diagnoses were established. Alarm symptoms were found in 57.5% (organic causes 56%, functional causes 61%). The evaluation for Rome symptom clusters revealed symptoms of irritable bowel syndrome in 27%, functional dyspepsia in 15%, functional abdominal pain in 28%, functional abdominal pain syndrome in 14.5%, and no pain syndrome in 15.5%. Rome diagnoses, based on symptoms and absence of alarm symptoms, predicted functional clinical diagnosis with sensitivity 0.35 (95% confidence interval 0.27-0.43), specificity 0.60 (0.46-0.73), positive predictive value 0.71 (0.61-0.82), and negative predictive value of 0.24 (0.17-0.32). The Rome III criteria for abdominal pain are not specific enough to rule out organic causes. Alarm symptoms do not differentiate between organic and functional abdominal pain.

  16. Changes in compliance rates of evaluation criteria after health care accreditation: Mainly on radiologic technologists working at University Hospitals in Daejeon area

    International Nuclear Information System (INIS)

    Ko, Eun Ju; Kim, Hyun Joo; Lee, Jin Yong; Bae, Seok Hwan

    2013-01-01

    This study aimed to assess whether the changes in compliance rates of evaluation criteria after healthcare accreditation among radiologic technologists working at four university hospitals which had acquired healthcare accreditation in Daejeon metropolitan area. In this study, the evaluation criteria of healthcare accreditation were reclassified and reevaluated to three areas which include patient safety, staff safety, and environmental safety. Each area has eight, three, and five questions, respectively. Each compliance rate was quantitatively measured on a scale of 0 to 10 before and after in this study. The result shows that the overall compliance rates were decreased on all areas compared to the time healthcare accreditation was obtained. The compliance rate of hand hygiene was drastically reduced. To maintain the compliance rates, not only individuals but healthcare organizations should simultaneously endeavor. In particular, healthcare organizations should make an effort to provide continuous education opportunity to their workers and supervise the compliance regularly

  17. [Financing, organization, costs and services performance of the Argentinean health sub-systems.

    Science.gov (United States)

    Yavich, Natalia; Báscolo, Ernesto Pablo; Haggerty, Jeannie

    2016-01-01

    To analyze the relationship between health system financing and services organization models with costs and health services performance in each of Rosario's health sub-systems. The financing and organization models were characterized using secondary data. Costs were calculated using the WHO/SHA methodology. Healthcare quality was measured by a household survey (n=822). Public subsystem:Vertically integrated funding and primary healthcare as a leading strategy to provide services produced low costs and individual-oriented healthcare but with weak accessibility conditions and comprehensiveness. Private subsystem: Contractual integration and weak regulatory and coordination mechanisms produced effects opposed to those of the public sub-system. Social security: Contractual integration and strong regulatory and coordination mechanisms contributed to intermediate costs and overall high performance. Each subsystem financing and services organization model had a strong and heterogeneous influence on costs and health services performance.

  18. Organic food - food quality and potential health effects

    OpenAIRE

    Mie, Axel; Wivstad, Maria

    2015-01-01

    In this report, we try to approach the question “Is organic food healthier than conventional food?” from a scientific perspective. We can conclude that science does not provide a clear answer to this question. A small number of animal studies and epidemiological studies on health effects from the consumption of organic vs. conventional feed/food have been performed. These studies indicate that the production system of the food has some influence on the immune system of the consuming animal or...

  19. Research-based-decision-making in Canadian health organizations: a behavioural approach.

    Science.gov (United States)

    Jbilou, Jalila; Amara, Nabil; Landry, Réjean

    2007-06-01

    Decision making in Health sector is affected by a several elements such as economic constraints, political agendas, epidemiologic events, managers' values and environment... These competing elements create a complex environment for decision making. Research-Based-Decision-Making (RBDM) offers an opportunity to reduce the generated uncertainty and to ensure efficacy and efficiency in health administrations. We assume that RBDM is dependant on decision makers' behaviour and the identification of the determinants of this behaviour can help to enhance research results utilization in health sector decision making. This paper explores the determinants of RBDM as a personal behaviour among managers and professionals in health administrations in Canada. From the behavioural theories and the existing literature, we build a model measuring "RBDM" as an index based on five items. These items refer to the steps accomplished by a decision maker while developing a decision which is based on evidence. The determinants of RBDM behaviour are identified using data collected from 942 health care decision makers in Canadian health organizations. Linear regression is used to model the behaviour RBDM. Determinants of this behaviour are derived from Triandis Theory and Bandura's construct "self-efficacy." The results suggest that to improve research use among managers in Canadian governmental health organizations, strategies should focus on enhancing exposition to evidence through facilitating communication networks, partnerships and links between researchers and decision makers, with the key long-term objective of developing a culture that supports and values the contribution that research can make to decision making in governmental health organizations. Nevertheless, depending on the organizational level, determinants of RBDM are different. This difference has to be taken into account if RBDM adoption is desired. Decision makers in Canadian health organizations (CHO) can help to build

  20. Applying total quality management concepts to public health organizations.

    Science.gov (United States)

    Kaluzny, A D; McLaughlin, C P; Simpson, K

    1992-01-01

    Total quality management (TQM) is a participative, systematic approach to planning and implementing a continuous organizational improvement process. Its approach is focused on satisfying customers' expectations, identifying problems, building commitment, and promoting open decision-making among workers. TQM applies analytical tools, such as flow and statistical charts and check sheets, to gather data about activities within an organization. TQM uses process techniques, such as nominal groups, brainstorming, and consensus forming to facilitate communication and decision making. TQM applications in the public sector and particularly in public health agencies have been limited. The process of integrating TQM into public health agencies complements and enhances the Model Standards Program and assessment methodologies, such as the Assessment Protocol for Excellence in Public Health (APEX-PH), which are mechanisms for establishing strategic directions for public health. The authors examine the potential for using TQM as a method to achieve and exceed standards quickly and efficiently. They discuss the relationship of performance standards and assessment methodologies with TQM and provide guidelines for achieving the full potential of TQM in public health organizations. The guidelines include redefining the role of management, defining a common corporate culture, refining the role of citizen oversight functions, and setting realistic estimates of the time needed to complete a task or project. PMID:1594734

  1. Tobacco and oral health--the role of the world health organization.

    Science.gov (United States)

    Petersen, Poul Erik

    2003-01-01

    In addition to several other chronic diseases, tobacco use is a primary cause of many oral diseases and adverse oral conditions. For example, tobacco is a risk factor for oral cancer, periodontal disease, and congenital defects in children whose mothers smoke during pregnancy. The epidemic of tobacco use is one of the greatest threats to global health; sadly the future appears worse because of the globalization of marketing. The World Health Organization (WHO) has strengthened the work for effective control of tobacco use. At the World Health Assembly in May 2003 the Member States agreed on a groundbreaking public health treaty to control tobacco supply and consumption. The treaty covers tobacco taxation, smoking prevention and treatment, illicit trade, advertising, sponsorship and promotion, and product regulation. Oral health professionals and dental associations worldwide should consider this platform for their future work for tobacco prevention since in several countries they play an important role in communication with patients and communities. The WHO Oral Health Programme gives priority to tobacco control in many ways through the development of national and community programmes which incorporates oral health and tobacco issues, tobacco prevention through schools, tobacco risk assessment in countries, and design of modern surveillance systems on risk factors and oral health. Systematic evaluation of coordinated efforts should be carried out at country and inter-country levels.

  2. Institutions involved in food Safety: World Health Organization (WHO)

    DEFF Research Database (Denmark)

    Schlundt, Jørgen

    2014-01-01

    The World Health Organization (WHO) has been a leading intergovernmental organization in the effort to prevent diseases related to food and improve global food safety and security. These efforts have been focused on the provision of independent scientific advice on foodborne risks, the development...... the focus on simple and efficient messaging toward preventing food risks through a better understanding of good food preparation practices in all sectors....

  3. Emergence of a new consumer health informatics framework: introducing the healthcare organization.

    Science.gov (United States)

    Reid, Paulette; Borycki, Elizabeth M

    2011-01-01

    Healthcare consumers are increasingly seeking reliable forms of health information on the Internet that can be used to support health related decision-making. Frameworks that have been developed and tested in the field of health informatics have attempted to describe the effects of the Internet upon the health care consumer and physician relationship. More recently, health care organizations are responding by providing information such as hospital wait lists or strategies for self-managing disease, and this information is being provided on organizational web-sites. The authors of this paper propose that current conceptualizations of the relationship between the Internet, physicians and patients are limited from a consumer informatics perspective and may need to be extended to include healthcare organizations.

  4. 78 FR 49756 - Notification of a Cooperative Agreement Award to the World Health Organization

    Science.gov (United States)

    2013-08-15

    ...: Notification of a sole source Cooperative Agreement Award to the World Health Organization for a grant titled... World Health Organization (WHO) as soon as possible, and any confirmed smallpox case would generate an... DEPARTMENT OF HEALTH AND HUMAN SERVICES Notification of a Cooperative Agreement Award to the World...

  5. Gender Incongruence of Childhood: Clinical Utility and Stakeholder Agreement with the World Health Organization’s Proposed ICD-11 Criteria

    Science.gov (United States)

    Beek, Titia F.; Cohen-Kettenis, Peggy T.; Bouman, Walter P.; de Vries, Annelou L. C.; Steensma, Thomas D.; Witcomb, Gemma L.; Arcelus, Jon; Richards, Christina; De Cuypere, Griet; Kreukels, Baudewijntje P. C.

    2017-01-01

    The World Health Organization (WHO) is revising the tenth version of the International Classification of Diseases and Related Health Problems (ICD-10). This includes a reconceptualization of the definition and positioning of Gender Incongruence of Childhood (GIC). This study aimed to: 1) collect the views of transgender individuals and professionals regarding the retention of the diagnosis; 2) see if the proposed GIC criteria were acceptable to transgender individuals and health care providers; 3) compare results between two countries with two different healthcare systems to see if these differences influence opinions regarding the GIC diagnosis; and 4) determine whether healthcare providers from high-income countries feel that the proposed criteria are clinically useful and easy to use. A total of 628 participants were included in the study: 284 from the Netherlands (NL; 45.2%), 8 from Flanders (Belgium; 1.3%), and 336 (53.5%) from the United Kingdom (UK). Most participants were transgender people (or their partners/relatives; TG) (n = 522), 89 participants were healthcare providers (HCPs) and 17 were both HCP and TG individuals. Participants completed an online survey developed for this study. Overall, the majority response from transgender participants (42.9%) was that if the diagnosis would be removed from the mental health chapter it should also be removed from the ICD-11 completely, while 33.6% thought it should remain in the ICD-11. Participants were generally satisfied with other aspects of the proposed ICD-11 GIC diagnosis: most TG participants (58.4%) thought the term Gender Identity Disorder should change, and most thought Gender Incongruence was an improvement (63.0%). Furthermore, most participants (76.1%) did not consider GIC to be a psychiatric disorder and placement in a separate chapter dealing with Gender and Sexual Health (the majority response in the NL and selected by 37.5% of the TG participants overall) or as a Z-code (the majority response

  6. Organ Donation European Quality System: ODEQUS project methodology.

    Science.gov (United States)

    Manyalich, M; Guasch, X; Gomez, M P; Páez, G; Teixeira, L

    2013-01-01

    Differences in the number of organ donors among hospitals cannot be explained only by the number of intensive care unit beds used or neurologic patients treated. The figures obtained are influenced by the organizational structure of the donation process and how efficient it is. The Organ Donation European Quality System (ODEQUS) is a 3-year project (from October 2010 to September 2013) co-financed by the European Agency for Health and Consumers (EAHC20091108) which aims to define a methodology to evaluate organ procurement performance at the hospital level. ODEQUS's specific objectives are to identify quality criteria and to develop quality indicators in three types of organ donation (after brain death, after cardiac death, and living donation). Those tools will be useful for hospitals' self-assessment as well as for developing an international auditing model. A consortium has been established involving 14 associated partners from Austria, Croatia, France, Germany, Italy, Poland, Portugal, Romania, Spain, Sweden, and the United Kingdom, as well as five collaborating partners from Greece, Hungary, Malta, Slovenia, and Turkey. The project has been established in three steps: 1) Design of a survey about the use of quality tools in a wide sample of European hospitals; 2) Development of quality criteria and quality indicators by the project experts. The main fields considered have been organizational structures, clinical procedures, and outcomes; and 3) Elaboration of an evaluation system to test the quality indicators in 11 European hospitals. Two types of training have been designed and performed: one concerns the development of quality criteria and quality indicators, whereas another is focused on how to use evaluation tools. Following this methodology, the project has so far identified 131 quality criteria and developed 31 quality indicators. Currently, the quality indicators are being tested in 11 selected hospitals. Copyright © 2013 Elsevier Inc. All rights

  7. Frailty and Organization of Health and Social Care.

    Science.gov (United States)

    Clegg, Andrew; Young, John

    2015-01-01

    In this chapter, we consider how health and social care can best be organized for older people with frailty. We will consider the merits of routine frailty identification, including risk stratification methods, to inform the provision of evidence-based treatment and holistic, goal-oriented care. We will also consider how best to place older people with frailty at the heart of health and social care systems so that the complex challenges associated with this vulnerable group are addressed. 2015 S. Karger AG, Basel.

  8. Development of aquatic life criteria for nitrobenzene in China

    International Nuclear Information System (INIS)

    Yan Zhenguang; Zhang Zhisheng; Wang Hong; Liang Feng; Li Ji; Liu Hongling; Sun Cheng; Liang Lijun; Liu Zhengtao

    2012-01-01

    Nitrobenzene is a toxic pollutant and was the main compound involved in the Songhuajiang accident in 2007, one of the largest water pollution accidents in China in the last decade. No aquatic life criteria for nitrobenzene have previously been proposed. In this study, published toxicity data of nitrobenzene to Chinese aquatic species were gathered, and six resident Chinese aquatic organisms were used in toxicity tests to supplement the existing toxicity data for nitrobenzene. Seventeen genuses mean acute values, three genuses mean chronic values to freshwater aquatic animals, and six genus toxicity values to aquatic plants were collected in total. A criterion maximum concentration of 0.018 mg/L and a criterion continuous concentration of 0.001 mg/L were developed based on these data, according to the U.S. Environmental Protection Agency guidelines. These criteria may be useful in the determination of water quality standard of nitrobenzene. - Highlights: ► China is embarking on development of national water quality criteria system. ► Nitrobenzene is a valuable case in development of water quality criteria in China. ► Several Chinese resident aquatic organisms were chosen to be tested. ► The aquatic life criteria for nitrobenzene were developed. - An acute criterion of 0.018 mg/L and a chronic criterion of 0.001 mg/L for nitrobenzene in China were developed according to the U.S. Environmental Protection Agency (USEPA) guidelines.

  9. World Health Organization approaches for surveys of health behaviour among schoolchildren and for health-promoting schools.

    Science.gov (United States)

    Honkala, Sisko

    2014-01-01

    Adolescents make up about one-sixth of the world's population. Most of the healthy and detrimental habits are adopted during childhood and adolescence. In the mid 1980s, a cross-national Health Behaviour in School-Aged Children (HBSC) survey was created to increase information about the well-being, health behaviours and social context of young people by using standard school-based questionnaires adopted by the World Health Organization (WHO) European office. The European Network of Health-Promoting Schools (HPS) was commenced in 1992, followed by the establishment of the WHO Global School Health Initiative in 1995. The initiative aims to improve the health of students, school personnel, families and other members of the community through schools by mobilizing and strengthening health promotion and educational activities at local, national, regional and global levels. The HBSC and HPS programmes have been accepted as activity areas for the WHO Collaborating Centre for Primary Oral Health Care in Kuwait. This article describes the HBSC and the HPS programmes and discusses the importance of establishing these programmes in Kuwait. © 2013 S. Karger AG, Basel.

  10. Developmentally sensitive diagnostic criteria for mental health disorders in early childhood: the diagnostic and statistical manual of mental disorders-IV, the research diagnostic criteria-preschool age, and the diagnostic classification of mental health and developmental disorders of infancy and early childhood-revised.

    Science.gov (United States)

    Egger, Helen L; Emde, Robert N

    2011-01-01

    As the infant mental health field has turned its focus to the presentation, course, and treatment of clinically significant mental health disorders, the need for reliable and valid criteria for identifying and assessing mental health symptoms and disorders in early childhood has become urgent. In this article we offer a critical perspective on diagnostic classification of mental health disorders in young children. We place the issue of early childhood diagnosis within the context of classification of psychopathology at other ages and describe, in some detail, diagnostic classifications that have been developed specifically for young children, including the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood (DC:0-3R; ZERO TO THREE, 2005), a diagnostic classification for mental health symptoms and disorders in infants, toddlers, and preschoolers. We briefly outline the role of diagnostic classification in clinical assessment and treatment planning. Last, we review the limitations of current approaches to the diagnostic classification of mental health disorders in young children. PsycINFO Database Record (c) 2010 APA, all rights reserved.

  11. Appropriate criteria set for personnel promotion across organizational levels using analytic hierarchy process (AHP

    Directory of Open Access Journals (Sweden)

    Charles Noven Castillo

    2017-01-01

    Full Text Available Currently, there has been limited established specific set of criteria for personnel promotion to each level of the organization. This study is conducted in order to develop a personnel promotion strategy by identifying specific sets of criteria for each level of the organization. The complexity of identifying the criteria set along with the subjectivity of these criteria require the use of multi-criteria decision-making approach particularly the analytic hierarchy process (AHP. Results show different sets of criteria for each management level which are consistent with several frameworks in literature. These criteria sets would help avoid mismatch of employee skills and competencies and their job, and at the same time eliminate the issues in personnel promotion such as favouritism, glass ceiling, and gender and physical attractiveness preference. This work also shows that personality and traits, job satisfaction and experience and skills are more critical rather than social capital across different organizational levels. The contribution of this work is in identifying relevant criteria in developing a personnel promotion strategy across organizational levels.

  12. Are organic consumers preferring or avoiding foods with nutrition and health claims?

    DEFF Research Database (Denmark)

    Aschemann-Witzel, Jessica; Maroschek, Nicole; Hamm, Ulrich

    2013-01-01

    consumer purchase motives in common. Organic food and functional food are, however, often described as contradictory rather than complementary in amongst others the concept of health. Functional food tends to be perceived as ‘unnatural’ by consumers. So far, it has not been researched how consumers react...... to a combination of both product concepts. A realistically designed purchase simulation was conducted with 210 organic consumers in Germany. Five organic products in three different categories were offered, unobtrusively altered so that they showed a nutrition, health or risk reduction claim on two products...

  13. Comparison of QSOFA score and SIRS criteria as screening mechanisms for emergency department sepsis.

    Science.gov (United States)

    Haydar, Samir; Spanier, Matthew; Weems, Patricia; Wood, Samantha; Strout, Tania

    2017-11-01

    The Quick Sequential [Sepsis-related] Organ Failure Assessment (qSOFA) score has been shown to accurately predict mortality in septic patients and is part of recently proposed diagnostic criteria for sepsis. We sought to ascertain the sensitive of the score in diagnosing sepsis, as well as the diagnostic timeliness of the score when compared to traditional systemic inflammatory response syndrome (SIRS) criteria in a population of emergency department (ED) patients treated in the ED, admitted, and subsequently discharged with a diagnosis of sepsis. Electronic health records of 200 patients who were treated for suspected sepsis in our ED and ultimately discharged from our hospital with a diagnosis of sepsis were randomly selected for review from a population of adult ED patients (N=1880). Data extracted included the presence of SIRS criteria and the qSOFA score as well as time required to meet said criteria. In this cohort, 94.5% met SIRS criteria while in the ED whereas only 58.3% met qSOFA. The mean time from arrival to SIRS documentation was 47.1min (95% CI: 36.5-57.8) compared to 84.0min (95% CI: 62.2-105.8) for qSOFA. The median ED "door" to positive SIRS criteria was 12min and 29min for qSOFA. Although qSOFA may be valuable in predicting sepsis-related mortality, it performed poorly as a screening tool for identifying sepsis in the ED. As the time to meet qSOFA criteria was significantly longer than for SIRS, relying on qSOFA alone may delay initiation of evidence-based interventions known to improve sepsis-related outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Do Different Diagnostic Criteria Impact Polycystic Ovary Syndrome Diagnosis for Adolescents?

    Science.gov (United States)

    Akgül, Sinem; Düzçeker, Yasemin; Kanbur, Nuray; Derman, Orhan

    2018-06-01

    Although early diagnosis of polycystic ovary syndrome (PCOS) in adolescents might allow for earlier treatment and prevention of chronic disorders, incorrect or premature diagnosis carries risks of unnecessary treatment and psychological distress. There is no consensus concerning which diagnostic criteria to use for adolescents and current criteria vary. The objective of this study was to determine whether using different diagnostic criteria will affect PCOS diagnosis in adolescents. Fifty-two patients aged 13-18 years with at least 2 of the following criteria were included in the study: (1) oligomenorrhea or amenorrhea; (2) Clinical or biochemical hyperandrogenism; and (3) polycystic ovaries on ultrasonography. Patients were then categorized according to the 6 different criteria for PCOS. National Institutes of Health, Rotterdam criteria, Androgen Excess Society, Amsterdam criteria, Endocrine Society criteria, and the Pediatric Endocrine Society criteria. The characteristics of adolescents who were diagnosed with PCOS were also evaluated. Forty-one patients out of 52 (78.8%) received diagnosis with National Institutes of Health and Endocrine Society criteria, all with Rotterdam criteria, 45/52 (86.5%) with Androgen Excess Society criteria, 36/52 (69.2%) with Amsterdam criteria and 34/52 (65.4%) with the Pediatric Endocrine Society criteria. This study shows that the choice of guideline used does have a great effect on whether an adolescent received the PCOS diagnosis or not. For physicians using the broader criteria, care should be taken to ensure the patient does not receive diagnosis because of the physiological changes seen during puberty, which might mimic PCOS. For those using stricter criteria, close monitoring of patients who do not receive diagnosis is necessary to prevent chronic complications. Copyright © 2017 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  15. [The transition from 'international' to 'global' public health and the World Health Organization].

    Science.gov (United States)

    Brown, Theodore M; Cueto, Marcos; Fee, Elizabeth

    2006-01-01

    Within the context of international public health, 'global health' seems to be emerging as a recognized term of preference. This article presents a critical analysis of the meaning and importance of 'global health' and situates its growing popularity within a historical context. A specific focus of this work is the role of the World Health Organization - WHO in both 'international' and 'global' health, and as na agent of transition from one to the other. Between 1948 and 1998, the WHO went through a period of hardship as it came up against an organizational crisis, budget cuts and a diminished status, especially when confronted with the growing influence of new, power players like the World Bank. We suggest that the WHO has responded to this changing international context by inititating its own process of restructuring and repositioning as an agent for coordinating, strategically planning and leading 'global health' initiatives.

  16. Updates to the World Health Organization's Recommendations for ...

    African Journals Online (AJOL)

    In July 2010, the World Health Organization (WHO) released new guidelines entitled, “Antiretroviral Drugs for Treating Pregnant Women and Preventing HIVInfection in Infants: Towards universal access.” Previewed in November 2009 in abridged form, the completed document highlights the key WHO recommendations for ...

  17. Review and Synthesis: Criteria for the Evaluation of Organizational Communication Effectiveness.

    Science.gov (United States)

    Farace, Richard V.; And Others

    Twenty-one criteria for assessing communication effectiveness in organizations provide the basis for discussion in this document. Grouped under the general heading of communication rules, the criteria are described according to five categories: structure, messages, media, communicator, and potpourri (factors that affect the decision making of…

  18. [Organization and functioning of health services of the IMSS-Solidaridad program].

    Science.gov (United States)

    Velázquez-Díaz, G

    1992-01-01

    In this report the organization and performance of the IMSS-Solidaridad Program of Mexico is described. This program is managed by the Mexican Institute for Social Security, which services 10.5 million inhabitants of the rural underserved areas, with federal government resources in 18 states. This study compares the structure and functioning of the IMSS-Solidaridad Program with Local Health Systems, as they have been proposed by the Panamerican Health Organization for country members and by the Ministry of Health of Mexico, particularly in relation to the decision-making process at local level. Some assets and limitations of the IMSS-Solidaridad Program are analyzed and, finally, concrete procedures to improve coordination between the IMSS-Solidaridad Program and other health services for similar populations (populations without social security protection) in Mexico are suggested, with the purpose of using resources more adequately and succeed in the national goal to achieve equity in health.

  19. Deceased donor organ transplantation with expanded criteria donors: a single-center experience from India.

    Science.gov (United States)

    Goplani, K R; Firoz, A; Ramakrishana, P; Shah, P R; Gumber, M R; Patel, H V; Vanikar, A V; Trivedi, H L

    2010-01-01

    Deceased donor organ transplantation (DDOT) accounts for DKT) and 19 single (SKT). Fourteen donors had hypertension, a cerebrovascular accident as the cause of death, 9 had both, and 4 had diabetes. Mean donor age was 70.3 +/- 8.9 years. Decisions on the procedure were based upon frozen section biopsy in 13 of 21 donors. Mean DKT donor age was 76 +/- 9.7 years versu 64 +/- 5.7 years of SKT donors. The native kidney diseases were chronic glomerulonephritis (n = 14), diabetic nephropathy (n = 7), tubulointerstitial nephritis (n = 4) and polycystic kidney disease, focal segmental glomerulosclerosis, lupus nephritis and patchy cortical necrosis, (n = 1 each). Mean recipient age of DKT versus SKT was 43.5 versus 42.3 years. All recipients received rabbit anti-thymocyte globulin, followed by steroid, mycophenolate mofetil/calcinueurin inhibitor. Over a mean follow-up of 341 days, the mean serum creatinine (SCr) of 25/29 patients was 1.60 mg/dL (range, 1.0-2.6). The mean SCr of SKT patients was 1.59 +/- 0.63 mg/dL and of DKT, 1.62 +/- 0.48 mg/dL. Ten patients had delayed graft function and 11 had biopsy proven acute tubular necrosis. Seven (24%) patients had rejection (grade 3 Banff update '05, type IA; 4, type 2A); 6 responded to antirejection; 1 graft was lost at 7 months due to chronic rejection. Three (10.3%) patients were lost, 1 each due to AMI, sepsis, and CMV disease. In the circumstances of organ shortage, DDOT with expanded criteria donor is a feasible option.

  20. Multiple Criteria Decision Analysis for Health Care Decision Making—An Introduction: Report 1 of the ISPOR MCDA Emerging Good Practices Task Force

    NARCIS (Netherlands)

    Thokala, Praveen; Devlin, Nancy; Marsh, Kevin; Baltussen, Rob; Boysen, Meindert; Kalo, Zoltan; Longrenn, Thomas; Mussen, Filip; Peacock, Stuart; Watkins, John; IJzerman, Maarten Joost

    2016-01-01

    Health care decisions are complex and involve confronting trade-offs between multiple, often conflicting, objectives. Using structured, explicit approaches to decisions involving multiple criteria can improve the quality of decision making and a set of techniques, known under the collective heading

  1. Top-level regulatory criteria for the standard MHTGR

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1986-10-15

    The Licensing Plan for the Standard MHTGR (Ref. 1) describes a program to support a U.S. Nuclear Regulatory Commission (NRC) design review and approval. The Plan calls for the submittal of Top-Level Regulatory Criteria to the NRC for concurrence with their completeness and acceptability for the MHTGR program. The Top-Level Regulatory Criteria are defined as the standards for judging licensability that directly specify acceptable limits for protection of the public health and safety and the environment. The criteria proposed herein are for normal plant operation and a broad spectrum of anticipated events, including accidents. The approach taken is to define a set of criteria which are general as opposed to being design specific. Specifically, it is recommended that criteria be met which: 1. Are less prescriptive than current regulation, thereby encouraging maximum flexibility in design approaches. 2. Are measurable. 3. Are not more strict than the criteria for current power plants.

  2. Sustainable Organic Farming For Environmental Health A Social Development Model

    Directory of Open Access Journals (Sweden)

    Ijun Rijwan Susanto

    2015-05-01

    Full Text Available ABSTRACT In this study the researcher attempted 1 to understand the basic features of organic farming in The Paguyuban Pasundans Cianjur 2 to describe and understand how the stakeholders were are able to internalize the challenges of organic farming on their lived experiences in the community 3 to describe and understand how the stakeholders were are able to internalize and applied the values of benefits of organic farming in support of environmental health on their lived experiences in the community 4 The purpose was to describe and understand how the stakeholders who are able to articulate their ideas regarding the model of sustainable organic farming 5 The Policy Recommendation for Organic Farming. The researcher employed triangulation thorough finding that provides breadth and depth to an investigation offering researchers a more accurate picture of the phenomenon. In the implementation of triangulation researchers conducted several interviews to get saturation. After completion of the interview results are written compiled and shown to the participants to check every statement by every participant. In addition researchers also checked the relevant documents and direct observation in the field The participants of this study were the stakeholders namely 1 The leader of Paguyuban Pasundans Organic Farmer Cianjur PPOFC 2 Members of Paguyuban Pasundans Organic FarmersCianjur 3 Leader of NGO 4 Government officials of agriculture 5 Business of organic food 6 and Consumer of organic food. Generally the findings of the study revealed the following 1 PPOFC began to see the reality as the impact of modern agriculture showed in fertility problems due to contaminated soil by residues of agricultural chemicals such as chemical fertilizers and chemical pesticides. So he wants to restore the soil fertility through environmentally friendly of farming practices 2 the challenges of organic farming on their lived experiences in the community farmers did not

  3. NWTS program criteria for mined geologic disposal of nuclear waste: program objectives, functional requirements, and system performance criteria

    International Nuclear Information System (INIS)

    1981-04-01

    At the present time, final repository criteria have not been issued by the responsible agencies. This document describes general objectives, requirements, and criteria that the DOE intends to apply in the interim to the National Waste Terminal Storage (NWTS) Program. These objectives, requirements, and criteria have been developed on the basis of DOE's analysis of what is needed to achieve the National objective of safe waste disposal in an environmentally acceptable and economic manner and are expected to be consistent with anticipated regulatory standards. The qualitative statements in this document address the broad issues of public and occupational health and safety, institutional acceptability, engineering feasibility, and economic considerations. A comprehensive set of criteria, general and project specific, of which these are a part, will constitute a portion of the technical basis for preparation and submittal by the DOE of formal documents to support future license applications for nuclear waste repositories

  4. NWTS program criteria for mined geologic disposal of nuclear waste: program objectives, functional requirements, and system performance criteria

    Energy Technology Data Exchange (ETDEWEB)

    None

    1981-04-01

    At the present time, final repository criteria have not been issued by the responsible agencies. This document describes general objectives, requirements, and criteria that the DOE intends to apply in the interim to the National Waste Terminal Storage (NWTS) Program. These objectives, requirements, and criteria have been developed on the basis of DOE's analysis of what is needed to achieve the National objective of safe waste disposal in an environmentally acceptable and economic manner and are expected to be consistent with anticipated regulatory standards. The qualitative statements in this document address the broad issues of public and occupational health and safety, institutional acceptability, engineering feasibility, and economic considerations. A comprehensive set of criteria, general and project specific, of which these are a part, will constitute a portion of the technical basis for preparation and submittal by the DOE of formal documents to support future license applications for nuclear waste repositories.

  5. PERFORMANCE PREMISES FOR HUMAN RESOURCES FROM PUBLIC HEALTH ORGANIZATIONS IN ROMANIA

    Directory of Open Access Journals (Sweden)

    Amalia-Luisa PUPĂZĂ

    2011-03-01

    Full Text Available Improving the performance of health sector human resources is a goal pursued by all developed or developing countries. However, the lack of human resources planning and lack of clear and transparent human resources policies may lead to a crisis in this area. Human resource planning should be a priority in terms of health policies. In Romania, the lack of a planning concept and the lack of a policy on human resources has led to the actual context, with a human resources crisis of public health organizations. The role that human resources play in the health care system is indisputable. Essential to achieve quality performance in health care is human resources management. To overcome the human resources crisis that public health organizations in Romania is facing , specialists in the field have made several key recommendations: development of a coherent policy formation, development and allocation of human resources in health, increasing the number of medical staff and opportunities of professional career development in the medical field. Health system reform involves changing some aspects of employment, working conditions, degree of decentralization of management, skills, salary system and staff motivation.

  6. Lost in processing? Perceived healthfulness, taste and caloric content of whole and processed organic food.

    Science.gov (United States)

    Prada, Marília; Garrido, Margarida V; Rodrigues, David

    2017-07-01

    The "organic" claim explicitly informs consumers about the food production method. Yet, based on this claim, people often infer unrelated food attributes. The current research examined whether the perceived advantage of organic over conventional food generalizes across different organic food types. Compared to whole organic foods, processed organic foods are less available, familiar and prototypical of the organic food category. In two studies (combined N = 258) we investigated how both organic foods types were perceived in healthfulness, taste and caloric content when compared to their conventional alternatives. Participants evaluated images of both whole (e.g., lettuce) and processed organic food exemplars (e.g., pizza), and reported general evaluations of these food types. The association of these evaluations with individual difference variables - self-reported knowledge and consumption of organic food, and environmental concerns - was also examined. Results showed that organically produced whole foods were perceived as more healthful, tastier and less caloric than those produced conventionally, thus replicating the well-established halo effect of the organic claim in food evaluation. The organic advantage was more pronounced among individuals who reported being more knowledgeable about organic food, consumed it more frequently, and were more environmentally concerned. The advantage of the organic claim for processed foods was less clear. Overall, processed organic (vs. conventional) foods were perceived as tastier, more healthful (Study 1) or equally healthful (Study 2), but also as more caloric. We argue that the features of processed food may modulate the impact of the organic claim, and outline possible research directions to test this assumption. Uncovering the specific conditions in which food claims bias consumer's perceptions and behavior may have important implications for marketing, health and public-policy related fields. Copyright © 2017 Elsevier

  7. Moving from the HIV Organ Policy Equity Act to HIV Organ Policy Equity in action: changing practice and challenging stigma.

    Science.gov (United States)

    Doby, Brianna L; Tobian, Aaron A R; Segev, Dorry L; Durand, Christine M

    2018-04-01

    The HIV Organ Policy Equity (HOPE) Act, signed in 2013, reversed the federal ban on HIV-to-HIV transplantation. In this review, we examine the progress in HOPE implementation, the current status of HIV-to-HIV transplantation, and remaining challenges. Pursuant to the HOPE Act, the Department of Health and Human Services revised federal regulations to allow HIV-to-HIV transplants under research protocols adherent to criteria published by the National Institutes of Health. The first HIV-to-HIV kidney and liver transplants were performed at Johns Hopkins in March of 2016. Legal and practical challenges remain. Further efforts are needed to educate potential HIV+ donors and to support Organ Procurement Organizations. As of November 2017, there are 22 transplant centers approved to perform HIV-to-HIV transplants in 10 United Network for Organ Sharing regions. To date, 16 Organ Procurement Organizations in 22 states have evaluated HIV+ donors. The National Institutes of Health-funded HOPE in Action: A Multicenter Clinical Trial of HIV-to-HIV Deceased Donor (HIVDD) Kidney Transplantation Kidney Trial will launch at 19 transplant centers in December of 2017. A HOPE in Action Multicenter HIVDD Liver Trial is in development. Significant progress toward full HOPE implementation has been made though barriers remain. Some challenges are unique to HIV-HIV transplantation, whereas others are amplifications of issues across the current transplant system. In addition to a public health benefit for all transplant candidates in the United States, partnership on the HOPE Act has the potential to address systemic challenges to national donation and transplantation.

  8. Prevalence and determinants of metabolic syndrome among newly diagnosed type 2 diabetic subjects according to different criteria.

    Science.gov (United States)

    Hossain, Sharmin; Fatema, Kaniz; Ahmed, Kazi R; Akter, Jesmin; Chowdhury, Hasina A; Shahjahan, Md; Acharyya, Amitava; Rahim, M A; Ali, Liaquat

    2015-01-01

    Metabolic syndrome (MS) is becoming a serious global public health problem. The prevalence of MS differs in different population by using different definitions. Present study aimed to find out the prevalence and determinants of MS among newly diagnosed type 2 diabetes (NDT2D) according to different criteria. This cross-sectional analytic study was conducted among 281 subjects selected purposively from the OPD of BIRDEM. Information on lifestyle factors and disease history were collected using a semi-structured questionnaire by face to face interview. The three definitions of MS used in this study are from the International Diabetes Federation (IDF), a modified version of the ATP III criteria for Asian populations (modified ATP III) and World Health Organization (WHO) criteria. Adjusted odds ratio and confidence limit were generated through logistic regression. The overall prevalence of metabolic syndrome among the study subjects according to modified ATPIII, WHO and IDF criteria were 79% (95% CI: 74.2-83.8), 81% (95% CI: 76.4-85.6) and 68% (95% CI: 62.6-73.5) respectively. The prevalence of metabolic syndrome among female were higher compared to males in all the criteria's. Female gender (OR=5.93), family history of diabetes (OR=1.92), overweight (OR=6.2), and obesity (OR=5.13) were found as important confounders associated with metabolic syndrome. The prevalence of the metabolic syndrome among NDT2D is considerably higher in our population which may indicate considerable risk of cardiovascular diseases in future. Female gender, family history of diabetes, overweight and obesity are important confounders of MS in this population. Copyright © 2014 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  9. Criteria for an advanced assessment of quality of moulding sands with organic binders and reclamation process products

    Directory of Open Access Journals (Sweden)

    R. Dańko

    2013-05-01

    Full Text Available Reclamation of used moulding and core sands has been defined as a treatment of waste moulding refractory materials, enabling a recovery of at least one of the components having properties similar to those of the fresh component, and reuse for production of casting moulds and cores. However, at present, there is a lack of a reclaimed material assessment index, which could be applied to each type of moulding sand and reclaim. Modern investigation methods and equipment for the estimation of the quality of the moulding sands matrices with organic binders, in their circulation process, are presented in this paper. These methods, utilizing the special equipment combined with the author’s investigation methods developed in the Faculty of Foundry Engineering, AGH - University of Science and Technology, allow the better estimation of the matrix quality both in an aspect of its application as a fresh sand substitute in the preparation of moulding sands, and also with regard to the environmental protection. The most important criteria for the technological assessment of the reclaimed materials and the quality of sands with organic binders are presented in this paper.

  10. Consumers in mental health service leadership: A systematic review.

    Science.gov (United States)

    Scholz, Brett; Gordon, Sarah; Happell, Brenda

    2017-02-01

    Contemporary mental health policies call for greater involvement of mental health service consumers in all aspects and at all levels of service planning, delivery, and evaluation. The extent to which consumers are part of the decision-making function of mental health organizations varies. This systematic review synthesizes empirical and review studies published in peer-reviewed academic journals relating to consumers in leadership roles within mental health organizations. The Cochrane Library, Medline, and PsycINFO were searched for articles specifically analysing and discussing consumers' mental health service leadership. Each article was critically appraised against the inclusion criteria, with 36 articles included in the final review. The findings of the review highlight current understandings of organizational resources and structures in consumer-led organizations, determinants of leadership involvement, and how consumer leadership interacts with traditional mental health service provision. It appears that organizations might still be negotiating the balance between consumer leadership and traditional structures and systems. The majority of included studies represent research about consumer-run organizations, with consumer leadership in mainstream mental health organizations being less represented in the literature. Advocates of consumer leadership should focus more on emphasizing how such leadership itself can be a valuable resource for organizations and how this can be better articulated. This review highlights the current gaps in understandings of consumer leadership in mental health, including a need for more research exploring the benefits of consumer leadership for other consumers of services. © 2016 Australian College of Mental Health Nurses Inc.

  11. Multiple Criteria Decision Analysis (MCDA) for evaluating new medicines in Health Technology Assessment and beyond: The Advance Value Framework.

    Science.gov (United States)

    Angelis, Aris; Kanavos, Panos

    2017-09-01

    Escalating drug prices have catalysed the generation of numerous "value frameworks" with the aim of informing payers, clinicians and patients on the assessment and appraisal process of new medicines for the purpose of coverage and treatment selection decisions. Although this is an important step towards a more inclusive Value Based Assessment (VBA) approach, aspects of these frameworks are based on weak methodologies and could potentially result in misleading recommendations or decisions. In this paper, a Multiple Criteria Decision Analysis (MCDA) methodological process, based on Multi Attribute Value Theory (MAVT), is adopted for building a multi-criteria evaluation model. A five-stage model-building process is followed, using a top-down "value-focused thinking" approach, involving literature reviews and expert consultations. A generic value tree is structured capturing decision-makers' concerns for assessing the value of new medicines in the context of Health Technology Assessment (HTA) and in alignment with decision theory. The resulting value tree (Advance Value Tree) consists of three levels of criteria (top level criteria clusters, mid-level criteria, bottom level sub-criteria or attributes) relating to five key domains that can be explicitly measured and assessed: (a) burden of disease, (b) therapeutic impact, (c) safety profile (d) innovation level and (e) socioeconomic impact. A number of MAVT modelling techniques are introduced for operationalising (i.e. estimating) the model, for scoring the alternative treatment options, assigning relative weights of importance to the criteria, and combining scores and weights. Overall, the combination of these MCDA modelling techniques for the elicitation and construction of value preferences across the generic value tree provides a new value framework (Advance Value Framework) enabling the comprehensive measurement of value in a structured and transparent way. Given its flexibility to meet diverse requirements and

  12. Three-Quarters of Persons in the US Population Reporting a Clinical Diagnosis of Fibromyalgia Do Not Satisfy Fibromyalgia Criteria: The 2012 National Health Interview Survey.

    Directory of Open Access Journals (Sweden)

    Brian Walitt

    Full Text Available Although fibromyalgia criteria have been in effect for decades, little is known about how the fibromyalgia diagnosis is applied and understood by clinicians and patients. We used the National Health Interview Survey (NHIS to determine the prevalence of self-reported clinician diagnosed fibromyalgia and then compared demographics, symptoms, disability and medical utilization measures of persons with a clinical diagnosis of fibromyalgia that did not meet diagnostic criteria (false-positive or prior [F/P] fibromyalgia to persons with and without criteria-positive fibromyalgia.The National Health Interview Survey (NHIS collected information about both clinical diagnosis and symptoms of fibromyalgia that was appropriately weighted to represent 225,726,257 US adults. Surrogate NHIS diagnostic criteria for fibromyalgia were developed based on the level of polysymptomatic distress (PSD as characterized in the 2011 modified American College of Rheumatology criteria (ACR for fibromyalgia. Persons with F/P fibromyalgia were compared with persons who do not have fibromyalgia and those meeting surrogate NHIS fibromyalgia criteria.Of the 1.78% of persons reporting a clinical diagnosis, 73.5% did not meet NHIS fibromyalgia criteria. The prevalence of F/P fibromyalgia is 1.3%. F/P fibromyalgia is associated with a mild degree of polysymptomatic distress (NHIS PSD score 6.2 and characterized by frequent but not widespread pain and insomnia. Measures of work disability and medical utilization in F/P fibromyalgia were equal to that seen with NHIS criteria positive fibromyalgia and were 6-7x greater in F/P fibromyalgia than in non-fibromyalgia persons. F/P fibromyalgia was best predicted by being female (Odds Ratio [OR] 8.81, married (OR 3.27, and white (OR 1.96. In contrast, being a white, married woman was only modestly predictive of NHIS (criteria positive fibromyalgia (OR 2.1.The majority of clinically diagnosed fibromyalgia cases in the US do not reach levels

  13. Recommendations from a meeting on health implications of genetically modified organism (GMO).

    Science.gov (United States)

    Amofah, George

    2014-06-01

    The Ghana Public Health Association organized a scientific seminar to examine the introduction of genetically modified organisms into public use and the health consequences. The seminar was driven by current public debate on the subject. The seminar identified some of the advantages of GMOs and also the health concerns. It is clear that there is the need to enhance local capacity to research the introduction and use of GMOs; to put in place appropriate regulatory mechanisms including particularly the labeling of GMO products and post-marketing surveillance for possible negative health consequences in the long term. Furthermore the appropriate state agency should put in place advocacy strategies to keep the public informed about GMOs.

  14. Conscience in health care and the definitions of death.

    Science.gov (United States)

    Kato, Yutaka

    2013-02-01

    Brain death or neurologic death has gradually become recognized as human death over the past decades worldwide. Nevertheless, in Japan, the New York State, and the State of New Jersey, death is declared based not on brain death criteria, but on cardio-pulmonary criteria. In Japan, the 1997 Organ Transplant Law legalized brain death determination exclusively when organs were to be procured from brain-dead patients. Even after 2009 law revision, the default definition of death continued to be based on cardio-pulmonary criteria, despite the criticism. The cases of Japan and the United States provide a good reference as social experiments of appreciating conscientious or religio-cultural dimensions in health care. This text theoretically examines the 1997 organ transplant law of Japan and its 2009 revision, presenting some characteristics of Japan's case compared to American cases and the implications its approach has for the rest of the world. This is an example in which a foreign idea that did not receive widespread support from Japanese citizens was transformed to fit the religio-cultural landscape.

  15. Climate Leadership Awards Application Process, Eligibility, and Evaluation Criteria

    Science.gov (United States)

    Learn about evaluation criteria and access applications for the 2018 Climate Leadership Awards, which publicly recognizes individuals and organizations for their outstanding leadership in reducing greenhouse gas emissions.

  16. NWTS program criteria for mined geologic disposal of nuclear waste: program objectives, functional requirements, and system performance criteria

    International Nuclear Information System (INIS)

    1982-03-01

    The NWTS-33 series, of which this document is a part, provides guidance for the National Waste Terminal Storage (NWTS) program in the development and implementation of licensed mined geologic disposal systems for solidified high-level and TRU wastes. Program objectives, functional requirements, and system performance criteria are found in this document. At the present time final criteria have not been issued by the Nuclear Regulatory Commission (NRC) and Environmental Protection Agency (EPA). The criteria in these documents have been developed on the basis of DOE's judgment of what is required to protect the health and safety of the public and the quality of the environment. It is expected that these criteria will be consistent with regulatory standards. The criteria will be re-evaluated on a periodic basis to ensure that they remain consistent with national waste management policy and regulatory requirements. A re-evaluation will be made when final criteria are promulgated by the NRC and EPA. A background section that briefly describes the mined geologic disposal system and explains the hierarchy and application of the NWTS criteria is included in Section 2.0. Secton 3.0 presents the program objectives, Section 4.0 functional requirements, Secton 5.0 the system performance criteria, and Section 6.0 quality assurance and standards. A draft of this document was issued for public comment in April 1981. Appendix A contains the DOE responses to the comments received. Appendix B is a glossary

  17. Sustainability Strategies for Regional Health Information Organization Startups

    DEFF Research Database (Denmark)

    Winkler, Till J.; Ozturk, Pinar; Brown, Carol V.

    2016-01-01

    the population health of an underserved urban population, and an HIE capability to enable the transition to a healthcare landscape that rewards care coordination across suburban hospitals and physician practices. Conclusions: We propose two models of technology and sustainability strategies for developing bottom...... initiatives by states and regional health information organizations (HIOs). Given the high failure rates of regional U.S. HIOs in the past, our primary objective is to identify the key characteristics of HIO startups that became operational and demonstrated sustainability with non-renewable SHIECAP funding...

  18. Selection of safety officers in an indian construction organization by using grey relational analysis

    Directory of Open Access Journals (Sweden)

    Sunku Venkata Siva Rajaprasad

    2018-03-01

    Full Text Available Stakeholders are responsible for implementing the occupational health and safety provisions in an organization. Irrespective of organization, the role of safety department is purely advisory as it coordinates with all the departments, and this is crucial to improve the performance. Selection of safety officer is vital job for any organization; it should not only be based on qualifications of the applicant, the incumbent should also have sufficient exposure in implementing proactive measures. The process of selection is complex and choosing the right safety professional is a vital decision. The safety performance of an organization relies on the systems being implemented by the safety officer. Application of multi criteria decision-making tools is helpful as a selection process. The present study proposes the grey relational analysis(GRA for selection of the safety officers in an Indian construction organization. This selection method considers fourteen criteria appropriate to the organization and has ranked the results. The data was also analyzed by using technique for order Preference by Similarity to an Ideal solution (TOPSIS and results of both the methods are strongly correlated

  19. Organizing seniors to protect the health safety net: the way forward.

    Science.gov (United States)

    Sharma, Leena; Regan, Carol; Villers, Katherine S

    2018-04-12

    Over the past century, the organized voice of seniors has been critical in building the U.S. health safety net. Since the 2016 election, that safety net, particularly the Medicaid program, is in jeopardy. As we have seen with the rise of the Tea Party, senior support for health care programs-even programs that they use in large numbers-cannot and should not be taken for granted. This article provides a brief history of senior advocacy and an overview of the current senior organizing landscape. It also identifies opportunities for building the transformational organizing of low-income seniors needed to defend against sustained attacks on critical programs. Several suggestions are made, drawn from years of work in philanthropy, advocacy, and campaigns, for strengthening the ability to organize seniors-particularly low-income seniors-into an effective political force advocating for Medicaid and other safety net programs.

  20. Dairy cattle management, health and welfare in smallholder farms: An organic farming perspective

    DEFF Research Database (Denmark)

    Odhong, Charles; Wahome, Raphael; Vaarst, Mette

    2015-01-01

    livestock production practices as specified by the International Federation of Organic Agriculture Movements and the East Africa Organic Product Standard. A longitudinal study of 24 farms was conducted to document and assess management practices and their potential effect on animal health and welfare......Organic production principles aim at achieving good animal health and welfare of livestock. The objective of the present study was to investigate animal management, health and welfare in smallholder dairy farms in Kenya, Africa, and to be able to give recommendations which can guide organic...... type, aspects of the housing system, farm characteristics, and management routines. The average herd size was 3.15 in Kiambu and 3.91 in Kajiado, with all the cows’ zero-grazed. Seventy five percent of the cubicles were small (less than 2.50m2). Many of the farmers sprayed their animals weekly (47...

  1. Explanation of diagnostic criteria for radiation-induced nervous system disease

    International Nuclear Information System (INIS)

    Xing Zhiwei; Jiang Enhai

    2012-01-01

    National occupational health standard-Diagnostic Criteria for Radiation-Induced Nervous System Disease has been issued and implemented by the Ministry of health. This standard contained three independent criteria of the brain, spinal cord and peripheral nerve injury. These three kinds of disease often go together in clinic,therefore,the three diagnostic criteria were merged into radioactive nervous system disease diagnostic criteria for entirety and maneuverability of the standard. This standard was formulated based on collection of the clinical practice experience, extensive research of relevant literature and foreign relevant publications. It is mainly applied to diagnosis and treatment of occupational radiation-induced nervous system diseases, and to nervous system diseases caused by medical radiation exposure as well. In order to properly implement this standard, also to correctly deal with radioactive nervous system injury, the main contents of this standard including dose threshold, clinical manifestation, indexing standard and treatment principle were interpreted in this article. (authors)

  2. Learning from the organic food system as a model for sustainable food systems - the Organic Food System Program

    DEFF Research Database (Denmark)

    Kahl, Johannes; Strassner, Carola; Hertwig, Jostein

    2016-01-01

    habits, cultural, social, ethical, economic and political criteria play an increasingly important role as values. An organic values-based supply chain links food production to values such as partnership, cooperation and trust. Within a values-based supply chain, all actors should be connected through......Today’s understanding of food systems includes product-specific values (e.g. palatability, taste, nutritional and safety values, health promotion) and process-oriented values (e.g. environmental impact, animal welfare and social fairness). These values are currently challenged and changing. Food...... a shared vision. Visions, indicators and parameters have been developed for the organic food system (OFS). In order to identify and leverage values within the OFS, it has to be critically analysed and documented. This makes the OFS a “living laboratory” for sustainable food systems, linking organic...

  3. Are health professionals responsible for the shortage of organs from deceased donors in Malaysia?

    Science.gov (United States)

    Abidin, Zada L Zainal; Ming, Wee Tong; Loch, Alexander; Hilmi, Ida; Hautmann, Oliver

    2013-02-01

    The rate of organ donations from deceased donors in Malaysia is among the lowest in the world. This may be because of the passivity among health professionals in approaching families of potential donors. A questionnaire-based study was conducted amongst health professionals in two tertiary hospitals in Kuala Lumpur, Malaysia. Four hundred and sixty-two questionnaires were completed. 93.3% of health professionals acknowledged a need for organ transplantation in Malaysia. 47.8% were willing to donate their organs (with ethnic and religious differences). Factors which may be influencing the shortage of organs from deceased donors include: nonrecognition of brainstem death (38.5%), no knowledge on how to contact the Organ Transplant Coordinator (82.3%), and never approaching families of a potential donor (63.9%). There was a general attitude of passivity in approaching families of potential donors and activating transplant teams among many of the health professionals. A misunderstanding of brainstem death and its definition hinder identification of a potential donor. Continuing medical education and highlighting the role of the Organ Transplant Coordinator, as well as increasing awareness of the public through religion and the media were identified as essential in improving the rate of organ donations from deceased donors in Malaysia. © 2012 The Authors Transplant International © 2012 European Society for Organ Transplantation. Published by Blackwell Publishing Ltd.

  4. The World Health Organization's mechanisms for increasing the ...

    African Journals Online (AJOL)

    These scenarios are a mixture of a surcharge on taxable income, an increase in value-added tax and a payroll tax. Five alternative options, suggested by the World Health Organization, are interrogated as ways to decrease the general taxation proposed in the White Paper. The five mechanisms (corporate tax, financial ...

  5. New facility shield design criteria

    International Nuclear Information System (INIS)

    Howell, W.P.

    1981-07-01

    The purpose of the criteria presented here is to provide standard guidance for the design of nuclear radiation shields thoughout new facilities. These criteria are required to assure a consistent and integrated design that can be operated safely and economically within the DOE standards. The scope of this report is confined to the consideration of radiation shielding for contained sources. The whole body dose limit established by the DOE applies to all doses which are generally distributed throughout the trunk of the body. Therefore, where the whole body is the critical organ for an internally deposited radionuclide, the whole body dose limit applies to the sum of doses received must assure control of the concentration of radionuclides in the building atmosphere and thereby limit the dose from internal sources

  6. Photovoltaic module certification/laboratory accreditation criteria development

    Energy Technology Data Exchange (ETDEWEB)

    Osterwald, C.R. [National Renewable Energy Lab., Golden, CO (United States); Hammond, R.L.; Wood, B.D.; Backus, C.E.; Sears, R.L. [Arizona State Univ., Tempe, AZ (United States); Zerlaut, G.A. [SC-International Inc., Phoenix, AZ (United States); D`Aiello, R.V. [RD Associates, Tempe, AZ (United States)

    1995-04-01

    This document provides an overview of the structure and function of typical product certification/laboratory accreditation programs. The overview is followed by a model program which could serve as the basis for a photovoltaic (PV) module certification/laboratory accreditation program. The model covers quality assurance procedures for the testing laboratory and manufacturer, third-party certification and labeling, and testing requirements (performance and reliability). A 30-member Criteria Development Committee was established to guide, review, and reach a majority consensus regarding criteria for a PV certification/laboratory accreditation program. Committee members represented PV manufacturers, end users, standards and codes organizations, and testing laboratories.

  7. Are Health Videos from Hospitals, Health Organizations, and Active Users Available to Health Consumers? An Analysis of Diabetes Health Video Ranking in YouTube

    Science.gov (United States)

    Borras-Morell, Jose-Enrique; Martinez-Millana, Antonio; Karlsen, Randi

    2017-01-01

    Health consumers are increasingly using the Internet to search for health information. The existence of overloaded, inaccurate, obsolete, or simply incorrect health information available on the Internet is a serious obstacle for finding relevant and good-quality data that actually helps patients. Search engines of multimedia Internet platforms are thought to help users to find relevant information according to their search. But, is the information recovered by those search engines from quality sources? Is the health information uploaded from reliable sources, such as hospitals and health organizations, easily available to patients? The availability of videos is directly related to the ranking position in YouTube search. The higher the ranking of the information is, the more accessible it is. The aim of this study is to analyze the ranking evolution of diabetes health videos on YouTube in order to discover how videos from reliable channels, such as hospitals and health organizations, are evolving in the ranking. The analysis was done by tracking the ranking of 2372 videos on a daily basis during a 30-day period using 20 diabetes-related queries. Our conclusions are that the current YouTube algorithm favors the presence of reliable videos in upper rank positions in diabetes-related searches. PMID:28243314

  8. Estimating the development assistance for health provided to faith-based organizations, 1990-2013.

    Science.gov (United States)

    Haakenstad, Annie; Johnson, Elizabeth; Graves, Casey; Olivier, Jill; Duff, Jean; Dieleman, Joseph L

    2015-01-01

    Faith-based organizations (FBOs) have been active in the health sector for decades. Recently, the role of FBOs in global health has been of increased interest. However, little is known about the magnitude and trends in development assistance for health (DAH) channeled through these organizations. Data were collected from the 21 most recent editions of the Report of Voluntary Agencies. These reports provide information on the revenue and expenditure of organizations. Project-level data were also collected and reviewed from the Bill & Melinda Gates Foundation and the Global Fund to Fight AIDS, Tuberculosis and Malaria. More than 1,900 non-governmental organizations received funds from at least one of these three organizations. Background information on these organizations was examined by two independent reviewers to identify the amount of funding channeled through FBOs. In 2013, total spending by the FBOs identified in the VolAg amounted to US$1.53 billion. In 1990, FB0s spent 34.1% of total DAH provided by private voluntary organizations reported in the VolAg. In 2013, FBOs expended 31.0%. Funds provided by the Global Fund to FBOs have grown since 2002, amounting to $80.9 million in 2011, or 16.7% of the Global Fund's contributions to NGOs. In 2011, the Gates Foundation's contributions to FBOs amounted to $7.1 million, or 1.1% of the total provided to NGOs. Development assistance partners exhibit a range of preferences with respect to the amount of funds provided to FBOs. Overall, estimates show that FBOS have maintained a substantial and consistent share over time, in line with overall spending in global health on NGOs. These estimates provide the foundation for further research on the spending trends and effectiveness of FBOs in global health.

  9. Estimating the development assistance for health provided to faith-based organizations, 1990-2013.

    Directory of Open Access Journals (Sweden)

    Annie Haakenstad

    Full Text Available Faith-based organizations (FBOs have been active in the health sector for decades. Recently, the role of FBOs in global health has been of increased interest. However, little is known about the magnitude and trends in development assistance for health (DAH channeled through these organizations.Data were collected from the 21 most recent editions of the Report of Voluntary Agencies. These reports provide information on the revenue and expenditure of organizations. Project-level data were also collected and reviewed from the Bill & Melinda Gates Foundation and the Global Fund to Fight AIDS, Tuberculosis and Malaria. More than 1,900 non-governmental organizations received funds from at least one of these three organizations. Background information on these organizations was examined by two independent reviewers to identify the amount of funding channeled through FBOs.In 2013, total spending by the FBOs identified in the VolAg amounted to US$1.53 billion. In 1990, FB0s spent 34.1% of total DAH provided by private voluntary organizations reported in the VolAg. In 2013, FBOs expended 31.0%. Funds provided by the Global Fund to FBOs have grown since 2002, amounting to $80.9 million in 2011, or 16.7% of the Global Fund's contributions to NGOs. In 2011, the Gates Foundation's contributions to FBOs amounted to $7.1 million, or 1.1% of the total provided to NGOs.Development assistance partners exhibit a range of preferences with respect to the amount of funds provided to FBOs. Overall, estimates show that FBOS have maintained a substantial and consistent share over time, in line with overall spending in global health on NGOs. These estimates provide the foundation for further research on the spending trends and effectiveness of FBOs in global health.

  10. Beyond QALYs: Multi-criteria based estimation of maximum willingness to pay for health technologies.

    Science.gov (United States)

    Nord, Erik

    2018-03-01

    The QALY is a useful outcome measure in cost-effectiveness analysis. But in determining the overall value of and societal willingness to pay for health technologies, gains in quality of life and length of life are prima facie separate criteria that need not be put together in a single concept. A focus on costs per QALY can also be counterproductive. One reason is that the QALY does not capture well the value of interventions in patients with reduced potentials for health and thus different reference points. Another reason is a need to separate losses of length of life and losses of quality of life when it comes to judging the strength of moral claims on resources in patients of different ages. An alternative to the cost-per-QALY approach is outlined, consisting in the development of two bivariate value tables that may be used in combination to estimate maximum cost acceptance for given units of treatment-for instance a surgical procedure, or 1 year of medication-rather than for 'obtaining one QALY.' The approach is a follow-up of earlier work on 'cost value analysis.' It draws on work in the QALY field insofar as it uses health state values established in that field. But it does not use these values to weight life years and thus avoids devaluing gained life years in people with chronic illness or disability. Real tables of the kind proposed could be developed in deliberative processes among policy makers and serve as guidance for decision makers involved in health technology assessment and appraisal.

  11. The power of servant leadership to transform health care organizations for the 21st-century economy.

    Science.gov (United States)

    Schwartz, Richard W; Tumblin, Thomas F

    2002-12-01

    Physician leadership is emerging as a vital component in transforming the nation's health care industry. Because few physicians have been introduced to the large body of literature on leadership and organizations, we herein provide a concise review, as this literature relates to competitive health care organizations and the leaders who serve them. Although the US health care industry has transitioned to a dynamic market economy governed by a wide range of internal and external forces, health care organizations continue to be dominated by leaders who practice an outmoded transactional style of leadership and by organizational hierarchies that are inherently stagnant. In contrast, outside the health care sector, service industries have repeatedly demonstrated that transformational, situational, and servant leadership styles are most successful in energizing human resources within organizations. This optimization of intellectual capital is further enhanced by transforming organizations into adaptable learning organizations where traditional institutional hierarchies are flattened and efforts to evoke change are typically team driven and mission oriented.

  12. [Reconsidering evaluation criteria regarding health care research: toward an integrative framework of quantitative and qualitative criteria].

    Science.gov (United States)

    Miyata, Hiroaki; Kai, Ichiro

    2006-05-01

    Debate about the relationship between quantitative and qualitative paradigms is often muddled and confused and the clutter of terms and arguments has resulted in the concepts becoming obscure and unrecognizable. It is therefore very important to reconsider evaluation criteria regarding rigor in social science. As Lincoln & Guba have already compared quantitative paradigms (validity, reliability, neutrality, generalizability) with qualitative paradigms (credibility, dependability, confirmability, transferability), we have discuss use of evaluation criteria based on pragmatic perspective. Validity/Credibility is the paradigm concerned to observational framework, while Reliability/Dependability refer to the range of stability in observations, Neutrality/Confirmability reflect influences between observers and subjects, Generalizability/Transferability have epistemological difference in the way findings are applied. Qualitative studies, however, does not always chose the qualitative paradigms. If we assume the stability to some extent, it is better to use the quantitative paradigm (reliability). Moreover as a quantitative study can not always guarantee a perfect observational framework, with stability in all phases of observations, it is useful to use qualitative paradigms to enhance the rigor in the study.

  13. Changing the internal health and safety organization through organizational learning and change management

    DEFF Research Database (Denmark)

    Hasle, Peter; Jensen, P.L.

    2006-01-01

    Research from several countries indicates that the internal health and safety organization is marginalized in most companies, and it is difficult for the professionals to secure a proper role in health and safety on the companies' present agenda. The goal of a Danish project involving a network...... of I I companies was to search for a solution to this problem. The health and safety managers and safety representatives played the role of "change agents" for local projects aiming to develop the health and safety organization. The study showed that 3 of the 11 companies proved to be able to implement...

  14. THE MULTIPLE CHOICE PROBLEM WITH INTERACTIONS BETWEEN CRITERIA

    Directory of Open Access Journals (Sweden)

    Luiz Flavio Autran Monteiro Gomes

    2015-12-01

    Full Text Available ABSTRACT An important problem in Multi-Criteria Decision Analysis arises when one must select at least two alternatives at the same time. This can be denoted as a multiple choice problem. In other words, instead of evaluating each of the alternatives separately, they must be combined into groups of n alternatives, where n = 2. When the multiple choice problem must be solved under multiple criteria, the result is a multi-criteria, multiple choice problem. In this paper, it is shown through examples how this problemcan be tackled on a bipolar scale. The Choquet integral is used in this paper to take care of interactions between criteria. A numerical application example is conducted using data from SEBRAE-RJ, a non-profit private organization that has the mission of promoting competitiveness, sustainable developmentand entrepreneurship in the state of Rio de Janeiro, Brazil. The paper closes with suggestions for future research.

  15. A resource-based view of partnership strategies in health care organizations.

    Science.gov (United States)

    Yarbrough, Amy K; Powers, Thomas L

    2006-01-01

    The distribution of management structures in health care has been shifting from independent ownership to interorganizational relationships with other firms. A shortage of resources has been cited as one cause for such collaboration among health care entities. The resource- based view of the firm suggests that organizations differentiate between strategic alliances and acquisition strategies based on a firm's internal resources and the types of resources a potential partner organization possesses. This paper provides a review of the literature using the resource-based theory of the firm to understand what conditions foster different types of health care partnerships. A model of partnership alliances using the resource-based view is presented, strategic linkages are presented, managerial implications are outlined, and directions for future research are given.

  16. Reporting intellectual capital in health care organizations: specifics, lessons learned, and future research perspectives.

    Science.gov (United States)

    Veltri, Stefania; Bronzetti, Giovanni; Sicoli, Graziella

    2011-01-01

    This article analyzes the concept of intellectual capital (IC) in the health sector sphere by studying the case of a major nonprofit research organization in this sector, which has for some time been publishing IC reports. In the last few years, health care organizations have been the object of great attention in the implementation and transfer of managerial models and tools; however, there is still a lack of attention paid to the strategic management of IC as a fundamental resource for supporting and enhancing performance improvement dynamics. The main aim of this article is to examine the IC reporting model used by the Center of Molecular Medicine (CMM), a Swedish health organization which is an outstanding benchmark in reporting its IC. We also consider the specifics of IC reporting for health organizations, the lessons learned by analyzing CMM's IC reporting, and future perspectives for research.

  17. Annual report. (Air quality criteria and plants as biological indicators)

    Energy Technology Data Exchange (ETDEWEB)

    1969-01-01

    Studies have been carried out to derive air quality criteria as the basis for establishing emission limits. Experiments have also been carried out on the resistance of plant species which are important to the economy and public health. Among the specific avenues of investigation have been: the determination of phytotoxic hydrogen fluoride concentrations; studies on the resistance behavior of cultivated plants; fluorine enrichment in plant organs as a function of exposure height and wind speed; development and use of biological methods for detecting atmospheric impurities; detection of sulfur dioxide effects on plants; the use of transplanted lichens as air pollution indicators; grass cultures as indicators of fluorine pollution; biological accumulation of fluorine as a function of HF concentration in air; and the determination of lead and zinc levels in plants. 5 figures, 4 tables.

  18. Hispanic Medical Organizations' Support for LGBT Health Issues.

    Science.gov (United States)

    Sánchez, John Paul; Sola, Orlando; Ramallo, Jorge; Sánchez, Nelson Felix; Dominguez, Kenneth; Romero-Leggott, Valerie

    2014-09-01

    Hispanics represent the fastest growing ethnic segment of the lesbian, gay, bisexual, and transgender (LGBT) community in the United States and are disproportionately burdened by LGBT-related health issues and limited political support from Hispanic medical organizations. Recently, the Latino Medical Student Association, the National Hispanic Medical Association, and the Hispanic Serving Health Professions Schools, representing over 60,000 Hispanic students and providers and 35 institutions, collaborated to support a resolution opposing discrimination based on sexual orientation or gender identity and recognizing the obstacles encountered by LGBTQ Hispanics. The resolution provides an important framework for organizational members and leaders to address LGBT health issues and serve to support a more positive sociopolitical climate for the Hispanic LGBT community nationally and internationally.

  19. Italian public health care organizations: specialization, institutional deintegration, and public networks relationships.

    Science.gov (United States)

    Del Vecchio, Mario; De Pietro, Carlo

    2011-01-01

    The Italian National Health Service (INHS) has undergone profound changes over the past three decades. With establishment of the INHS in 1978--a tax-based public health care system with universal coverage--one of the underlying principles was integration. The recognition of health and health care as requiring integrated answers led to the creation of a single public organization, the Local Health Unit, responsible for the health status of the population of its catchment area. At the beginning of the 1990s, the scenario radically changed. The creation of hospital trusts, the development of quasi-market mechanisms and management control tools, the adoption of a prospective payment system for reimbursing health care providers--all were signs of deintegration and institutional unbundling. Two structural changes have deeply sustained this deintegration: patients' empowerment and the increased possibilities for outsourcing practices. In more recent years, a new reintegration effort has occurred, often led by regional governments and based on institutional cooperation and network relationships. However, the earlier structural changes require innovative approaches and solutions if public health care organizations want to retain their leading role.

  20. Is organic farming safer to farmers' health? A comparison between organic and traditional farming.

    Science.gov (United States)

    Costa, Carla; García-Lestón, Julia; Costa, Solange; Coelho, Patrícia; Silva, Susana; Pingarilho, Marta; Valdiglesias, Vanessa; Mattei, Francesca; Dall'Armi, Valentina; Bonassi, Stefano; Laffon, Blanca; Snawder, John; Teixeira, João Paulo

    2014-10-15

    Exposure to pesticides is a major public health concern, because of the widespread distribution of these compounds and their possible long term effects. Recently, organic farming has been introduced as a consumer and environmental friendly agricultural system, although little is known about the effects on workers' health. The aim of this work was to evaluate genetic damage and immunological alterations in workers of both traditional and organic farming. Eighty-five farmers exposed to several pesticides, thirty-six organic farmers and sixty-one controls took part in the study. Biomarkers of exposure (pyrethroids, organophosphates, carbamates, and thioethers in urine and butyrylcholinesterase activity in plasma), early effect (micronuclei in lymphocytes and reticulocytes, T-cell receptor mutation assay, chromosomal aberrations, comet assay and lymphocytes subpopulations) and susceptibility (genetic polymorphisms related to metabolism - EPHX1, GSTM1, GSTT1 and GSTP1 - and DNA repair-XRCC1 and XRCC2) were evaluated. When compared to controls and organic farmers, pesticide farmers presented a significant increase of micronuclei in lymphocytes (frequency ratio, FR=2.80) and reticulocytes (FR=1.89), chromosomal aberrations (FR=2.19), DNA damage assessed by comet assay (mean ratio, MR=1.71), and a significant decrease in the proportion of B lymphocytes (MR=0.88). Results were not consistent for organic farmers when compared to controls, with a 48% increase of micronuclei in lumphocytes frequency (p=0.016) contrasted by the significant decreases of TCR-Mf (p=0.001) and %T (p=0.001). Our data confirm the increased presence of DNA damage in farmers exposed to pesticides, and show as exposure conditions may influence observed effects. These results must be interpreted with caution due to the small size of the sample and the unbalanced distribution of individuals in the three study groups. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  1. [HADASSAH MEDICAL ORGANIZATION - A PIONEER IN POPULATION HEALTH].

    Science.gov (United States)

    Calderon-Margalit, Ronit; Levine, Hagai; Israeli, Avi; Paltiel, Ora

    2018-03-01

    Population health is a term encompassing "the health outcomes of a group of individuals, including the distribution of such outcomes within the group." Only recently have hospitals viewed themselves as focal points for promoting health in a community, involving themselves with population health. Hadassah Medical Organization (HMO), however, has been in the business of population health since its founding. Its early programs, promoting and delivering nutritional support, maternal-child health and other services to the Yishuv's inhabitants, showed that the HMO defined its community broadly. Hospital care came later. The HMO was established together with the Hebrew University Israel's first School of Public Health and Community Medicine in the 1960's, contributing >1200 Israeli alumni, and exposing thousands of medical students to population health. The School's founders developed Community-Oriented Primary Care, aimed at assessing and addressing health determinants and outcomes at the community level implemented in many centers worldwide. Reaching beyond Israel's borders, the School has trained a global public health workforce through its International Masters in Public Health with >820 graduates from 92 countries. HMO's researchers have made important contributions in the fields of epidemiology, health economics and policy and population health methodology as well as hospital and community quality of care. This article reviews HMO's contribution to population health at local, municipal, national and international levels. We will demonstrate the unique circumstances in Hadassah, Jerusalem and Israel which have enabled world-class research and training in population health, identifying important contributions to policy and service provision, as well as addressing future population health challenges.

  2. Classifying Clinical Trial Eligibility Criteria to Facilitate Phased Cohort Identification Using Clinical Data Repositories.

    Science.gov (United States)

    Wang, Amy Y; Lancaster, William J; Wyatt, Matthew C; Rasmussen, Luke V; Fort, Daniel G; Cimino, James J

    2017-01-01

    A major challenge in using electronic health record repositories for research is the difficulty matching subject eligibility criteria to query capabilities of the repositories. We propose categories for study criteria corresponding to the effort needed for querying those criteria: "easy" (supporting automated queries), mixed (initial automated querying with manual review), "hard" (fully manual record review), and "impossible" or "point of enrollment" (not typically in health repositories). We obtained a sample of 292 criteria from 20 studies from ClinicalTrials.gov. Six independent reviewers, three each from two academic research institutions, rated criteria according to our four types. We observed high interrater reliability both within and between institutions. The analysis demonstrated typical features of criteria that map with varying levels of difficulty to repositories. We propose using these features to improve enrollment workflow through more standardized study criteria, self-service repository queries, and analyst-mediated retrievals.

  3. MDS clinical diagnostic criteria for Parkinson's disease in China.

    Science.gov (United States)

    Li, Jun; Jin, Miao; Wang, Li; Qin, Bin; Wang, Kang

    2017-03-01

    The Movement Disorder Society Clinical Diagnostic Criteria for Parkinson's disease (MDS-PD Criteria) was introduced by the Movement Disorder Society in 2015 for research purposes. However, its use for clinical diagnosis of Parkinson disease still needs further revision. This study compares the UK-Criteria versus MDS-PD Criteria in the clinical diagnosis of Parkinson disease referred to the China-Japan Friendship Hospital of Beijing, China. To compare the MDS-PD Criteria with the UK-Criteria and discuss the feasibility of the clinical application of MDS-PD Criteria as a general guide to clinical diagnosis of PD in Chinese PD patients. 150 patients of neurology clinic of China-Japan Friendship Hospital of Beijing were recruited in our research. They were divided into three groups: UK-Criteria group, MDS-PD Criteria group and a combined group of UK and MDS-PD Criteria. Clinical history was collected while physical and auxiliary examinations were done by a trained neurologist according to the corresponding criteria. An interrater reliability analysis using the Kappa statistic claimed substantial agreement (κ = 0.626) between the MDS-PD Criteria and the UK-Criteria. The differences between the diagnostic results of these two criteria were statistically significant by paired Chi-square test (p = 0.000). It was found that levodopa-induced dyskinesia had a good positive predictive value, while early bulbar impairment and inspiratory dysfunction presented a negative predictive value. The MDS-PD Criteria emphasize the importance of non-motor symptoms, keeping the motor symptoms as the core for the clinical diagnosis of PD, and establish categories of diagnosis features and levels of certainty which are more complete and organized to be used and replicated by non specialized physicians to evaluated patients with Parkinsonism. The higher sensitivity of MDS-PD Criteria compared with UK-Criteria is worth being widely used in clinical work.

  4. Multiple Criteria Decision Analysis for Health Care Decision Making—Emerging Good Practices: Report 2 of the ISPOR MCDA Emerging Good Practices Task Force

    NARCIS (Netherlands)

    Marsh, Kevin; IJzerman, Maarten Joost; Thokala, Praveen; Baltussen, Rob; Boysen, Meindert; Kalo, Zoltan; Longrenn, Thomas; Mussen, Filip; Peacock, Stuart; Watkins, John; Devlin, Nancy

    2016-01-01

    Health care decisions are complex and involve confronting trade-offs between multiple, often conflicting objectives. Using structured, explicit approaches to decisions involving multiple criteria can improve the quality of decision making. A set of techniques, known under the collective heading

  5. Vertical funding, non-governmental organizations, and health system strengthening: perspectives of public sector health workers in Mozambique.

    Science.gov (United States)

    Mussa, Abdul H; Pfeiffer, James; Gloyd, Stephen S; Sherr, Kenneth

    2013-06-14

    In the rapid scale-up of human immunodeficiency virus (HIV) care and acquired immunodeficiency syndrome (AIDS) treatment, many donors have chosen to channel their funds to non-governmental organizations and other private partners rather than public sector systems. This approach has reinforced a private sector, vertical approach to addressing the HIV epidemic. As progress on stemming the epidemic has stalled in some areas, there is a growing recognition that overall health system strengthening, including health workforce development, will be essential to meet AIDS treatment goals. Mozambique has experienced an especially dramatic increase in disease-specific support over the last eight years. We explored the perspectives and experiences of key Mozambican public sector health managers who coordinate, implement, and manage the myriad donor-driven projects and agencies. Over a four-month period, we conducted 41 individual qualitative interviews with key Ministry workers at three levels in the Mozambique national health system, using open-ended semi-structured interview guides. We also reviewed planning documents. All respondents emphasized the value and importance of international aid and vertical funding to the health sector and each highlighted program successes that were made possible by recent increased aid flows. However, three serious concerns emerged: 1) difficulties coordinating external resources and challenges to local control over the use of resources channeled to international private organizations; 2) inequalities created within the health system produced by vertical funds channeled to specific services while other sectors remain under-resourced; and 3) the exodus of health workers from the public sector health system provoked by large disparities in salaries and work. The Ministry of Health attempted to coordinate aid by implementing a "sector-wide approach" to bring the partners together in setting priorities, harmonizing planning, and coordinating

  6. Leadership, organization and health at work: a case study of a Swedish industrial company.

    Science.gov (United States)

    Eriksson, Andrea; Jansson, Bjarne; Haglund, Bo J A; Axelsson, Runo

    2008-06-01

    The application of knowledge on organization and leadership is important for the promotion of health at workplace. The purpose of this article is to analyse the leadership and organization, including the organizational culture, of a Swedish industrial company in relation to the health of the employees. The leadership in this company has been oriented towards developing and actively promoting a culture and a structure of organization where the employees have a high degree of control over their work situation. According to the employees, this means extensive possibilities for personal development and responsibility, as well as good companionship, which makes them feel well at work. This is also supported by the low sickness rate of the company. The results indicate that the leadership and organization of this company may have been conducive to the health of the employees interviewed. However, the culture of personal responsibility and the structure of self-managed teams seemed to suit only those who were able to manage the demands of the company and adapt to that kind of organization. Therefore, the findings indicate that the specific context of the technology, the environment and the professional level of the employees need to be taken into consideration when analysing the relation between leadership, organization and health at work.

  7. The effect of graphic organizers on subjective and objective comprehension of a health education text.

    Science.gov (United States)

    Kools, Marieke; van de Wiel, Margaretha W J; Ruiter, Robert A C; Crüts, Anica; Kok, Gerjo

    2006-12-01

    This study examined the effect of graphic organizers on the comprehension of a health education brochure text and compared subjective with objective comprehension measures. Graphic organizers are graphical depictions of relations among concepts in a text. Participants read a brochure text about asthma with and without these organizers, and subjective and objective text comprehension was measured. It was found that graphic organizers had effects on four levels of objective comprehension as indicated by open comprehension questions. However, on the subjective comprehension measure using Likert-type scales, the groups with and without graphic organizers did not differ from each other. It is concluded that health education texts could benefit from relatively simple techniques to increase comprehension. Furthermore, in developing health education materials, comprehension should be measured objectively.

  8. Towards a Framework for Evaluating Mobile Mental Health Apps.

    Science.gov (United States)

    Chan, Steven; Torous, John; Hinton, Ladson; Yellowlees, Peter

    2015-12-01

    Mobile phones are ubiquitous in society and owned by a majority of psychiatric patients, including those with severe mental illness. Their versatility as a platform can extend mental health services in the areas of communication, self-monitoring, self-management, diagnosis, and treatment. However, the efficacy and reliability of publicly available applications (apps) have yet to be demonstrated. Numerous articles have noted the need for rigorous evaluation of the efficacy and clinical utility of smartphone apps, which are largely unregulated. Professional clinical organizations do not provide guidelines for evaluating mobile apps. Guidelines and frameworks are needed to evaluate medical apps. Numerous frameworks and evaluation criteria exist from the engineering and informatics literature, as well as interdisciplinary organizations in similar fields such as telemedicine and healthcare informatics. We propose criteria for both patients and providers to use in assessing not just smartphone apps, but also wearable devices and smartwatch apps for mental health. Apps can be evaluated by their usefulness, usability, and integration and infrastructure. Apps can be categorized by their usability in one or more stages of a mental health provider's workflow. Ultimately, leadership is needed to develop a framework for describing apps, and guidelines are needed for both patients and mental health providers.

  9. Validation of the World Health Organization's Quality of Life Questionnaire with parents of children with autistic disorder.

    Science.gov (United States)

    Dardas, Latefa A; Ahmad, Muayyad M

    2014-09-01

    The World Health Organization's Quality of Life Questionnaire-BREF (WHOQOL-BREF) has been used in many studies that target parents of children with Autistic Disorder. However, the measure has yet to be validated and adapted to this sample group whose daily experiences are considered substantially different from those of parents of children with typical development and parents of children with other disabilities. Therefore, this study was designed to examine the psychometric properties and the theoretical structure of the WHOQOL-BREF with a sample of 184 parents of children with Autistic Disorder. The factor structure for the WHOQOL-BREF was examined using exploratory and confirmatory factor analyses. Our analyses provided no evidence of a better model than the original 4-domain model. Nevertheless, some items in the measure were re-distributed to different domains based on theoretical meanings and/or clean loading criteria. The new model structure gained the measure's required validity with parents of children with Autistic Disorder.

  10. Diagnostic criteria, clinical features, and incidence of thyroid storm based on nationwide surveys.

    Science.gov (United States)

    Akamizu, Takashi; Satoh, Tetsurou; Isozaki, Osamu; Suzuki, Atsushi; Wakino, Shu; Iburi, Tadao; Tsuboi, Kumiko; Monden, Tsuyoshi; Kouki, Tsuyoshi; Otani, Hajime; Teramukai, Satoshi; Uehara, Ritei; Nakamura, Yosikazu; Nagai, Masaki; Mori, Masatomo

    2012-07-01

    Thyroid storm (TS) is life threatening. Its incidence is poorly defined, few series are available, and population-based diagnostic criteria have not been established. We surveyed TS in Japan, defined its characteristics, and formulated diagnostic criteria, FINAL-CRITERIA1 and FINAL-CRITERIA2, for two grades of TS, TS1, and TS2 respectively. We first developed diagnostic criteria based on 99 patients in the literature and 7 of our patients (LIT-CRITERIA1 for TS1 and LIT-CRITERIA2 for TS2). Thyrotoxicosis was a prerequisite for TS1 and TS2 as well as for combinations of the central nervous system manifestations, fever, tachycardia, congestive heart failure (CHF), and gastrointestinal (GI)/hepatic disturbances. We then conducted initial and follow-up surveys from 2004 through 2008, targeting all hospitals in Japan, with an eight-layered random extraction selection process to obtain and verify information on patients who met LIT-CRITERIA1 and LIT-CRITERIA2. We identified 282 patients with TS1 and 74 patients with TS2. Based on these data and information from the Ministry of Health, Labor, and Welfare of Japan, we estimated the incidence of TS in hospitalized patients in Japan to be 0.20 per 100,000 per year. Serum-free thyroxine and free triiodothyroine concentrations were similar among patients with TS in the literature, Japanese patients with TS1 or TS2, and a group of patients with thyrotoxicosis without TS (Tox-NoTS). The mortality rate was 11.0% in TS1, 9.5% in TS2, and 0% in Tox-NoTS patients. Multiple organ failure was the most common cause of death in TS1 and TS2, followed by CHF, respiratory failure, arrhythmia, disseminated intravascular coagulation, GI perforation, hypoxic brain syndrome, and sepsis. Glasgow Coma Scale results and blood urea nitrogen (BUN) were associated with irreversible damages in 22 survivors. The only change in our final diagnostic criteria for TS as compared with our initial criteria related to serum bilirubin concentration >3 mg

  11. Talent management best practices: how exemplary health care organizations create value in a down economy.

    Science.gov (United States)

    Groves, Kevin S

    2011-01-01

    : Difficult economic conditions and powerful workforce trends pose significant challenges to managing talent in health care organizations. Although robust research evidence supports the many benefits of maintaining a strong commitment to talent management practices despite these challenges, many organizations compound the problem by resorting to workforce reductions and limiting or eliminating investments in talent management. : This study examines how nationwide health care systems address these challenges through best practice talent management systems. Addressing important gaps in talent management theory and practice, this study develops a best practice model of talent management that is grounded in the contextual challenges facing health care practitioners. : Utilizing a qualitative case study that examined 15 nationwide health care systems, data were collected through semistructured interviews with 30 executives and document analysis of talent management program materials submitted by each organization. : Exemplary health care organizations employ a multiphased talent management system composed of six sequential phases and associated success factors that drive effective implementation. Based on these findings, a model of talent management best practices in health care organizations is presented. : Health care practitioners may utilize the best practice model to assess and enhance their respective talent management systems by establishing the business case for talent management, defining, identifying, and developing high-potential leaders, carefully communicating high-potential designations, and evaluating talent management outcomes.

  12. Radiological criteria in nuclear emergencies

    International Nuclear Information System (INIS)

    Carrillo, D.; Diaz de la Cruz, F.

    1985-01-01

    It is pretended to enlighten the way to adopt the recommendations, from supranational organizations or the practices followed in other countries, to the peculiarities existing in Spain for the specific case of Nuclear Emergency Response Planning. The adaptation has been focalized in the criteria given by the Spanish Nuclear Safety Council and has taken into account the radiological protection levels, which have been considered adequate for Spanish population in case of nuclear accidents. (author)

  13. Tuberculosis-a World Health Organization Perspective.

    Science.gov (United States)

    Sotgiu, Giovanni; Sulis, Giorgia; Matteelli, Alberto

    2017-01-01

    Tuberculosis (TB) is an important cause of morbidity and mortality worldwide. The World Health Organization (WHO) has implemented and scaled-up three important global public health strategies (i.e., DOTS, Stop TB, and End TB) to improve the international scenario. Their epidemiological impact was relevant, as they decreased the number of potential new cases of disease and death. However, the emergence and spread of TB/HIV coinfection and multidrug-resistant TB have hindered the progress towards the elimination of TB by 2050. More efforts are required to increase the global annual decline of the TB incidence rate. Political commitment is necessary, with global and national strategies oriented to the adoption and adaptation of the international, evidence-based recommendations on diagnosis, treatment, and prevention. Research and development activities should be planned to improve the current tools adopted to fight the disease. New rapid diagnostics, an updated and effective therapeutic armamentarium, and an effective preventive vaccine could represent the solution to address the current epidemiological threats.

  14. INFORMATION AND COMMUNICATION TECHNOLOGIES TRAINING: CRITERIA FOR INTERNAL QUALITY ASSESSMENT

    Directory of Open Access Journals (Sweden)

    Oleg M. Spirin

    2011-02-01

    Full Text Available In the article the concept of information and communication technology training is specified. It is grounded an internal criteria of information and communication technologies training quality assessment based on experience of the organization, carrying out, analysis of experimental work results on quality assessment of designing, working out, efficiency of methodical system of informatics teachers base vocational training introduction in the conditions of credit-modular technology. Indicators and approaches of their assessment to define the criteria degree are resulted. Indicators of criteria "level differentiation", "individualization" and "intensification" of educational process for information and communication technologies training quality assessment are specified.

  15. [The League of Nations Health Organization and the rise of Latin American participation, 1920-40].

    Science.gov (United States)

    Weindling, Paul

    2006-01-01

    The League of Nations Health Organization collaborated with Latin American specialists in public health and infectious diseases from the early 1920s to the outbreak of the Second World War. The League developed studies of infant health and nutrition, and leprosy. The approach was expert-oriented, and designed to develop public health on a scientific basis. There were conferences, tours and reports in Latin America. This paper demonstrates that the Latin American collaboration with the Health Organization was extensive and multi-faceted.

  16. The World Health Organization and global smallpox eradication.

    Science.gov (United States)

    Bhattacharya, S

    2008-10-01

    This article examines the multifaceted structures and complex operations of the World Health Organization and its regional offices; it also reassesses the form and the workings of the global smallpox eradication programme with which these bodies were closely linked in the 1960s and 1970s. Using the case study of South Asia, it seeks to highlight the importance of writing nuanced histories of international health campaigns through an assessment of differences between official rhetoric and practice. The article argues that the detailed examination of the implementation of policy in a variety of localities, within and across national borders, allows us to recognise the importance of the agency of field managers and workers. This analytical approach also helps us acknowledge that communities were able to influence the shape and the timing of completion of public health campaigns in myriad ways. This, in turn, can provide useful pointers for the design and management of health programmes in the contemporary world.

  17. Managing workplace health promotion in municipal organizations: The perspective of senior managers.

    Science.gov (United States)

    Larsson, Robert; Åkerlind, Ingemar; Sandmark, Hélène

    2015-01-01

    Previous research indicates that companies manage workplace health in various ways, but more in-depth empirical knowledge of how workplace health promotion (WHP) is managed in public sector organizations is needed. The aim of this study was to explore how WHP is managed and incorporated into the general management system in two large Swedish municipal organizations. A qualitative descriptive approach was used. Fourteen senior managers were purposefully selected and interviewed using semi-structured interviews. Documents were used as supplementary data. All data were analysed using qualitative content analysis. The management of WHP was described as a set of components that together contribute to the organization's capacity for WHP. The informants described WHP as dominated by fitness programmes and as following a problem-solving cycle, in which the annual employee survey emerged as an important managerial tool. Achieving feasible WHP measures and appropriate follow-ups were described as challenges. The provision of leadership competence for WHP and use of supportive resources were described as additional components. The WHP management approach needs to be broadened to include work environment and organizational factors. Further integration with occupational health and safety and the general management system in the organizations is also needed.

  18. A Comparison of the Green Building’s Criteria

    Directory of Open Access Journals (Sweden)

    Bahaudin A.Y.

    2014-01-01

    Full Text Available Designers and clients alike are now emphasising on how to make their buildings green. Currently a lot of green councils worldwide are dealing with innovative ways to implement energy efficient new buildings. They have adopted various criteria and rating systems in an endeavour to classify buildings that contribute to environment sustainability, efficiency and users health. The aim of the paper is to present an overview of the criteria adopted by selected green building councils. This paper discusses five of the rating systems available in terms of their similarities and differences and proposes a new framework based on the project life cycle for the development of the green building criteria. Criteria during the construction phase of the building is certainly lacking such as pollution control in terms of CO2 emission, dust, and other pollutants.

  19. Stakeholder views on criteria and processes for priority setting in Norway: a qualitative study.

    Science.gov (United States)

    Aidem, Jeremy M

    2017-06-01

    Since 2013, Norway has engaged in political processes to revise criteria for priority setting. These processes have yielded key efficiency and equity criteria, but excluded potentially relevant social values. This study describes the views of 27 stakeholders in Norway's health system regarding a wider set of priority-setting criteria and procedural characteristics. Between January and February 2016, semi-structured interviews and focus groups were conducted with a purposive sample of policymakers, hospital administrators, practitioners, university students and seniors. Improving health among low-socioeconomic-status groups was considered an important policy objective: some favored giving more priority to diseases affecting socioeconomically disadvantaged groups, and some believed inequalities in health could be more effectively addressed outside the health sector. Age was not widely accepted as an independent criterion, but deemed relevant as an indicator of capacity to benefit, cost-effectiveness and health loss. Cost-effectiveness, severity and health-loss measures were judged relevant to policymaking, but cost-effectiveness and health loss were considered less influential to clinical decision-making. Public engagement was seen as essential yet complicated by media and stakeholder pressures. This study highlights how views on the relevance and implementation of criteria can vary significantly according to the health system level being evaluated. Further, the findings suggest that giving priority to socioeconomically disadvantaged groups and reducing inequalities in health may be relevant preferences not captured in recent policy proposals. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Mental health problems in Austrian adolescents: a nationwide, two-stage epidemiological study applying DSM-5 criteria.

    Science.gov (United States)

    Wagner, Gudrun; Zeiler, Michael; Waldherr, Karin; Philipp, Julia; Truttmann, Stefanie; Dür, Wolfgang; Treasure, Janet L; Karwautz, Andreas F K

    2017-12-01

    This is a nationwide epidemiological study using DSM-5 criteria to assess the prevalence of mental disorders in a large sample of Austrian adolescents between 10 and 18 years including hard-to-reach samples. A sample of 3615 adolescents from four cohorts (school grades 5, 7, 9, 11; age range 10-18 years) was recruited from 261 schools, samples of unemployed adolescents (n = 39) and adolescents from mental health institutions (n = 137) were added. The Youth Self-Report and SCOFF were used to screen for mental health problems. In a second phase, the Childrens' Diagnostic Interview for Mental Disorders was used to make point and lifetime psychiatric diagnoses. Mental health service use was also assessed. Point prevalence and lifetime prevalence rates for at least one psychiatric disorder were 23.9% and 35.8%. The highest lifetime prevalence rates were found for anxiety disorders (15.6%), neurodevelopmental disorders (9.3%; ADHD 5.2%) and depressive disorders (6.2%). Forty-seven percent of adolescents with a lifetime psychiatric disorder had a second diagnosis. Internalising disorders were more prevalent in girls, while neurodevelopmental disorders and disruptive, impulse control and conduct disorders were more prevalent in boys. Of those with a lifetime psychiatric disorder, 47.5% had contacted mental health services. Of the residual 52.5% who had not contacted mental health services, 18.1% expressed an interest in treatment. DSM-5 mental health disorders are highly prevalent among Austrian adolescents. Over 50% had or were interested in accessing treatment. Early access to effective interventions for these problems is needed to reduce burden due to mental health disorders.

  1. Effects of organic food consumption on human health; the jury is still out!

    Science.gov (United States)

    Barański, Marcin; Rempelos, Leonidas; Iversen, Per Ole; Leifert, Carlo

    2017-01-01

    The most recent systematic literature reviews and meta-analyses have indicated significant and nutritionally-relevant composition differences between organic and conventional foods. This included higher antioxidant, but lower cadmium and pesticide levels in organic crops, and higher omega-3 fatty acids concentrations in organic meat and dairy products. Also, results from a small number of human cohort studies indicate that there are positive associations between organic food consumption and reduced risk/incidence of certain acute diseases (e.g. pre-eclampsia, hypospadias) and obesity. Concerns about potential negative health impacts of organic food consumption (e.g. risks linked to lower iodine levels in organic milk) have also been raised, but are not currently supported by evidence from human cohort studies. However, there is virtually no published data from (1) long-term cohort studies focusing on chronic diseases (e.g. cardiovascular disease, diabetes, cancer, and neurodegenerative conditions) and (2) controlled human dietary intervention studies comparing effects of organic and conventional diets. It is therefore currently not possible to quantify to what extent organic food consumption may affect human health.

  2. 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.

  3. 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.

  4. Development of a comprehensive list of criteria for evaluating consumer education materials on colorectal cancer screening.

    Science.gov (United States)

    Dreier, Maren; Borutta, Birgit; Seidel, Gabriele; Kreusel, Inga; Töppich, Jürgen; Bitzer, Eva M; Dierks, Marie-Luise; Walter, Ulla

    2013-09-13

    Appropriate patient information materials may support the consumer's decision to attend or not to attend colorectal cancer (CRC) screening tests (fecal occult blood test and screening colonoscopy). The aim of this study was to develop a list of criteria to assess whether written health information materials on CRC screening provide balanced, unbiased, quantified, understandable, and evidence-based health information (EBHI) about CRC and CRC screening. The list of criteria was developed based on recommendations and assessment tools for health information in the following steps: (1) Systematic literature search in 13 electronic databases (search period: 2000-2010) and completed by an Internet search (2) Extraction of identified criteria (3) Grouping of criteria into categories and domains (4) Compilation of a manual of adequate answers derived from systematic reviews and S3 guidelines (5) Review by external experts (6) Modification (7) Final discussion with external experts. Thirty-one publications on health information tools and recommendations were identified. The final list of criteria includes a total of 230 single criteria in three generic domains (formal issues, presentation and understandability, and neutrality and balance) and one CRC-specific domain. A multi-dimensional rating approach was used whenever appropriate (e.g., rating for the presence, correctness, presentation and level of evidence of information). Free text input was allowed to ensure the transparency of assessment. The answer manual proved to be essential to the rating process. Quantitative analyses can be made depending on the level and dimensions of criteria. This comprehensive list of criteria clearly has a wider range of evaluation than previous assessment tools. It is not intended as a final quality assessment tool, but as a first step toward thorough evaluation of specific information materials for their adherence to EBHI requirements. This criteria list may also be used to revise

  5. Managing the conflict between individual needs and group interests--ethical leadership in health care organizations.

    Science.gov (United States)

    Shale, Suzanne

    2008-03-01

    This paper derives from a grounded theory study of how Medical Directors working within the UK National Health Service manage the moral quandaries that they encounter as leaders of health care organizations. The reason health care organizations exist is to provide better care for individuals through providing shared resources for groups of people. This creates a paradox at the heart of health care organization, because serving the interests of groups sometimes runs counter to serving the needs of individuals. The paradox presents ethical dilemmas at every level of the organization, from the boardroom to the bedside. Medical Directors experience these organizational ethical dilemmas most acutely by virtue of their position in the organization. As doctors, their professional ethic obliges them to put the interests of individual patients first. As executive directors, their role is to help secure the delivery of services that meet the needs of the whole patient population. What should they do when the interests of groups of patients, and of individual patients, appear to conflict? The first task of an ethical healthcare organization is to secure the trust of patients, and two examples of medical ethical leadership are discussed against this background. These examples suggest that conflict between individual and population needs is integral to health care organization, so dilemmas addressed at one level of the organization inevitably re-emerge in altered form at other levels. Finally, analysis of the ethical activity that Medical Directors have described affords insight into the interpersonal components of ethical skill and knowledge.

  6. Deceased Organ Donors and PHS Risk Identification: Impact on Organ Usage and Outcomes.

    Science.gov (United States)

    Pruett, Timothy L; Clark, Marissa A; Taranto, Sarah E

    2017-07-01

    In 2013, the public health service (PHS) changed the criteria intended to identify organ donors that put the associated organ recipients at increased risk for acquiring human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV). The changing donor demographics, organ utilization, and outcomes associated with this change are not known. A review of the Organ Procurement and Transplantation Network database was performed to assess the impact of PHS donor designation on organ utilization and outcomes. After the 2013 modification, over 20% of all deceased organ donors in the United States were identified as PHS increased risk. Compared with the standard risk deceased organ donor, the PHS donor was younger, male, died from anoxia, more likely to be HCV and antibody reacting to hepatitis B core antigen+, and less likely to have diabetes or hypertension. Organs from the 18- to 34-year-old deceased donors with PHS risks (but relatively few medical comorbidities) and tested negative for HCV were less frequently transplanted compared with the standard risk donors (3.9 vs 4.2 organs transplanted per donor). However, the transplant patient and graft survival as well as risk of unexpected transmission of HIV, HBV, and HCV were equivalent, irrespective of PHS donor status. The rationale of using PHS donor designation that negatively impacts utilization of high-quality organs without the benefit of identifying the subset of organs with demonstrable proclivity to transmit HIV, HBV, or HCV needs to be reexamined.

  7. The role of non-governmental organizations in the social and the health system.

    Science.gov (United States)

    Piotrowicz, Maria; Cianciara, Dorota

    2013-01-01

    The article presents the definitions, objectives, fields and tasks of non-governmental organizations in social life, health system and health policy. In addition, the article addresses the issue of effectiveness and quality of NGOs' activity. The term "NGOs" (Non-governmental Organizations) includes different categories of entities that operate not to obtain financial gain, and also do not belong to the government sector. Non-governmental Organizations' fields of activity were described in the International Classification of Non-Profit Organizations (ICNPO). NGOs are an integral part of a democratic society. Sociological sciences emphasize their importance in enhancing social integration, implementation of the principle of subsidiarity, building civil society, social dialogue and participatory democracy. The main tasks of NGOs in the health system are providing services and health advocacy. Provision of services includes medical, social and psychological services as well as, integration activities, care and nursing, material and financial support, educational and information services and training. Health advocacy is a combination of individual and social actions designed to gain political commitment, policy support, social acceptance and systems support for a particular health goal or program. An important task carried out by NGOs is participation in the formation of health policy. The increasing role of NGOs in providing social services and the participation in political processes, result in the need to confirm the validity and credibility of their operation. One of the ways could be to introduce the mechanisms to assess quality and efficiency, such as registration as a part of a legal system, self-regulatory activities (card rules, codes of ethics), certification, participation in networks, monitoring and audit.

  8. A Latent Class Analysis of Pathological-Gambling Criteria Among High School Students: Associations With Gambling, Risk and Health/Functioning Characteristics

    Science.gov (United States)

    Kong, Grace; Tsai, Jack; Krishnan-Sarin, Suchitra; Cavallo, Dana A.; Hoff, Rani A.; Steinberg, Marvin A.; Rugle, Loreen; Potenza, Marc N.

    2015-01-01

    Objectives To identify subtypes of adolescent gamblers based on the 10 Diagnostic and Statistical Manual of Mental Disorders, fourth edition criteria for pathological gambling and the 9 Diagnostic and Statistical Manual of Mental Disorders, fifth edition criteria for gambling disorder and to examine associations between identified subtypes with gambling, other risk behaviors, and health/functioning characteristics. Methods Using cross-sectional survey data from 10 high schools in Connecticut (N = 3901), we conducted latent class analysis to classify adolescents who reported past-year gambling into gambling groups on the basis of items from the Massachusetts Gambling Screen. Adolescents also completed questions assessing demographic information, substance use (cigarette, marijuana, alcohol, and other drugs), gambling behaviors (relating to gambling formats, locations, motivations, and urges), and health/functioning characteristics (eg, extracurricular activities, mood, aggression, and body mass index). Results The optimal solution consisted of 4 classes that we termed low-risk gambling (86.4%), at-risk chasing gambling (7.6%), at-risk negative consequences gambling (3.7%), and problem gambling (PrG) (2.3%). At-risk and PrG classes were associated with greater negative functioning and more gambling behaviors. Different patterns of associations between at-risk and PrG classes were also identified. Conclusions Adolescent gambling classifies into 4 classes, which are differentially associated with demographic, gambling patterns, risk behaviors, and health/functioning characteristics. Early identification and interventions for adolescent gamblers should be sensitive to the heterogeneity of gambling subtypes. PMID:25275877

  9. Facility location of organ procurement organisations in Indian health care supply chain management

    OpenAIRE

    Rajmohan, M.; Theophilus, C.; Sumalatha, M.R.; Saravanakumar, S.

    2017-01-01

    In health care supply chain management, particularly in the area of organ transplantation, organ procurement and the transplantation network play an important role. The organ procurement organisation (OPO) should coordinate so that organs are prepared and transported to the recipients when donors become available. The scarcity of organ supply leads to life-challenging issues for the organ recipient. In this research, the importance of the location of OPOs to coordinate with the transplant cen...

  10. Outsourcing. Health care organizations are considering strategic goals in making outsourcing decisions.

    Science.gov (United States)

    Chin, T L

    1997-08-01

    More health care organizations are outsourcing the management of some or all of their information systems. Executives at many organizations that have tried outsourcing say it enables them to focus on core competencies, better allocate resources, get more information technology at less cost, share risks of implementing information technology with outsourcers and guarantee access to skilled labor. But the information technology outsourcing market remains relatively small in health care because many CIOs still are wary of turning over control of important functions to outsiders.

  11. Redefining design criteria for Pu-238 gloveboxes

    International Nuclear Information System (INIS)

    Acosta, S.V.

    1998-01-01

    Enclosures for confinement of special nuclear materials (SNM) have evolved into the design of gloveboxes. During the early stages of glovebox technology, established practices and process operation requirements defined design criteria. Proven boxes that performed and met or exceeded process requirements in one group or area, often could not be duplicated in other areas or processes, and till achieve the same success. Changes in materials, fabrication and installation methods often only met immediate design criteria. Standardization of design criteria took a big step during creation of ''Special-Nuclear Materials R and D Laboratory Project, Glovebox standards''. The standards defined design criteria for every type of process equipment in its most general form. Los Alamos National Laboratory (LANL) then and now has had great success with Pu-238 processing. However with ever changing Environment Safety and Health (ES and H) requirements and Ta-55 Facility Configuration Management, current design criteria are forced to explore alternative methods of glovebox design fabrication and installation. Pu-238 fuel processing operations in the Power Source Technologies Group have pushed the limitations of current design criteria. More than half of Pu-238 gloveboxes are being retrofitted or replaced to perform the specific fuel process operations. Pu-238 glovebox design criteria are headed toward process designed single use glovebox and supporting line gloveboxes. Gloveboxes that will house equipment and processes will support TA-55 Pu-238 fuel processing needs into the next century and extend glovebox expected design life

  12. 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...

  13. [Integrated health care organizations: guideline for analysis].

    Science.gov (United States)

    Vázquez Navarrete, M Luisa; Vargas Lorenzo, Ingrid; Farré Calpe, Joan; Terraza Núñez, Rebeca

    2005-01-01

    There has been a tendency recently to abandon competition and to introduce policies that promote collaboration between health providers as a means of improving the efficiency of the system and the continuity of care. A number of countries, most notably the United States, have experienced the integration of health care providers to cover the continuum of care of a defined population. Catalonia has witnessed the steady emergence of increasing numbers of integrated health organisations (IHO) but, unlike the United States, studies on health providers' integration are scarce. As part of a research project currently underway, a guide was developed to study Catalan IHOs, based on a classical literature review and the development of a theoretical framework. The guide proposes analysing the IHO's performance in relation to their final objectives of improving the efficiency and continuity of health care by an analysis of the integration type (based on key characteristics); external elements (existence of other suppliers, type of services' payment mechanisms); and internal elements (model of government, organization and management) that influence integration. Evaluation of the IHO's performance focuses on global strategies and results on coordination of care and efficiency. Two types of coordination are evaluated: information coordination and coordination of care management. Evaluation of the efficiency of the IHO refers to technical and allocative efficiency. This guide may have to be modified for use in the Catalan context.

  14. Multiple Criteria Decision Analysis for Health Care Decision Making--Emerging Good Practices: Report 2 of the ISPOR MCDA Emerging Good Practices Task Force.

    Science.gov (United States)

    Marsh, Kevin; IJzerman, Maarten; Thokala, Praveen; Baltussen, Rob; Boysen, Meindert; Kaló, Zoltán; Lönngren, Thomas; Mussen, Filip; Peacock, Stuart; Watkins, John; Devlin, Nancy

    2016-01-01

    Health care decisions are complex and involve confronting trade-offs between multiple, often conflicting objectives. Using structured, explicit approaches to decisions involving multiple criteria can improve the quality of decision making. A set of techniques, known under the collective heading, multiple criteria decision analysis (MCDA), are useful for this purpose. In 2014, ISPOR established an Emerging Good Practices Task Force. The task force's first report defined MCDA, provided examples of its use in health care, described the key steps, and provided an overview of the principal methods of MCDA. This second task force report provides emerging good-practice guidance on the implementation of MCDA to support health care decisions. The report includes: a checklist to support the design, implementation and review of an MCDA; guidance to support the implementation of the checklist; the order in which the steps should be implemented; illustrates how to incorporate budget constraints into an MCDA; provides an overview of the skills and resources, including available software, required to implement MCDA; and future research directions. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  15. Exploring Business Strategy in Health Information Exchange Organizations.

    Science.gov (United States)

    Langabeer, James R; Champagne, Tiffany

    2016-01-01

    Unlike consumer goods industries, healthcare has been slow to implement technolo gies that support exchange of data in patients' health records. This results in avoid able medication errors, avoidable hospital readmissions, unnecessary duplicate testing, and other inefficient or wasteful practices. Community-based regional health information exchange (HIE) organizations have evolved in response to federal aims to encourage interoperability, yet little is known about their strategic approach. We use the lens of institutional and strategic management theories to empirically explore the differences in business strategies deployed in HIEs that are, to date, financially sustainable versus those that are not. We developed a 20-question survey targeted to CEOs to assess HIE business strategies. Our sample consisted of 60 community-based exchanges distributed throughout the United States, and we achieved a 58% response rate. Questions centered on competitive strategy and financial sustainability. We relied on logistic regression methods to explore relationships between variables. Our regression identified characteristics common to sustainable organizations. We defined sustainability as revenues exceeding operational costs. Seventeen of the 35 organizations (49%) defined themselves as currently sustainable. Focus and cost leadership strategies were significantly associated with sustainability. Growth strate gies, which were much more common than other strategies, were not associated with sustainability. We saw little evidence of a differentiation strategy (i.e., the basis of competition whereby the attributes of a product or service are unmatched by rivals). Most CEOs had a relatively optimistic outlook, with 60% stating they were confident of surviving over the next 5 years; however, nearly 9% of the organizations were in some phase of divestiture or exit from the market. HIEs are evolving differently based on local leadership decisions, yet their strategic approach is

  16. Meeting report: knowledge and gaps in developing microbial criteria for inland recreational waters

    Science.gov (United States)

    Dorevitch, Samuel; Ashbolt, Nicholas J.; Ferguson, Christobel M.; Fujioka, Roger; McGee, Charles D.; Soller, Jeffrey A.; Whitman, Richard L.

    2010-01-01

    The U.S. Environmental Protection Agency (EPA) has committed to issuing in 2012 new or revised criteria designed to protect the health of those who use surface waters for recreation. For this purpose, the U.S. EPA has been conducting epidemiologic studies to establish relationships between microbial measures of water quality and adverse health outcomes among swimmers. New methods for testing water quality that would provide same-day results will likely be elements of the new criteria. Although the epidemiologic studies upon which the criteria will be based were conducted at Great Lakes and marine beaches, the new water quality criteria may be extended to inland waters (IWs). Similarities and important differences between coastal waters (CWs) and IWs that should be considered when developing criteria for IWs were the focus of an expert workshop. Here, we summarize the state of knowledge and research needed to base IWs microbial criteria on sound science. Two key differences between CWs and IWs are the sources of indicator bacteria, which may modify the relationship between indicator microbes and health risk, and the relationship between indicators and pathogens, which also may vary within IWs. Monitoring using rapid molecular methods will require the standardization and simplification of analytical methods, as well as greater clarity about their interpretation. Research needs for the short term and longer term are described.

  17. Can branding by health care provider organizations drive the delivery of higher technical and service quality?

    Science.gov (United States)

    Snihurowych, Roman R; Cornelius, Felix; Amelung, Volker Eric

    2009-01-01

    Despite the widespread use of branding in nearly all other major industries, most health care service delivery organizations have not fully embraced the practices and processes of branding. Facilitating the increased and appropriate use of branding among health care delivery organizations may improve service and technical quality for patients. This article introduces the concepts of branding, as well as making the case that the use of branding may improve the quality and financial performance of organizations. The concepts of branding are reviewed, with examples from the literature used to demonstrate their potential application within health care service delivery. The role of branding for individual organizations is framed by broader implications for health care markets. Branding strategies may have a number of positive effects on health care service delivery, including improved technical and service quality. This may be achieved through more transparent and efficient consumer choice, reduced costs related to improved patient retention, and improved communication and appropriateness of care. Patient satisfaction may be directly increased as a result of branding. More research into branding could result in significant quality improvements for individual organizations, while benefiting patients and the health system as a whole.

  18. Estimating the Development Assistance for Health Provided to Faith-Based Organizations, 1990–2013

    Science.gov (United States)

    Haakenstad, Annie; Johnson, Elizabeth; Graves, Casey; Olivier, Jill; Duff, Jean; Dieleman, Joseph L.

    2015-01-01

    Background Faith-based organizations (FBOs) have been active in the health sector for decades. Recently, the role of FBOs in global health has been of increased interest. However, little is known about the magnitude and trends in development assistance for health (DAH) channeled through these organizations. Material and Methods Data were collected from the 21 most recent editions of the Report of Voluntary Agencies. These reports provide information on the revenue and expenditure of organizations. Project-level data were also collected and reviewed from the Bill & Melinda Gates Foundation and the Global Fund to Fight AIDS, Tuberculosis and Malaria. More than 1,900 non-governmental organizations received funds from at least one of these three organizations. Background information on these organizations was examined by two independent reviewers to identify the amount of funding channeled through FBOs. Results In 2013, total spending by the FBOs identified in the VolAg amounted to US$1.53 billion. In 1990, FB0s spent 34.1% of total DAH provided by private voluntary organizations reported in the VolAg. In 2013, FBOs expended 31.0%. Funds provided by the Global Fund to FBOs have grown since 2002, amounting to $80.9 million in 2011, or 16.7% of the Global Fund’s contributions to NGOs. In 2011, the Gates Foundation’s contributions to FBOs amounted to $7.1 million, or 1.1% of the total provided to NGOs. Conclusion Development assistance partners exhibit a range of preferences with respect to the amount of funds provided to FBOs. Overall, estimates show that FBOS have maintained a substantial and consistent share over time, in line with overall spending in global health on NGOs. These estimates provide the foundation for further research on the spending trends and effectiveness of FBOs in global health. PMID:26042731

  19. A comparison of water quality criteria for the Great Lakes based on human and wildlife health

    Science.gov (United States)

    Ludwig, James P.; Giesy, John P.; Summer, Cheryl L.; Bowerman, William; Aulerich, Richard J.; Bursian, Steven J.; Auman, Heidi J.; Jones, Paul D.; Williams, Lisa L.; Tillitt, Donald E.; Gilbertson, Michael

    1993-01-01

    Water quality criteria (WQC) can be derived in several ways. The usual techniques involve hazard and risk assessment procedures. For non-persistent, non-biomagnified compounds and elements, WQC are experimentally derived from their acute and chronic toxicity to aquatic organisms. For those persistent chlorinated hydrocarbons (PCHs) that are bioaccumulated and biomagnified, these traditional techniques have not been effective, partly because effects higher in the food web were not considered. Polychlorinated biphenyls (PCBs) are the bioaccumulative synthetic chemicals of primary toxicological significance to the Great Lakes biota which have caused widespread injury to wildlife. In the Laurentian Great Lakes, the primary emphasis of hazard assessments has been on the potential for adverse effects in humans who eat fish. The primary regulatory endpoint of traditional hazard and risk assessments underlying current WQC are the probabilities of additional cancers occurring in the human population. The analysis presented here indicates that this is not adequate to restore sensitive wildlife species that are highly exposed to PCBs, especially those that have suffered serious population declines. Because WQC are legal instruments, the methods of deriving WQC have large implications for remediation, litigation, and damage assessments. Here WQC are derived for six species based on the responses of wildlife in the field or produced by feeding fish to surrogate species, rather than projecting a potential of increased cancer rates in humans. If the most sensitive wildlife species are restored and protected for very sensitive reproductive endpoints, then all components of the ecosystem, including human health, should be more adequately protected. The management of Great Lakes wildlife requires an understanding of the injury and causal relationships to persistent toxic substances.

  20. Setting health research priorities using the CHNRI method: I. Involving funders

    Directory of Open Access Journals (Sweden)

    Igor Rudan

    2016-06-01

    Full Text Available In 2007 and 2008, the World Health Organization's Department for Child and Adolescent Health and Development commissioned five large research priority setting exercises using the CHNRI (Child Health and Nutrition Research Initiative method. The aim was to define research priorities related to the five major causes of child deaths for the period up to the year 2015. The selected causes were childhood pneumonia, diarrhoea, birth asphyxia, neonatal infections and preterm birth/low birth weight. The criteria used for prioritization in all five exercises were the “standard” CHNRI criteria: answerability, effectiveness, deliverability, potential for mortality burden reduction and the effect on equity. Having completed the exercises, the WHO officers were left with another question: how “fundable” were the identified priorities, i.e. how attractive were they to research funders?

  1. Rome Criteria and a Diagnostic Approach to Irritable Bowel Syndrome

    Directory of Open Access Journals (Sweden)

    Brian E. Lacy

    2017-10-01

    Full Text Available Functional gastrointestinal disorders (FGIDs account for at least 40% of all referrals to gastroenterologists. Of the 33 recognized adult FGIDs, irritable bowel syndrome (IBS is the most prevalent, with a worldwide prevalence estimated at 12%. IBS is an important health care concern as it greatly affects patients’ quality of life and imposes a significant economic burden to the health care system. Cardinal symptoms of IBS include abdominal pain and altered bowel habits. The absence of abdominal pain makes the diagnosis of IBS untenable. The diagnosis of IBS can be made by performing a careful review of the patient’s symptoms, taking a thoughtful history (e.g., diet, medication, medical, surgical, and psychological history, evaluating the patient for the presence of warning signs (e.g., “red flags” of anemia, hematochezia, unintentional weight loss, or a family history of colorectal cancer or inflammatory bowel disease, performing a guided physical examination, and using the Rome IV criteria. The Rome criteria were developed by a panel of international experts in the field of functional gastrointestinal disorders. Although initially developed to guide researchers, these criteria have undergone several revisions with the intent of making them clinically useful and relevant. This monograph provides a brief overview on the development of the Rome criteria, discusses the utility of the Rome IV criteria, and reviews how the criteria can be applied clinically to diagnose IBS. In addition, a diagnostic strategy for the cost-effective diagnosis of IBS will be reviewed.

  2. Qualification criteria for persons responsible for radiation protection

    International Nuclear Information System (INIS)

    Wehner, G

    1980-01-01

    A survey of the qualification criteria included in the German atomic law (Atomic Energy Act, Radiological Protection Ordinance and X-ray Protection Ordinance) for persons responsible for radiation protection is given. Especially the various activities for which a health physics officer is required, the range of qualification in each case and the way the qualification has to be proved, are pointed out. Also the different guides that are issued to complete the legal requirements are mentioned. The definitions of the term qualification for health physics given in the different guides are cited and it is shown, that the qualification of a healt physics officer has to be based on the three criteria (I) vocational training. (II) professional experience and (III) the necessary knowledge in radiation protection. (orig./HP) [de

  3. Outpatient Management of Children With World Health Organization Chest Indrawing Pneumonia: Implementation Risks and Proposed Solutions.

    Science.gov (United States)

    McCollum, Eric D; Ginsburg, Amy Sarah

    2017-10-16

    This Viewpoints article details our recommendation for the World Health Organization Integrated Management of Childhood Illness guidelines to consider additional referral or daily monitoring criteria for children with chest indrawing pneumonia in low-resource settings. We review chest indrawing physiology in children and relate this to the risk of adverse pneumonia outcomes. We believe there is sufficient evidence to support referring or daily monitoring of children with chest indrawing pneumonia and signs of severe respiratory distress, oxygen saturation <93% (when not at high altitude), moderate malnutrition, or an unknown human immunodeficiency virus (HIV) status in an HIV-endemic setting. Pulse oximetry screening should be routine and performed at the earliest point in the patient care pathway as possible. If outpatient clinics lack capacity to conduct pulse oximetry, nutritional assessment, or HIV testing, then we recommend considering referral to complete the evaluation. When referral is not possible, careful daily monitoring should be performed. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

  4. Multi-criteria group decision making for evaluating the performance of e-waste recycling programs under uncertainty.

    Science.gov (United States)

    Wibowo, Santoso; Deng, Hepu

    2015-06-01

    This paper presents a multi-criteria group decision making approach for effectively evaluating the performance of e-waste recycling programs under uncertainty in an organization. Intuitionistic fuzzy numbers are used for adequately representing the subjective and imprecise assessments of the decision makers in evaluating the relative importance of evaluation criteria and the performance of individual e-waste recycling programs with respect to individual criteria in a given situation. An interactive fuzzy multi-criteria decision making algorithm is developed for facilitating consensus building in a group decision making environment to ensure that all the interest of individual decision makers have been appropriately considered in evaluating alternative e-waste recycling programs with respect to their corporate sustainability performance. The developed algorithm is then incorporated into a multi-criteria decision support system for making the overall performance evaluation process effectively and simple to use. Such a multi-criteria decision making system adequately provides organizations with a proactive mechanism for incorporating the concept of corporate sustainability into their regular planning decisions and business practices. An example is presented for demonstrating the applicability of the proposed approach in evaluating the performance of e-waste recycling programs in organizations. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Implementation of eMental Health care: viewpoints from key informants from organizations and agencies with eHealth mandates.

    Science.gov (United States)

    Wozney, Lori; Newton, Amanda S; Gehring, Nicole D; Bennett, Kathryn; Huguet, Anna; Hartling, Lisa; Dyson, Michele P; McGrath, Patrick

    2017-06-02

    The use of technology such as computers, tablets, and smartphones to improve access to and the delivery of mental health care (eMental Health care) is growing worldwide. However, despite the rapidly expanding evidence base demonstrating the efficacy of eMental Health care, its implementation in clinical practice and health care systems remains fragmented. To date, no peer-reviewed, key-informant studies have reported on the perspectives of decision-makers concerned with whether and how to implement eMental Health care. From September to November 2015, we conducted 31 interviews with key informants responsible for leadership, policy, research, and/ or information technology in organizations influential in the adoption of technology for eMental Health care. Deductive and inductive thematic analyses of transcripts were conducted using the Behavior Change Wheel as an organizing framework. Frequency and intensity effect sizes were calculated for emerging themes to further explore patterns within the data. Key informant responses (n = 31) representing 6 developed countries and multiple organizations showed consensus on common factors impacting implementation: individual and organizational capacities (e.g., computer literacy skills [patients and providers], knowledge gaps about cyber security, limited knowledge of available services); motivational drivers of technology-based care (e.g., extending care, data analytics); and opportunities for health systems to advance eMental Health care implementation (e.g., intersectoral research, rapid testing cycles, sustainable funding). Frequency effect sizes showed strong associations between implementation and credibility, knowledge, workflow, patient empowerment, electronic medical record (EMR) integration, sustained funding and intersectoral networks. Intensity effect sizes showed the highest concentration of statements (>10% of all comments) related to funding, credibility, knowledge gaps, and patient empowerment. This study

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

    Science.gov (United States)

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

    2015-01-01

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

  7. Knowledge and Ethical Issues in Organ Transplantation and Organ Donation: Perspectives from Iranian Health Personnel.

    Science.gov (United States)

    Abbasi, Mahmoud; Kiani, Mehrzad; Ahmadi, Mehdi; Salehi, Bahare

    2018-05-04

    BACKGROUND Organ transplantation is one of the most critical topics in medical ethics that is commonplace in various countries. This study aimed to evaluate the knowledge and the ethical issues surrounding organ transplantation and organ donation among healthcare personnel in Tehran, Iran. MATERIAL AND METHODS In a cross-sectional study performed on 450 healthcare personnel, self-administered questionnaires were used to derive data from individuals. Among the 450 health personnel who received the questionnaires, 377 completed their questionnaires (83.77%). RESULTS The willingness and unwillingness to donate organs among individuals were 47.48% (n=179) and 52.51% (n=198), respectively. Among the individuals who signed the organ donation card, 96.5% (n=55) were willing to donate their organs and 3.5% (n=2) were unwilling to donate their organs. Most of the individuals that were willing (48.34%; n=175) and unwilling (51.66%; n=187) to donate their organs claimed religious support for organ donation (P=0.00). Out of these people, 110 willing people (67.48%) and 53 (32.52%) unwilling people were familiar with the idea of brain death. The individuals who selected cadavers (67.64%; n=255) and brain death (24.4%; n=92) were chosen as the best candidates for organ donation. Most individuals believed that young patients (n=123; 32.62%) and people who had not already had organ transplants (n=90; 23.87%) should be the preferred recipients of organs. Most individuals had learned about organ transplantation from television (30.24%; n=114), newspapers (23.61%; n=89), and the radio (19.89%; n=75). CONCLUSIONS In conclusion, there is a need for more educational programs for the improvement of knowledge and ethical consideration with regard to organ transplantation and organ donation among healthcare personnel.

  8. Maintaining Department of Energy facilities general design criteria

    International Nuclear Information System (INIS)

    Metzler, J.F.

    1985-01-01

    A General Design Criteria (GDC) Planning Board has been established in the Department of Energy to streamline the improvement and maintenance of the GDC Manual. This Planning Board, composed of a membership from field organizations and Headquarters programmatic offices, started work on 15 enhancements to the GDC Manual. One of those enhancements details natural phenomena hazards criteria. In the past year the Planning Board submitted a major recommendation which has been implemented into what is known as the GDC Improvements project. The result of this project pledges to dramatically increase the GDC Manual's utilization and effectiveness

  9. The World Health Organization World Mental Health Survey Initiative.

    Science.gov (United States)

    Kessler, Ronald C; Haro, Josep Maria; Heeringa, Steven G; Pennell, Beth-Ellen; Ustün, T Bedirhan

    2006-01-01

    To present an overview of the World Health Organization World Mental Health (WMH) Survey Initiative. The discussion draws on knowledge gleaned from the authors' participation as principals in WMH. WMH has carried out community epidemiological surveys in more than two dozen countries with more than 200,000 completed interviews. Additional surveys are in progress. Clinical reappraisal studies embedded in WMH surveys have been used to develop imputation rules to adjust prevalence estimates for within- and between-country variation in accuracy. WMH interviews include detailed information about sub-threshold manifestations to address the problem of rigid categorical diagnoses not applying equally to all countries. Investigations are now underway of targeted substantive issues. Despite inevitable limitations imposed by existing diagnostic systems and variable expertise in participating countries, WMH has produced an unprecedented amount of high-quality data on the general population cross-national epidemiology of mental disorders. WMH collaborators are in thoughtful and subtle investigations of cross-national variation in validity of diagnostic assessments and a wide range of important substantive topics. Recognizing that WMH is not definitive, finally, insights from this round of surveys are being used to carry out methodological studies aimed at improving the quality of future investigations.

  10. The missing millions: organized labor, business, and the defeat of Clinton's Health Security Act.

    Science.gov (United States)

    Gottschalk, M

    1999-06-01

    During the battle over comprehensive health care reform in the early 1990s, organized labor was not only unable to put together a winning coalition but also found itself divided and on the defensive as it struggled to prevent any further erosion of the private-sector safety net of the U.S. welfare state. Labor's relative ineffectiveness has deep institutional and political roots and was not merely a consequence of its dwindling membership base. Several key institutions of the private welfare state, notably the Taft-Hartley health and welfare funds and the Employment Retirement Income Security Act (ERISA) preemption, brought the interests of organized labor more closely in line with those of large employers and commercial insurers and aggravated divisions within organized labor and between unions and public interest groups. In addition, several political factors conspired to reinforce labor's tendency to stick to a policy path on health care issues that was predicated on an employer-mandate solution and that had been charted primarily by business and leading Democrats. As a result, organized labor did not emerge from the 1993-1994 struggle with its political base fortified nor with a viable long-term political strategy to achieve universal health care and to shift the political debate over health policy in a more desirable direction.

  11. Criteria procedure development for tender in construction design

    Directory of Open Access Journals (Sweden)

    Malykha Galina Gennad’evna

    Full Text Available This article deals with the problem of criteria optimization in order to objectively evaluate the experience of an applicant (a project organization and the quality of a design product (project documentation. The methodology to be developed is based on introduction of new evaluation criteria (sub-criteria that in conjunction with the applicable criteria specified by the Law on the Contract System will allow developing the optimal procedure to evaluate competitive bids of the participants in tenders and determining the most appropriate candidate, with whom the contract will be further concluded. The article analyzes the existing criteria and their interaction with each other and describes the specifics of tenders for design in the form of open competition. The list decreases to three criteria, such as "contract price", "quality, functional and environmental characteristics of a procurement facility", "qualification of procurement participants, including availability of financial resources, equipment and other material resources necessary for the execution of the contract material resources, the presence of goodwill, professionals and other employees of a certain experience level". However, in order to upgrade the quality of assurance procedures for the design works to be performed, it was decided to apply new evaluation criteria (sub-criteria components, such as "availability of positive findings of the state out-of-departmental examination that are similar to the subject of competition, on a participant in placement of order", "availability of the certificate on approval of architectural and urban planning decisions that are similar to the subject of competition, on a participant in placement of order", "availability of the permit for the commissioning of facilities that are similar to the subject of competition, on a participant in placement of order", "availability of the contract for designer's supervision with a participant in placement of

  12. Scientific Issues Relevant to Setting Regulatory Criteria to Identify Endocrine-Disrupting Substances in the European Union.

    Science.gov (United States)

    Slama, Rémy; Bourguignon, Jean-Pierre; Demeneix, Barbara; Ivell, Richard; Panzica, Giancarlo; Kortenkamp, Andreas; Zoeller, R Thomas

    2016-10-01

    Endocrine disruptors (EDs) are defined by the World Health Organization (WHO) as exogenous compounds or mixtures that alter function(s) of the endocrine system and consequently cause adverse effects in an intact organism, or its progeny, or (sub)populations. European regulations on pesticides, biocides, cosmetics, and industrial chemicals require the European Commission to establish scientific criteria to define EDs. We address the scientific relevance of four options for the identification of EDs proposed by the European Commission. Option 1, which does not define EDs and leads to using interim criteria unrelated to the WHO definition of EDs, is not relevant. Options 2 and 3 rely on the WHO definition of EDs, which is widely accepted by the scientific community, with option 3 introducing additional categories based on the strength of evidence (suspected EDs and endocrine-active substances). Option 4 adds potency to the WHO definition, as a decision criterion. We argue that potency is dependent on the adverse effect considered and is scientifically ambiguous, and note that potency is not used as a criterion to define other particularly hazardous substances such as carcinogens and reproductive toxicants. The use of potency requires a context that goes beyond hazard identification and corresponds to risk characterization, in which potency (or, more relevantly, the dose-response function) is combined with exposure levels. There is scientific agreement regarding the adequacy of the WHO definition of EDs. The potency concept is not relevant to the identification of particularly serious hazards such as EDs. As is common practice for carcinogens, mutagens, and reproductive toxicants, a multi-level classification of ED based on the WHO definition, and not considering potency, would be relevant (corresponding to option 3 proposed by the European Commission). Slama R, Bourguignon JP, Demeneix B, Ivell R, Panzica G, Kortenkamp A, Zoeller RT. 2016. Scientific issues relevant

  13. Critical factors in recruiting health maintenance organization physicians.

    Science.gov (United States)

    Fisher, N B; Smith, H L; Pasternak, D P

    1993-01-01

    What factors facilitate successful physician recruiting by health care organizations? Answers surfaced in a study of physician recruiting by a large HMO in the Southwest. Professional networking and word-of-mouth advertising appear to be the prominent means by which physicians learn of attractive staff positions. Successful recruiting also depends on a practice setting that fosters quality care, emphasis on patient care delivery, and collegial interaction.

  14. Comparison of some yield and quality criteria in organically and ...

    African Journals Online (AJOL)

    STORAGESEVER

    2008-05-02

    May 2, 2008 ... The simplest definition organic farming is a production system, which excludes ... Key words: Organic growing, conventional growing, lettuce, yield, quality. ... capitata cv Gloria, an iceberg type) were sown in seed trays.

  15. Effects of organically and conventionally produced feed on biomarkers of health in a chicken model

    NARCIS (Netherlands)

    Huber, M.; Vijver, L.P.L. van de; Parmentier, H.; Savelkoul, H.; Coulier, L.; Wopereis, S.; Verheij, E.; Greef, J. van der; Nierop, D.; Hoogenboom, R.A.P.

    2010-01-01

    Consumers expect organic products to be healthier. However, limited research has been performed to study the effect of organic food on health. The present study aimed to identify biomarkers of health to enable future studies in human subjects. A feeding experiment was performed in two generations of

  16. World Health Organization on nuclear power

    International Nuclear Information System (INIS)

    Anon.

    1977-01-01

    A report published by the World Health Organization in cooperation with, and at the instigation of, the Belgian authorities, is summarised. The report was prepared by an international multidisciplinary working group, and concentrated on the somatic and genetic risks from ionising radiation, the environmental effects of nuclear power from the mining of uranium to the disposal of waste and the probability and consequences of accidents, sabotage and theft of nuclear materials. In general positive to nuclear power, the report nevertheless recommends for RESEARCH AND EVALUATION IN SEVERAL SECTORS: The duties of the authorities in providing full and open information on the consequences of the exploitation of nuclear power are emphasised. (JIW)

  17. Organizational Barriers to Adopting an Alcohol Screening and Brief Intervention in Community-Based Mental Health Organizations.

    Science.gov (United States)

    Patterson, David A; Wolf Adelv Unegv Waya, Silver; Dulmus, Catherine N

    2012-06-01

    This paper examines two factors related to successfully implementing a brief alcohol screening throughout all community-based mental health organizations. The first issue is related to an organization's internal structures, such as culture and climate that can impede evidenced-based practice implementation. There is literature suggesting that organizational culture and climate affect decisions about whether evidence-based practices are adopted and implemented within health care agencies. Following this literature review on organizational barriers, the history and successes of adopting an alcohol screening and brief intervention are reviewed. Studying, identifying, and understanding the organizational factors associated with the successful dissemination and implementation of best practices throughout community-based mental health organizations would contribute to increasing the likelihood that an alcohol screening and brief intervention are implemented throughout mental health organizations.

  18. Camelot 3: Habitability criteria space research and design studio

    Science.gov (United States)

    Arroyo, F.; Budet, O.; Garcia, A.; Lee, J.; Lopez, R.; Lugo, R.; Mateo, A.; Mellado, R.; Mendez, H.; Ortiz, N.

    1989-01-01

    Acknowledging the importance of human beings on a mission to Mars, the University of Puerto Rico studied both psychological and physiological aspects. Different conditions necessary for human health and well-being were considered. As a result, habitability criteria were developed. The criteria are as follows: personal identification; social interaction; unpredictable conditions; contact with nature; mental landscapes; privacy; equalitarian conditions; variety; functionality; sensory stimulation; music and environmental sound; stability and security; comfort; and sense of orientation.

  19. How Health Care Organizations Are Using Data on Patients' Race and Ethnicity to Improve Quality of Care

    Science.gov (United States)

    Thorlby, Ruth; Jorgensen, Selena; Siegel, Bruce; Ayanian, John Z

    2011-01-01

    Context: Racial and ethnic disparities in the quality of health care are well documented in the U.S. health care system. Reducing these disparities requires action by health care organizations. Collecting accurate data from patients about their race and ethnicity is an essential first step for health care organizations to take such action, but these data are not systematically collected and used for quality improvement purposes in the United States. This study explores the challenges encountered by health care organizations that attempted to collect and use these data to reduce disparities. Methods: Purposive sampling was used to identify eight health care organizations that collected race and ethnicity data to measure and reduce disparities in the quality and outcomes of health care. Staff, including senior managers and data analysts, were interviewed at each site, using a semi-structured interview format about the following themes: the challenges of collecting and collating accurate data from patients, how organizations defined a disparity and analyzed data, and the impact and uses of their findings. Findings: To collect accurate self-reported data on race and ethnicity from patients, most organizations had upgraded or modified their IT systems to capture data and trained staff to collect and input these data from patients. By stratifying nationally validated indicators of quality for hospitals and ambulatory care by race and ethnicity, most organizations had then used these data to identify disparities in the quality of care. In this process, organizations were taking different approaches to defining and measuring disparities. Through these various methods, all organizations had found some disparities, and some had invested in interventions designed to address them, such as extra staff, extended hours, or services in new locations. Conclusion: If policymakers wish to hold health care organizations accountable for disparities in the quality of the care they

  20. What is a good health check? An interview study of health check providers' views and practices.

    Science.gov (United States)

    Stol, Yrrah H; Asscher, Eva C A; Schermer, Maartje H N

    2017-10-02

    Health checks identify (risk factors for) disease in people without symptoms. They may be offered by the government through population screenings and by other providers to individual users as 'personal health checks'. Health check providers' perspective of 'good' health checks may further the debate on the ethical evaluation and possible regulation of these personal health checks. In 2015, we interviewed twenty Dutch health check providers on criteria for 'good' health checks, and the role these criteria play in their practices. Providers unanimously formulate a number of minimal criteria: Checks must focus on (risk factors for) treatable/preventable disease; Tests must be reliable and clinically valid; Participation must be informed and voluntary; Checks should provide more benefits than harms; Governmental screenings should be cost-effective. Aspirational criteria mentioned were: Follow-up care should be provided; Providers should be skilled and experienced professionals that put the benefit of (potential) users first; Providers should take time and attention. Some criteria were contested: People should be free to test on any (risk factor for) disease; Health checks should only be performed in people at high risk for disease that are likely to implement health advice; Follow up care of privately funded tests should not drain on collective resources. Providers do not always fulfil their own criteria. Their reasons reveal conflicts between criteria, conflicts between criteria and other ethical values, and point to components in the (Dutch) organisation of health care that hinder an ethical provision of health checks. Moreover, providers consider informed consent a criterion that is hard to establish in practice. According to providers, personal health checks should meet the same criteria as population screenings, with the exception of cost-effectiveness. Providers do not always fulfil their own criteria. Results indicate that in thinking about the ethics of health

  1. Leadership and characteristics of nonprofit mental health peer-run organizations nationwide.

    Science.gov (United States)

    Ostrow, Laysha; Hayes, Stephania L

    2015-04-01

    Mental health peer-run organizations are nonprofits providing venues for support and advocacy among people diagnosed as having mental disorders. It has been proposed that consumer involvement is essential to their operations. This study reported organizational characteristics of peer-run organizations nationwide and how these organizations differ by degree of consumer control. Data were from the 2012 National Survey of Peer-Run Organizations. The analyses described the characteristics of the organizations (N=380) on five domains of nonprofit research, comparing results for organizations grouped by degree of involvement by consumers in the board of directors. Peer-run organizations provided a range of supports and educational and advocacy activities and varied in their capacity and resources. Some variation was explained by the degree of consumer control. These organizations seemed to be operating consistently with evidence on peer-run models. The reach of peer-run organizations, and the need for in-depth research, continues to grow.

  2. Health risks of climate change in the World Health Organization South-East Asia Region.

    Science.gov (United States)

    Bowen, Kathryn J; Ebi, Kristie L

    2017-09-01

    Countries in the World Health Organization (WHO) South-East Asia Region are particularly vulnerable to a changing climate. Changes in extreme weather events, undernutrition and the spread of infectious diseases are projected to increase the number of deaths due to climate change by 2030, indicating the need to strengthen activities for adaptation and mitigation. With support from the WHO Regional Office for South-East Asia and others, countries have started to include climate change as a key consideration in their national public health policies. Further efforts are needed to develop evidence-based responses; garner the necessary support from partner ministries; and access funding for activities related to health and climate change. National action plans for climate change generally identify health as one of their priorities; however, limited information is available on implementation processes, including which ministries and departments would be involved; the time frame; stakeholder responsibilities; and how the projects would be financed. While progress is being made, efforts are needed to increase the capacity of health systems to manage the health risks of climate change in South-East Asia, if population health is to be protected and strengthened while addressing changing weather and climate patterns. Enhancing the resilience of health systems is key to ensuring a sustainable path to improved planetary and population health.

  3. Using Professional Organizations to Prepare the Behavioral Health Workforce to Respond to the Needs of Pediatric Populations Impacted by Health-Related Disasters: Guiding Principles and Challenges.

    Science.gov (United States)

    Sprang, Ginny; Silman, Miriam

    2015-12-01

    Behavioral health professional organizations are in the unique role of aggregating and disseminating information to their membership before, during, and after health-related disasters to promote the integration of behavioral health services into the public health disaster response plan. This article provides a set of 5 principles to direct this undertaking that are based on the current literature and previous evaluation of the online guidance provided by 6 prominent behavioral health professional organizations. These principles use a strengths-based approach to prioritize resilience; underscore the importance of context, collaboration, and coordination; recognize the unique needs of pediatric populations; and guide ongoing training and content development in the area of biopsychosocial responses to health-related disasters. Recognizing important innovations and strides made by the behavioral health organizations noted in a previous study, this article recommends additional areas in which behavioral health professional organizations can contribute to overall pandemic disaster preparedness and response efforts.

  4. From Charity to Development: Christian International Health Organizations, 1945-1978

    Directory of Open Access Journals (Sweden)

    Walter Bruchhausen

    2016-12-01

    Full Text Available With the exception of the Red Cross the history of non-governmental international organizations in the field of health has received less attention from historians than intergovernmental organizations and national non-governmental organizations (NGOs. This article takes up the challenge of redressing this by examining the origins and policies of Christian agencies such as Medicus Mundi Internationalis (International Organisation for Medical Cooperation and the World Council of Churches Christian Medical Commission. Despite denominational and theological differences a story emerges of a common trajectory from a hospital-based focus on curative medicine to community-focused primary healthcare in the three decades or so after 1945.

  5. Global policy for improvement of oral health in the 21st century--implications to oral health research of World Health Assembly 2007, World Health Organization

    DEFF Research Database (Denmark)

    Petersen, Poul Erik

    2009-01-01

    The World Health Organization (WHO) Global Oral Health Programme has worked hard over the past 5 years to increase the awareness of oral health worldwide as oral health is important component of general health and quality of life. Meanwhile, oral disease is still a major public health problem...... in high income countries and the burden of oral disease is growing in many low- and middle income countries. In the World Oral Health Report 2003, the WHO Global Oral Health Programme formulated the policies and necessary actions to the continuous improvement of oral health. The strategy is that oral...... disease prevention and the promotion of oral health needs to be integrated with chronic disease prevention and general health promotion as the risks to health are linked. The World Health Assembly (WHA) and the Executive Board (EB) are supreme governance bodies of WHO and for the first time in 25 years...

  6. Managing health care organizations in an age of rapid change.

    Science.gov (United States)

    Benjamin, S; al-Alaiwat, S

    1998-03-01

    Health care managers find their work increasingly difficult, due in part to rapid environmental change that plagues organizational life. Management practices and attitudes that may have been appropriate in previous eras are ineffective today. A study was conducted among managers in the Ministry of Health, State of Bahrain, seeking information about current trends in the macro or external environment that affect the Ministry of Health, as well as internal environmental pressures that may be similar or different. This article provides a clear picture of the context in which managers perform their work and offers recommendations for coping with change in dynamic, complex organizations.

  7. Benefits of implementation of ISO 9001 Quality System in the health sector

    OpenAIRE

    Petkovska, Sofija; Gjorgjeska, Biljana

    2012-01-01

    Quality Standard ISO 9001 helps and enables organizations, regardless of the sector they exist in, to implement the quality management properly. Recent years have attracted attention to the possibilities of implementing this standard in the health sector and the economic viability of that long-term investment. Healthcare organizations are recognizing the value system that combines all the criteria for managing quality, including management of business, compliance and management of procedural ...

  8. Risk of Cardiovascular Disease and Death in Individuals With Prediabetes Defined by Different Criteria

    DEFF Research Database (Denmark)

    Vistisen, Dorte; Witte, Daniel R; Brunner, Eric J

    2018-01-01

    OBJECTIVE: We compared the risk of cardiovascular disease (CVD) and all-cause mortality in subgroups of prediabetes defined by fasting plasma glucose (FPG), 2-h plasma glucose (2hPG), or HbA1c. RESEARCH DESIGN AND METHODS: In the Whitehall II cohort, 5,427 participants aged 50-79 years, without...... diabetes, were followed for a median of 11.5 years. A total of 628 (11.6%) had prediabetes by the World Health Organization (WHO)/International Expert Committee (IEC) criteria (FPG 6.1-6.9 mmol/L and/or HbA1c6.0-6.4%), and 1,996 (36.8%) by the American Diabetes Association (ADA) criteria (FPG 5.6-6.9 mmol....../L and/or HbA1c5.7-6.4%). In a subset of 4,730 individuals with additional measures of 2hPG, 663 (14.0%) had prediabetes by 2hPG. Incidence rates of a major event (nonfatal/fatal CVD or all-cause mortality) were compared for different definitions of prediabetes, with adjustment for relevant confounders...

  9. The Role of the World Health Organization in Eliminating Iodine Deficiency Worldwide.

    Science.gov (United States)

    Karwowska, Paulina; Breda, Joao

    2017-01-01

    Iodine deficiency has been one of the most prevalent micronutrient deficiencies in the world, causing many health disorders, particularly in pregnant women and children. Despite increased salt iodization in some countries and regions, the process has lacked global coordination and sustainability, two prerequisites for reaching the aim of eliminating iodine deficiency. This goal can be reached only by evidence-based, effectively monitored joint and committed actions of all countries. The aim of the article is to present the role of WHO in leading and coordinating public health actions aiming elimination of iodine deficiency. WHO was given a mandate to coordinate such public health actions, including developing and strengthening relevant public health legislation, issuing technically sound and evidence-based norms and standards, and monitoring the health situation and trends. WHO has coordinated and fostered collaboration between countries, international organizations, scientific associations and non-governmental organization to reach the goal of eliminating iodine deficiency. No recent patents are discussed for this WHO report. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  10. Organization and Finance of China’s Health Sector

    Directory of Open Access Journals (Sweden)

    Hui Li PhD

    2016-01-01

    Full Text Available China has exploded onto the world economy over the past few decades and is undergoing rapid transformation toward relatively more services. The health sector is an important part of this transition. This article provides a historical account of the development of health care in China since 1949. It also focuses on health insurance and macroeconomic structural adjustment to less saving and more consumption. In particular, the question of how health insurance impacts precautionary savings is considered. Multivariate analysis using data from 1990 to 2012 is employed. The household savings rate is the dependent variable in 3 models segmented for rural and urban populations. Independent variables include out-of-pocket health expenditures, health insurance payouts, housing expenditure, education expenditure, and consumption as a share of gross domestic product (GDP. Out-of-pocket health expenditures were positively correlated with household savings rates. But health insurance remains weak, and increased payouts by health insurers have not been associated with lower levels of household savings so far. Housing was positively correlated, whereas education had a negative association with savings rates. This latter finding was unexpected. Perhaps education is perceived as investment and a substitute for savings. China’s shift toward a more service-oriented economy includes growing dependence on the health sector. Better health insurance is an important part of this evolution. The organization and finance of health care is integrally linked with macroeconomic policy in an environment constrained by prevailing institutional convention. Problems of agency relationships, professional hegemony, and special interest politics feature prominently, as they do elsewhere. China also has a dual approach to medicine relying heavily on providers of traditional Chinese medicine. Both of these segments will take part in China’s evolution, adding another layer of

  11. Investment Portfolio Formation Using Multi-criteria evaluation Method MULTIMOORA

    Directory of Open Access Journals (Sweden)

    Vilius Vaišvilas

    2017-06-01

    Full Text Available Information that has to be analyzed by investors is complicated and can be interpreted differently by different people, which is why choosing what should be added to the investment portfolio is complicated task. Complexity grows substantially when there are more alternatives to choose from. Multi – criteria evaluation method can be used to choose the best alternatives. Multi–criteria evaluation method MULTIMOORA is not subjective because there is no need to decide ratio of any given variable that is evaluated. MULTIMOORA consists of: formation of ratio system, application of multi – criteria evaluation method as well as investment evaluation and ranking. Purpose of this article is to apply multi – criteria evaluation method MULTIMOORA for the formation and management of investment portfolio from stocks of the Baltic stock market companies. Methods used in the analysis for the article: analysis of scientific literature, statistical analysis, organization and comparison of data, idealization, calculations of MULTIMOORA.

  12. Assessing, and understanding, European organic dairy farmers’ intentions to improve herd health

    NARCIS (Netherlands)

    Jones, P.J.; Sok, J.; Tranter, R.B.; Blanco-Penedo, I.; Fall, N.; Fourichon, C.; Hogeveen, H.; Krieger, M.C.; Sundrum, A.

    2016-01-01

    Many believe the health status of organic dairy herds in Europe should be improved to meet consumers’ and legislators’ expectations to improve animal welfare. This paper reports on a study in four countries that examined dairy farmers’ intentions towards improving the health status of their

  13. Enhancing the role of faith-based organizations to improve health: a commentary.

    Science.gov (United States)

    Schoenberg, Nancy E

    2017-09-01

    Researchers, policymakers, and community members increasingly recognize the potential to leverage faith-based organizations (FBOs) to improve health. This commentary complements Leyva and colleagues' article on whether and how members of FBOs view such a role. The commentary draws on our 13+ years operating a faith-based and community-based research organization, Faith Moves Mountains, in the Appalachian context. Issues to be addressed in the further development of faith-based health promotion include sustainability; adherence to the evidence-based operations of interventions, training, and privacy and protection protocols; and understanding the changing landscape of American public life.

  14. World Health Organization Public Health Model: A Roadmap for Palliative Care Development.

    Science.gov (United States)

    Callaway, Mary V; Connor, Stephen R; Foley, Kathleen M

    2018-02-01

    The Open Society Foundation's International Palliative Care Initiative (IPCI) began to support palliative care development in Central and Eastern Europe and the Former Soviet Union in 1999. Twenty-five country representatives were invited to discuss the need for palliative care in their countries and to identify key areas that should be addressed to improve the care of adults and children with life-limiting illnesses. As a public health concern, progress in palliative care requires integration into health policy, education and training of health care professionals, availability of essential pain relieving medications, and health care services. IPCI created the Palliative Care Roadmap to serve as a model for government and/or nongovernment organizations to use to frame the necessary elements and steps for palliative care integration. The roadmap includes the creation of multiple Ministry of Health-approved working groups to address: palliative care inclusion in national health policy, legislation, and finance; availability of essential palliative care medications, especially oral opioids; education and training of health care professionals; and the implementation of palliative care services at home or in inpatient settings for adults and children. Each working group is tasked with developing a pathway with multiple signposts as indicators of progress made. The roadmap may be entered at different signposts depending upon the state of palliative care development in the country. The progress of the working groups often takes place simultaneously but at variable rates. Based on our experience, the IPCI Roadmap is one possible framework for palliative care development in resource constrained countries but requires both health care professional engagement and political will for progress to be made. Copyright © 2017. Published by Elsevier Inc.

  15. Lean Information Management: Criteria For Selecting Key Performance Indicators At Shop Floor

    Science.gov (United States)

    Iuga, Maria Virginia; Kifor, Claudiu Vasile; Rosca, Liviu-Ion

    2015-07-01

    Most successful organizations worldwide use key performance indicators as an important part of their corporate strategy in order to forecast, measure and plan their businesses. Performance metrics vary in their purpose, definition and content. Therefore, the way organizations select what they think are the optimal indicators for their businesses varies from company to company, sometimes even from department to department. This study aims to answer the question of what is the most suitable way to define and select key performance indicators. More than that, it identifies the right criteria to select key performance indicators at shop floor level. This paper contributes to prior research by analysing and comparing previously researched selection criteria and proposes an original six-criteria-model, which caters towards choosing the most adequate KPIs. Furthermore, the authors take the research a step further by further steps to closed research gaps within this field of study.

  16. 78 FR 49757 - Notification of an Expansion to the Cooperative Agreement Award to the World Health Organization

    Science.gov (United States)

    2013-08-15

    ... Award to the World Health Organization AGENCY: Biomedical Advanced Research and Development Authority... requires notification to World Health Organization (WHO) as soon as possible, and any confirmed smallpox... Services (HHS). ACTION: Notification of an expansion to the Cooperative Agreement Award to the World Health...

  17. Participatory flood vulnerability assessment: a multi-criteria approach

    Science.gov (United States)

    Madruga de Brito, Mariana; Evers, Mariele; Delos Santos Almoradie, Adrian

    2018-01-01

    This paper presents a participatory multi-criteria decision-making (MCDM) approach for flood vulnerability assessment while considering the relationships between vulnerability criteria. The applicability of the proposed framework is demonstrated in the municipalities of Lajeado and Estrela, Brazil. The model was co-constructed by 101 experts from governmental organizations, universities, research institutes, NGOs, and private companies. Participatory methods such as the Delphi survey, focus groups, and workshops were applied. A participatory problem structuration, in which the modellers work closely with end users, was used to establish the structure of the vulnerability index. The preferences of each participant regarding the criteria importance were spatially modelled through the analytical hierarchy process (AHP) and analytical network process (ANP) multi-criteria methods. Experts were also involved at the end of the modelling exercise for validation. The final product is a set of individual and group flood vulnerability maps. Both AHP and ANP proved to be effective for flood vulnerability assessment; however, ANP is preferred as it considers the dependences among criteria. The participatory approach enabled experts to learn from each other and acknowledge different perspectives towards social learning. The findings highlight that to enhance the credibility and deployment of model results, multiple viewpoints should be integrated without forcing consensus.

  18. Water quality criteria for hexachloroethane: Final report

    Energy Technology Data Exchange (ETDEWEB)

    Davidson, K.A.; Hovatter, P.S.; Ross, R.H.

    1988-03-01

    The available data regarding the environmental fate, aquatic toxicity, and mammalian toxicity of hexachloroethane, which is used in military screening smokes, were reviewed. The USEPA guidelines were used to generate water quality criteria for the protection of aquatic life and its uses and of human health. 16 tabs.

  19. Developing remediation criteria on the basis of health and ecological risks at a former sour gas plant site

    International Nuclear Information System (INIS)

    Brown, G. L.; Wilson, R. M.; Clyde, G. A.; Chollak, D. F.

    1997-01-01

    A human health and ecological risk assessment was completed for the Okotoks sour gas processing gas plant, based on the existing environmental sampling and toxicity testing that has been collected at the site since 1987. For the human health risk assessment, two potential scenarios were considered, including industrial use and parkland use. The ecological risk assessment involved synthesis of existing sampling and toxicity testing results as well as the assessment of potential risk to ecological receptors such as the meadow vole, red-tailed hawk and cattle. The assessment included chemical screening, receptor and exposure pathway selection, toxicity assessment of chemicals of concern, estimation of exposures, risk characterization and generation of soil and groundwater remediation criteria. Results of the assessments to date indicate that limited subsurface remediation is required for the protection of human health under industrial/parkland use. In contrast, ecological considerations will require remediation or reclamation of surface soil and the imposition of certain risk management controls, such as e. g. encumbrances on land title. 2 figs

  20. Multiplex Competition, Collaboration, and Funding Networks Among Health and Social Organizations: Toward Organization-based HIV Interventions for Young Men Who Have Sex With Men.

    Science.gov (United States)

    Fujimoto, Kayo; Wang, Peng; Kuhns, Lisa M; Ross, Michael W; Williams, Mark L; Garofalo, Robert; Klovdahl, Alden S; Laumann, Edward O; Schneider, John A

    2017-02-01

    Young men who have sex with men (YMSM) have the highest rates of human immunodeficiency virus (HIV) infection in the United States. Decades into the HIV epidemic, the relationships that YMSM-serving health and social organizations have with one another has not been studied in depth. The aim of this study was to examine the competition, collaboration, and funding source structures of multiplex organization networks and the mechanisms that promote fruitful relationships among these organizations. The study data collection method was a survey of health and social organizations from 2013-2014 in 2 cities, Chicago, IL and Houston, TX. Study participants were representatives from 138 health and social organizations. Responses to survey questions were used to reconstruct competition, collaboration, and combined competition-collaboration networks. While taking into consideration the collaborative relationships among organizations, we provide statistical evidence that organizations of similar type, similar social media use patterns, comparable patterns of funding, and similar network contexts tended to compete with one another. This competition was less likely to be accompanied by any sort of collaboration if the organizations shared common funding sources. Competition that excludes potential collaboration may be detrimental to mobilizing the collective efforts that serve local YMSM communities. System-level interventions may provide promising approaches to scaling-up HIV prevention and treatment efforts so as to encourage organizations to form partnerships with otherwise competing providers.