WorldWideScience

Sample records for health organization grade

  1. Correlation of DNA content and nucleomorphometric features with World Health Organization grading of meningiomas.

    Science.gov (United States)

    Grunewald, J P; Röhl, F W; Kirches, E; Dietzmann, K

    1998-02-01

    Many studies dealing with extracranial cancer showed a strong correlation of DNA ploidy to a poor clinical outcome, recurrence, or malignancy. In brain tumors, analysis of DNA content did not always provided significant diagnostic information. In this study, DNA density and karyometric parameters of 50 meningiomas (26 Grade I, 10 Grade II, 14 Grade III) were quantitatively evaluated by digital cell image analyses of Feulgen-stained nuclei. In particular, the densitometric parameter SEXT, which describes nuclear DNA content, as well as the morphometric values LENG (a computer-assisted measurement of nuclear circumference), AREA (a computer-assisted measurement of nuclear area), FCON (a parameter that describes nuclear roundness), and CONC (a describing nuclear contour), evaluated with the software IMAGE C, were correlated to World Health Organization (WHO) grading using univariate and multivariate methods. AREA and LENG values showed significant differences between tumors of Grades I and III. FCON values were unable to distinguish WHO Grade III from Grade I/II but were useful in clearly separating Grade II from Grade I tumors. CONC values detected differences between WHO Grades II and I/III tumors but not between the latter. SEXT values clearly distinguished Grade III from Grade I/II tumors. The 1c, 2c, 2.5c, and 5c exceeding rates showed no predictive values. Only the 6c exceeding rate showed a significant difference between Grades I and III. These results outline the characteristic features of the atypical (Grade II) meningiomas, which make them a recognizable tumor entity distinct from benign and anaplastic meningiomas. The combination of DNA densitometric and morphometric findings seems to be a powerful addition to the histopathologic classification of meningiomas, as suggested by the WHO.

  2. Clear cell renal cell carcinoma: validation of World Health Organization/International Society of Urological Pathology grading.

    Science.gov (United States)

    Dagher, Julien; Delahunt, Brett; Rioux-Leclercq, Nathalie; Egevad, Lars; Srigley, John R; Coughlin, Geoffrey; Dunglinson, Nigel; Gianduzzo, Troy; Kua, Boon; Malone, Greg; Martin, Ben; Preston, John; Pokorny, Morgan; Wood, Simon; Yaxley, John; Samaratunga, Hemamali

    2017-12-01

    In 2012, the International Society of Urological Pathology (ISUP) introduced a novel grading system for clear cell renal cell carcinoma (ccRCC) and papillary renal cell carcinoma. This system is incorporated into the latest World Health Organization renal tumour classification, being designated WHO/ISUP grading. This study was undertaken to compare WHO/ISUP and Fuhrman grading and to validate WHO/ISUP grading as a prognostic parameter in a series of clear cell RCC. Analysis of 681 cases of ccRCC showed that 144 tumours could not be assigned a Fuhrman grade on the basis of ambiguous grading features. The application of WHO/ISUP grading resulted in a general down-grading of cases when compared with Fuhrman grading. In a sub-group of 374 cases, for which outcome data were available, 9.3% were WHO/ISUP grade 1, 50.3% were grade 2, 24.1% grade 3 and 16.3% grade 4, while the distribution of Fuhrman grades was 0.4% grade 1, 48.7% grade 2, 29.4% grade 3 and 21.5% grade 4. There were no recurrence/metastases amongst patients with WHO/ISUP grade 1 tumours and there was a significant difference in outcome for WHO/ISUP grades 2, 3 and 4. For Fuhrman grading the cancer-free survival was not significantly different for grade 2 and grade 3 tumours. On multivariate analysis WHO/ISUP grade and pT staging category were found to retain prognostic significance. The study demonstrates that FG cannot be applied in >20% of cases of ccRCC and the WHO/ISUP provides superior prognostic information. © 2017 John Wiley & Sons Ltd.

  3. Long-Term Experience With World Health Organization Grade III (Malignant) Meningiomas at a Single Institution

    International Nuclear Information System (INIS)

    Rosenberg, Lewis A.; Prayson, Richard A.; Lee, Joung; Reddy, Chandana; Chao, Samuel T.; Barnett, Gene H.; Vogelbaum, Michael A.; Suh, John H.

    2009-01-01

    Purpose: To evaluate the outcomes for patients with Grade III meningiomas as defined by the 2007 World Health Organization standards. Methods and Materials: The slides from patients who had been treated at the Cleveland Clinic for malignant meningiomas were reviewed by a single neuropathologist. The data from 13 patients treated between 1984 and 2006 satisfied the World Health Organization 2007 definition of Grade III meningioma. A total of 24 surgeries were performed, including 13 primary, 7 salvage, and 4 second salvage. Also, 14 courses of radiotherapy (RT) were administered, including fractionated RT in 3 patients after primary surgery, fractionated RT in 4 patients after salvage surgery, salvage stereotactic radiosurgery to six separate areas in 3 patients, and salvage intensity-modulated RT in 1 patient. Results: From the primary surgery, the median survival was 3.4 years, the 5-year survival rate was 47.2%, and the 8-year survival rate was 12.2%. The median time to recurrence was 9.6 months. A trend was seen toward longer survival for patients who had received adjuvant RT after initial surgery compared with those treated with surgery alone. Two patients developed radiation necrosis, and three had surgical complications. Conclusion: This is one of the few studies reporting the outcomes for malignant meningioma patients according to recent definitions. Our results are consistent with existing reports of the overall poor outcomes for atypical and malignant meningioma patients. From the available data, surgical resection followed by RT and salvage therapy can lead to extended survival.

  4. Correlation Between Ki-67 Index, World Health Organization Grade and Patient Survival in Glial Tumors With Astrocytic Differentiation

    Science.gov (United States)

    Dzhenkov, Deyan L; Kitanova, Martina; Donev, Ivan S; Ghenev, Peter

    2017-01-01

    Background Glioblastoma multiforme (GBM) is a class IV astrocytic tumor, the most malignant of the four groups of World Health Organization (WHO) tumors with astrocytic differentiation. Aim The aim of this study was to estab­lish whether a correlation exists between the Ki-67 index of tumors with astrocytic differentiation, WHO grade, and patient survival. Materials and methods A retrospective non-clinical approach to patient selection was chosen for the aim of the study. A total of 47 patients diagnosed and treated for CNS tumors with astrocytic differentiation in the St. Marina University Hospital, Varna, Bulgaria, from September 2012 to July 2016 were retrospectively included into the study cohort. The cases were tested for their immunohistochemistry (IHC) reaction with Ki-67 after their original Hematoxylin and Eosin and IHC slides were reviewed by a single author and blind coded. The Ki-67 positivity index of the nuclei was estimated after digitalization of the slides and calculated by the ImmunoRatio automated count­ing tool. The individual Ki-67 index and patient survival of each case were statistically compared. Results The histopathological groups, after the blind Ki-67 index automated calculation was carried out, revealed no WHO grade I, two WHO grade II samples, four WHO grade III samples and 41 WHO grade IV cases, and these were included in the analysis. The two samples of WHO grade II astrocytic tumors had a mean Ki-67 index of 25%; however, they comprised tumors with an individual index of 43% and 7%, both individual values with a highly unlikely index for this group. The four samples of WHO grade III had a mean Ki-67 index of 4%, standard deviation ±2.16 (p>0.05), with the lowest index being 1% and the highest one being 6%. Both WHO grade II and III did not include enough samples to allow for a proper statistical analysis of patient survival. The 41 GBM cases had a mean Ki-67 index of 17.34%, standard deviation ±10.79 (p>0

  5. Higher World Health Organization grades of follicular lymphoma correlate with better outcome in two Nordic Lymphoma Group trials of rituximab without chemotherapy

    DEFF Research Database (Denmark)

    Wahlin, Björn Engelbrekt; Sundström, Christer; Sander, Birgitta

    2014-01-01

    Abstract A common treatment for follicular lymphoma is rituximab monotherapy. To identify patients for whom this regimen is adequate as first-line therapy, we applied the World Health Organization (WHO) classification for grading follicular lymphoma in a prospective central pathology review...... increased with the malignant cell size (p useful tool for personalized therapy....

  6. 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.

  7. Peer Victimization in Fifth Grade and Health in Tenth Grade

    Science.gov (United States)

    Elliott, Marc N.; Klein, David J.; Tortolero, Susan R.; Mrug, Sylvie; Peskin, Melissa F.; Davies, Susan L.; Schink, Elizabeth T.; Schuster, Mark A.

    2014-01-01

    BACKGROUND AND OBJECTIVES: Children who experience bullying, a type of peer victimization, show worse mental and physical health cross-sectionally. Few studies have assessed these relationships longitudinally. We examined longitudinal associations of bullying with mental and physical health from elementary to high school, comparing effects of different bullying histories. METHODS: We analyzed data from 4297 children surveyed at 3 time points (fifth, seventh, and tenth grades) in 3 cities. We used multivariable regressions to test longitudinal associations of bullying with mental and physical health by comparing youth who experienced bullying in both the past and present, experienced bullying in the present only, experienced bullying in the past only, or did not experience bullying. RESULTS: Bullying was associated with worse mental and physical health, greater depression symptoms, and lower self-worth over time. Health was significantly worse for children with both past and present bullying experiences, followed by children with present-only experiences, children with past-only experiences, and children with no experiences. For example, 44.6% of children bullied in both the past and present were at the lowest decile of psychosocial health, compared with 30.7% of those bullied in the present only (P = .005), 12.1% of those bullied in the past only (P bullied (P bullying are associated with substantially worse health. Clinicians who recognize bullying when it first starts could intervene to reverse the downward health trajectory experienced by youth who are repeated targets. PMID:24534401

  8. Prognostic Performance and Reproducibility of the 1973 and 2004/2016 World Health Organization Grading Classification Systems in Non-muscle-invasive Bladder Cancer: A European Association of Urology Non-muscle Invasive Bladder Cancer Guidelines Panel Systematic Review.

    Science.gov (United States)

    Soukup, Viktor; Čapoun, Otakar; Cohen, Daniel; Hernández, Virginia; Babjuk, Marek; Burger, Max; Compérat, Eva; Gontero, Paolo; Lam, Thomas; MacLennan, Steven; Mostafid, A Hugh; Palou, Joan; van Rhijn, Bas W G; Rouprêt, Morgan; Shariat, Shahrokh F; Sylvester, Richard; Yuan, Yuhong; Zigeuner, Richard

    2017-11-01

    Tumour grade is an important prognostic indicator in non-muscle-invasive bladder cancer (NMIBC). Histopathological classifications are limited by interobserver variability (reproducibility), which may have prognostic implications. European Association of Urology NMIBC guidelines suggest concurrent use of both 1973 and 2004/2016 World Health Organization (WHO) classifications. To compare the prognostic performance and reproducibility of the 1973 and 2004/2016 WHO grading systems for NMIBC. A systematic literature search was undertaken incorporating Medline, Embase, and the Cochrane Library. Studies were critically appraised for risk of bias (QUIPS). For prognosis, the primary outcome was progression to muscle-invasive or metastatic disease. Secondary outcomes were disease recurrence, and overall and cancer-specific survival. For reproducibility, the primary outcome was interobserver variability between pathologists. Secondary outcome was intraobserver variability (repeatability) by the same pathologist. Of 3593 articles identified, 20 were included in the prognostic review; three were eligible for the reproducibility review. Increasing tumour grade in both classifications was associated with higher disease progression and recurrence rates. Progression rates in grade 1 patients were similar to those in low-grade patients; progression rates in grade 3 patients were higher than those in high-grade patients. Survival data were limited. Reproducibility of the 2004/2016 system was marginally better than that of the 1973 system. Two studies on repeatability showed conflicting results. Most studies had a moderate to high risk of bias. Current grading classifications in NMIBC are suboptimal. The 1973 system identifies more aggressive tumours. Intra- and interobserver variability was slightly less in the 2004/2016 classification. We could not confirm that the 2004/2016 classification outperforms the 1973 classification in prediction of recurrence and progression. This article

  9. Strand I: Physical Health Nutrition. Health Curriculum Materials. Grades 4-6.

    Science.gov (United States)

    New York State Education Dept., Albany. Bureau of Elementary Curriculum Development.

    GRADES OR AGES: Grades 4-6. SUBJECT MATTER: Physical health and nutrition. ORGANIZATION AND PHYSICAL APPEARANCE: The guide is divided into five sections: factors determining what people eat, the role of food in growth and development, the uses of nutrients in food, selection of foods to meet bodily needs, and food in the history of man. The…

  10. 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...

  11. Whole-Tumor Histogram and Texture Analyses of DTI for Evaluation of IDH1-Mutation and 1p/19q-Codeletion Status in World Health Organization Grade II Gliomas.

    Science.gov (United States)

    Park, Y W; Han, K; Ahn, S S; Choi, Y S; Chang, J H; Kim, S H; Kang, S-G; Kim, E H; Lee, S-K

    2018-04-01

    Prediction of the isocitrate dehydrogenase 1 (IDH1)-mutation and 1p/19q-codeletion status of World Health Organization grade ll gliomas preoperatively may assist in predicting prognosis and planning treatment strategies. Our aim was to characterize the histogram and texture analyses of apparent diffusion coefficient and fractional anisotropy maps to determine IDH1 -mutation and 1p/19q-codeletion status in World Health Organization grade II gliomas. Ninety-three patients with World Health Organization grade II gliomas with known IDH1- mutation and 1p/19q-codeletion status (18 IDH1 wild-type, 45 IDH1 mutant and no 1p/19q codeletion, 30 IDH1- mutant and 1p/19q codeleted tumors) underwent DTI. ROIs were drawn on every section of the T2-weighted images and transferred to the ADC and the fractional anisotropy maps to derive volume-based data of the entire tumor. Histogram and texture analyses were correlated with the IDH1 -mutation and 1p/19q-codeletion status. The predictive powers of imaging features for IDH1 wild-type tumors and 1p/19q-codeletion status in IDH1 -mutant subgroups were evaluated using the least absolute shrinkage and selection operator. Various histogram and texture parameters differed significantly according to IDH1 -mutation and 1p/19q-codeletion status. The skewness and energy of ADC, 10th and 25th percentiles, and correlation of fractional anisotropy were independent predictors of an IDH1 wild-type in the least absolute shrinkage and selection operator. The area under the receiver operating curve for the prediction model was 0.853. The skewness and cluster shade of ADC, energy, and correlation of fractional anisotropy were independent predictors of a 1p/19q codeletion in IDH1 -mutant tumors in the least absolute shrinkage and selection operator. The area under the receiver operating curve was 0.807. Whole-tumor histogram and texture features of the ADC and fractional anisotropy maps are useful for predicting the IDH1 -mutation and 1p/19q

  12. Stereotactic Radiosurgery for Benign (World Health Organization Grade I) Cavernous Sinus Meningiomas-International Stereotactic Radiosurgery Society (ISRS) Practice Guideline: A Systematic Review.

    Science.gov (United States)

    Lee, Cheng-Chia; Trifiletti, Daniel M; Sahgal, Arjun; DeSalles, Antonio; Fariselli, Laura; Hayashi, Motohiro; Levivier, Marc; Ma, Lijun; Álvarez, Roberto Martínez; Paddick, Ian; Regis, Jean; Ryu, Samuel; Slotman, Ben; Sheehan, Jason

    2018-03-15

    Stereotactic radiosurgery (SRS) has become popular as a standard treatment for cavernous sinus (CS) meningiomas. To summarize the published literature specific to the treatment of CS meningioma with SRS found through a systematic review, and to create recommendations on behalf of the International Stereotactic Radiosurgery Society. Articles published from January 1963 to December 2014 were systemically reviewed. Three electronic databases, PubMed, EMBASE, and The Cochrane Central Register of Controlled Trials, were searched. Publications in English with at least 10 patients (each arm) were included. Of 569 screened abstracts, a total of 49 full-text articles were included in the analysis. All studies were retrospective. Most of the reports had favorable outcomes with 5-yr progression-free survival (PFS) rates ranging from 86% to 99%, and 10-yr PFS rates ranging from 69% to 97%. The post-SRS neurological preservation rate ranged from 80% to 100%. Resection can be considered for the treatment of larger (>3 cm in diameter) and symptomatic CS meningioma in patients both receptive to and medically eligible for open surgery. Adjuvant or salvage SRS for residual or recurrent tumor can be utilized depending on factors such as tumor volume and proximity to adjacent critical organs at risk. The literature is limited to level III evidence with respect to outcomes of SRS in patients with CS meningioma. Based on the observed results, SRS offers a favorable benefit to risk profile for patients with CS meningioma.

  13. Physical Education and Health Education for Wyoming Elementary Schools, Grades Kindergarten-Six.

    Science.gov (United States)

    Woods, John B., Ed.

    GRADES OR AGES: K-6. SUBJECT MATTER: Physical education and health education. ORGANIZATION AND PHYSICAL APPEARANCE: There are 10 main sections--1) the elementary school program--organization and administration; 2) movement exploration and education; 3) rhythmic activities; 4) games; 5) stunts, tumbling, trampoline, and apparatus; 6) individual,…

  14. 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 ...

  15. Home Economics/Health Grades 6-12. Program Evaluation.

    Science.gov (United States)

    Des Moines Public Schools, IA. Teaching and Learning Div.

    Home economics programs are offered to students in grades 6-12 in the Des Moines INdependent Community School District (Iowa). Programs at the middle school level are exploratory, leading to occupational training in family and consumer science, child care, food service, and textile and fashion arts at the high school level. Health education…

  16. Assessment of health surveys: fitting a multidimensional graded response model.

    Science.gov (United States)

    Depaoli, Sarah; Tiemensma, Jitske; Felt, John M

    The multidimensional graded response model, an item response theory (IRT) model, can be used to improve the assessment of surveys, even when sample sizes are restricted. Typically, health-based survey development utilizes classical statistical techniques (e.g. reliability and factor analysis). In a review of four prominent journals within the field of Health Psychology, we found that IRT-based models were used in less than 10% of the studies examining scale development or assessment. However, implementing IRT-based methods can provide more details about individual survey items, which is useful when determining the final item content of surveys. An example using a quality of life survey for Cushing's syndrome (CushingQoL) highlights the main components for implementing the multidimensional graded response model. Patients with Cushing's syndrome (n = 397) completed the CushingQoL. Results from the multidimensional graded response model supported a 2-subscale scoring process for the survey. All items were deemed as worthy contributors to the survey. The graded response model can accommodate unidimensional or multidimensional scales, be used with relatively lower sample sizes, and is implemented in free software (example code provided in online Appendix). Use of this model can help to improve the quality of health-based scales being developed within the Health Sciences.

  17. 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.

  18. 48 CFR 846.470 - Use of commercial organizations for inspections and grading services.

    Science.gov (United States)

    2010-10-01

    ... organizations for inspections and grading services. 846.470 Section 846.470 Federal Acquisition Regulations System DEPARTMENT OF VETERANS AFFAIRS CONTRACT MANAGEMENT QUALITY ASSURANCE Government Contract Quality Assurance 846.470 Use of commercial organizations for inspections and grading services. The contracting...

  19. Multidimensional profiles of health status: an application of the grade of membership model to the world health survey.

    Directory of Open Access Journals (Sweden)

    Alessandra Andreotti

    Full Text Available BACKGROUND: The World Health Organization (WHO conducted the World Health Survey (WHS between 2002 and 2004 in 70 countries to provide cross-population comparable data on health, health-related outcomes and risk factors. The aim of this study was to apply Grade of Membership (GoM modelling as a means to condense extensive health information from the WHS into a set of easily understandable health profiles and to assign the degree to which an individual belongs to each profile. PRINCIPAL FINDINGS: This paper described the application of the GoM models to summarize population health status using World Health Survey data. Grade of Membership analysis is a flexible, non-parametric, multivariate method, used to calculate health profiles from WHS self-reported health state and health conditions. The WHS dataset was divided into four country economic categories based on the World Bank economic groupings (high, upper-middle, lower-middle and low income economies for separate GoM analysis. Three main health profiles were produced for each of the four areas: I. Robust; II. Intermediate; III. Frail; moreover population health, wealth and inequalities are defined for countries in each economic area as a means to put the health results into perspective. CONCLUSIONS: These analyses have provided a robust method to better understand health profiles and the components which can help to identify healthy and non-healthy individuals. The obtained profiles have described concrete levels of health and have clearly delineated characteristics of healthy and non-healthy respondents. The GoM results provided both a useable way of summarising complex individual health information and a selection of intermediate determinants which can be targeted for interventions to improve health. As populations' age, and with limited budgets for additional costs for health care and social services, applying the GoM methods may assist with identifying higher risk profiles for decision

  20. 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.

  1. GRADE: Assessing the quality of evidence in environmental and occupational health

    NARCIS (Netherlands)

    Morgan, Rebecca L.; Thayer, Kristina A.; Bero, Lisa; Bruce, Nigel; Falck-Ytter, Yngve; Ghersi, Davina; Guyatt, Gordon; Hooijmans, Carlijn; Langendam, Miranda; Mandrioli, Daniele; Mustafa, Reem A.; Rehfuess, Eva A.; Rooney, Andrew A.; Shea, Beverley; Silbergeld, Ellen K.; Sutton, Patrice; Wolfe, Mary S.; Woodruff, Tracey J.; Verbeek, Jos H.; Holloway, Alison C.; Santesso, Nancy; Schünemann, Holger J.

    2016-01-01

    There is high demand in environmental health for adoption of a structured process that evaluates and integrates evidence while making decisions and recommendations transparent. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework holds promise to address this

  2. The Effectiveness of Graphic Organizers to Support Executive Function for Ninth Grade Struggling Readers

    Science.gov (United States)

    Barry, Elaine

    2016-01-01

    Struggling readers, or students who read below grade level but have strong phonological awareness, may benefit from using instructional tools like graphic organizers (GOs) while reading. The purpose of this study was to investigate the relationship between reading comprehension and teacher-generated graphic organizers (GOs) as they support…

  3. 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.

  4. Clinical Signs and Organ Pathology in Rats Exposed To Graded ...

    African Journals Online (AJOL)

    Olaleye

    pyrethroids-containing insecticides on farm and market produce and in human ... Key words: Pyrethroids, insecticides, rats, tissue pathology, public health hazard ... ingredients, differing in chemical structure or in ... meat shops, in poultry pens and on dogs and cats ... A total of 54 (27 male and 27 female) albino rats.

  5. Advance Organizers and Examining of their Usage in 9th Grade Chemistry Textbooks

    OpenAIRE

    Canan NAKİBOĞLU; Nihan KAŞMER; Cem GÜLTEKİN; Füsun DÖNMEZ

    2010-01-01

    An advance organizer is the tool that is presented prior to the material to be learned, and that helps learners to organize and interpret new incoming information. In this study, a concept map concerning the classification of advance organizer was developed. Then, 9th grade chemistry textbooks written according to both current (year 2007) and past (year 1996) high school chemistry curriculum were examined by taking into account the concept map prepared. Next, the findings of each textbook ana...

  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. World Health Organization guideline development: an evaluation.

    Directory of Open Access Journals (Sweden)

    David Sinclair

    Full Text Available BACKGROUND: Research in 2007 showed that World Health Organization (WHO recommendations were largely based on expert opinion, rarely used systematic evidence-based methods, and did not follow the organization's own "Guidelines for Guidelines". In response, the WHO established a "Guidelines Review Committee" (GRC to implement and oversee internationally recognized standards. We examined the impact of these changes on WHO guideline documents and explored senior staff's perceptions of the new procedures. METHODS AND FINDINGS: We used the AGREE II guideline appraisal tool to appraise ten GRC-approved guidelines from nine WHO departments, and ten pre-GRC guidelines matched by department and topic. We interviewed 20 senior staff across 16 departments and analyzed the transcripts using the framework approach. Average AGREE II scores for GRC-approved guidelines were higher across all six AGREE domains compared with pre-GRC guidelines. The biggest changes were noted for "Rigour of Development" (up 37.6%, from 30.7% to 68.3% and "Editorial Independence" (up 52.7%, from 20.9% to 73.6%. Four main themes emerged from the interviews: (1 high standards were widely recognized as essential for WHO credibility, particularly with regard to conflicts of interest; (2 views were mixed on whether WHO needed a single quality assurance mechanism, with some departments purposefully bypassing the procedures; (3 staff expressed some uncertainties in applying the GRADE approach, with departmental staff concentrating on technicalities while the GRC remained concerned the underlying principles were not fully institutionalized; (4 the capacity to implement the new standards varied widely, with many departments looking to an overstretched GRC for technical support. CONCLUSIONS: Since 2007, WHO guideline development methods have become more systematic and transparent. However, some departments are bypassing the procedures, and as yet neither the GRC, nor the quality assurance

  8. Highly transparent vanadium oxide-graded indium zinc oxide electrodes for flexible organic solar cells

    International Nuclear Information System (INIS)

    Ko, Eun-Hye; Kim, Han-Ki

    2016-01-01

    We investigated characteristics of amorphous V_2O_5-graded InZnO (IZO) films to use as a flexible anode for flexible organic solar cells (FOSCs). Graded sputtering of the V_2O_5 layer on the IZO layer produced V_2O_5-graded IZO anodes (VGIZO) with a sheet resistance of 42.14 Ω/square, a resistivity of 6.32 × 10"−"4 Ω cm, and an optical transmittance of 82.15%, as well as good mechanical flexibility. In addition, the VGIZO electrode showed a greater work function of 5.2 eV than that (4.9 eV) of an IZO anode, which is beneficial for hole extraction from an organic active layer. Due to the higher work function of the VGIZO electrodes, FOSCs fabricated on the flexible VGIZO anode exhibited a higher power conversion efficiency 2.753% than that of FOSCs on the IZO anode. This indicates that the V_2O_5 graded sputtering is a promising technique to increase the work function of the IZO anode without change in sheet resistance and transmittance. - Highlights: • Transparent and flexible V_2O_5 graded IZO (VGIZO) electrodes. • High work function of VGIZO electrodes • The VGIZO film is a promising flexible anode for flexible organic solar cells.

  9. 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

  10. 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.

  11. Using the Grade Approach to Support the Development of Recommendations for Public Health Interventions in Radiation Emergencies

    International Nuclear Information System (INIS)

    Carr, Z.; Clarke, M.; Akl, E.A.; Schneider, R.; Murith, C.; Li, C.; Parrish-Sprowl, J.; Stenke, L.; Cui-Ping, L.; Bertrand, S.; Miller, C.

    2016-01-01

    The World Health Organization (WHO) guideline development policy requires that WHO guidelines be developed in a manner that is transparent and based on all available evidences, which must be synthesised and formally assessed for quality. To fulfil this requirement, the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach of rating quality of evidence and grading strength of recommendations was applied when developing the WHO recommendations on public health interventions in radiation emergencies. The guideline development group (GDG) formulated 10 PICO (P: population; I: intervention; C: comparator; O: outcomes) questions to guide the development of recommendations on response interventions during the early/intermediate and late emergency phases and on risk communications for mitigating psycho-social impact of radiation emergencies. For each PICO question, an extensive evidence search and systematic review was conducted. The GDG then formulated the recommendations using the evidence to recommendation (E-2-R) decision-making matrix and evaluated the strength of each recommendation. (authors)

  12. GRADE: Assessing the quality of evidence in environmental and occupational health.

    Science.gov (United States)

    Morgan, Rebecca L; Thayer, Kristina A; Bero, Lisa; Bruce, Nigel; Falck-Ytter, Yngve; Ghersi, Davina; Guyatt, Gordon; Hooijmans, Carlijn; Langendam, Miranda; Mandrioli, Daniele; Mustafa, Reem A; Rehfuess, Eva A; Rooney, Andrew A; Shea, Beverley; Silbergeld, Ellen K; Sutton, Patrice; Wolfe, Mary S; Woodruff, Tracey J; Verbeek, Jos H; Holloway, Alison C; Santesso, Nancy; Schünemann, Holger J

    2016-01-01

    There is high demand in environmental health for adoption of a structured process that evaluates and integrates evidence while making decisions and recommendations transparent. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework holds promise to address this demand. For over a decade, GRADE has been applied successfully to areas of clinical medicine, public health, and health policy, but experience with GRADE in environmental and occupational health is just beginning. Environmental and occupational health questions focus on understanding whether an exposure is a potential health hazard or risk, assessing the exposure to understand the extent and magnitude of risk, and exploring interventions to mitigate exposure or risk. Although GRADE offers many advantages, including its flexibility and methodological rigor, there are features of the different sources of evidence used in environmental and occupational health that will require further consideration to assess the need for method refinement. An issue that requires particular attention is the evaluation and integration of evidence from human, animal, in vitro, and in silico (computer modeling) studies when determining whether an environmental factor represents a potential health hazard or risk. Assessment of the hazard of exposures can produce analyses for use in the GRADE evidence-to-decision (EtD) framework to inform risk-management decisions about removing harmful exposures or mitigating risks. The EtD framework allows for grading the strength of the recommendations based on judgments of the certainty in the evidence (also known as quality of the evidence), as well as other factors that inform recommendations such as social values and preferences, resource implications, and benefits. GRADE represents an untapped opportunity for environmental and occupational health to make evidence-based recommendations in a systematic and transparent manner. The objectives of this article are

  13. 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 ...

  14. Organic food and health concerns

    DEFF Research Database (Denmark)

    Denver, Sigrid; Christensen, Tove

    2015-01-01

    A number of studies based on stated behaviour suggest that consumption of organic food is part of a life style that involves healthy eating habits that go beyond shifting to organic varieties of the individual food products. However, so far no studies based on observed behaviour have addressed...... the relationship between organic purchases and diet composition. The aim of the present paper is to fill this gab using purchase data for a large sample of Danish households. Using a Tobit regression analysis, the diets of households with higher organic consumption were found to include more vegetables and fruits...... but less fat/confectionary and meat which is in accordance with the official Danish Dietary Recommendations. Moreover, higher organic budget shares were found among well-educated consumers in urban areas and clearly linked to a belief that organic products are healthier. No statistical relations were found...

  15. 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...

  16. Organic solar cells with graded absorber layers processed from nanoparticle dispersions.

    Science.gov (United States)

    Gärtner, Stefan; Reich, Stefan; Bruns, Michael; Czolk, Jens; Colsmann, Alexander

    2016-03-28

    The fabrication of organic solar cells with advanced multi-layer architectures from solution is often limited by the choice of solvents since most organic semiconductors dissolve in the same aromatic agents. In this work, we investigate multi-pass deposition of organic semiconductors from eco-friendly ethanol dispersion. Once applied, the nanoparticles are insoluble in the deposition agent, allowing for the application of further nanoparticulate layers and hence for building poly(3-hexylthiophene-2,5-diyl):indene-C60 bisadduct absorber layers with vertically graded polymer and conversely graded fullerene concentration. Upon thermal annealing, we observe some degrees of polymer/fullerene interdiffusion by means of X-ray photoelectron spectroscopy and Kelvin probe force microscopy. Replacing the common bulk-heterojunction by such a graded photo-active layer yields an enhanced fill factor of the solar cell due to an improved charge carrier extraction, and consequently an overall power conversion efficiency beyond 4%. Wet processing of such advanced device architectures paves the way for a versatile, eco-friendly and industrially feasible future fabrication of organic solar cells with advanced multi-layer architectures.

  17. 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

  18. Organizing emotions in health care.

    Science.gov (United States)

    Mark, Annabelle

    2005-01-01

    To introduce the articles in this special issue, discussing emotion in the in health-care organisations. Discusses such topics as what makes health care different, editorial perspectives, how health care has explored emotion so far, and the impact of emotion on patients and the consequences for staff. Health care provides a setting that juxtaposes emotion and rationality, the individual and the body corporate, the formal and the deeply personal, the public and the private, all of which must be understood better if changes in expectations and delivery are to remain coherent. The papers indicate a shared international desire to understand meaning in emotion that is now spreading across organizational process and into all professional roles within health care.

  19. Parametric optimization and comparative study of organic Rankine cycle (ORC) for low grade waste heat recovery

    International Nuclear Information System (INIS)

    Dai Yiping; Wang Jiangfeng; Gao Lin

    2009-01-01

    Organic Rankine cycles for low grade waste heat recovery are described with different working fluids. The effects of the thermodynamic parameters on the ORC performance are examined, and the thermodynamic parameters of the ORC for each working fluid are optimized with exergy efficiency as an objective function by means of the genetic algorithm. The optimum performance of cycles with different working fluids was compared and analyzed under the same waste heat condition. The results show that the cycles with organic working fluids are much better than the cycle with water in converting low grade waste heat to useful work. The cycle with R236EA has the highest exergy efficiency, and adding an internal heat exchanger into the ORC system could not improve the performance under the given waste heat condition. In addition, for the working fluids with non-positive saturation vapor curve slope, the cycle has the best performance property with saturated vapor at the turbine inlet

  20. A general method for selection of riboflavin-overproducing food grade micro-organisms

    OpenAIRE

    Burgess, Catherine M; Smid, Eddy J; Rutten, Ger; van Sinderen, Douwe

    2006-01-01

    Abstract Background This study describes a strategy to select and isolate spontaneous riboflavin-overproducing strains of Lactobacillus (Lb.) plantarum, Leuconostoc (Lc.) mesenteroides and Propionibacterium (P.) freudenreichii. Results The toxic riboflavin analogue roseoflavin was used to isolate natural riboflavin-overproducing variants of the food grade micro-organisms Lb. plantarum, Lc. mesenteroides and P. freudenreichii strains. The method was successfully employed for strains of all thr...

  1. 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.

  2. 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?

  3. 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.

  4. 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...

  5. Flipped Classroom in Organic Chemistry Has Significant Effect on Students’ Grades

    Directory of Open Access Journals (Sweden)

    Caroline Cormier

    2018-01-01

    Full Text Available The flipped classroom as a form of active pedagogy in postsecondary chemistry has been developed during the last 10 years and has been gaining popularity with instructors and students ever since. In the current paradigm in science, technology, engineering, and mathematics education, it is widely recognized that active learning has significant positive effects on students’ grades. Postsecondary organic chemistry is a difficult course for students, and the traditional way of teaching does not foster students’ active involvement. Implementation of active pedagogy could increase students’ achievement in this course. However, few quantitative data are available on the impact of active pedagogy in general, or flipped classrooms in particular, on learning in organic chemistry at a postsecondary level. Thus, in this study, we evaluated the gain on final grade scores in organic chemistry after implementing a flipped classroom approach to promote active learning in this course. We encouraged students to be active by having them watch educational videos before each class and then having them work during class time on problems that focused on applying the concepts presented in the videos. Exams were the same as those completed by students in the traditional classrooms of our college. In an a posteriori analysis of our students’ grades, we compared final grades in traditional classrooms (control group, N = 66 and in flipped classrooms (experimental group, N = 151. The sample was stratified in three categories depending on students’ academic ability in college, from low-achieving to high-achieving students. Our results show that students in the experimental group have significantly higher final grades in organic chemistry than those in the control group, that is, 77% for students in the active classroom vs. 73% in the traditional classroom (p < 0.05. The effect was the greatest for low-achieving students, with final scores of 70% in

  6. 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.

  7. 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.

  8. Effects of Guided Inquiry versus Lecture Instruction on Final Grade Distribution in a One-Semester Organic and Biochemistry Course

    Science.gov (United States)

    Conway, Colleen J.

    2014-01-01

    A comprehensive guided-inquiry approach was used in a combined organic and biochemistry course for prenursing and predietetics students rather than lecture. To assess its effectiveness, exam grades and final course grades of students in three instructional techniques were compared. The three groups were the following: (i) lecture only, (ii)…

  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. 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.

  11. 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.

  12. [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.

  13. 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.

  14. 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.

  15. Revised Guidelines for Comprehensive Health Education, Grades 10-12.

    Science.gov (United States)

    Nebraska State Dept. of Education, Lincoln. Div. of Instructional Services.

    These health curriculum guidelines were designed for teachers of secondary students. Four major topic areas are covered: 1) anatomy, physiology, tissues, systems, heredity, physical activity, and nutriition; 2) family structures, functions, and responsibilities; 3) values, stress, and drug abuse; and 4) the environment, disease control, cancer,…

  16. The evaluation of organic inhibitors for the protection of grade 5 titanium in chloride media

    International Nuclear Information System (INIS)

    Popa, L.; Tunaru, M.; Velciu, L.

    2013-01-01

    The corrosion failures of titanium and titanium alloys are inevitably associated with the non-observance of environmental limits prescribed in corrosion handbooks, such as its use in solutions chloride. Titanium alloys are often used in the thermal transfer technology especially in the heat exchangers cooled with sea cooled water. However, it is not indicated its use in strong oxidant and any concentrated chloride environments. For the evaluation of grade 5 titanium alloy samples behaviour in solutions containing chloride ions in presence, respectively, absence of some organic inhibitors were performed by potentiodynamic polarization method. On the basis of our experimental results we consider that the most adequate inhibitor for the system Ti- 5 alloys/0 .083 M NaCl solution is the resorcinol. (authors)

  17. 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 ...

  18. 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.

  19. Health-related quality of life of long-term high-grade glioma survivors

    NARCIS (Netherlands)

    Bosma, Ingeborg; Reijneveld, Jaap C.; Douw, Linda; Vos, Maaike J.; Postma, Tjeerd J.; Aaronson, Neil K.; Muller, Martin; Vandertop, W. Peter; Slotman, Ben J.; Taphoorn, Martin J. B.; Heimans, Jan J.; Klein, Martin

    2009-01-01

    The objective of this study was to compare the health-related quality of life (HRQOL) of long-term to short-term high-grade glioma (HGG) survivors, determine the prognostic value of HRQOL for overall survival, and determine the effect of tumor recurrence on HRQOL for long-term survivors. Following

  20. [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.

  1. Effects of high grade bentonite on performance, organ weights and serum biochemistry during aflatoxicosis in broilers

    Directory of Open Access Journals (Sweden)

    H. C. Indresh

    2013-12-01

    Full Text Available Aim: To evaluate the effect of different levels of High Bentonite on growth performance, organ weight and serum biochemistry in broiler fed on diets containing aflatoxin. Materials and Methods: A total of 360 day-old commercial broiler chicks were divided at random into 8 dietary treatment groups of 42 chicks each having 3 replicates. Dietary levels of aflatoxin (0.5 ppm and High-grade bentonite (0.5, 0.75 and 1.00% were tested in a completely randomized design manner, forming a total of 8 dietary treatments each with three replicates. Body weight and feed intake were recorded weekly. At 5 wk, six birds from each treatment were sacrificed and liver, kidney, gizzard, pancreas, spleen, bursa of Fabricius and thymus were extracted and weighed. The serum samples were analyzed for total proteins, uric acid, serum albumin, serum globulin and the activities of gamma glutamyl transferase (GGT, alanine amino transferase (ALT and for antibody titers against Newcastle disease (ND and infectious bursal disease (IBD using ELISA technique. Results: A significant (P<0.05 decrease in body weight, feed consumption, relative weights of bursa, thymus, serum protein, anti body titers against NDV and IBDV, and increase in FCR, mortality, relative weight of liver, kidney, and the activity of Gamma Glutamyl Transferase (GGT was observed. However, the relative weights of gizzard, pancreas, spleen, serum albumin, uric acid and the activity of Alanine Amino Transferase (ALT were not influenced by inclusion of AF or HGB. Conclusion: The addition of HGB restored the harmful effects of AF on body weight, feed consumption, FCR, mortality, relative weight of liver, kidney, serum protein, IBDV and NDV. Supplementation of high grade bentonite at 1.0 per cent level was found to be beneficial in ameliorating the adverse effects of aflatoxin (AF in broiler chickens. [Vet World 2013; 6(6.000: 313-317

  2. [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.

  3. Effect of Mula Bandha Yoga in Mild Grade Pelvic Organ Prolapse: A Randomized Controlled Trial.

    Science.gov (United States)

    Sweta, K M; Godbole, Amrit; Awasthi, H H; Pandey, Uma

    2018-01-01

    Pelvic organ prolapse is the growing health issue related to women of the reproductive and postmenopausal age group in India and across the globe. Treatment option for pelvic organ prolapse includes both surgical and non-surgical intervention. The development of pelvic organ prolapse is an indication for major surgery among 20% of all women. Nevertheless, the recurrence of pelvic organ prolapse is detected among 58% of the patient after surgery. This highlights the need for preventive measures for reducing the impact of pelvic organ prolapse. To study the effect of 3 months yoga therapy in female patients suffering from mild pelvic organ prolapse. 50 Participants were allocated into two groups (25 in each group) by generating Random allocation sequence. Women aged 20-60 with symptomatic mild pelvic organ prolapse in the yoga group were offered Mulabandha yoga therapy along with other conventional treatment modalities, while the control group was only on conventional treatment. All participants gave written informed consent. An assessment was done by improvement in chief complaints and Pelvic Floor Distress Inventory-20 (PFDI-20) & Pelvic floor impact Questionnaire-7 (PFIQ-7) at baseline and at the end of 4, 8 & 12 weeks. Results At the end of 12 weeks, Post-study comparison between the two groups showed a significant improvement in chief complaints like perennial pain, P/V discharge, Perineal muscle laxity and Feeling of something coming out P/V ( P control group ( P = 0.1) and a mean score of PFIQ-7 was also improved significantly. Although Mulabandha (Root Lock) yoga therapy led to a significantly greater improvement in PFDI-20 & PFIQ-7 scores the difference between the groups was below the presumed level of clinical relevance (15 points). More studies are needed to identify factors related to the success of Mulabandha (Root Lock) yoga therapy and to investigate long-term effects.

  4. 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)

  5. 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.

  6. A general method for selection of riboflavin-overproducing food grade micro-organisms

    Directory of Open Access Journals (Sweden)

    Rutten Ger

    2006-07-01

    Full Text Available Abstract Background This study describes a strategy to select and isolate spontaneous riboflavin-overproducing strains of Lactobacillus (Lb. plantarum, Leuconostoc (Lc. mesenteroides and Propionibacterium (P. freudenreichii. Results The toxic riboflavin analogue roseoflavin was used to isolate natural riboflavin-overproducing variants of the food grade micro-organisms Lb. plantarum, Lc. mesenteroides and P. freudenreichii strains. The method was successfully employed for strains of all three species. The mutation(s responsible for the observed overproduction of riboflavin were identified for isolates of two species. Conclusion Selection for spontaneous roseoflavin-resistant mutants was found to be a reliable method to obtain natural riboflavin-overproducing strains of a number of species commonly used in the food industry. This study presents a convenient method for deriving riboflavin-overproducing strains of bacterial starter cultures, which are currently used in the food industry, by a non-recombinant methodology. Use of such starter strains can be exploited to increase the vitamin content in certain food products.

  7. Strand V: Education for Survival. First Aid and Survival Education. Health Curriculum Materials Grades 10-12.

    Science.gov (United States)

    New York State Education Dept., Albany. Bureau of Secondary Curriculum Development.

    GRADES OR AGES: Grades 10-12. SUBJECT MATTER: First aid and survival education. ORGANIZATION AND PHYSICAL APPEARANCE: The guide is divided into six sections: transportation of the injured, automobile accidents, conditions resulting from nuclear explosion, chemical warfare, natural catastrophes, and psychological first aid. The publication format…

  8. Physical education problems of 5–9 grade pupils in the context of health preservation

    Directory of Open Access Journals (Sweden)

    Natalia Idrisova

    2017-08-01

    Full Text Available Purpose: determination of the causes of deterioration of health and related problems of physical education of 5–9 grade pupils. Material & Methods: analysis of the causes and definition of the behavioral characteristics of pupils in relation to physical education was studied during 2012–2017 in one parallel class. In the experiment conducted in two stages, 52 pupils of the secondary school No. 1 of Melitopol took part. In the study used questionnaires, analytical, comparative, experimental and statistical methods. Result: tendency of deterioration of pupils health during training in middle classes is proved; obtained data in accordance with the typology compiled reflect the awareness of some students health as a means of raising the status, as well as the failure to understand half the researched values of physical education in maintaining health and disinterest in physical education. Conclusion: problems of school physical education are determined by the low level of the culture of health of the entire Ukrainian society.

  9. 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…

  10. Persistent organic pollutants and male reproductive health

    Directory of Open Access Journals (Sweden)

    Anne Vested

    2014-02-01

    Full Text Available Environmental contaminants such as persistent organic pollutants (POPs are man-made bioaccumulative compounds with long half-lives that are found throughout the world as a result of heavy use in a variety of consumer products during the twentieth century. Wildlife and animal studies have long suggested adverse effects of exposure to these compounds on human reproductive health, which, according to the endocrine disrupter hypothesis, are ascribed to the compounds' potential to interfere with endocrine signaling, especially when exposure occurs during certain phases of fetal and childhood development. An extensive number of epidemiological studies have addressed the possible effects of exposure to POPs on male reproductive health, but the results are conflicting. Thus far, most studies have focused on investigating exposure and the different reproductive health outcomes during adulthood. Some studies have addressed the potential harmful effects of fetal exposure with respect to malformations at birth and/or reproductive development, whereas only a few studies have been able to evaluate whether intrauterine exposure to POPs has long-term consequences for male reproductive health with measurable effects on semen quality markers and reproductive hormone levels in adulthood. Humans are not exposed to a single compound at a time, but rather, to a variety of different substances with potential divergent hormonal effects. Hence, how to best analyze epidemiological data on combined exposures remains a significant challenge. This review on POPs will focus on current knowledge regarding the potential effects of exposure to POPs during fetal and childhood life and during adulthood on male reproductive health, including a critical revision of the endocrine disruption hypothesis, a comment on pubertal development as part of reproductive development and a comment on how to account for combined exposures in epidemiological research.

  11. 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.

  12. 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...

  13. Karyometry detects subvisual differences in chromatin organization state between cribriform and flat high-grade prostatic intraepithelial neoplasia.

    Science.gov (United States)

    Montironi, Rodolfo; Thompson, Deborah; Scarpelli, Marina; Mazzucchelli, Roberta; Peketi, Prasanthi; Hamilton, Peter W; Bostwick, David G; Bartels, Peter H

    2004-08-01

    This digital texture analysis-based study evaluates the chromatin organization state in flat and cribriform high-grade prostatic intraepithelial neoplasia (PIN), in the adjacent normal looking secretory epithelium and in the co-occurring adenocarcinoma. Digital texture analysis (karyometry) was carried out on hematoxylin and eosin-stained sections from 24 radical prostatectomy specimens with high-grade PIN (12 with flat and 12 with cribriform architectural pattern, respectively) and cancer. Quantification was also conducted on the normal looking secretory epithelium. Discriminant analysis and the nonsupervised learning algorithm P-index were used to identify suitable subsets of features useful for the discrimination and classification of pathological groups and to explore multivariate data structure in the pathological subgroups. The average nuclear abnormality increases monotonically from the histologically normal appearing secretory epithelium to high-grade PIN and to adenocarcinoma. The nuclei from the so-called perimeter compartment of the flat high-grade PIN lesions show a higher nuclear abnormality compared to the nuclei of the cribriform high-grade PINs. Discriminant analysis shows that flat and cribriform high-grade PINs fall into two populations. Processing by the nonsupervised learning algorithm P-index revealed the existence of three well-defined, distinct subpopulations of nuclei of different chromatin phenotype. In the flat high-grade PIN lesions the proportions of nuclei in the three subpopulations are 16.5% (low abnormality), 25.0% (mid abnormality) and 58.5% (high abnormality), respectively. In the cribriform high-grade PIN lesions, 100% of the nuclei are in the mid-abnormality subpopulation. These differences are also discernible in the co-occurring adenocarcinoma and the histologically normal appearing secretory epithelium. To conclude, karyometry and statistical analysis detect the existence of distinct cell subpopulations of different chromatin

  14. Into Adolescence: Fitness, Health and Hygiene. A Curriculum for Grades 5-8. Contemporary Health Series.

    Science.gov (United States)

    Garzino, Mary S.

    The Contemporary Health Series is intended to help teachers address critical health issues in their classrooms. It is designed to provide educators with the curricular tools necessary to challenge students to take personal responsibility for their health. This learning module, directed at middle school teachers, focuses on several health and…

  15. 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.

  16. 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.

  17. Health-related quality of life in patients with high-grade gliomas

    DEFF Research Database (Denmark)

    Piil, K; Jakobsen, J; Christensen, Karl Bang

    2015-01-01

    follow-up after 1 year. Scores of Karnofsky Performance Status (KPS), physical activity, anxiety and depression and health-related quality of life (FACT-Br) are obtained. Patients' physical activity level and KPS decrease during the disease- and treatment trajectory. The majority of patients did......The diagnosis of a high-grade glioma usual is followed by functional impairment(s), cognitive decline and an impaired psycho-social well-being. This might well have a significant and negative impact on the health related quality of life. The purpose of this study was to explore physical activity...... levels, prevalence and severity of anxiety and depressive symptoms and health-related quality of life among patients with a highgrade glioma. This paper is based on a longitudinal mixed methods study. Patients (n = 30) completed questionnaires at 5 time points from time of diagnosis until the final...

  18. Exposure of Seventh and Eighth Grade Urban Youth to Dentistry and Oral Health Careers.

    Science.gov (United States)

    Mayberry, Melanie E; Young, Deirdre D; Sawilowsky, Shlomo; Hoelscher, Diane

    2018-01-01

    While pipeline programs for students from underrepresented minority groups have been established at the high school and college levels, fewer programs have been developed for middle school students. In an effort to reach this cohort, the University of Detroit Mercy School of Dentistry embarked on a grassroots collaborative pipeline program with two distinct segments: Urban Impressions and Dental Imprint. Their purpose is to expose Detroit-area seventh and eighth grade students to careers in dentistry, provide oral health education, and introduce role models. The aim of this pilot study was to determine outcomes for the middle school participants in Urban Impressions (n=86) and Dental Imprint (n=68). Both segments featured hands-on dental activities at the dental school. Outcomes were assessed by pretest-posttest surveys. Across the three cohorts, a total of 86 students participated in one or more sessions, with 57 completing the pre- and post-program surveys, for a 66% response rate. The results showed that the Dental Imprint respondents' knowledge of oral health, dental admissions, and specialties increased by an average 26% over three years. The gain in knowledge for each cohort was statistically significant (pdentistry as a career following the program. These results suggest that the two segments of this program are meeting their goals of increasing middle grade students' awareness of oral health professions including dentistry and providing access to role models. Institutions may benefit from the description of strategies used by this program to address challenges related to establishing early pipeline programs.

  19. Health behaviours, body weight and self-esteem among grade five students in Canada.

    Science.gov (United States)

    Wu, Xiuyun; Kirk, Sara F L; Ohinmaa, Arto; Veugelers, Paul

    2016-01-01

    This study sought to identify the principal components of self-esteem and the health behavioural determinants of these components among grade five students. We analysed data from a population-based survey among 4918 grade five students, who are primarily 10 and 11 years of age, and their parents in the Canadian province of Nova Scotia. The survey comprised the Harvard Youth and Adolescent Questionnaire, parental reporting of students' physical activity (PA) and time spent watching television or using computer/video games. Students heights and weights were objectively measured. We applied principal component analysis (PCA) to derive the components of self-esteem, and multilevel, multivariable logistic regression to quantify associations of diet quality, PA, sedentary behaviour and body weight with these components of self-esteem. PCA identified four components for self-esteem: self-perception, externalizing problems, internalizing problems, social-perception. Influences of health behaviours and body weight on self-esteem varied across the components. Better diet quality was associated with higher self-perception and fewer externalizing problems. Less PA and more use of computer/video games were related to lower self-perception and social-perception. Excessive TV watching was associated with more internalizing problems. Students classified as obese were more likely to report low self- and social-perception, and to experience fewer externalizing problems relative to students classified as normal weight. This study demonstrates independent influences of diet quality, physical activity, sedentary behaviour and body weight on four aspects of self-esteem among children. These findings suggest that school programs and health promotion strategies that target health behaviours may benefit self-esteem in childhood, and mental health and quality of life later in life.

  20. 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.

  1. 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.

  2. 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.

  3. Emotional attribution of 6th grade students in Physical Education and Health

    Directory of Open Access Journals (Sweden)

    Felipe Nicolás Mujica Johnson

    2016-12-01

    Full Text Available This research aims to determine the causal attribution of emotions in sixth grade primary school children in a process of development of physical condition in the classes of Physical Education and Health. The study is qualitative, descriptive and with a design of action research. The participants are thirty students in the age range between eleven to thirteen years old. The results indicate that students attribute their positive emotions to the fatigue overcoming, to the achievement of goals, to body benefits and to the entertainment with session activities. As for the negative emotions, these are attributed to expectations, pessimistic thinking, ridicule, envy, and health problems, physical inactivity, the academic consequences and lack of achievement of goals in the overcoming of the physical condition. In conclusion, the identified emotional attributions must be understood from the teaching work, to encourage the creation of learning strategies that promote subjective well-being and development of active lifestyle habits from a psychosocial perspective.

  4. World Health Organization cardiovascular risk stratification and target organ damage.

    Science.gov (United States)

    Piskorz, D; Bongarzoni, L; Citta, L; Citta, N; Citta, P; Keller, L; Mata, L; Tommasi, A

    2016-01-01

    Prediction charts allow treatment to be targeted according to simple markers of cardiovascular risk; many algorithms do not recommend screening asymptomatic target organ damage which could change dramatically the assessment. To demonstrate that target organ damage is present in low cardiovascular risk hypertensive patients and it is more frequent and severe as global cardiovascular risk increases. Consecutive hypertensive patients treated at a single Latin American center. Cardiovascular risk stratified according to 2013 WHO/ISH risk prediction chart America B. Left ventricular mass assessed by Devereux method, left ventricular hypertrophy considered >95g/m(2) in women and >115g/m(2) in men. Transmitral diastolic peak early flow velocity to average septal/lateral peak early diastolic relaxation velocity (E/e' ratio) measured cut off value >13. Systolic function assessed by tissue Doppler average interventricular septum/lateral wall mitral annulus rate systolic excursion (s wave). A total of 292 patients were included of whom 159 patients (54.5%) had cardiovascular risk of 20%. Left ventricular hypertrophy was detected in 17.6% low risk patients, 27.8% in medium risk and 23.3% in high risk (p<0.05), abnormal E/e' ratio was found in 13.8%, 31.1% and 27.9%, respectively (p<0.05). Mean s wave was 8.03+8, 8.1+9 and 8.7+1cm/s for low, intermediate and high risk patients, respectively (p<0.025). Target organ damage is more frequent and severe in high risk; one over four subjects was misclassified due to the presence of asymptomatic target organ damage. Copyright © 2015 SEHLELHA. Published by Elsevier España, S.L.U. All rights reserved.

  5. Identification of organic components and commercial grade dedication using Fourier Transform near infrared spectroscopy

    International Nuclear Information System (INIS)

    Azizian, H.

    2000-01-01

    The over all quality assurance programs for the design, fabrication, and construction of nuclear power plants, both in Canada and USA have long been established. A need for an acceptance process to allow the use of commercial grade items to be utilized in safety related applications has been recognized. A guideline in the EPRI NP-5652 report and in the Appendix D of the CAN3-N286.2-86 standard is outlined for testing of commercial grade components. A new nondestructive and cost effective NIR identification technology is now available to meet the above requirements. The Fourier Transform near infrared spectroscopy (FT-NIR), in the past, has shown to have the capabilities to identify cable insulation non-destructively and in-situ. This paper presents data to show the diversity of the NIR technology in the identification of three different non-metallic materials (wire insulation, 0-rings, and greases, all part of the operation of the safety related equipment) for the purposes of quality assurance, quality control, and the commercial grade dedication of components. The enhanced quality control and quality assurance will result in significant savings not only in testing but also in the continuous and reliable operations of power plants. (author)

  6. Pricing health care services: applications to the health maintenance organization.

    Science.gov (United States)

    Sweeney, R E; Franklin, S P

    1986-01-01

    This article illustrates how management in one type of service industry, the health maintenance organization (HMO), have attempted to formalize pricing. This effort is complicated by both the intangibility of the service delivered and the relatively greater influence in service industries of non-cost price factors such as accessibility, psychology, and delays. The presentation describes a simple computerized approach that allows the marketing manager to formally estimate the effect of incremental changes in rates on the firm's projected patterns of enrollment growth and net revenues. The changes in turn reflect underlying variations in the mix of pricing influences including psychological and other factors. Enrollment projections are crucial to the firm's financial planning and staffing. In the past, most HMO enrollment and revenue projections of this kind were notoriously unreliable. The approach described here makes it possible for HMOs to fine-tune their pricing policies. It also provides a formal and easily understood mechanism by which management can evaluate and reach consensus on alternative scenarios for enrollment growth, staff recruitment and capacity expansion.

  7. The correlation between physical activity and grade point average for health science graduate students.

    Science.gov (United States)

    Gonzalez, Eugenia C; Hernandez, Erika C; Coltrane, Ambrosia K; Mancera, Jayme M

    2014-01-01

    Researchers have reported positive associations between physical activity and academic achievement. However, a common belief is that improving academic performance comes at the cost of reducing time for and resources spent on extracurricular activities that encourage physical activity. The purpose of this study was to examine the relationship between self-reported physical activity and grade point average (GPA) for health science graduate students. Graduate students in health science programs completed the International Physical Activity Questionnaire and reported their academic progress. Most participants (76%) reported moderate to vigorous physical activity levels that met or exceeded the recommended levels for adults. However, there was no significant correlation between GPA and level of physical activity. Negative findings for this study may be associated with the limited range of GPA scores for graduate students. Future studies need to consider more sensitive measures of cognitive function, as well as the impact of physical activity on occupational balance and health for graduate students in the health fields. Copyright 2014, SLACK Incorporated.

  8. The pathologist's mean grade is constant and individualizes the prognostic value of bladder cancer grading.

    Science.gov (United States)

    van Rhijn, Bas W G; van Leenders, Geert J L H; Ooms, Bert C M; Kirkels, Wim J; Zlotta, Alexandre R; Boevé, Egbert R; Jöbsis, Adriaan C; van der Kwast, Theo H

    2010-06-01

    A new grading system for bladder cancer (BCa) was adopted in 2004 to reduce observer variability and provide better prognostic information. We compared the World Health Organization (WHO) 1973 and 2004 systems for observer variability and prognosis. Slides of 173 primary non-muscle-invasive BCa were reviewed two times by four pathologists. Intra- and interobserver variability were assessed using κ statistics. We determined the mean grade (eg, G1/low malignant potential is 1 grade point, G2/low grade is 2 grade points) of the pathologists per grading cycle. Kaplan-Meier analyses were applied for prediction of recurrence and progression. For WHO 2004 and 1973 grading, the agreement between the pathologists was 39-74% (κ: 0.14-0.58) and 39-64% (κ: 0.15-0.41), respectively. The intraobserver agreement varied from 71% to 88% (κ: 0.55-0.81). The mean grade of a pathologist was constant (difference below 0.1 grade point) irrespective of the grading system. Conversely, mean-grade differences among the pathologists were high, up to 0.7 grade point. The mean grades for the WHO 2004 system were 0.3-0.5 grade point higher than those of WHO 1973. Mean grade distinguished low and high graders among the pathologists and was strongly linked with risk of progression in each grade category. The variation in mean grade among individual pathologists exceeded the grade shift caused by WHO 2004 grading. Knowledge of the pathologist's mean grade allows a better assessment of the prognostic value of grading. Mean grade has the potential to become a tool for quality assurance in pathology. Copyright © 2009 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  9. 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.

  10. A test of the effect of advance organizers and reading ability on seventh-grade science achievement

    Science.gov (United States)

    Underhill, Patricia Annette

    The use of advance organizers was first introduced by Ausubel in his learning theory of meaningful learning. Subsequent research focused on the efficacy of advance organizers. Although, earlier research produced inconclusive results, more recent research suggests advance organizers do facilitate recall. However, the bulk of the research focused on older subjects (students in high school and college and adults). Prior research did not consider that a subject's reading ability may affect the effectiveness of an advance organizer. The purposes of this study were to investigate whether (1) an advance organizer facilitates both immediate and delayed recall, (2) the reading ability of students and the type of pre-instructional material they receive effect recall, and (3) reading ability has an effect on recall with younger students. Seventy-five seventh-grade students were divided into three groups. One group received a written organizer, one group received a graphic organizer, and one group received an introductory passage before reading a learning passage. After completing the reading passage, all subjects received an immediate posttest. Fourteen days later, subjects received the same posttest incorporated in an end-of-the-chapter test. Results of the study indicate the following: (1) no significant difference in immediate and delayed recall of learning material between students who received a written organizer, a graphic organizer, or an introductory passage, (2) there was a main effect for time of testing and a main effect for reading ability, and (3) there was not an interaction between reading ability and the type of pre-instructional material. These findings did not support previous research.

  11. Clinical signs and organ pathology in rats exposed to graded doses ...

    African Journals Online (AJOL)

    haemorrhages, vasculitis and thrombosis in many organs, and Kuppfer and intestinal goblet cells hyperplasia. The severity of the lesions was dose and time dependent. The lesions observed suggest interference with tissue energy metabolism and widespread vascular damage and multi-organ degeneration and necrosis.

  12. Perceived Demands of Schooling, Stress and Mental Health: Changes from Grade 6 to Grade 9 as a Function of Gender and Cognitive Ability.

    Science.gov (United States)

    Giota, Joanna; Gustafsson, Jan-Eric

    2017-08-01

    The link between perceived demands of school, stress and mental health in relation to gender is complex. The study examined, with two waves of longitudinal data at age 13 and age 16, how changes in perceived academic demands relate to changes in perceived stress, taking into account gender and cognitive ability, and to investigate how these factors affect the level of psychosomatic and depressive symptoms at the age of 16. A nationally representative sample including about 9000 individuals from the Swedish longitudinal Evaluation Through Follow up database born in 1998 was included. A growth modelling approach was applied to examine relations over time. The results show girls to have a considerably higher self-reported level of mental health problems at the end of compulsory school than boys. This gender difference is entirely accounted for by perceived school demands and stress in grades 6 and 9. Students who were stronger in inductive than vocabulary ability reported lower levels of perceived academic demands and less stress in grade 6. There is a need to develop interventions for minimizing the consequences of stress among adolescents and modify those particular aspects of academic demands which cause stress and poor mental health, especially among girls. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  13. 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.)

  14. Grade retention risk among children with asthma and other chronic health conditions in a large urban school district.

    Science.gov (United States)

    Moonie, Sheniz; Cross, Chad L; Guillermo, Chrisalbeth J; Gupta, Tina

    2010-09-01

    Asthma accounts for 12.8 million missed school days for children nationwide. Whether this excess absenteeism contributes to poor outcomes such as grade retention is of interest. The Clark County School District in Las Vegas, NV has incorporated the Federal "No Child Left Behind Act," which states that absences per individual in excess of 10 per school year are considered unapproved and may put a child at risk for repeating a grade. The purpose of this study was to determine if children with asthma are at increased risk for absenteeism associated with grade retention. Secondary data were obtained for students in attendance for the 2006-2007 school year. Days absent were weighted for enrollment time. Frequencies were obtained using descriptive statistics, and multivariate logistic regression was used to model the odds of absenteeism > 10 days per year. Of 300 881 students, 27 299 (9.1%) reported having asthma, as determined by school health records. The population was 52% male, 37% white, and 39% Hispanic. Significant predictors of missing > 10 days per school year included ethnicity, gender, grade, and health status (P 10 school days per year compared with healthy students or those with a medical condition other than asthma (P grade point average by race, gender, and asthma status. Children with asthma have a greater risk of absenteeism associated with grade retention. Therefore, improved asthma management and tailored education is necessary to identify and eliminate asthma triggers in the home and school setting for school-aged children.

  15. The health care burden of high grade chronic obstructive pulmonary disease in Korea: analysis of the Korean Health Insurance Review and Assessment Service data.

    Science.gov (United States)

    Kim, JinHee; Rhee, Chin Kook; Yoo, Kwang Ha; Kim, Young Sam; Lee, Sei Won; Park, Yong Bum; Lee, Jin Hwa; Oh, YeonMok; Lee, Sang Do; Kim, Yuri; Kim, KyungJoo; Yoon, HyoungKyu

    2013-01-01

    Patients with high grade chronic pulmonary obstructive disease (COPD) account for much of the COPD-related mortality and incur excessive financial burdens and medical care utilization. We aimed to determine the characteristics and medical care use of such patients using nationwide data from the Korean Health Insurance Review and Assessment Service in 2009. Patients with COPD were identified by searching with the International Classification of Diseases-10th Revision for those using medication. Patients with high grade COPD were selected based on their patterns of tertiary institute visits and medication use. The numbers of patients with high grade COPD increased rapidly in Korea during the study period, and they showed a high prevalence of comorbid disease. The total medical costs were over three times higher in patients with high grade COPD compared with those without it ($3,744 versus $1,183; P system in Korea. Prevention of progression to high grade COPD is important, both clinically and economically.

  16. Persistent organic pollutants and male reproductive health

    DEFF Research Database (Denmark)

    Vested, Anne; Giwercman, Aleksander; Bonde, Jens Peter

    2014-01-01

    development. An extensive number of epidemiological studies have addressed the possible effects of exposure to POPs on male reproductive health, but the results are conflicting. Thus far, most studies have focused on investigating exposure and the different reproductive health outcomes during adulthood. Some...... suggested adverse effects of exposure to these compounds on human reproductive health, which, according to the endocrine disrupter hypothesis, are ascribed to the compounds' potential to interfere with endocrine signaling, especially when exposure occurs during certain phases of fetal and childhood...... studies have addressed the potential harmful effects of fetal exposure with respect to malformations at birth and/or reproductive development, whereas only a few studies have been able to evaluate whether intrauterine exposure to POPs has long-term consequences for male reproductive health with measurable...

  17. Volatile Organic Compunds (Environmental Health Student Portal)

    Science.gov (United States)

    ... Weather Health Effects Take Action Water Pollution Water Pollution Home Chemicals and Pollutants Natural Disasters Drinking Water Waterborne Diseases & Illnesses Water Cycle Water Treatment Videos Games Experiments For Teachers Home Chemicals Volatile ...

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

    Science.gov (United States)

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

    2002-01-01

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

  20. 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.

  1. 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...

  2. 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.

  3. 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.

  4. World health organization perspective on implementation of International Health Regulations.

    Science.gov (United States)

    Hardiman, Maxwell Charles

    2012-07-01

    In 2005, the International Health Regulations were adopted at the 58th World Health Assembly; in June 2007, they were entered into force for most countries. In 2012, the world is approaching a major 5-year milestone in the global commitment to ensure national capacities to identify, investigate, assess, and respond to public health events. In the past 5 years, existing programs have been boosted and some new activities relating to International Health Regulations provisions have been successfully established. The lessons and experience of the past 5 years need to be drawn upon to provide improved direction for the future.

  5. Examining Fourth-Grade Mathematics Writing: Features of Organization, Mathematics Vocabulary, and Mathematical Representations

    Science.gov (United States)

    Hebert, Michael A.; Powell, Sarah R.

    2016-01-01

    Increasingly, students are expected to write about mathematics. Mathematics writing may be informal (e.g., journals, exit slips) or formal (e.g., writing prompts on high-stakes mathematics assessments). In order to develop an effective mathematics-writing intervention, research needs to be conducted on how students organize mathematics writing and…

  6. Low-temperature conversion of low-grade organic raw, part 1 (technical aspects

    Directory of Open Access Journals (Sweden)

    Kazakov Alexander V.

    2014-01-01

    Full Text Available Relevance of the local organic raw using in Russian fuel and energy market was shown. Status of Tomsk region decentralized energy supply was analyzed. Variants of power units on the basis of the low-temperature intracyclic conversion were presented. The results of the design calculation power units were given.

  7. Low-temperature conversion of low-grade organic raw, part 1 (technical aspects)

    OpenAIRE

    Kazakov Alexander V.; Tabakaev Roman B.; Novoseltsev Pavel Y.; Astafev Alexander V.

    2014-01-01

    Relevance of the local organic raw using in Russian fuel and energy market was shown. Status of Tomsk region decentralized energy supply was analyzed. Variants of power units on the basis of the low-temperature intracyclic conversion were presented. The results of the design calculation power units were given.

  8. 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.

  9. 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.

  10. Are GOLD ABCD groups better associated with health status and costs than GOLD 1234 grades? A cross-sectional study

    NARCIS (Netherlands)

    M.R.S. Boland (Melinde); A. Tsiachristas (Apostolos); A.L. Kruis (Annemarije); N.H. Chavannes (Nicolas); M.P.M.H. Rutten-van Mölken (Maureen)

    2014-01-01

    markdownabstract__Abstract__ Aims: To investigate the association of the GOLD ABCD groups classification with costs and health-related quality of life (HR-QoL) and to compare this with the GOLD 1234 grades classification that was primarily based on lung function only. Methods: In a

  11. 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.

  12. 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.

  13. [On the clients of public health organizations].

    Science.gov (United States)

    Duran, Júlia; Villalbí, Joan R; Guix, Joan

    2004-01-01

    Public services must satisfy a variety of agents: users of these services, the citizens who pay the taxes that finance them, politicians, and those that work in them. To obtain public services that give priority to the citizen-user, knowledge of clients, their expectations, preferences, complaints and degree of satisfaction is essential. This article presents the process of internal discussion in our agency about its clients, who differ from those of an industrial or commercial organization. A proposal for the classification of clients, as well as the process that has led to a client portfolio, are presented and steps to improve services from the perspective of the client are suggested.

  14. 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.

  15. 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.

  16. The World Health Organization Fetal Growth Charts

    DEFF Research Database (Denmark)

    Kiserud, Torvid; Piaggio, Gilda; Carroli, Guillermo

    2017-01-01

    BACKGROUND: Perinatal mortality and morbidity continue to be major global health challenges strongly associated with prematurity and reduced fetal growth, an issue of further interest given the mounting evidence that fetal growth in general is linked to degrees of risk of common noncommunicable...... longitudinal study of fetal growth in low-risk singleton pregnancies of women of high or middle socioeconomic status and without known environmental constraints on fetal growth. Centers in ten countries (Argentina, Brazil, Democratic Republic of the Congo, Denmark, Egypt, France, Germany, India, Norway...

  17. 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.

  18. 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.

  19. [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.

  20. 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...

  1. Organizing the public health-clinical health interface: theoretical bases.

    Science.gov (United States)

    St-Pierre, Michèle; Reinharz, Daniel; Gauthier, Jacques-Bernard

    2006-01-01

    This article addresses the issue of the interface between public health and clinical health within the context of the search for networking approaches geared to a more integrated delivery of health services. The articulation of an operative interface is complicated by the fact that the definition of networking modalities involves complex intra- and interdisciplinary and intra- and interorganizational systems across which a new transversal dynamics of intervention practices and exchanges between service structures must be established. A better understanding of the situation is reached by shedding light on the rationale underlying the organizational methods that form the bases of the interface between these two sectors of activity. The Quebec experience demonstrates that neither the structural-functionalist approach, which emphasizes remodelling establishment structures and functions as determinants of integration, nor the structural-constructivist approach, which prioritizes distinct fields of practice in public health and clinical health, adequately serves the purpose of networking and integration. Consequently, a theoretical reframing is imperative. In this regard, structuration theory, which fosters the simultaneous study of methods of inter-structure coordination and inter-actor cooperation, paves the way for a better understanding of the situation and, in turn, to the emergence of new integration possibilities.

  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. Developing ethical competence in health care organizations.

    Science.gov (United States)

    Kälvemark Sporrong, Sofia; Arnetz, Bengt; Hansson, Mats G; Westerholm, Peter; Höglund, Anna T

    2007-11-01

    Increased work complexity and financial strain in the health care sector have led to higher demands on staff to handle ethical issues. These demands can elicit stress reactions, that is, moral distress. One way to support professionals in handling ethical dilemmas is education and training in ethics. This article reports on a controlled prospective study evaluating a structured education and training program in ethics concerning its effects on moral distress. The results show that the participants were positive about the training program. Moral distress did not change significantly. This could be interpreted as competence development, with no effects on moral distress. Alternatively, the result could be attributed to shortcomings of the training program, or that it was too short, or it could be due to the evaluation instrument used. Organizational factors such as management involvement are also crucial. There is a need to design and evaluate ethics competence programs concerning their efficacy.

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. 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

  9. Graded effects in hierarchical figure-ground organization: reply to Peterson (1999).

    Science.gov (United States)

    Vecera, S P; O'Reilly, R C

    2000-06-01

    An important issue in vision research concerns the order of visual processing. S. P. Vecera and R. C. O'Reilly (1998) presented an interactive, hierarchical model that placed figure-ground segregation prior to object recognition. M. A. Peterson (1999) critiqued this model, arguing that because it used ambiguous stimulus displays, figure-ground processing did not precede object processing. In the current article, the authors respond to Peterson's (1999) interpretation of ambiguity in the model and her interpretation of what it means for figure-ground processing to come before object recognition. The authors argue that complete stimulus ambiguity is not critical to the model and that figure-ground precedes object recognition architecturally in the model. The arguments are supported with additional simulation results and an experiment, demonstrating that top-down inputs can influence figure-ground organization in displays that contain stimulus cues.

  10. 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.

  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. Thermal energy storage for low grade heat in the organic Rankine cycle

    Science.gov (United States)

    Soda, Michael John

    Limits of efficiencies cause immense amounts of thermal energy in the form of waste heat to be vented to the atmosphere. Up to 60% of unrecovered waste heat is classified as low or ultra-low quality, making recovery difficult or inefficient. The organic Rankine cycle can be used to generate mechanical power and electricity from these low temperatures where other thermal cycles are impractical. A variety of organic working fluids are available to optimize the ORC for any target temperature range. San Diego State University has one such experimental ORC using R245fa, and has been experimenting with multiple expanders. One limitation of recovering waste heat is the sporadic or cyclical nature common to its production. This inconsistency makes sizing heat recovery ORC systems difficult for a variety of reasons including off-design-point efficiency loss, increased attrition from varying loads, unreliable outputs, and overall system costs. Thermal energy storage systems can address all of these issues by smoothing the thermal input to a constant and reliable level and providing back-up capacity for times when the thermal input is deactivated. Multiple types of thermal energy storage have been explored including sensible, latent, and thermochemical. Latent heat storage involves storing thermal energy in the reversible phase change of a phase change material, or PCM, and can have several advantages over other modalities including energy storage density, cost, simplicity, reliability, relatively constant temperature output, and temperature customizability. The largest obstacles to using latent heat storage include heat transfer rates, thermal cycling stability, and potentially corrosive PCMs. Targeting 86°C, the operating temperature of SDSU's experimental ORC, multiple potential materials were explored and tested as potential PCMs including Magnesium Chloride Hexahydrate (MgCl2˙6H2O), Magnesium Nitrate Hexahydrate (Mg(NO3)2˙6H 2O), montan wax, and carnauba wax. The

  13. 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

  14. [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.

  15. 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...

  16. Economic assessment of greenhouse gas reduction through low-grade waste heat recovery using organic Rankine cycle (ORC)

    Energy Technology Data Exchange (ETDEWEB)

    Imran, Muhammad; Park, Byung Sik; Kim, Hyouck Ju; Usman, Muhammad [University of Science and Technology, Daejeon (Korea, Republic of); Lee, Dong Hyun [Korea Institute of Energy Research, Daejeon (Korea, Republic of)

    2015-02-15

    Low-grade waste heat recovery technologies reduce the environmental impact of fossil fuels and improve overall efficiency. This paper presents the economic assessment of greenhouse gas (GHG) reduction through waste heat recovery using organic Rankine cycle (ORC). The ORC engine is one of the mature low temperature heat engines. The low boiling temperature of organic working fluid enables ORC to recover low-temperature waste heat. The recovered waste heat is utilized to produce electricity and hot water. The GHG emissions for equivalent power and hot water from three fossil fuels-coal, natural gas, and diesel oil-are estimated using the fuel analysis approach and corresponding emission factors. The relative decrease in GHG emission is calculated using fossil fuels as the base case. The total cost of the ORC system is used to analyze the GHG reduction cost for each of the considered fossil fuels. A sensitivity analysis is also conducted to investigate the effect of the key parameter of the ORC system on the cost of GHG reduction. Throughout the 20-year life cycle of the ORC plant, the GHG reduction cost for R245fa is 0.02 $/kg to 0.04 $/kg and that for pentane is 0.04 $/kg to 0.05 $/kg. The working fluid, evaporation pressure, and pinch point temperature difference considerably affect the GHG emission.

  17. 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.

  18. 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

  19. 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.

  20. Membrane-based osmotic heat engine with organic solvent for enhanced power generation from low-grade heat.

    Science.gov (United States)

    Shaulsky, Evyatar; Boo, Chanhee; Lin, Shihong; Elimelech, Menachem

    2015-05-05

    We present a hybrid osmotic heat engine (OHE) system that uses draw solutions with an organic solvent for enhanced thermal separation efficiency. The hybrid OHE system produces sustainable energy by combining pressure-retarded osmosis (PRO) as a power generation stage and membrane distillation (MD) utilizing low-grade heat as a separation stage. While previous OHE systems employed aqueous electrolyte draw solutions, using methanol as a solvent is advantageous because methanol is highly volatile and has a lower heat capacity and enthalpy of vaporization than water. Hence, the thermal separation efficiency of a draw solution with methanol would be higher than that of an aqueous draw solution. In this study, we evaluated the performance of LiCl-methanol as a potential draw solution for a PRO-MD hybrid OHE system. The membrane transport properties as well as performance with LiCl-methanol draw solution were evaluated using thin-film composite (TFC) PRO membranes and compared to the results obtained with a LiCl-water draw solution. Experimental PRO methanol flux and maximum projected power density of 47.1 L m(-2) h(-1) and 72.1 W m(-2), respectively, were achieved with a 3 M LiCl-methanol draw solution. The overall efficiency of the hybrid OHE system was modeled by coupling the mass and energy flows between the thermal separation (MD) and power generation (PRO) stages under conditions with and without heat recovery. The modeling results demonstrate higher OHE energy efficiency with the LiCl-methanol draw solution compared to that with the LiCl-water draw solution under practical operating conditions (i.e., heat recovery<90%). We discuss the implications of the results for converting low-grade heat to power.

  1. Membrane-Based Osmotic Heat Engine with Organic Solvent for Enhanced Power Generation from Low-Grade Heat

    Energy Technology Data Exchange (ETDEWEB)

    Shaulsky, E; Boo, C; Lin, SH; Elimelech, M

    2015-05-05

    We present a hybrid osmotic heat engine (OHE) system that uses draw solutions with an organic solvent for enhanced thermal separation efficiency. The hybrid OHE system produces sustainable energy by combining pressure-retarded osmosis (PRO) as a power generation stage and membrane distillation (MD) utilizing low-grade heat as a separation stage. While previous OHE systems employed aqueous electrolyte draw solutions, using methanol as a solvent is advantageous because methanol is highly volatile and has a lower heat capacity and enthalpy of vaporization than water. Hence, the thermal separation efficiency of a draw solution with methanol would be higher than that of an aqueous draw solution. In this study, we evaluated the performance of LiCl-methanol as a potential draw solution for a PRO-MD hybrid OHE system. The membrane transport properties as well as performance with LiCl methanol draw solution were evaluated using thin-film composite (TFC) PRO membranes and compared to the results obtained with a LiCl water draw solution. Experimental PRO methanol flux and maximum projected power density of 47.1 L m(-2) h(-1) and 72.1 W m(-2), respectively, were achieved with a 3 M LiCl-methanol draw solution. The overall efficiency of the hybrid OHE system was modeled by coupling the mass and energy flows between the thermal separation (MD) and power generation (PRO) stages under conditions with and without heat recovery. The modeling results demonstrate higher ORE energy efficiency with the LiCl methanol draw solution compared to that with the LiCl water draw solution under practical operating conditions (i.e., heat recovery <90%). We discuss the implications of the results for converting low-grade heat to power.

  2. A genetic optimization of a hybrid organic Rankine plant for solar and low-grade energy sources

    International Nuclear Information System (INIS)

    Scardigno, Domenico; Fanelli, Emanuele; Viggiano, Annarita; Braccio, Giacobbe; Magi, Vinicio

    2015-01-01

    This paper provides a multi-objective optimization of a hybrid organic Rankine plant for solar and low-grade energy sources. In this plant, water, with a mass flow rate of 1 kg/s at a temperature of 90 °C, preheats the working fluid. The objective of this work is to search for solutions with the highest first and second law efficiencies of the plant and the lowest LEC (levelized energy cost). The design parameters are i) the working fluid, ii) the evaporating and condensing pressure, iii) the maximum temperature of the collector thermal fluid and iv) a parameter representative of the temperature profiles in the heat exchangers. A NSGAII (non-dominated sorting genetic algorithm) has been used. The Pareto front solutions provide Cyclopropane, R143a and R32 as working fluids. The lowest LEC (0.114 $/kWh) and the highest first law efficiency (9.65%) are achieved by using Cyclopropane, with a power output greater than 100 kW. The highest second law efficiency (44%) is obtained by employing R143a, with a low contribution of the solar source and a power output greater than 10 kW. Finally, R32 solutions have comparable performance with respect to R143a solutions. - Highlights: • The optimization of a low-grade energy source in an ORC hybrid solar power plant is carried out. • Thermodynamic and economic indicators are computed with different design parameters. • The study employs the NSGAII (non-dominated sorting genetic algorithm II). • Cyclopropane is the working fluid that provides the lowest cost and the highest first law efficiency. • R143a is the working fluid that provides the highest second law efficiency.

  3. Health literacy and the determinants of obesity: a population-based survey of sixth grade school children in Taiwan.

    Science.gov (United States)

    Shih, Shu-Fang; Liu, Chieh-Hsing; Liao, Li-Ling; Osborne, Richard H

    2016-03-22

    Health literacy has become an important health policy and health promotion agenda item in recent years. It had been seen as a means to reduce health disparities and a critical empowerment strategy to increase people's control over their health. So far, most of health literacy studies mainly focus on adults with few studies investigating associations between child health literacy and health status. This study aimed to investigate the association between health literacy and body weight in Taiwan's sixth grade school children. Using a population-based survey, 162,209 sixth grade (11-12 years old) school children were assessed. The response rate at school level was 83%, with 70% of all students completing the survey. The Taiwan child health literacy assessment tool was applied and information on sex, ethnicity, self-reported health, and health behaviors were also collected. BMI was used to classify the children as underweight, normal, overweight, or obese. A multinomial logit model with robust estimation was used to explore associations between health literacy and the body weight with an adjustment for covariates. The sample consisted of 48.9% girls, 3.8% were indigenous and the mean BMI was 19.55 (SD = 3.93). About 6% of children self-reported bad or very bad health. The mean child health literacy score was 24.03 (SD = 6.12, scale range from 0 to 32). The overall proportion of obese children was 15.2%. Children in the highest health literacy quartile were less likely to be obese (12.4%) compared with the lowest quartile (17.4%). After controlling for gender, ethnicity, self-rated health, and health behaviors, children with higher health literacy were less likely to be obese (Relative Risk Ratio (RRR) = 0.94, p 1.10, p obese. This study demonstrates strong links between health literacy and obesity, even after adjusting for key potential confounders, and provides new insights into potential intervention points in school education for obesity prevention. Systematic

  4. Health literacy and the determinants of obesity: a population-based survey of sixth grade school children in Taiwan

    Directory of Open Access Journals (Sweden)

    Shu-Fang Shih

    2016-03-01

    Full Text Available Abstract Background Health literacy has become an important health policy and health promotion agenda item in recent years. It had been seen as a means to reduce health disparities and a critical empowerment strategy to increase people’s control over their health. So far, most of health literacy studies mainly focus on adults with few studies investigating associations between child health literacy and health status. This study aimed to investigate the association between health literacy and body weight in Taiwan’s sixth grade school children. Methods Using a population-based survey, 162,209 sixth grade (11–12 years old school children were assessed. The response rate at school level was 83 %, with 70 % of all students completing the survey. The Taiwan child health literacy assessment tool was applied and information on sex, ethnicity, self-reported health, and health behaviors were also collected. BMI was used to classify the children as underweight, normal, overweight, or obese. A multinomial logit model with robust estimation was used to explore associations between health literacy and the body weight with an adjustment for covariates. Results The sample consisted of 48.9 % girls, 3.8 % were indigenous and the mean BMI was 19.55 (SD = 3.93. About 6 % of children self-reported bad or very bad health. The mean child health literacy score was 24.03 (SD = 6.12, scale range from 0 to 32. The overall proportion of obese children was 15.2 %. Children in the highest health literacy quartile were less likely to be obese (12.4 % compared with the lowest quartile (17.4 %. After controlling for gender, ethnicity, self-rated health, and health behaviors, children with higher health literacy were less likely to be obese (Relative Risk Ratio (RRR = 0.94, p  1.10, p < 0.0001 were more likely to report being overweight or obese. Conclusions This study demonstrates strong links between health literacy and obesity, even after

  5. 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...

  6. 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....

  7. 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

  8. 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.

  9. 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).

  10. 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.

  11. 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.

  12. Behavioral and psychosocial effects of two middle school sexual health education programs at tenth-grade follow-up.

    Science.gov (United States)

    Markham, Christine M; Peskin, Melissa F; Shegog, Ross; Baumler, Elizabeth R; Addy, Robert C; Thiel, Melanie; Escobar-Chaves, Soledad Liliana; Robin, Leah; Tortolero, Susan R

    2014-02-01

    An earlier randomized controlled trial found that two middle school sexual education programs-a risk avoidance (RA) program and a risk reduction (RR) program-delayed initiation of sexual intercourse (oral, vaginal, or anal sex) and reduced other sexual risk behaviors in ninth grade. We examined whether these effects extended into 10th grade. Fifteen middle schools were randomly assigned to RA, RR, or control conditions. Follow-up surveys were conducted with participating students in 10th grade (n = 1,187; 29.2% attrition). Participants were 60% female, 50% Hispanic, and 39% black; seventh grade mean age was 12.6 years. In 10th grade, compared with the control condition, both programs significantly delayed anal sex initiation in the total sample (RA: adjusted odds ratio [AOR], .64, 95% confidence interval [CI], .42-.99; RR: AOR, .65, 95% CI, .50-.84) and among Hispanics (RA: AOR, .53, 95% CI, .31-.91; RR: AOR, .82, 95% CI, .74-.93). Risk avoidance students were less likely to report unprotected vaginal sex, either by using a condom or by abstaining from sex (AOR: .61, 95% CI, .45-.85); RR students were less likely to report recent unprotected anal sex (AOR: .34, 95% CI, .20-.56). Both programs sustained positive impact on some psychosocial outcomes. Although both programs delayed anal sex initiation into 10th grade, effects on the delayed initiation of oral and vaginal sex were not sustained. Additional high school sexual education may help to further delay sexual initiation and reduce other sexual risk behaviors in later high school years. Copyright © 2014 Society for Adolescent Health and Medicine. All rights reserved.

  13. [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.

  14. 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.

  15. Cytology and Human Papillomavirus Testing 6 to 12 Months after ASCUS or LSIL Cytology in Organized Screening To Predict High-Grade Cervical Neoplasia between Screening Rounds

    Science.gov (United States)

    Sjøborg, Katrine D.; Nygård, Mari; Røysland, Kjetil; Campbell, Suzanne; Alfsen, G. Cecilie; Jonassen, Christine M.

    2012-01-01

    We carried out a prospective study comparing the performance of human papillomavirus (HPV) E6/E7 mRNA (PreTect HPV-Proofer; NorChip, Klokkarstua, Norway) and DNA (Amplicor HPV test; Roche Diagnostics, Basel, Switzerland) triage testing of women 6 to 12 months after atypical-squamous-cells-of-undetermined-significance (ASCUS) or low-grade-squamous-intraepithelial-lesion (LSIL) cytology in organized screening to predict high-grade cervical intraepithelial neoplasia of grade 2 or worse (CIN2+) between screening rounds. Between January 2005 and April 2008, 692 study women with screening-detected ASCUS/LSIL cytology 6 to 12 months earlier returned for HPV mRNA and DNA testing and repeat cytology. The median follow-up time was 3 years, using existing health care facilities. Follow-up test results were available for 625 women. Of the 145 CIN2+ cases detected during the study period, 95 (65.5%) were HPV mRNA positive 6 to 12 months after screening-detected ASCUS/LSIL, 44 (30.4%) were HPV mRNA negative, and 6 (4.1%) were invalid. The corresponding HPV DNA results were 139 (95.9%), 5 (3.4%), and 1 (0.7%), respectively. The cumulative incidences of CIN2+ 3 years after a negative HPV mRNA and DNA test were 10.3% (95% confidence interval [CI], 7.2 to 13.3%) and 1.8% (95% CI, 0.0 to 3.6%), respectively. The cumulative incidences of CIN2+ 3 years after positive HPV mRNA and DNA tests were 52.8% (95% CI, 40.1 to 60.1%) and 41.3% (95% CI, 35.5 to 46.6%), respectively. In conclusion, both positive HPV mRNA and DNA test results have a high enough long-term prediction of CIN2+ risk to consider referral to colposcopy as good practice when performed in delayed triage of women with ASCUS/LSIL cytology. In addition, the low CIN2+ risk among women with a negative Amplicor HPV test in our study confirms its safe use in a clinical setting. PMID:22518869

  16. 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.

  17. [Relationship between occupational stress, recovery experience, and physiological health of nurses in a municipal grade A tertiary hospital].

    Science.gov (United States)

    He, L; Zhang, C L; Yang, T; Lan, Y J

    2017-06-20

    Objective: To examine the relationship between recovery experience, occupational stress, and physiological health of nurses in a municipal grade A tertiary hospital. Methods: A total of 296 in-service nurses from 7 municipal grade A tertiary hospitals were selected from October 2015 to February 2016. Individual characteristics of the subjects were collected using a self-made questionnaire. The recovery experience, occupational stress, and physiological health of the subjects were assessed based on the physiological health dimensions in the Chinese version of Recovery Experience Questionnaire (REQ-C) , Job Content Questionnaire (JCQ) , and Quality of Work Life (QWL7-32) . Results: The mean recovery experience score of nurses from the municipal grade A tertiary hospital was 45.04±7.72, and 51.35% of the nurses had satisfactory recovery experience. Occupational stress was identified in 81.76% of the nurses. Based on the four categories of occupational stress, 65 nurses were identified with high-strain jobs (21.95%) , 56 with relaxed (low-strain) jobs (18.92%) , 49 with passive jobs (16.55%) , and 126 with active jobs (42.57%) . In addition, the mean physiological health score of the nurses was 21.20±4.24. Physiological health was negatively correlated with occupational stress ( r =-0.173, P stress ( r =-0.116, P stress, where subjects with high-demand active jobs had the poorest recovery experience ( F =2.610, P stress of nurses, where increased job demand can lead to stronger stress response, reduced recovery experience, and poorer physiological health.

  18. 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.

  19. The health care burden of high grade chronic obstructive pulmonary disease in Korea: analysis of the Korean Health Insurance Review and Assessment Service data

    Directory of Open Access Journals (Sweden)

    Kim JH

    2013-11-01

    Full Text Available JinHee Kim,1 Chin Kook Rhee,2 Kwang Ha Yoo,3 Young Sam Kim,4 Sei Won Lee,5 Yong Bum Park,6 Jin Hwa Lee,7 YeonMok Oh,5 Sang Do Lee,5 Yuri Kim,8 KyungJoo Kim,8 HyoungKyu Yoon9 1Office of Health Service Research, National Evidence-Based Healthcare Collaborating Agency, Seoul, Korea; 2Department of Internal Medicine, Seoul St Mary’s Hospital, Catholic University of Korea College of Medicine, Seoul, Korea; 3Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea; 4Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea; 5Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; 6Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea; 7Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Korea; 8Department of Clinical Research Support, National Strategic Coordinating Center for Clinical Research, Seoul, Korea; 9Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Yeouido St Mary’s Hospital, Catholic University of Korea College of Medicine, Seoul, Korea Background: Patients with high grade chronic pulmonary obstructive disease (COPD account for much of the COPD-related mortality and incur excessive financial burdens and medical care utilization. We aimed to determine the characteristics and medical care use of such patients using nationwide data from the Korean Health Insurance Review and Assessment Service in 2009. Materials and methods: Patients with COPD were identified by searching with the International Classification of Diseases–10th Revision for those using medication. Patients with high grade COPD were selected based on their patterns of tertiary institute visits and medication use. Results: The numbers of patients with high grade COPD increased rapidly

  20. Multi-objective optimization of an organic Rankine cycle (ORC) for low grade waste heat recovery using evolutionary algorithm

    International Nuclear Information System (INIS)

    Wang, Jiangfeng; Yan, Zhequan; Wang, Man; Li, Maoqing; Dai, Yiping

    2013-01-01

    Highlights: • Multi-objective optimization of an ORC is conducted to obtain optimum performance. • NSGA-II is employed to solve this multi-objective optimization problem. • The effects of parameters on the exergy efficiency and capital cost are examined. - Abstract: Organic Rankine cycle (ORC) can effectively recover low grade waste heat due to its excellent thermodynamic performance. Based on the examinations of the effects of key thermodynamic parameters on the exergy efficiency and overall capital cost, multi-objective optimization of the ORC with R134a as working fluid is conducted to achieve the system optimization design from both thermodynamic and economic aspects using Non-dominated sorting genetic algorithm-II (NSGA-II). The exergy efficiency and overall capital cost are selected as two objective functions to maximize the exergy efficiency and minimize the overall capital cost under the given waste heat conditions. Turbine inlet pressure, turbine inlet temperature, pinch temperature difference, approach temperature difference and condenser temperature difference are selected as the decision variables owing to their significant effects on the exergy efficiency and overall capital cost. A Pareto frontier obtained shows that an increase in the exergy efficiency can increase the overall capital cost of the ORC system. The optimum design solution with their corresponding decision variables is selected from the Pareto frontier. The optimum exergy efficiency and overall capital cost are 13.98% and 129.28 × 10 4 USD, respectively, under the given waste heat conditions

  1. Cost-effectiveness performance analysis of organic Rankine cycle for low grade heat utilization coupling with operation condition

    International Nuclear Information System (INIS)

    Wang, Dongxiang; Ling, Xiang; Peng, Hao

    2013-01-01

    This paper analyzed the influence of working fluids selection and operation conditions on the cost-effectiveness performance and net power output of an ORC for low grade heat utilization. A net power output model has been proposed theoretically and compared with the theoretical data calculated from thermodynamic analysis, exhibiting excellent agreements with the theoretical data. The proposed net power output model theoretically indicates that Jacob number and the ratio of evaporating temperature and heat rejected temperature play essential roles in discriminating the net power output among various working fluids at the same operation condition. For a given condensing and evaporating temperature, it can be concluded theoretically that fluid with low Jacob number will show attractive performance in an ORC. The maximum net power output is determined by the heat source rather than working fluids with a low inlet temperature of heat source. Cost-effectiveness performance analysis reveals that the maximum net power output and the best CEP cannot be achieved at the same time and compromise must be made when choosing the most suitable organic working fluids in different ORC designs. -- Highlights: • A net power output model is proposed and compared with theoretical data. • For fixed operation condition, low Ja fluid shows attractive performance in ORC. • The heat source rather than working fluid determines ORC performance at low T hs,in • The peak W net and best CEP cannot be achieved at the same time, compromise must be made

  2. Exergoeconomic comparison of TLC (trilateral Rankine cycle), ORC (organic Rankine cycle) and Kalina cycle using a low grade heat source

    International Nuclear Information System (INIS)

    Yari, M.; Mehr, A.S.; Zare, V.; Mahmoudi, S.M.S.; Rosen, M.A.

    2015-01-01

    Recently, the TLC (trilateral power cycle) has attracted significant interest as it provides better matching between the temperature profiles in the evaporator compared to conventional power cycles. This article investigates the performance of this cycle and compares it with those for the ORC (organic Rankine cycle) and the Kalina cycle, from the viewpoints of thermodynamics and thermoeconomics. A low-grade heat source with a temperature of 120 °C is considered for all the three systems. Parametric studies are performed for the systems for several working fluids in the ORC and TLC. The systems are then optimized for either maximum net output power or minimum product cost, using the EES (engineering equation solver) software. The results for the TLC indicate that an increase in the expander inlet temperature leads to an increase in net output power and a decrease in product cost for this power plant, whereas this is not the case for the ORC system. It is found that, although the TLC can achieve a higher net output power compared with the ORC and Kalina (KCS11 (Kalina cycle system 11)) systems, its product cost is greatly affected by the expander isentropic efficiency. It is also revealed that using n-butane as the working fluid can result in the lowest product cost in the ORC and the TLC. In addition, it is observed that, for both the ORC and Kalina systems, the optimum operating condition for maximum net output power differs from that for minimum product cost. - Highlights: • Exergoeconomic analysis of trilateral Rankine cycle is performed. • The system performance is compared with Organic Rankine and Kalina cycles. • Net power from trilateral Rankine cycle is higher than the other power systems. • Superiority of trilateral cycle depends on its expander isentropic efficiency

  3. 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.

  4. Social networks of professionals in health care organizations: a review.

    Science.gov (United States)

    Tasselli, Stefano

    2014-12-01

    In this article, we provide an overview of social network research in health care, with a focus on social interactions between professionals in organizations. We begin by introducing key concepts defining the social network approach, including network density, centrality, and brokerage. We then review past and current research on the antecedents of health care professionals' social networks-including demographic attributes, professional groups, and organizational arrangements-and their consequences-including satisfaction at work, leadership, behaviors, knowledge transfer, diffusion of innovation, and performance. Finally, we examine future directions for social network research in health care, focusing on micro-macro linkages and network dynamics. © The Author(s) 2014.

  5. World Health Organization guidelines should not change the CD4 ...

    African Journals Online (AJOL)

    2013-03-02

    Mar 2, 2013 ... The World Health Organization (WHO) currently recommends that HIV-positive adults start antiretroviral therapy (ART) at. CD4 counts <350 cells/µl. Several countries have changed their guidelines to recommend ART irrespective of CD4 count or at a threshold of 500 CD4 cells/µl. Consequently, WHO is ...

  6. [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.

  7. World Health Organization guidelines should not change the CD4 ...

    African Journals Online (AJOL)

    The World Health Organization (WHO) currently recommends that HIV-positive adults start antiretroviral therapy (ART) at CD4 counts <350 cells/μl. Several countries have changed their guidelines to recommend ART irrespective of CD4 count or at a threshold of 500 CD4 cells/μl. Consequently, WHO is currently revising its ...

  8. 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 ...

  9. The impact of a modified World Health Organization surgical safety ...

    African Journals Online (AJOL)

    The impact of a modified World Health Organization surgical safety checklist on maternal ... have shown an alarming increase in deaths during or after caesarean delivery. ... Methods. The study was a stratified cluster-randomised controlled trial ... Training of healthcare personnel took place over 1 month, after which the ...

  10. 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 ...

  11. High-grade acute organ toxicity as positive prognostic factor in primary radio(chemo)therapy for locally advanced, inoperable head and neck cancer

    Energy Technology Data Exchange (ETDEWEB)

    Wolff, Hendrik Andreas; Bosch, Jan; Hennies, Steffen; Hess, Clemens F.; Christiansen, Hans [Dept. of Radiotherapy and Radiooncology, Univ. Medicine Goettingen (Germany); Jung, Klaus [Dept. of Medical Statistics, Univ. Medicine Goettingen (Germany); Overbeck, Tobias [Dept. of Haematology and Oncology, Univ. Medicine Goettingen (Germany); Matthias, Christoph; Roedel, Ralph M. [Dept. of Otorhinolaryngology, Univ. Medicine Goettingen (Germany)

    2010-05-15

    Purpose: to test for a possible correlation between high-grade acute organ toxicity during primary radio(chemo)therapy and treatment outcome in patients with locally advanced head and neck squamous cell carcinoma (HNSCC). Patients and methods: from 05/1994 to 01/2009, 216 HNSCC patients were treated with radio(chemo)therapy in primary approach. They received normofractionated (2 Gy/fraction) irradiation including associated nodal drainage sites to a cumulative dose of 70 Gy. 151 patients received additional concomitant chemotherapy (111 patients 5-fluorouracil/mitomycin C, 40 patients cisplatin-based). Toxicity during treatment was monitored weekly according to the Common Toxicity Criteria (CTC), and any toxicity grade CTC {>=} 3 of mucositis, dysphagia or skin reaction was assessed as high-grade acute organ toxicity for later analysis. Results: a statistically significant coherency between high-grade acute organ toxicity and overall survival as well as locoregional control was found: patients with CTC {>=} 3 acute organ toxicity had a 5-year overall survival rate of 4% compared to 8% in patients without (p < 0.01). Thereby, multivariate analyses revealed that the correlation was independent of other possible prognostic factors or factors that may influence treatment toxicity, especially concomitant chemotherapy and radiotherapy technique or treatment-planning procedure. Conclusion: these data indicate that normal tissue and tumor tissue may behave similarly with respect to treatment response, as high-grade acute organ toxicity during radio(chemo)therapy showed to be an independent prognostic marker in the own patient population. However, the authors are aware of the fact that a multivariate analysis in a retrospective study generally has statistical limitations. Therefore, their hypothesis should be further analyzed on biomolecular and clinical levels and other tumor entities in prospective trials. (orig.)

  12. 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.

  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. 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.

  15. 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

  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. 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

  18. 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

  19. School Contextual Features of Social Disorder and Mental Health Complaints—A Multilevel Analysis of Swedish Sixth-Grade Students

    Directory of Open Access Journals (Sweden)

    Bitte Modin

    2018-01-01

    Full Text Available This study addressed school-contextual features of social disorder in relation to sixth-grade students’ experiences of bullying victimization and mental health complaints. It investigated, firstly, whether the school’s concentrations of behavioural problems were associated with individual students’ likelihood of being bullied, and secondly, whether the school’s concentrations of behavioural problems and bullying victimization predicted students’ emotional and psychosomatic health complaints. The data were derived from the Swedish National Survey of Mental Health among Children and Young People, carried out among sixth-grade students (approximately 12–13 years old in Sweden in 2009. The analyses were based on information from 59,510 students distributed across 1999 schools. The statistical method used was multilevel modelling. While students’ own behavioural problems were associated with an elevated risk of being bullied, attending a school with a higher concentration of students with behavioural problems also increased the likelihood of being bullied. Attending a school with higher levels of bullying victimization and behavioural problems predicted more emotional and psychosomatic complaints, even when adjusting for their individual level analogues. The findings indicate that school-level features of social disorder influence bullying victimization and mental health complaints among students.

  20. 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...

  1. Mobile Health in Solid Organ Transplant: The Time Is Now.

    Science.gov (United States)

    Fleming, J N; Taber, D J; McElligott, J; McGillicuddy, J W; Treiber, F

    2017-09-01

    Despite being in existence for >40 years, the application of telemedicine has lagged significantly in comparison to its generated interest. Detractors include the immobile design of most historic telemedicine interventions and the relative lack of smartphones among the general populace. Recently, the exponential increase in smartphone ownership and familiarity have provided the potential for the development of mobile health (mHealth) interventions that can be mirrored realistically in clinical applications. Existing studies have demonstrated some potential clinical benefits of mHealth in the various phases of solid organ transplantation (SOT). Furthermore, studies in nontransplant chronic diseases may be used to guide future studies in SOT. Nevertheless, substantially more must be accomplished before mHealth becomes mainstream. Further evidence of clinical benefits and a critical need for cost-effectiveness analysis must prove its utility to patients, clinicians, hospitals, insurers, and the federal government. The SOT population is an ideal one in which to demonstrate the benefits of mHealth. In this review, the current evidence and status of mHealth in SOT is discussed, and a general path forward is presented that will allow buy-in from the health care community, insurers, and the federal government to move mHealth from research to standard care. © 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.

  2. 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...

  3. 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.

  4. 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...

  5. GRADE Equity Guidelines 3

    DEFF Research Database (Denmark)

    Welch, Vivian A; Akl, Elie A; Pottie, Kevin

    2017-01-01

    OBJECTIVE: The aim of this paper is to describe a conceptual framework for how to consider health equity in the GRADE (Grading Recommendations Assessment and Development Evidence) guideline development process. STUDY DESIGN AND SETTING: Consensus-based guidance developed by the GRADE working grou...

  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. 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

  8. 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.

  9. 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...

  10. 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.

  11. 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.

  12. 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

  13. Managing corporate governance risks in a nonprofit health care organization.

    Science.gov (United States)

    Troyer, Glenn T; Brashear, Andrea D; Green, Kelly J

    2005-01-01

    Triggered by corporate scandals, there is increased oversight by governmental bodies and in part by the Sarbanes-Oxley Act of 2002. Corporations are developing corporate governance compliance initiatives to respond to the scrutiny of regulators, legislators, the general public and constituency groups such as investors. Due to state attorney general initiatives, new legislation and heightened oversight from the Internal Revenue Service, nonprofit entities are starting to share the media spotlight with their for-profit counterparts. These developments are changing nonprofit health care organizations as well as the traditional role of the risk manager. No longer is the risk manager focused solely on patients' welfare and safe passage through a complex delivery system. The risk manager must be aware of corporate practices within the organization that could allow the personal objectives of a few individuals to override the greater good of the community in which the nonprofit organization serves.

  14. 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.

  15. 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.

  16. Pedagogic renovation and school organization. Ezequiel Cazaña’s project as base of the general regulation of graded schools of 1918

    Directory of Open Access Journals (Sweden)

    Fernando VICENTE JARA

    2013-11-01

    Full Text Available The beginning of the 20th century in its two first decades corresponds to the phase of birth and childhood of the graduated public school in Spain, entering a process of change of the archaic organizing models of the unitary school by the most modern and rational of the graded school. In those first years Murcia is going to reach an outstanding place, with important people worried about the school matter. And it is in this context where this work is located, with the purpose to present the remarkable contribution of the inspector Ezequiel Cazaña Ruiz to the organization and internal operation of the graded schools, since the contents and forms of teaching, students, personal and school equipment, to the circumscholastic works and classes for adults.

  17. The World Health Organization "Rehabilitation 2030: a call for action".

    Science.gov (United States)

    Gimigliano, Francesca; Negrini, Stefano

    2017-04-01

    February 6th-7th, 2017 might become a memorable date in the future of rehabilitation. On these two days, the World Health Organization (WHO) has summoned over 200 stakeholders in the Executive Board Room of the WHO Headquarters in Geneva, Switzerland. Their common aim was to a launch the "Rehabilitation 2030" call to action and to present the WHO Recommendations on rehabilitation in health systems. These initiatives are meant to draw attention to the increasing unmet need for rehabilitation in the world; to highlight the role of rehabilitation in achieving the Sustainable Development Goals proposed by the United Nations; to call for coordinated and concerted global action towards strengthening rehabilitation in health systems. The aim of this paper is to report on the scientific events of these 2 days, which will most likely mark the history of rehabilitation.

  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. (SPartners for Heart Health: a school-based program for enhancing physical activity and nutrition to promote cardiovascular health in 5th grade students

    Directory of Open Access Journals (Sweden)

    Sehnert Scott T

    2008-12-01

    Full Text Available Abstract Background The American Heart Association Position Statement on Cardiovascular Health Promotion in Public Schools encourages school-based interventions for the primary prevention of cardiovascular disease (CVD through risk factor prevention or reduction in children with an emphasis on creating an environment that promotes healthy food choices and physical activity (PA. In an effort to address issues related to CVD risk factors including obesity in Michigan children, a multi-disciplinary team of Michigan State University (MSU faculty, clinicians, and health profession students was formed to "(Spartner" with elementary school physical education (PE teachers and MSU Extension staff to develop and implement a cost-effective, sustainable program aimed at CVD risk factor prevention and management for 5th grade students. This (Spartnership is intended to augment and improve the existing 5th grade PE, health and nutrition curriculum by achieving the following aims: 1 improve the students' knowledge, attitudes and confidence about nutrition, PA and heart health; 2 increase the number of students achieving national recommendations for PA and nutrition; and 3 increase the number of students with a desirable CVD risk factor status based on national pediatric guidelines. Secondary aims include promoting school staff and parental support for heart health to help children achieve their goals and to provide experiential learning and service for MSU health profession students for academic credit. Methods/Design This pilot effectiveness study was approved by the MSU IRB. At the beginning and the end of the school year students undergo a CVD risk factor assessment conducted by MSU medical students and graduate students. Key intervention components include eight lesson plans (conducted bi-monthly designed to promote heart healthy nutrition and PA behaviors conducted by PE teachers with assistance from MSU undergraduate dietetic and kinesiology students

  20. (S)Partners for Heart Health: a school-based program for enhancing physical activity and nutrition to promote cardiovascular health in 5th grade students.

    Science.gov (United States)

    Carlson, Joseph J; Eisenmann, Joey C; Pfeiffer, Karin A; Jager, Kathleen B; Sehnert, Scott T; Yee, Kimbo E; Klavinski, Rita A; Feltz, Deborah L

    2008-12-22

    The American Heart Association Position Statement on Cardiovascular Health Promotion in Public Schools encourages school-based interventions for the primary prevention of cardiovascular disease (CVD) through risk factor prevention or reduction in children with an emphasis on creating an environment that promotes healthy food choices and physical activity (PA). In an effort to address issues related to CVD risk factors including obesity in Michigan children, a multi-disciplinary team of Michigan State University (MSU) faculty, clinicians, and health profession students was formed to "(S)partner" with elementary school physical education (PE) teachers and MSU Extension staff to develop and implement a cost-effective, sustainable program aimed at CVD risk factor prevention and management for 5th grade students. This (S)partnership is intended to augment and improve the existing 5th grade PE, health and nutrition curriculum by achieving the following aims: 1) improve the students' knowledge, attitudes and confidence about nutrition, PA and heart health; 2) increase the number of students achieving national recommendations for PA and nutrition; and 3) increase the number of students with a desirable CVD risk factor status based on national pediatric guidelines. Secondary aims include promoting school staff and parental support for heart health to help children achieve their goals and to provide experiential learning and service for MSU health profession students for academic credit. This pilot effectiveness study was approved by the MSU IRB. At the beginning and the end of the school year students undergo a CVD risk factor assessment conducted by MSU medical students and graduate students. Key intervention components include eight lesson plans (conducted bi-monthly) designed to promote heart healthy nutrition and PA behaviors conducted by PE teachers with assistance from MSU undergraduate dietetic and kinesiology students (Spartners). The final 10 minutes of each lesson

  1. 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

  2. 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.

  3. Organized Sport Trajectories from Childhood to Adolescence and Health Associations.

    Science.gov (United States)

    Howie, Erin K; McVeigh, Joanne A; Smith, Anne J; Straker, Leon M

    2016-07-01

    The purpose of this study was to identify unique organized sport trajectories from early childhood to late adolescence in an Australian pregnancy cohort, the Raine Study. Participation in organized sport was assessed at ages 5, 8, 10, 14, and 17 yr. Physical activity, body composition, and self-rated physical and mental health were assessed at the age of 20 yr. Latent class analysis was used to identify patterns of sport participation. To assess the internal validity of the trajectory classes, differences in health characteristics between trajectories were analyzed using generalized linear models. For girls, three trajectory classes were identified: consistent sport participators (47.5%), sport dropouts (34.3%), and sport nonparticipators (18.1%). For boys, three trajectory classes were identified: consistent sport participators (55.2%), sport dropouts (36.9%), and sport joiners (8.1%). For girls, there were overall differences across trajectory classes in lean body mass (P = 0.003), lean mass index (P = 0.06), and physical health (P = 0.004). For boys, there were differences across classes in physical activity (P = 0.018), percent body fat (P = 0.002), lean body mass (P sport participation. The differences in health outcomes between trajectory classes, such as participants with consistent sport participation having more preferable health outcomes at the age of 20 yr, support the internal validity of the trajectories. Strategies are needed to identify and encourage those in the dropout trajectory to maintain their participation and those in the nonparticipator or joiner trajectories to join sport earlier. Specifically, interventions to encourage early sport participation in girls and help nonparticipating boys to join sport during adolescence may help more children receive the benefits of sport participation.

  4. 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.

  5. 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

  6. [Study on sub-health status and the relationship between it and personal life habits of grade one students in high school in Nanchang City].

    Science.gov (United States)

    Ren, Qingfeng; Li, Weijuan; Ren, Xiaohui; Xu, Qunying; Zhang, Zhongwei; Xiao, Yuanmei

    2015-03-01

    To investigate the prevalence and its influential factors about personal life habits of sub-health of grade one students in high school in Nanchang City. A self-designed sub-health questionnaire was used to measure the sub-health of 653 grade one students in high school in Nanchang sampled with stratified randomly cluster sampling. The prevalence of sub-health among the students was 85. 2% , and the prevalence. of physiological sub-health, psychological sub-health and social sub-health was 64. 3%, 55. 9% and 74. 7% respectively. In their personal life habits, the degree of activity, vegetables and fruits consumed, staying up late were the main influencing factors of sub-health (P bad habits of personal life. More attention should be given to girls, boarders, non-cadres students and students in non-key class.

  7. Udder health in organic dairy cattle in Northern Spain

    Directory of Open Access Journals (Sweden)

    Ana Villar

    2015-09-01

    Full Text Available This paper presents first data on the udder health status of organic dairy farms in Northern Spain and analyses some management and productive characteristics related to milk production comparing with the conventional sector. Five certified organic farms from the Cantabrian Region were monitored monthly from February 2006 to January 2008 and individual samples of all lactating cows were taken from parturition to the end of lactation. Although organic farms in our study showed a great individual variability, overall these were small (<50 lactating cows traditional farms, with a high degree of pasture (66-82% dry matter intake and a milk production (average milk yield: 5950 L 23% lower compared with the reference conventional sector (<50 cow farms. The organic farms had higher (p<0.05 average number of calves per cow (3.93 and a lower number of first-lactation cows (16.9% than the comparable conventional farms (2.47 calves per cow and 33.1% first-lactation cows. Organic farms showed higher (p<0.05 somatic cell counts (SCC than the reference conventional farms (mean log10±SD for all cows: 5.25±0.49 and 5.06±0.59, respectively. Detailed analysis of the SCC depending on the number of lactation and % of monthly SCC tests with linear scores indicative of udder infection suggest that while the heifers’ sanitary condition at the beginning of their productive cycle was similar in both types of farms, this seems to become worse along the productive cycle in the organics. This could be related to a low use of antibiotics for prophylaxis and treatment of udder infections and merits further investigation.

  8. Udder health in organic dairy cattle in Northern Spain

    Energy Technology Data Exchange (ETDEWEB)

    Villar, A.; López-Alonso, M.

    2015-07-01

    This paper presents first data on the udder health status of organic dairy farms in Northern Spain and analyses some management and productive characteristics related to milk production comparing with the conventional sector. Five certified organic farms from the Cantabrian Region were monitored monthly from February 2006 to January 2008 and individual samples of all lactating cows were taken from parturition to the end of lactation. Although organic farms in our study showed a great individual variability, overall these were small (<50 lactating cows) traditional farms, with a high degree of pasture (66-82% dry matter intake) and a milk production (average milk yield: 5950 L) 23% lower compared with the reference conventional sector (<50 cow farms). The organic farms had higher (p<0.05) average number of calves per cow (3.93) and a lower number of first-lactation cows (16.9%) than the comparable conventional farms (2.47 calves per cow and 33.1% first-lactation cows). Organic farms showed higher (p<0.05) somatic cell counts (SCC) than the reference conventional farms (mean log10±SD for all cows: 5.25±0.49 and 5.06±0.59, respectively). Detailed analysis of the SCC depending on the number of lactation and % of monthly SCC tests with linear scores indicative of udder infection suggest that while the heifers’ sanitary condition at the beginning of their productive cycle was similar in both types of farms, this seems to become worse along the productive cycle in the organics. This could be related to a low use of antibiotics for prophylaxis and treatment of udder infections and merits further. (Author)

  9. 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

  10. 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.

  11. Associations between Finnish 9th Grade Students' School Perceptions, Health Behaviors, and Family Factors

    Science.gov (United States)

    Ilona, Haapasalo; Raili, Valimaa; Lasse, Kannas

    2012-01-01

    Purpose: The aim of this study was to examine the associations between students' perceptions of the psychosocial school environment, health-compromising behaviours, and selected family factors. The analyses were based on data provided for the Health Behaviour in School-aged Children Study (2006). Design/methodology/approach: The data were obtained…

  12. 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

  13. [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.

  14. 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.

  15. 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.

  16. 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

  17. Five focus strategies to organize health care delivery.

    Science.gov (United States)

    Peltokorpi, Antti; Linna, Miika; Malmström, Tomi; Torkki, Paulus; Lillrank, Paul Martin

    2016-01-01

    The focused factory is one of the concepts that decision-makers have adopted for improving health care delivery. However, disorganized definitions of focus have led to findings that cannot be utilized systematically. The purpose of this paper is to discuss strategic options to focus health care operations. First the literature on focus in health care is reviewed revealing conceptual challenges. Second, a definition of focus in terms of demand and requisite variety is defined, and the mechanisms of focus are explicated. A classification of five focus strategies that follow the original idea to reduce variety in products and markets is presented. Finally, the paper examines managerial possibilities linked to the focus strategies. The paper proposes a framework of five customer-oriented focus strategies which aim at reducing variety in different characteristics of care pathways: population; urgency and severity; illnesses and symptoms; care practices and processes; and care outcomes. Empirical research is needed to evaluate the costs and benefits of the five strategies and about system-level effects of focused units on competition and coordination. Focus is an enabling condition that needs to be exploited using specific demand and supply management practices. It is essential to understand how focus mechanisms differ between strategies, and to select focus that fits with organization's strategy and key performance indicators. Compared to previous more resource-oriented approaches, this study provides theoretically solid and practically relevant customer-oriented framework for focusing in health care.

  18. Demoralization in mental health organizations: leadership and social support help.

    Science.gov (United States)

    Gabel, Stewart

    2012-12-01

    Demoralization is a commonly observed feeling state that is characterized by a sense of loss of or threat to one's personal values or goals and a perceived inability to overcome obstacles toward achieving these goals. Demoralization has features in common with burnout and may precede or accompany it. Psychiatrists working in many mental health care organizational settings, be they in the public or private sectors, may be at particular risk for demoralization. This is due partly to stressors that threaten their own professional values because of factors such as programmatic cut backs, budgetary reductions and changing social emphases on the value of mental health treatments. They also may be at risk for demoralization because of the effects on them of the governance styles of the agencies in which they are employed. The leadership or governance style in large organizational settings often is authoritarian, hierarchical and bureaucratic, approaches that are antithetical to the more participative leadership styles favored by many mental health professionals in their clinical activities. Clinical leaders in mental health organizations must exhibit various competencies to successfully address demoralization in clinical staff and to provide a counterbalance to the effects of the governance style of many agencies in which they are employed. Appropriate leadership skills, sometimes too simplistically termed "social support", have been found to reduce burnout in various populations and are likely to lessen demoralization as well. This paper reviews these important leadership issues and the relationship of social support to recognized leadership competencies.

  19. The accuracy of FAST in relation to grade of solid organ injuries: A retrospective analysis of 226 trauma patients with liver or splenic lesion

    Directory of Open Access Journals (Sweden)

    Candinas Daniel

    2009-03-01

    Full Text Available Abstract Background This study investigated the role of a negative FAST in the diagnostic and therapeutic algorithm of multiply injured patients with liver or splenic lesions. Methods A retrospective analysis of 226 multiply injured patients with liver or splenic lesions treated at Bern University Hospital, Switzerland. Results FAST failed to detect free fluid or organ lesions in 45 of 226 patients with spleen or liver injuries (sensitivity 80.1%. Overall specificity was 99.5%. The positive and negative predictive values were 99.4% and 83.3%. The overall likelihood ratios for a positive and negative FAST were 160.2 and 0.2. Grade III-V organ lesions were detected more frequently than grade I and II lesions. Without the additional diagnostic accuracy of a CT scan, the mean ISS of the FAST-false-negative patients would be significantly underestimated and 7 previously unsuspected intra-abdominal injuries would have been missed. Conclusion FAST is an expedient tool for the primary assessment of polytraumatized patients to rule out high grade intra-abdominal injuries. However, the low overall diagnostic sensitivity of FAST may lead to underestimated injury patterns and delayed complications may occur. Hence, in hemodynamically stable patients with abdominal trauma, an early CT scan should be considered and one must be aware of the potential shortcomings of a "negative FAST".

  20. Segmenting health maintenance organizations to study productivity and profitability.

    Science.gov (United States)

    Sobol, M G

    2000-01-01

    As the decade ended, health maintenance organizations (HMOs) were increasing in popularity as a means of health care delivery. These groups take many forms, so it is important for the analyst to see if the efficiency and financial results for these different forms vary. The four major forms are profit vs. not-for-profit, chain vs. non-chain, group/staff vs. individual practice association (IPA), and federally qualified vs. non-federally qualified. Using a nationwide database of all the HMOs in the United States, the article compares liquidity rates, leverage ratios, profitability ratios, marketing, and per member ratios across the four groups using paired t tests. The two classifications that showed the most differences were group/staff vs. IPA and federally qualified vs. non-federally qualified. IPAs have a better liquidity position and lower leverage ratios than group/staff but their administrative costs are higher and the time to receive payments and to pay debts is higher. Non-federally qualified have somewhat higher liquidity ratios and higher profitability ratios. These significant differences in financial outcomes indicate that studies of HMOs should segment different major forms of organizations and study them separately before trying to show the effects of different policies on HMO efficiency and effectiveness.

  1. Can we reliably benchmark health technology assessment organizations?

    Science.gov (United States)

    Drummond, Michael; Neumann, Peter; Jönsson, Bengt; Luce, Bryan; Schwartz, J Sanford; Siebert, Uwe; Sullivan, Sean D

    2012-04-01

    In recent years, there has been growth in the use of health technology assessment (HTA) for making decisions about the reimbursement, coverage, or guidance on the use of health technologies. Given this greater emphasis on the use of HTA, it is important to develop standards of good practice and to benchmark the various HTA organizations against these standards. This study discusses the conceptual and methodological challenges associated with benchmarking HTA organizations and proposes a series of audit questions based on a previously published set of principles of good practice. It is concluded that a benchmarking exercise would be feasible and useful, although the question of who should do the benchmarking requires further discussion. Key issues for further research are the alternative methods for weighting the various principles and for generating an overall score, or summary statement of adherence to the principles. Any weighting system, if developed, would need to be explored in different jurisdictions to assess the extent to which the relative importance of the principles is perceived to vary. Finally, the development and precise wording of the audit questions requires further study, with a view to making the questions as unambiguous as possible, and the reproducibility of the assessments as high as possible.

  2. Relationship of Family Particulars with Mental Health in Tehran Girls\\' Students at Third Grade in the Field of Experimental Sciences

    Directory of Open Access Journals (Sweden)

    Davoud Shoja'ei-Zadeh

    2000-07-01

    Full Text Available Objective: Personality development is a complicated phenomenon. Several external and internal factors such as hereditary background, congenital status, events afterbirth, individual differences, positive and negative promoting behaviors, and other cultural and social factors alone or in combination affect individual personality. Based on the theory of psychological analysis, experiences at childhood, especially interaction with parents have an undeniable effect on individual personality in adulthood. The subject of the present study is to investigate the relationship of family particulars with mental health in high school girls' students in Tehran at third grade in the field of experimental sciences. The present study is a case-study and its purpose is to study theories on dissatisfaction of students at disorganized families and its relationship with anxiety, depression, violence, and obsession. Materials & Methods: The study subjects were 80 girl students studying at third grade in field of experimental sciences at Tehran high schools. Half of these students were selected as case group and half of them as control group. The subjects were selected with screening method and the SCL-90 test was used to study hypothesis. Results: The results revealed that there was a significant difference between case and control group. The quality of family relationship had a strong correlation with mental growth of child.   Conclusion: Based on obtained results, the atmosphere around the control group was happier than the case group. The members of the case group usually did not talk about their problems with father.

  3. Contingency Management of Health Care Organizations: It Depends.

    Science.gov (United States)

    Olden, Peter C

    Managers in health care organizations (HCOs) must perform many processes and activities, such as planning goals, designing organization structure, leading people, motivating employees, making decisions, and resolving conflict. How they do all this strongly affects the performance and outcomes of their organizations and themselves. Some managers develop a usual way of performing their jobs and achieve some success with a preferred method of leading or a favorite approach to motivating. However, their success will be limited if they always rely on a standard "1-size-fits-all" approach. This is because contingency factors influence the effectiveness of a given approach to managing. The "best" approach depends on contingency factors, including the situation and the people involved. Managers should choose an approach to fit with the changing contingency factors. This article explains why and how managers should develop a contingency approach to managing HCOs. The development of contingency theory is briefly described. Practical application of contingency management is explained for leading, motivating, decision making, and resolving conflict. By using a contingency approach, managers can be more effective when managing their HCOs.

  4. 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...

  5. 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...

  6. [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.

  7. 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.

  8. Consequences of Physical Health and Mental Illness Risks for Academic Achievement in Grades K-12

    Science.gov (United States)

    Joe, Sean; Joe, Emanique; Rowley, Larry L.

    2009-01-01

    Educational research, practice, and institutions regularly highlight the significance of factors outside of schooling that affect children's engagement and participation in classroom learning. The health of children and families is one such issue with implications for the quality of children's school experiences, treatment in school, and academic…

  9. 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...

  10. Grain Grading and Handling.

    Science.gov (United States)

    Rendleman, Matt; Legacy, James

    This publication provides an introduction to grain grading and handling for adult students in vocational and technical education programs. Organized in five chapters, the booklet provides a brief overview of the jobs performed at a grain elevator and of the techniques used to grade grain. The first chapter introduces the grain industry and…

  11. The Pan American Health Organization and the mainstreaming of human rights in regional health governance.

    Science.gov (United States)

    Meier, Benjamin Mason; Ayala, Ana S

    2014-01-01

    In the absence of centralized human rights leadership in an increasingly fragmented global health policy landscape, regional health offices have stepped forward to advance the rights-based approach to health. Reviewing the efforts of the Pan American Health Organization (PAHO), this article explores the evolution of human rights in PAHO policy, assesses efforts to mainstream human rights in the Pan American Sanitary Bureau (PASB), and analyzes the future of the rights-based approach through regional health governance, providing lessons for other regional health offices and global health institutions. This article explores PAHO's 15-year effort to mainstream human rights through PASB technical units, national capacity-building, the Inter-American human rights system, and the PAHO Directing Council. Through documentary analysis of PAHO policies and semi-structured interviews with key PASB stakeholders, the authors analyze the understandings and actions of policymakers and technical officers in implementing human rights through PAHO governance. Analyzing the themes arising from this narrative, the authors examine the structural role of secretariat leadership, state support, legal expertise, and technical unit commitment in facilitating a rights-based approach to the health in the Americas. Human rights are increasingly framing PAHO efforts, and this analysis of the structures underlying PAHO's approach provides an understanding of the institutional determinants of the rights-based approach to health, highlighting generalizable themes for the mainstreaming of human rights through regional health governance. With this regional-level understanding of health governance, future national-level research can begin to understand the causal forces linking regional human rights work with national policy reforms and public health outcomes. © 2014 American Society of Law, Medicine & Ethics, Inc.

  12. Social Health Maintenance Organizations: assessing their initial experience.

    Science.gov (United States)

    Newcomer, R; Harrington, C; Friedlob, A

    1990-08-01

    The Social/Health Maintenance Organization (S/HMO) is a four-site national demonstration. This program combines Medicare Part A and B coverage, with various extended and chronic care benefits, into an integrated health plan. The provision of these services extends both the traditional roles of HMOs and that of long-term care community-service case management systems. During the initial 30 months of operation the four S/HMOs shared financial risk with the Health Care Financing Administration. This article reports on this developmental period. During this phase the S/HMOs had lower-than-expected enrollment levels due in part to market competition, underfunding of marketing efforts, the limited geographic area served, and an inability to differentiate the S/HMO product from that of other Medicare HMOs. The S/HMOs were allowed to conduct health screening of applicants prior to enrolling them. The number of nursing home-certifiable enrollees was controlled through this mechanism, but waiting lists were never very long. Persons joining S/HMOs and other Medicare HMOs during this period were generally aware of the alternatives available. S/HMO enrollees favored the more extensive benefits; HMO enrollees considerations of cost. The S/HMOs compare both newly formed HMOs and established HMOs. On the basis of administrator cost, it is more efficient to add chronic care benefits to an HMO than to add an HMO component to a community care provider. All plans had expenses greater than their revenues during the start-up period, but they were generally able to keep service expenditures within planned levels.

  13. Improved Correlation of the Neuropathologic Classification According to Adapted World Health Organization Classification and Outcome After Radiotherapy in Patients With Atypical and Anaplastic Meningiomas

    International Nuclear Information System (INIS)

    Combs, Stephanie E.; Schulz-Ertner, Daniela; Debus, Jürgen; Deimling, Andreas von; Hartmann, Christian

    2011-01-01

    Purpose: To evaluate the correlation between the 1993 and 2000/2007 World Health Organization (WHO) classification with the outcome in patients with high-grade meningiomas. Patients and Methods: Between 1985 and 2004, 73 patients diagnosed with atypical or anaplastic meningiomas were treated with radiotherapy. Sections from the paraffin-embedded tumor material from 66 patients (90%) from 13 different pathology departments were re-evaluated according to the first revised WHO classification from 1993 and the revised classifications from 2000/2007. In 4 cases, the initial diagnosis meningioma was not reproducible (5%). Therefore, 62 patients with meningiomas were analyzed. Results: All 62 tumors were reclassified according to the 1993 and 2000/2007 WHO classification systems. Using the 1993 system, 7 patients were diagnosed with WHO grade I meningioma (11%), 23 with WHO grade II (37%), and 32 with WHO grade III meningioma (52%). After scoring using the 2000/2007 system, we found 17 WHO grade I meningiomas (27%), 32 WHO grade II meningiomas (52%), and 13 WHO grade III meningiomas (21%). According to the 1993 classification, the difference in overall survival was not statistically significant among the histologic subgroups (p = .96). Using the 2000/2007 WHO classifications, the difference in overall survival became significant (p = .02). Of the 62 reclassified patients 29 developed tumor progression (47%). No difference in progression-free survival was observed among the histologic subgroups (p = .44). After grading according to the 2000/2007 WHO classifications, significant differences in progression-free survival were observed among the three histologic groups (p = .005). Conclusion: The new 2000/2007 WHO classification for meningiomas showed an improved correlation between the histologic grade and outcome. This classification therefore provides a useful basis to determine the postoperative indication for radiotherapy. According to our results, a comparison of the

  14. Improved Correlation of the Neuropathologic Classification According to Adapted World Health Organization Classification and Outcome After Radiotherapy in Patients With Atypical and Anaplastic Meningiomas

    Energy Technology Data Exchange (ETDEWEB)

    Combs, Stephanie E., E-mail: Stephanie.Combs@med.uni-heidelberg.de [Department of Radiation Oncology, University Hospital of Heidelberg, Heidelberg (Germany); Schulz-Ertner, Daniela [Radiologisches Institut, Markuskrankenhaus Frankfurt, Frankfurt am Main (Germany); Debus, Juergen [Department of Radiation Oncology, University Hospital of Heidelberg, Heidelberg (Germany); Deimling, Andreas von; Hartmann, Christian [Department of Neuropathology, Institute for Pathology, University Hospital of Heidelberg, Heidelberg (Germany); Clinical Cooperation Unit Neuropathology, German Cancer Research Center, Heidelberg (Germany)

    2011-12-01

    Purpose: To evaluate the correlation between the 1993 and 2000/2007 World Health Organization (WHO) classification with the outcome in patients with high-grade meningiomas. Patients and Methods: Between 1985 and 2004, 73 patients diagnosed with atypical or anaplastic meningiomas were treated with radiotherapy. Sections from the paraffin-embedded tumor material from 66 patients (90%) from 13 different pathology departments were re-evaluated according to the first revised WHO classification from 1993 and the revised classifications from 2000/2007. In 4 cases, the initial diagnosis meningioma was not reproducible (5%). Therefore, 62 patients with meningiomas were analyzed. Results: All 62 tumors were reclassified according to the 1993 and 2000/2007 WHO classification systems. Using the 1993 system, 7 patients were diagnosed with WHO grade I meningioma (11%), 23 with WHO grade II (37%), and 32 with WHO grade III meningioma (52%). After scoring using the 2000/2007 system, we found 17 WHO grade I meningiomas (27%), 32 WHO grade II meningiomas (52%), and 13 WHO grade III meningiomas (21%). According to the 1993 classification, the difference in overall survival was not statistically significant among the histologic subgroups (p = .96). Using the 2000/2007 WHO classifications, the difference in overall survival became significant (p = .02). Of the 62 reclassified patients 29 developed tumor progression (47%). No difference in progression-free survival was observed among the histologic subgroups (p = .44). After grading according to the 2000/2007 WHO classifications, significant differences in progression-free survival were observed among the three histologic groups (p = .005). Conclusion: The new 2000/2007 WHO classification for meningiomas showed an improved correlation between the histologic grade and outcome. This classification therefore provides a useful basis to determine the postoperative indication for radiotherapy. According to our results, a comparison of the

  15. 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.

  16. Food protection activities of the Pan American Health Organization.

    Science.gov (United States)

    1994-03-01

    One of the most widespread health problems in the Caribbean and Latin America is contaminated food and foodborne illness. The Pan American Health Organization (PAHO) has been a major force in activities to strengthen food protection. The program within the regional Program of Technical Cooperation is administered by the Veterinary Public Health program and under the guidance of the Pan American Institute for Food protection and Zoonoses in Buenos Aires, Argentina. A food action plan for 1986-90 was established at the 1986 Pan American Sanitary Conference, and extended to cover 1991-95. Program activities during the 1990s covered cholera, epidemiologic surveillance, street food vendors, shellfish poisoning, meat, national programs, information systems, air catering, food irradiation, and tourism. The action plan for 1991-95 promoted greater political support and cooperation within and between related sectors and institutions, management, and education. The aims were to organize national integrated programs, to strengthen laboratory services, to strengthen inspection services, to establish epidemiologic surveillance systems, and to promote food protection through community participation. Program activities included the initiatives of the Veterinary Public Health Program in 1991 to distribute literature on the transmission of cholera by foods. Studies were conducted in Bolivia, Colombia, and Peru on food contamination. Microbiologists received training on standard methods for detecting Vibrio cholerae in foods. A working group of experts from 10 countries examined the issues and produced a guide for investigating the incidence of foodborne disease. PAHO has contributed to the formation of an Inter-American Network for Epidemiologic Surveillance of Foodborne Diseases. PAHO has worked to improve hygienic practices among street food vendors. Seminars on paralytic shellfish poisoning were conducted in 1990; the outcome was a network working to strengthen national

  17. World Health Organization's International Radon Project 2005-2008

    International Nuclear Information System (INIS)

    Carr, Zhanat; Shannoun, Ferid; Zielinski, Jan M.

    2008-01-01

    Recent epidemiological studies of people exposed to indoor radon have confirmed that radon in homes is a serious health hazard that can be easily mitigated. To address the issue at an international level, the World Health Organization (WHO) established the International Radon Project (IRP). The project was launched in January 2005 with its first meeting attended by 36 experts representing 17 countries. The project's scope and the key objectives were outlined at this meeting and later refined: 1-) To identify effective strategies for reducing the health impact of radon; 2-) To promote sound policy options, prevention and mitigation programs (including monitoring and evaluation of programs; 3-) To raise public, political and economical awareness about the consequences of exposure to radon (including financial institutions as target group); 4-) To estimate the global health impact of exposure to residential radon using available data on radon worldwide. WHO and its member states strive through the WHO-IRP to succeed in putting indoor radon on the environmental health agenda in countries with lower awareness of radon as a health problem and in strengthening local and national radon-related activities in countries with ongoing radon programs. Two subsequent working meetings were held: in March, 2006 in Geneva with 63 participants from 25 countries, along with representatives of the International Atomic Energy Agency (IAEA), the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR), the International Commission on Radiological Protection (ICRP), and European Commission (EC); and in March 2007 in Munich with 61 participants from 27 countries. Both meetings reviewed the IRP progress and focused on the two main outputs: 'The WHO Report on the Global Burden of Disease (GBD) due to Radon' and 'The WHO Radon Handbook'. The former applies the WHO methodology for GBD assessment and considers ways to graphically map residential radon concentrations

  18. Analysis of accidents with organic material in health workers.

    Science.gov (United States)

    Vieira, Mariana; Padilha, Maria Itayra; Pinheiro, Regina Dal Castel

    2011-01-01

    This retrospective and descriptive study with a quantitative design aimed to evaluate occupational accidents with exposure to biological material, as well as the profile of workers, based on reporting forms sent to the Regional Reference Center of Occupational Health in Florianópolis/SC. Data collection was carried out through a survey of 118 reporting forms in 2007. Data were analyzed electronically. The occurrence of accidents was predominantly among nursing technicians, women and the mean age was 34.5 years. 73% of accidents involved percutaneous exposure, 78% had blood and fluid with blood, 44.91% resulted from invasive procedures. It was concluded that strategies to prevent the occurrence of accidents with biological material should include joint activities between workers and service management and should be directed at improving work conditions and organization.

  19. 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.

  20. 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.

  1. World Health Organization Global Disability Action Plan: The Mongolian Perspective

    Directory of Open Access Journals (Sweden)

    Fary Khan

    2017-01-01

    Full Text Available Objective: To provide an update on disability and rehabilitation in Mongolia, and to identify potential barriers and facilitators for implementation of the World Health Organization (WHO Global Disability Action Plan (GDAP. Methods: A 4-member rehabilitation team from the Royal Melbourne Hospital conducted an intensive 6-day workshop at the Mongolian National University of Medical Sciences, for local healthcare professionals (n = 77 from medical rehabilitation facilities (urban/rural, public/private and non-governmental organizations. A modified Delphi method (interactive sessions, consensus agreement identified challenges for rehabilitation service provision and disability education and attitudes, using GDAP objectives. Results: The GDAP summary actions were considered useful for clinicians, policy-makers, government and persons with disabilities. The main challenges identified were: limited knowledge of disability services and rehabilitation within healthcare sectors; lack of coordination between sectors; geo-topographical issues; limited skilled workforces; lack of disability data, guidelines and accreditation standards; poor legislation and political commitment. The facilitators were: strong leadership; advocacy of disability-inclusive development; investment in local infrastructure/human resources; opportunities for coordination and partnerships between the healthcare sector and other stakeholders; research opportunities; and dissemination of information. Conclusion: Disability and rehabilitation is an emerging priority in Mongolia to address the rights and needs of persons with disabilities. The GDAP provides guidance to facilitate access and strengthen rehabilitation services.

  2. Explicit Instruction of Graphic Organizers as an Informational Text Reading Comprehension Strategy: Third-Grade Students' Strategies and Perceptions

    Science.gov (United States)

    Fealy, Erin Marie

    2010-01-01

    The purpose of this case study research was to explore the effects of explicit instruction of graphic organizers to support students' understandings of informational text. An additional purpose was to investigate students' perceptions of using graphic organizers as a comprehension strategy. Using case study methodology, this study occurred…

  3. Surgical Safety Training of World Health Organization Initiatives.

    Science.gov (United States)

    Davis, Christopher R; Bates, Anthony S; Toll, Edward C; Cole, Matthew; Smith, Frank C T; Stark, Michael

    2014-01-01

    Undergraduate training in surgical safety is essential to maximize patient safety. This national review quantified undergraduate surgical safety training. Training of 2 international safety initiatives was quantified: (1) World Health Organization (WHO) "Guidelines for Safe Surgery" and (2) Department of Health (DoH) "Principles of the Productive Operating Theatre." Also, 13 additional safety skills were quantified. Data were analyzed using Mann-Whitney U tests. In all, 23 universities entered the study (71.9% response). Safety skills from WHO and DoH documents were formally taught in 4 UK medical schools (17.4%). Individual components of the documents were taught more frequently (47.6%). Half (50.9%) of the additional safety skills identified were taught. Surgical societies supplemented safety training, although the total amount of training provided was less than that in university curricula (P < .0001). Surgical safety training is inadequate in UK medical schools. To protect patients and maximize safety, a national undergraduate safety curriculum is recommended. © 2013 by the American College of Medical Quality.

  4. Financial risk sharing with providers in health maintenance organizations, 1999.

    Science.gov (United States)

    Gold, Marsha R; Lake, Timothy; Hurley, Robert; Sinclair, Michael

    2002-01-01

    The transfer of financial risk from health maintenance organizations (HMOs) to providers is controversial. To provide timely national data on these practices, we conducted a telephone survey in 1999 of a multi-staged probability sample of HMOs in 20 of the nation's 60 largest markets, accounting for 86% of all HMO enrollees nationally. Among those sampled, 82% responded. We found that HMOs' provider networks with physicians, hospitals, skilled nursing homes, and home health agencies are complex and multi-tiered Seventy-six percent of HMOs in our study use contracts for their HMO products that involve global, professional services, or hospital risk capitation to intermediate entities. These arrangements account for between 24.5 million and 27.4 million of the 55.9 million commercial and Medicare HMO enrollees in the 60 largest markets. While capitation arrangements are particularly common in California, they are more common elsewhere than many assume. The complex layering of risk sharing and delegation of care management responsibility raise questions about accountability and administrative costs in managed care. Do complex structures provide a way to involve providers more directly in managed care, or do they diffuse authority and add to administrative costs?

  5. Interventions to improve employee health and well-being within health care organizations: A systematic review.

    Science.gov (United States)

    Williams, Stephen P; Malik, Humza T; Nicolay, Christopher R; Chaturvedi, Sankalp; Darzi, Ara; Purkayastha, Sanjay

    2018-04-01

    In response to an increasing body of evidence on the importance of employee health and well-being (HWB) within health care, there has been a shift in focus from both policymakers and individual organizations toward improving health care employee HWB. However, there is something of a paucity of evidence regarding the impact and value of specific HWB interventions within a health care setting. The aim of this article was to systematically review the literature on this topic utilizing the EMBASE, Global Health, Health Management Information Consortium, MEDLINE, and PsycINFO databases. Forty-four articles were identified and, due to a large degree of heterogeneity, were considered under different headings as to the type of intervention employed: namely, those evaluating changing ways of working, physical health promotion, complementary and alternative medicine, and stress management interventions, and those utilizing multimodal interventions. Our results consider both the efficacy and reliability of each intervention in turn and reflect on the importance of careful study design and measure selection when evaluating the impact of HWB interventions. © 2017 American Society for Healthcare Risk Management of the American Hospital Association.

  6. Mental and somatic health complaints associated with school bullying between 10th and 12th grade students; results from cross sectional studies in Oslo, Norway.

    Science.gov (United States)

    Lien, Lars; Green, Kristian; Welander-Vatn, Audun; Bjertness, Espen

    2009-03-23

    Bullying is a widespread and serious problem that might influence both mental and psychical well being as well as school performance and social life. The aim of this study was to describe the prevalence of bullying, mental health problems and psychical complaints among 10th and 12th grade students and to analyze the association between bullying, mental health problems and muscle and skeletal complaints. Two cross sectional studies of adolescents living in Oslo, Norway the first conducted in 2001 among 10th grade students (15/16 years old) and the second in 2004 among 12th grade students (18/19 years old). Both surveys were based on self report, were mostly school based and had almost identical questionnaires. There were around 3700 participants in both surveys, but the participation rate was lower in the latter survey (88 versus 80%). The Hopkins Symptoms Check List (HSCL-10) and the Strength and Difficulties Questionnaire (SDQ) were used to measure mental health problems. Bullying is decreasing both among boys and girls while the prevalence of internalized mental health problems are increasing from 10th to 12th grade. For muscle and skeletal pain there is a diverging trend between boys and girls, with an increase among girls and a decrease among boys. The highest Odds Ratios, as a measure for the association between bullying, mental health problems and pain, were found for internalized mental health problems at both 10th and 12th grade both for boys and girls. Both internalized and externalized mental health problems together with pain seem to be associated with bullying irrespective of school type and gender.

  7. 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.

  8. World Health Organization (WHO) guidelines on use of medically important antimicrobials in food-producing animals.

    Science.gov (United States)

    Aidara-Kane, Awa; Angulo, Frederick J; Conly, John M; Minato, Yuki; Silbergeld, Ellen K; McEwen, Scott A; Collignon, Peter J

    2018-01-01

    Antimicrobial use in food-producing animals selects for antimicrobial resistance that can be transmitted to humans via food or other transmission routes. The World Health Organization (WHO) in 2005 ranked the medical importance of antimicrobials used in humans. In late 2017, to preserve the effectiveness of medically important antimicrobials for humans, WHO released guidelines on use of antimicrobials in food-producing animals that incorporated the latest WHO rankings. WHO commissioned systematic reviews and literature reviews, and convened a Guideline Development Group (GDG) of external experts free of unacceptable conflicts-of-interest. The GDG assessed the evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, and formulated recommendations using a structured evidence-to-decision approach that considered the balance of benefits and harms, feasibility, resource implications, and impact on equity. The resulting guidelines were peer-reviewed by an independent External Review Group and approved by the WHO Guidelines Review Committee. These guidelines recommend reductions in the overall use of medically important antimicrobials in food-producing animals, including complete restriction of use of antimicrobials for growth promotion and for disease prevention (i.e., in healthy animals considered at risk of infection). These guidelines also recommend that antimicrobials identified as critically important for humans not be used in food-producing animals for treatment or disease control unless susceptibility testing demonstrates the drug to be the only treatment option. To preserve the effectiveness of medically important antimicrobials, veterinarians, farmers, regulatory agencies, and all other stakeholders are urged to adopt these recommendations and work towards implementation of these guidelines.

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

    Science.gov (United States)

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

    2015-02-12

    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. We searched 20 health, education and social science databases, and trials registries and relevant websites in 2011 and 2013. We included cluster randomised controlled trials. Participants were children and young people aged four to 18 years attending schools/colleges. HPS interventions had to include the following three elements: input into the curriculum; changes to the school's ethos or environment; and engagement with families and/or local communities. Two reviewers identified relevant trials, extracted data and assessed risk of bias. We grouped studies according to the health topic(s) targeted. Where data permitted, we performed random-effects meta-analyses. We identified 67 eligible trials tackling a range of health issues. Few studies included any academic/attendance outcomes. We found positive average intervention effects for: body mass index (BMI), physical activity, physical fitness, fruit and vegetable intake, tobacco use, and being bullied. Intervention effects were generally small. On average across studies, we found little evidence of effectiveness for zBMI (BMI, standardized for age and gender), and no evidence for fat intake, alcohol use, drug use, mental health, violence and bullying others. It was not possible to meta-analyse data on other health outcomes due to lack of data. Methodological limitations were identified including reliance on self-reported data, lack of long-term follow-up, and high attrition rates. This Cochrane review has found the WHO HPS framework is effective at improving some aspects of student health. The effects are small but potentially important at a population level.

  10. Health and Welfare in Dutch Organic Laying Hens

    Directory of Open Access Journals (Sweden)

    Monique Bestman

    2014-06-01

    Full Text Available From 2007–2008, data on animal health and welfare and farm management during rearing and laying periods were collected from 49 flocks of organic laying hens in the Netherlands. Our aim was to investigate how organic egg farms performed in terms of animal health and welfare and which farm factors affected this performance. The flocks in our study were kept on farms with 34 to 25,000 hens (average 9,300 hens. Seventy-one percent of the flocks consisted of ‘silver hybrids’: white hens that lay brown eggs. Fifty-five percent of the flocks were kept in floor-based housing and 45% of the flocks in aviaries. No relation was found between the amount of time spent outdoors during the laying period and mortality at 60 weeks. Flocks that used their outdoor run more intensively had better feather scores. In 40% of the flocks there was mortality caused by predators. The average feed intake was 129 g/day at 30 weeks and 133 g/day at 60 weeks of age. The average percentage of mislaid eggs decreased from three at 30 weeks to two at 60 weeks. The average mortality was 7.8% at 60 weeks. Twenty-five percent of the flocks were not treated for worms in their first 50 weeks. Flubenol© was applied to the flocks that were treated. Ten percent of the flocks followed Flubenol© instructions for use and were wormed five or more times. The other 65% percent were treated irregularly between one and four times. Sixty-eight percent of the flocks showed little or no feather damage, 24% showed moderate damage and 8% showed severe damage. The feather score was better if the hens used the free-range area more intensely, the laying percentage at 60 weeks was higher, and if they were allowed to go outside sooner after arrival on the laying farm. In 69% of the flocks, hens had peck wounds in the vent area: on average this was 18% of the hens. Keel bone deformations were found in all flocks, on average in 21% of the birds. In 78% of the flocks, an average of 13% of the hens

  11. Health and Welfare in Dutch Organic Laying Hens.

    Science.gov (United States)

    Bestman, Monique; Wagenaar, Jan-Paul

    2014-06-20

    From 2007-2008, data on animal health and welfare and farm management during rearing and laying periods were collected from 49 flocks of organic laying hens in the Netherlands. Our aim was to investigate how organic egg farms performed in terms of animal health and welfare and which farm factors affected this performance. The flocks in our study were kept on farms with 34 to 25,000 hens (average 9,300 hens). Seventy-one percent of the flocks consisted of 'silver hybrids': white hens that lay brown eggs. Fifty-five percent of the flocks were kept in floor-based housing and 45% of the flocks in aviaries. No relation was found between the amount of time spent outdoors during the laying period and mortality at 60 weeks. Flocks that used their outdoor run more intensively had better feather scores. In 40% of the flocks there was mortality caused by predators. The average feed intake was 129 g/day at 30 weeks and 133 g/day at 60 weeks of age. The average percentage of mislaid eggs decreased from three at 30 weeks to two at 60 weeks. The average mortality was 7.8% at 60 weeks. Twenty-five percent of the flocks were not treated for worms in their first 50 weeks. Flubenol(©) was applied to the flocks that were treated. Ten percent of the flocks followed Flubenol(©) instructions for use and were wormed five or more times. The other 65% percent were treated irregularly between one and four times. Sixty-eight percent of the flocks showed little or no feather damage, 24% showed moderate damage and 8% showed severe damage. The feather score was better if the hens used the free-range area more intensely, the laying percentage at 60 weeks was higher, and if they were allowed to go outside sooner after arrival on the laying farm. In 69% of the flocks, hens had peck wounds in the vent area: on average this was 18% of the hens. Keel bone deformations were found in all flocks, on average in 21% of the birds. In 78% of the flocks, an average of 13% of the hens had foot-sole wounds

  12. Dataset of working conditions and thermo-economic performances for hybrid organic Rankine plants fed by solar and low-grade energy sources.

    Science.gov (United States)

    Scardigno, Domenico; Fanelli, Emanuele; Viggiano, Annarita; Braccio, Giacobbe; Magi, Vinicio

    2016-06-01

    This article provides the dataset of operating conditions of a hybrid organic Rankine plant generated by the optimization procedure employed in the research article "A genetic optimization of a hybrid organic Rankine plant for solar and low-grade energy sources" (Scardigno et al., 2015) [1]. The methodology used to obtain the data is described. The operating conditions are subdivided into two separate groups: feasible and unfeasible solutions. In both groups, the values of the design variables are given. Besides, the subset of feasible solutions is described in details, by providing the thermodynamic and economic performances, the temperatures at some characteristic sections of the thermodynamic cycle, the net power, the absorbed powers and the area of the heat exchange surfaces.

  13. Dataset of working conditions and thermo-economic performances for hybrid organic Rankine plants fed by solar and low-grade energy sources

    Directory of Open Access Journals (Sweden)

    Domenico Scardigno

    2016-06-01

    Full Text Available This article provides the dataset of operating conditions of a hybrid organic Rankine plant generated by the optimization procedure employed in the research article “A genetic optimization of a hybrid organic Rankine plant for solar and low-grade energy sources” (Scardigno et al., 2015 [1]. The methodology used to obtain the data is described. The operating conditions are subdivided into two separate groups: feasible and unfeasible solutions. In both groups, the values of the design variables are given. Besides, the subset of feasible solutions is described in details, by providing the thermodynamic and economic performances, the temperatures at some characteristic sections of the thermodynamic cycle, the net power, the absorbed powers and the area of the heat exchange surfaces.

  14. The world health organization multicountry survey on maternal and newborn health: study protocol

    Directory of Open Access Journals (Sweden)

    Souza João

    2011-10-01

    Full Text Available Abstract Background Effective interventions to reduce mortality and morbidity in maternal and newborn health already exist. Information about quality and performance of care and the use of critical interventions are useful for shaping improvements in health care and strengthening the contribution of health systems towards the Millennium Development Goals 4 and 5. The near-miss concept and the criterion-based clinical audit are proposed as useful approaches for obtaining such information in maternal and newborn health care. This paper presents the methods of the World Health Organization Multicountry Study in Maternal and Newborn Health. The main objectives of this study are to determine the prevalence of maternal near-miss cases in a worldwide network of health facilities, evaluate the quality of care using the maternal near-miss concept and the criterion-based clinical audit, and develop the near-miss concept in neonatal health. Methods/Design This is a large cross-sectional study being implemented in a worldwide network of health facilities. A total of 370 health facilities from 29 countries will take part in this study and produce nearly 275,000 observations. All women giving birth, all maternal near-miss cases regardless of the gestational age and delivery status and all maternal deaths during the study period comprise the study population. In each health facility, medical records of all eligible women will be reviewed during a data collection period that ranges from two to three months according to the annual number of deliveries. Discussion Implementing the systematic identification of near-miss cases, mapping the use of critical evidence-based interventions and analysing the corresponding indicators are just the initial steps for using the maternal near-miss concept as a tool to improve maternal and newborn health. The findings of projects using approaches similar to those described in this manuscript will be a good starter for a more

  15. Increasing compliance with the World Health Organization Surgical Safety Checklist-A regional health system's experience.

    Science.gov (United States)

    Gitelis, Matthew E; Kaczynski, Adelaide; Shear, Torin; Deshur, Mark; Beig, Mohammad; Sefa, Meredith; Silverstein, Jonathan; Ujiki, Michael

    2017-07-01

    In 2009, NorthShore University HealthSystem adapted the World Health Organization Surgical Safety Checklist (SSC) at each of its 4 hospitals. Despite evidence that SSC reduces intraoperative mistakes and increase patient safety, compliance was found to be low with the paper form. In November 2013, NorthShore integrated the SSC into the electronic health record (EHR). The aim was to increase communication between operating room (OR) personnel and to encourage best practices during the natural workflow of surgeons, anesthesiologists, and nurses. The purpose of this study was to examine the impact of an electronic SSC on compliance and patient safety. An anonymous OR observer selected cases at random and evaluated the compliance rate before the rollout of the electronic SSC. In June 2014, an electronic audit was performed to assess the compliance rate. Random OR observations were also performed throughout the summer in 2014. Perioperative risk events, such as consent issues, incorrect counts, wrong site, and wrong procedure were compared before and after the electronic SSC rollout. A perception survey was also administered to NorthShore OR personnel. Compliance increased from 48% (n = 167) to 92% (n = 1,037; P World Health Organization SSC is a validated tool to increase patient safety and reduce intraoperative complications. The electronic SSC has demonstrated an increased compliance rate, a reduced number of risk events, and most OR personnel believe it will have a positive impact on patient safety. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. [The WHO/ISUP grading system for renal carcinoma].

    Science.gov (United States)

    Moch, H

    2016-07-01

    Histological tumor grading is an accepted prognostic parameter of renal cell carcinoma (RCC). In 2012, the International Society of Urologic Pathologists (ISUP) proposed a novel grading system for RCC, mainly based on the evaluation of nucleoli: grade 1 tumors have nucleoli that are inconspicuous and basophilic at ×400 magnification; grade 2 tumors have nucleoli that are clearly visible at ×400 magnification and eosinophilic; grade 3 tumors have clearly visible nucleoli at ×100 magnification; and grade 4 tumors have extreme pleomorphism or rhabdoid and/or sarcomatoid morphology. This grading system was validated for clear cell renal cell carcinoma and papillary renal cell carcinoma. At the same time, the ISUP proposed not grading chromophobe renal cell carcinomas according to this system. At a consensus conference in Zurich the World Health Organization (WHO) recommended the ISUP grading system; thus, the WHO/ISUP grading system is now going to be implemented internationally. The ISUP/WHO grading system has not been validated as a prognostic parameter for other tumor subtypes, but can be used for descriptive purposes.

  17. 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...

  18. Measuring health-related quality of life in high-grade glioma patients at the end of life using a proxy-reported retrospective questionnaire

    NARCIS (Netherlands)

    Sizoo, E.M.; Dirven, L.; Reijneveld, J.C.; Postma, T.J.; Heimans, J.J.; Deliens, L.; Pasman, H.R.W.; Taphoorn, M.J.B.

    2014-01-01

    To develop, validate, and report on the use of a retrospective proxy-reported questionnaire measuring health-related quality of life (HRQoL) in the end-of-life (EOL) phase of high-grade glioma (HGG) patients. Items relevant for the defined construct were selected using existing questionnaires,

  19. Terahertz reflectometry imaging for low and high grade gliomas

    Science.gov (United States)

    Ji, Young Bin; Oh, Seung Jae; Kang, Seok-Gu; Heo, Jung; Kim, Sang-Hoon; Choi, Yuna; Song, Seungri; Son, Hye Young; Kim, Se Hoon; Lee, Ji Hyun; Haam, Seung Joo; Huh, Yong Min; Chang, Jong Hee; Joo, Chulmin; Suh, Jin-Suck

    2016-01-01

    Gross total resection (GTR) of glioma is critical for improving the survival rate of glioma patients. One of the greatest challenges for achieving GTR is the difficulty in discriminating low grade tumor or peritumor regions that have an intact blood brain barrier (BBB) from normal brain tissues and delineating glioma margins during surgery. Here we present a highly sensitive, label-free terahertz reflectometry imaging (TRI) that overcomes current key limitations for intraoperative detection of World Health Organization (WHO) grade II (low grade), and grade III and IV (high grade) gliomas. We demonstrate that TRI provides tumor discrimination and delineation of tumor margins in brain tissues with high sensitivity on the basis of Hematoxylin and eosin (H&E) stained image. TRI may help neurosurgeons to remove gliomas completely by providing visualization of tumor margins in WHO grade II, III, and IV gliomas without contrast agents, and hence, improve patient outcomes. PMID:27782153

  20. Does the Press Ganey Survey Correlate to Online Health Grades for a Major Academic Otolaryngology Department?

    Science.gov (United States)

    Ryan, Timothy; Specht, Jessica; Smith, Sarah; DelGaudio, John M

    2016-09-01

    Analyze the correlation between online-based review websites and the Press Ganey Patient Satisfaction Survey (PGPSS) in an academic otolaryngology department. Retrospective cross sectional. Tertiary academic institution. All available data were collected for Vitals.com and Healthgrades.com, along with PGPSS data for 16 otolaryngology attending physicians from 2012 to 2014. A mean rating was calculated for each topic category for online websites and compared with 7 PGPSS content questions using zero-order correlations. A paired t test was used to analyze the difference between the PGPSS and online scores. There were no statistically significant correlations between time spent with the patient (r = 0.391, P = .208) and overall provider scores (r = 0.193, P = .508) when compared between Vitals.com and the PGPSS. The correlations were not statistically significant when Healthgrades.com was compared with the PGPSS in the items "probability of recommending the provider" (r = -0.122, P = .666) and "trust in provider" (r = -0.025, P = .929). The most important factors in a patient recommending the provider were as follows, per resource: time spent with the patient for Vitals.com (r = 0.685, P = .014), listening for Healthgrades.com (r = 0.981, P ≤ .001), and trust in the provider for the PGPSS (r = 0.971, P ≤ .001). This study suggests that online-based reviews do not have statistically significant correlations with the widely used PGPSS and may not be an accurate source of information for patients. Patients should have access to the most reliable and least biased surveys available to the public to allow for better-informed decisions regarding their health care. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

  1. Using GRADE methodology for the development of public health guidelines for the prevention and treatment of HIV and other STIs among men who have sex with men and transgender people

    Directory of Open Access Journals (Sweden)

    Akl Elie A

    2012-05-01

    Full Text Available Abstract Background The World Health Organization (WHO Department of HIV/AIDS led the development of public health guidelines for delivering an evidence-based, essential package of interventions for the prevention and treatment of HIV and other sexually transmitted infections (STIs among men who have sex with men (MSM and transgender people in the health sector in low- and middle-income countries. The objective of this paper is to review the methodological challenges faced and solutions applied during the development of the guidelines. Methods The development of the guidelines followed the WHO guideline development process, which utilizes the GRADE approach. We identified, categorized and labeled the challenges identified in the guidelines development process and described the solutions through an interactive process of in-person and electronic communication. Results We describe how we dealt with the following challenges: (1 heterogeneous and complex interventions; (2 paucity of trial data; (3 selecting outcomes of interest; (4 using indirect evidence; (5 integrating values and preferences; (6 considering resource use; (7 addressing social and legal barriers; (8 wording of recommendations; and (9 developing global guidelines. Conclusion We were able to successfully apply the GRADE approach for developing recommendations for public health interventions. Applying the general principles of the approach while carefully considering specific challenges can enhance both the process and the outcome of guideline development.

  2. Performance, health and physiological responses of newly weaned feedlot cattle supplemented with feed-grade antibiotics or alternative feed ingredients.

    Science.gov (United States)

    de Souza, K A; Cooke, R F; Schubach, K M; Brandão, A P; Schumaher, T F; Prado, I N; Marques, R S; Bohnert, D W

    2018-03-26

    With increased regulations regarding the use of feed-grade antimicrobials in livestock systems, alternative strategies to enhance growth and immunity of feedlot cattle are warranted. Hence, this experiment compared performance, health and physiological responses of cattle supplemented with feed-grade antibiotics or alternative feed ingredients during the initial 60 days in the feedlot. Angus×Hereford calves (63 steers+42 heifers) originating from two cow-calf ranches were weaned on day -3, obtained from an auction yard on day -2 and road-transported (800 km; 12 h) to the feedlot. Upon arrival on day -1, shrunk BW was recorded. On day 0, calves were ranked by sex, source and shrunk BW, and allocated to one of 21 pens. Pens were assigned to receive (7 pens/treatment) a free-choice total mixed ration containing: (1) lasalocid (360 mg/calf daily of Bovatec; Zoetis, Florham Park, NJ, USA)+chlortetracycline (350 mg/calf of Aureomycin at cycles of 5-day inclusion and 2-day removal from diet; Zoetis) from days 0 to 32, and monensin only (360 mg/calf daily of Rumensin; Elanco Animal Health, Greenfield, IN, USA) from days 33 to 60 (PC), (2) sodium saccharin-based sweetener (Sucram at 0.04 g/kg of diet dry matter; Pancosma SA; Geneva, Switzerland)+plant extracts containing eugenol, cinnamaldehyde and capsicum (800 mg/calf daily of XTRACT Ruminants 7065; Pancosma SA) from days 0 to 32 and XTRACT only (800 mg/calf daily) from days 33 to 60 (EG) or (3) no supplemental ingredients (CON; days 0 to 60). Calves were assessed for bovine respiratory disease (BRD) signs and dry matter intake was recorded from each pen daily. Calves were vaccinated against BRD pathogens on days 0 and 22. Shrunk BW was recorded on day 61, and blood samples collected on days 0, 6, 11, 22, 33, 43 and 60. Calf ADG was greater (P=0.04) in PC v. EG and tended (P=0.09) to be greater in PC v. CON. Feed efficiency also tended (P=0.09) to be greater in PC v. CON, although main treatment effect for this response

  3. 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...

  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. Improving GRADE evidence tables part 2

    DEFF Research Database (Denmark)

    Langendam, Miranda; Carrasco-Labra, Alonso; Santesso, Nancy

    2016-01-01

    OBJECTIVES: The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) working group has developed GRADE evidence profiles (EP) and summary of findings (SoF) tables to present evidence summaries in systematic reviews, clinical guidelines, and health technology assessments. Exp...

  6. Comparative efficiency of high (trip super phosphate) and low (rock phosphate) grade p nutrition source enriched with organic amendment in maize crop

    International Nuclear Information System (INIS)

    Sabah, N.U.; Sarwar, G.; Tahir, M.A.

    2016-01-01

    Pakistan falls under arid to semi-arid climate and therefore, Pakistani soils are sufferer of phosphorus deficiency. Costly phosphatic commercial fertilizers and their unavailability at the time of crop demand is the burning issue in Pakistan. Under such circumstances, use of locally available rock phosphate (RP) grasps the interest of researchers now a day. Pakistan has blessed with considerable quantity of cheaper low grade RP in Abbottabad and Hazara districts of KPK province. Due to this scenario, a pot experiment was carried out to evaluate growth efficiency of maize crop by adding organic manure fortified with RP in comparison with TSP in normal soil (pHs= 8.15, ECe= 1.28 dSm-1, SAR = 4.77 mmol L-1, saturation percentage = 29% and sandy clay loam texture). The study was comprised of 7 treatments replicated three times including: T1 = Control (0 P); T2 = Recommended NK + organic material; T3 = Recommended NK + RRP; T4 = Recommended NK + RRP + OM; T5 = Recommended NK + TSP; T6 = Recommended NK + TSP + OM and T7 = N + K + TSP + 0.5 Organic manure. It was concluded that integrated use of organic amendment with RP (Local Hazara Red Rock Phosphate) and TSP proved superior as compared to their sole use on maize crop growth. A significant increase in available P concentration of the growth medium was observed due to addition of organic material along with TSP as a source of P. Addition of organic material also enhanced the soil carbon level as compared to control. It can be concluded that rock phosphate (RP) could be an effective and economic substitution for TSP when it is integrated with suitable organic amendment with specific size. (author)

  7. 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.

  8. Mental and somatic health complaints associated with school bullying between 10th and 12th grade students; results from cross sectional studies in Oslo, Norway

    OpenAIRE

    Lien, Lars; Green, Kristian; Welander-Vatn, Audun; Bjertness, Espen

    2009-01-01

    Background Bullying is a widespread and serious problem that might influence both mental and psychical well being as well as school performance and social life. The aim of this study was to describe the prevalence of bullying, mental health problems and psychical complaints among 10th and 12th grade students and to analyze the association between bullying, mental health problems and muscle and skeletal complaints. Metho...

  9. 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.

  10. 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...

  11. Does the school performance variable used in the International Health Behavior in School-Aged Children (HBSC) Study reflect students' school grades?

    Science.gov (United States)

    Felder-Puig, Rosemarie; Griebler, Robert; Samdal, Oddrun; King, Matthew A; Freeman, John; Duer, Wolfgang

    2012-09-01

    Given the pressure that educators and policy makers are under to achieve academic standards for students, understanding the relationship of academic success to various aspects of health is important. The international Health Behavior in School-Aged Children (HBSC) questionnaire, being used in 41 countries with different school and grading systems, has contained an item assessing perceived school performance (PSP) since 1986. Whereas the test-retest reliability of this item has been reported previously, we determined its convergent and discriminant validity. This cross-sectional study used anonymous self-report data from Austrian (N = 266), Norwegian (N = 240), and Canadian (N = 9,717) samples. Students were between 10 and 17 years old. PSP responses were compared to the self-reported average school grades in 6 subjects (Austria) or 8 subjects (Norway), respectively, or to a general, 5-category-based appraisal of most recent school grades (Canada). Correlations between PSP and self-reported average school grade scores were between 0.51 and 0.65, representing large effect sizes. Differences between the median school grades in the 4 categories of the PSP item were statistically significant in all 3 samples. The PSP item showed predominantly small associations with some randomly selected HBSC items or scales designed to measure different concepts. The PSP item seems to be a valid and useful question that can distinguish groups of respondents that get good grades at school from those that do not. The meaning of PSP may be context-specific and may have different connotations across student populations from different countries with different school systems. © 2012, American School Health Association.

  12. Instruments and Taxonomy of Workplace Bullying in Health Care Organizations

    Directory of Open Access Journals (Sweden)

    Eun-Jun Park, PhD, RN

    2017-12-01

    Full Text Available Summary: Purpose: This study was aimed to evaluate the methodological issues and comprehensiveness of workplace bullying instruments and to suggest a taxonomy of psychological abuse. Methods: Nineteen instruments applied in health care organizations and 469 questionnaire items mainly regarding psychological abuse were collected through a literature review. Three researchers classified the questionnaire items according to a “taxonomy of psychological abuse in the workplace.” Results: Many instruments of workplace bullying were developed in the 2000s using a reflective measurement model, but their psychometric property was not sufficient and the measurement model is questioned. Based on the questionnaire items, the “taxonomy of psychological abuse in the workplace” was modified by adding two new subcategories (unachievable work and unfair treatment and clarifying some operational definitions. According to the modified taxonomy of 11 (subcategories, the reviewed instruments assessed 6.5 (subcategories on average. No instrument measured all (subcategories. Category 4.2 (disrespect, humiliation, and rejection of the person was measured in all instruments, followed by Categories 5 (professional discredit and denigration and 1.2 (social isolation behaviors. Conclusion: The current instruments are not comprehensive enough. It is suggested that the modified taxonomy is verified and guide more reliable and inclusive instruments in the future. Furthermore, a formative measurement model, which defines a bullying as an inventory of different types of behaviors, should be used. Keywords: aggression, bullying, hostility, mobbing, surveys and questionnaires

  13. Determinants of engagement in mental health consumer-run organizations.

    Science.gov (United States)

    Brown, Louis Davis; Townley, Greg

    2015-04-01

    Mental health consumer-run organizations (CROs) are a low-cost, evidence-based strategy for promoting recovery. To increase CRO utilization, characteristics that promote engagement need to be identified and encouraged. The study examined individual and organizational characteristics that predict three types of engagement in CROs-attendance, leadership involvement, and socially supportive involvement. Surveys were administered to 250 CRO members attending 20 CROs. Leaders of each CRO reported organizational characteristics through a separate questionnaire. Multilevel regression models examined relationships between predictors and indicators of CRO engagement. Perceived sense of community was the only characteristic that predicted attendance, leadership involvement, and socially supportive involvement (p<.001). Perceived organizational empowerment, shared leadership, peer counseling, and several demographic characteristics also predicted some measures of engagement. CROs that can effectively promote sense of community, organizational empowerment, shared leadership, and peer counseling may be better able to engage participants. The discussion considers several strategies to enhance these characteristics, such as collectively establishing values and practicing shared decision making.

  14. Introducing the World Health Organization Postpartum Family Planning Compendium.

    Science.gov (United States)

    Sonalkar, Sarita; Gaffield, Mary E

    2017-01-01

    The postpartum period offers multiple opportunities for healthcare providers to assist with family planning decision making. However, there are also many changing factors during the first year after delivery that can affect family planning choices. Given that several different documents have addressed WHO guidance on postpartum family planning, the electronic WHO Postpartum Family Planning Compendium (http://srhr.org/postpartumfp) has been introduced. This resource integrates essential guidance on postpartum family planning for clinicians, program managers, and policy makers. The development of the Compendium included consultations with family planning experts, key international stakeholders, and web developers. Once the website had been created, user testing by family planning experts allowed for improvements to be made before the official launch. Future directions are adaptation of the website into a mobile application that can be more easily integrated to low-resource settings, and translation of the content into French and Spanish. © 2016 World Health Organization. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.

  15. Benchmarking of World Health Organization surgical safety checklist

    International Nuclear Information System (INIS)

    Messahel, Farouk M.; AlQahtani, Ali S.

    2009-01-01

    To compare the quality of our services with the World Health Organization (WHO) surgical safety recommendations as a reference, to improve our services if they fall short of that of the WHO, and to publish our additional standards, so that they may be included in future revision of WHO checklist. We conducted this study on 15th July 2008 at the Armed Forces Hospital, Wadi Al-Dawasir, Kingdom of Saudi Arabia. We compared each WHO safety standard item with its corresponding standard in our checklist. There were 4 possibilities for the comparison: that our performance meet, was less than or exceeded the quality-of-care measures in the WHO checklist, or that there are additional safety measures in either checklist that need to be considered by each party. Since its introduction in 1997, our checklist was applied to 11828 patients and resulted in error-free outcomes. Benchmarking proved that our surgical safety performance does not only match the standards of the WHO surgical safety checklist, but also exceeds it in other safety areas (for example measures to prevent perioperative hypothermia and venous thromboembolism). Benchmarking is a continuous quality improvement process aimed at providing the best available at the time in healthcare, and we recommend its adoption by healthcare providers. The WHO surgical safety checklist is a bold step in the right direction towards safer surgical outcomes. Feedback from other medical establishments should be encouraged. (author)

  16. 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.

  17. Partnerships in Health Systems: Social Organization as limits and possibilities in the Family Health Strategy Management.

    Science.gov (United States)

    Silva, Vanessa Costa E; Barbosa, Pedro Ribeiro; Hortale, Virgínia Alonso

    2016-05-01

    This is a case study in the municipality of Rio de Janeiro about management in the Family Health Strategy based on the Social Organizations model. The aims were to characterize and analyze aspects of the governance system adopted by the Rio de Janeiro Municipal Health Department and identify limits and possibilities of this model as a management option in Brazil's Unified Health System. A qualitative study was performed based on a literature review, document analysisand interviews with key informants. This management model facilitated the expansion of access to primary healthcare through the Family Health Strategy in Rio - where the population covered increased from 7.2% of the population in 2008 to 45.5% in 2015. The results showthat some practices in the contractual logic need to be improved, including negotiation and accountability with autonomywith the service suppliers. Evaluation and control has focus on processes, not results, and there has not been an increase in transparency and social control. The system of performance incentives has been reported as inducing improvements in the work process of the health teams. It is concluded that the regulatory capacity of the municipal management would need to be improved. On the other hand, there is an important and significant process of learning in progress.

  18. Data resource profile: the World Health Organization Study on global AGEing and adult health (SAGE).

    Science.gov (United States)

    Kowal, Paul; Chatterji, Somnath; Naidoo, Nirmala; Biritwum, Richard; Fan, Wu; Lopez Ridaura, Ruy; Maximova, Tamara; Arokiasamy, Perianayagam; Phaswana-Mafuya, Nancy; Williams, Sharon; Snodgrass, J Josh; Minicuci, Nadia; D'Este, Catherine; Peltzer, Karl; Boerma, J Ties

    2012-12-01

    Population ageing is rapidly becoming a global issue and will have a major impact on health policies and programmes. The World Health Organization's Study on global AGEing and adult health (SAGE) aims to address the gap in reliable data and scientific knowledge on ageing and health in low- and middle-income countries. SAGE is a longitudinal study with nationally representative samples of persons aged 50+ years in China, Ghana, India, Mexico, Russia and South Africa, with a smaller sample of adults aged 18-49 years in each country for comparisons. Instruments are compatible with other large high-income country longitudinal ageing studies. Wave 1 was conducted during 2007-2010 and included a total of 34 124 respondents aged 50+ and 8340 aged 18-49. In four countries, a subsample consisting of 8160 respondents participated in Wave 1 and the 2002/04 World Health Survey (referred to as SAGE Wave 0). Wave 2 data collection will start in 2012/13, following up all Wave 1 respondents. Wave 3 is planned for 2014/15. SAGE is committed to the public release of study instruments, protocols and meta- and micro-data: access is provided upon completion of a Users Agreement available through WHO's SAGE website (www.who.int/healthinfo/systems/sage) and WHO's archive using the National Data Archive application (http://apps.who.int/healthinfo/systems/surveydata).

  19. Selection and optimization of pure and mixed working fluids for low grade heat utilization using organic Rankine cycles

    DEFF Research Database (Denmark)

    Andreasen, Jesper Graa; Larsen, Ulrik; Knudsen, Thomas

    2014-01-01

    We present a generic methodology for organic Rankine cycle optimization, where the working fluid is included as an optimization parameter, in order to maximize the net power output of the cycle. The method is applied on two optimization cases with hot fluid inlet temperatures at 120°C and 90°C. P...

  20. Practical state of health estimation of power batteries based on Delphi method and grey relational grade analysis

    Science.gov (United States)

    Sun, Bingxiang; Jiang, Jiuchun; Zheng, Fangdan; Zhao, Wei; Liaw, Bor Yann; Ruan, Haijun; Han, Zhiqiang; Zhang, Weige

    2015-05-01

    The state of health (SOH) estimation is very critical to battery management system to ensure the safety and reliability of EV battery operation. Here, we used a unique hybrid approach to enable complex SOH estimations. The approach hybridizes the Delphi method known for its simplicity and effectiveness in applying weighting factors for complicated decision-making and the grey relational grade analysis (GRGA) for multi-factor optimization. Six critical factors were used in the consideration for SOH estimation: peak power at 30% state-of-charge (SOC), capacity, the voltage drop at 30% SOC with a C/3 pulse, the temperature rises at the end of discharge and charge at 1C; respectively, and the open circuit voltage at the end of charge after 1-h rest. The weighting of these factors for SOH estimation was scored by the 'experts' in the Delphi method, indicating the influencing power of each factor on SOH. The parameters for these factors expressing the battery state variations are optimized by GRGA. Eight battery cells were used to illustrate the principle and methodology to estimate the SOH by this hybrid approach, and the results were compared with those based on capacity and power capability. The contrast among different SOH estimations is discussed.

  1. The World Health Organization and public health research and practice in tuberculosis in India.

    Science.gov (United States)

    Banerji, Debabar

    2012-01-01

    Two major research studies carried out in India fundamentally affected tuberculosis treatment practices worldwide. One study demonstrated that home treatment of the disease is as efficacious as sanatorium treatment. The other showed that BCG vaccination is of little protective value from a public health viewpoint. India had brought together an interdisciplinary team at the National Tuberculosis Institute (NTI) with a mandate to formulate a nationally applicable, socially acceptable, and epidemiologically sound National Tuberculosis Programme (NTP). Work at the NTI laid the foundation for developing an operational research approach to dealing with tuberculosis as a public health problem. The starting point for this was not operational research as enunciated by experts in this field; rather, the NTI achieved operational research by starting from the people. This approach was enthusiastically welcomed by the World Health Organization's Expert Committee on Tuberculosis of 1964. The NTP was designed to "sink or sail with the general health services of the country." The program was dealt a major blow when, starting in 1967, a virtual hysteria was worked up to mobilize most of the health services for imposing birth control on the people. Another blow to the general health services occurred when the WHO joined the rich countries in instituting a number of vertical programs called "Global Initiatives". An ill-conceived, ill-designed, and ill-managed Global Programme for Tuberculosis was one outcome. The WHO has shown rank public health incompetence in taking a very casual approach to operational research and has been downright quixotic in its thinking on controlling tuberculosis worldwide.

  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. The Health Costs and Diseases in Medical Services Insurance Organization, Tehran Province, 1386 (2008

    Directory of Open Access Journals (Sweden)

    Ali Shojaei

    2012-01-01

    Full Text Available Objectives: The current research in addition to study of the diseases in the elders, surveys the health costs of these diseases. Methods & Materials: Study of the cost information and related diseases in (MSIO- Medical Services Insurance Organization, Tehran province, surveys costs and Medical Services of this group on 183093 hospitalized files. Results: 31% of hospital`s referrals and 37% of inpatient costs related to elders and display the expensive Services of this group of the Insured. The mean costs of every hospitalization in elderly groups were 4634384 rials, which was more than total mean costs, from all groups. Diagnostic code I27 (other cardio-vascular diseases, I20 (Angina pectoris, H25 (cataract, I25 (chronic IHD, I50 (heart failure, devote first to fifth grade of the prevalent Diagnosis cods (ICD in the aged group older than 60 and displays the most prevalence of the cardio-vascular system diseases in the elders. The most common surgical Code (California code in elderly (above 60 yrs. was related to Coronary Angioplasty, with its mean cost of 9116371 rials. And then was Cataract. 15% of the Global files are related to the elders which is equal to 23% of the charges of these files in this group of the elders. Extraction of Lens (Intra-capsular and extra-capsular Lens Insertion (57 code One-lateral Inguinal Hernia with or without excision of Hydrocele or Spermatocele except Incarcerated Inguinal Hernia (Global code 28, cholecystectomy with or without cholangiography or exploration of Biliary ducts (Global code 27 from first to third grade of the prevalent Global surgeries of the elders. Statistical test displays the Pierson coherent between the age and residence period and paid costs, There is a little positive coherent between the age and residence period in hospital and paid costs. Conclusion: These reviews show the results of the current study (the prevalent in-patient causes are adapted to the performed studies in this field and

  4. 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.

  5. Organ harvesting from anencephalic infants: health management over a sinkhole.

    Science.gov (United States)

    Alatis, A J

    As technology increases in the field of organ transplantation for newborns, a problematic limitation persists: too few organ donors are available to match the number of needy organ donees. Anencephalic newborns have been suggested (and recently used) as organ sources. Anencephalic infants are born without the upper part of their brain and usually die within a week after birth. This article will address the ethical considerations of using these infants as organ sources, particularly from the view of a physician and an attorney. This piece will further analyze the medico-legal ramifications of the various legislative proposals addressing this subject.

  6. Trade and health: how World Trade Organization (WTO) law affects alcohol and public health.

    Science.gov (United States)

    Baumberg, Ben; Anderson, Peter

    2008-12-01

    The alcohol field is becoming more aware of the consequences of world trade law for alcohol policies. However, there is a need for greater clarity about the different effects of trade on alcohol-related harm. A comprehensive review of all literature on alcohol and world trade [including World Trade Organization (WTO) disputes on alcohol], supported by a more selective review of other relevant cases, academic reports and the grey literature on trade and health. The burden of WTO law on alcohol policies depends upon the type of policy in question. Purely protectionist policies are likely to be struck down, which may lead to increases in alcohol-related harm. Partly protectionist and partly health-motivated policies are also at risk of being struck down. However, purely health-motivated policies are likely to be defended by the WTO-and to the extent that policy makers misunderstand this, they are needlessly avoiding effective ways of reducing alcohol-related harm. WTO agreements contain genuine and substantial risks to alcohol policies, and various ways of minimizing future risks are suggested. However, the 'chilling effect' of mistakenly overestimating these constraints should be avoided. Health policy makers should decide on which policies to pursue based primarily on considerations of effectiveness, ethics and politics rather than legality. As long as any effect of these policies on trade is minimized, they are overwhelmingly likely to win any challenges at the WTO.

  7. 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.

  8. The mediating role of organizational subcultures in health care organizations.

    Science.gov (United States)

    Lok, Peter; Rhodes, Jo; Westwood, Bob

    2011-01-01

    This study aims to investigate the mediating role of organizational subculture between job satisfaction, organizational commitment (dependent variables) and leadership, culture (independent variables) in health care organizations. A survey on nurses from 26 wards from various types of hospital was used. A total of 251 usable returns were collected for the analysis (i.e. response rate of 63 per cent). Structural equation analysis was conducted to obtain the best fit model and to determine the direction of the causal effect between job satisfaction and commitment, and the role of subculture as a mediating variable, between commitment of its other antecedents. Comparisons with alternative models confirmed satisfaction as an antecedent of commitment and the role of subculture as a mediating variable. The results of this study contribute to the clarification of the causal relations of the antecedents of commitment, and highlight the important role of local leadership and subculture in determining employees' job satisfaction and commitment. The results of this study should not be generalized to other industries and other national cultural context. Furthermore, a longitudinal study may be necessary to determine the causal relationship of variables used in this study. The findings could provide managers with valuable insight to focus their limited resources on improving the level of organizational commitment via the mediating role of organizational culture. The research findings provide managers with a new lens to examine organizational culture using the three perspectives of: bureaucratic, supportive, and innovative. Furthermore, the results could renew interest in developing other organizational subculture models that determine the relationship between organizational subculture and commitment

  9. Structure of health-care dyad leadership: an organization's experience.

    Science.gov (United States)

    Saxena, Anurag; Davies, Maura; Philippon, Don

    2018-05-08

    Purpose This study aims to explore the structural aspects (roles, responsibilities and reporting) of dyad leadership in one health-care organization (HCO). Design/methodology/approach The perceptions of 32 leaders (17 physician leaders and 15 dyad co-leaders) in formal leadership positions (six first-level with formal authority limited to teams or divisions, 23 middle-level with wider departmental or program responsibility and three senior-level with institution-wide authority) were obtained through focus groups and surveys. In addition, five senior leaders were interviewed. Descriptive statistics was used for quantitative data, and qualitative data were analyzed for themes by coding and categorization. Findings There are a large number of shared responsibilities in the hybrid model, as most activities in HCOs bridge administrative and professional spheres. These span the leadership (e.g. global performance and quality improvement) and management (e.g. human resources, budgets and education delivery) domains. The individual responsibilities, except for staff and physician engagement are in the management domain (e.g. operations and patient care). Both partners are responsible for joint decision-making, projecting a united front and joint reporting through a quadrat format. The mutual relationship and joint accountability are key characteristics and are critical to addressing potential conflicts and contradictions and achieving coherence. Practical implications Clarity of role will assist development of standardized job descriptions and required competencies, recruitment and leadership development. Originality/value This is an original empirical study presenting an integrated view of dyad leaders and senior leadership, meaningful expansion of shared responsibilities including academic functions and developing mutual relationship and emphasizing the central role of stability generating management functions.

  10. Validity of Students Worksheet Based Problem-Based Learning for 9th Grade Junior High School in living organism Inheritance and Food Biotechnology.

    Science.gov (United States)

    Jefriadi, J.; Ahda, Y.; Sumarmin, R.

    2018-04-01

    Based on preliminary research of students worksheet used by teachers has several disadvantages such as students worksheet arranged directly drove learners conduct an investigation without preceded by directing learners to a problem or provide stimulation, student's worksheet not provide a concrete imageand presentation activities on the students worksheet not refer to any one learning models curicullum recommended. To address problems Reviews these students then developed a worksheet based on problem-based learning. This is a research development that using Ploom models. The phases are preliminary research, development and assessment. The instruments used in data collection that includes pieces of observation/interviews, instrument self-evaluation, instruments validity. The results of the validation expert on student worksheets get a valid result the average value 80,1%. Validity of students worksheet based problem-based learning for 9th grade junior high school in living organism inheritance and food biotechnology get valid category.

  11. The shape modulation of osteoblast-osteocyte transformation and its correlation with the fibrillar organization in secondary osteons: a SEM study employing the graded osmic maceration technique.

    Science.gov (United States)

    Pazzaglia, Ugo E; Congiu, Terenzio; Marchese, Marcella; Dell'Orbo, Carlo

    2010-06-01

    Cortex fractured surface and graded osmic maceration techniques were used to study the secretory activity of osteoblasts, the transformation of osteoblast to osteocytes, and the structural organization of the matrix around the cells with scanning electron microscopy (SEM). A specialized membrane differentiation at the base of the cell was observed with finger-like, flattened processes which formed a diffuse meshwork. These findings suggested that this membrane differentiation below the cells had not only functioned in transporting collagen through the membrane but also in orienting the fibrils once assembled. Thin ramifications arose from the large and flat membrane foldings oriented perpendicular to the plane of the osteoblasts. This meshwork of fine filaments could not be visualized with SEM because they were obscured within the matrix substance. Their 3-D structure, however, should be similar to the canalicular system. The meshwork of large, flattened processes was no more evident in the cells which had completed their transformation into osteocytes.

  12. World Health Organization treatment guidelines for drug-resistant tuberculosis, 2016 update.

    Science.gov (United States)

    Falzon, Dennis; Schünemann, Holger J; Harausz, Elizabeth; González-Angulo, Licé; Lienhardt, Christian; Jaramillo, Ernesto; Weyer, Karin

    2017-03-01

    Antimicrobial resistance is a major global concern. Tuberculosis (TB) strains resistant to rifampicin and other TB medicines challenge patient survival and public health. The World Health Organization (WHO) has published treatment guidelines for drug-resistant TB since 1997 and last updated them in 2016 based on reviews of aggregated and individual patient data from published and unpublished studies. An international expert panel formulated recommendations following the GRADE approach. The new WHO guidelines recommend a standardised 9-12 months shorter treatment regimen as first choice in patients with multidrug- or rifampicin-resistant TB (MDR/RR-TB) strains not resistant to fluoroquinolones or second-line injectable agents; resistance to these two classes of core second-line medicines is rapidly detectable with molecular diagnostics also approved by WHO in 2016. The composition of longer regimens for patients ineligible for the shorter regimen was modified. A first-ever meta-analysis of individual paediatric patient data allowed treatment recommendations for childhood MDR/RR-TB to be made. Delamanid is now also recommended in patients aged 6-17 years. Partial lung resection is a recommended option in MDR/RR-TB care. The 2016 revision highlighted the continued shortage of high-quality evidence and implementation research, and reiterated the need for clinical trials and best-practice studies to improve MDR/RR-TB patient treatment outcomes and strengthen policy. The content of this work is copyright of the authors or their employers. Design and branding are copyright ©ERS 2017.

  13. Health care in the United States: organization, management, and policy

    National Research Council Canada - National Science Library

    Greenwald, Howard P

    2010-01-01

    .... Through an accessible approach, this text clarifies the complexities of health care services and health system finance, as well as presents an overview of how all of the components fit together...

  14. Canada Selects African Health Organizations to Help Save the Lives ...

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

    IDRC-CRDI

    supported by the program and decision-makers in Africa. ... ensuring that high quality health care is delivered in clinics and hospitals. • working ... identifying how nurses, doctors, and other health professionals can better deliver the care that is.

  15. Health care in the United States: organization, management, and policy

    National Research Council Canada - National Science Library

    Greenwald, Howard P

    2010-01-01

    "Health Care in the United States discusses the basic structures and operations of the U.S. health system. This resource includes examples, tables, and a glossary with key terms and acronyms to help understand important concepts...

  16. The World Health Organization's mechanisms for increasing the ...

    African Journals Online (AJOL)

    South Africa (SA) has limited scope for raising income taxes, and the proposed National Health Insurance (NHI) scheme will necessitate ..... [31] If the tax is high enough to affect consumption, the health ..... Selective Consumption Taxation.

  17. Performance Analysis and Working Fluid Selection of a Supercritical Organic Rankine Cycle for Low Grade Waste Heat Recovery

    Directory of Open Access Journals (Sweden)

    Yourong Li

    2012-08-01

    Full Text Available The performance analysis of a supercritical organic Rankine cycle system driven by exhaust heat using 18 organic working fluids is presented. Several parameters, such as the net power output, exergy efficiency, expander size parameter (SP, and heat exchanger requirement of evaporator and the condenser, were used to evaluate the performance of this recovery cycle and screen the working fluids. The results reveal that in most cases, raising the expander inlet temperature is helpful to improve the net power output and the exergy efficiency. However, the effect of the expander inlet pressure on those parameters is related to the expander inlet temperature and working fluid used. Either lower expander inlet temperature and pressure, or higher expander inlet temperature and pressure, generally makes the net power output more. Lower expander inlet temperature results in larger total heat transfer requirement and expander size. According to the screening criteria of both the higher output and the lower investment, the following working fluids for the supercritical ORC system are recommended: R152a and R143a.

  18. Diabetes HealthSense: Resources for Living Well

    Medline Plus

    Full Text Available ... for diabetes Family member, friend, or caregiver Health care professional Teacher or school health professional K-8th grade Community health worker Community organization Age Select one: Child ...

  19. Diabetes HealthSense: Resources for Living Well

    Medline Plus

    Full Text Available ... for diabetes Family member, friend, or caregiver Health care professional Teacher or school health professional K-8th grade Community health worker Community organization Age Select one: Child Teen and ...

  20. 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.

  1. 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.

  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. 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.

  4. 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

  5. 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.

  6. 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

  7. Internal marketing: creating quality employee experiences in health care organizations.

    Science.gov (United States)

    Masri, Maysoun Dimachkie; Oetjen, Dawn; Rotarius, Timothy

    2011-01-01

    To cope with the recent challenges within the health care industry, health care managers need to engage in the internal marketing of their various services. Internal marketing has been used as an effective management tool to increase employees' motivation, satisfaction, and productivity (J Mark Commun. 2010;16(5):325-344). Health care managers should understand that an intense focus on internal marketing factors will lead to a quality experience for employees that will ultimately have a positive effect on the patient experiences.

  8. 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

  9. Energy, Exergy and Economic Evaluation Comparison of Small-Scale Single and Dual Pressure Organic Rankine Cycles Integrated with Low-Grade Heat Sources

    Directory of Open Access Journals (Sweden)

    Armando Fontalvo

    2017-09-01

    Full Text Available Low-grade heat sources such as solar thermal, geothermal, exhaust gases and industrial waste heat are suitable alternatives for power generation which can be exploited by means of small-scale Organic Rankine Cycle (ORC. This paper combines thermodynamic optimization and economic analysis to assess the performance of single and dual pressure ORC operating with different organic fluids and targeting small-scale applications. Maximum power output is lower than 45 KW while the temperature of the heat source varies in the range 100–200 °C. The studied working fluids, namely R1234yf, R1234ze(E and R1234ze(Z, are selected based on environmental, safety and thermal performance criteria. Levelized Cost of Electricity (LCOE and Specific Investment Cost (SIC for two operation conditions are presented: maximum power output and maximum thermal efficiency. Results showed that R1234ze(Z achieves the highest net power output (up to 44 kW when net power output is optimized. Regenerative ORC achieves the highest performance when thermal efficiency is optimized (up to 18%. Simple ORC is the most cost-effective among the studied cycle configurations, requiring a selling price of energy of 0.3 USD/kWh to obtain a payback period of 8 years. According to SIC results, the working fluid R1234ze(Z exhibits great potential for simple ORC when compared to conventional R245fa.

  10. Global Health Security Demands a Strong International Health Regulations Treaty and Leadership From a Highly Resourced World Health Organization.

    Science.gov (United States)

    Burkle, Frederick M

    2015-10-01

    If the Ebola tragedy of West Africa has taught us anything, it should be that the 2005 International Health Regulations (IHR) Treaty, which gave unprecedented authority to the World Health Organization (WHO) to provide global public health security during public health emergencies of international concern, has fallen severely short of its original goal. After encouraging successes with the 2003 severe acute respiratory syndrome (SARS) pandemic, the intent of the legally binding Treaty to improve the capacity of all countries to detect, assess, notify, and respond to public health threats has shamefully lapsed. Despite the granting of 2-year extensions in 2012 to countries to meet core surveillance and response requirements, less than 20% of countries have complied. Today it is not realistic to expect that these gaps will be solved or narrowed in the foreseeable future by the IHR or the WHO alone under current provisions. The unfortunate failures that culminated in an inadequate response to the Ebola epidemic in West Africa are multifactorial, including funding, staffing, and poor leadership decisions, but all are reversible. A rush by the Global Health Security Agenda partners to fill critical gaps in administrative and operational areas has been crucial in the short term, but questions remain as to the real priorities of the G20 as time elapses and critical gaps in public health protections and infrastructure take precedence over the economic and security needs of the developed world. The response from the Global Outbreak Alert and Response Network and foreign medical teams to Ebola proved indispensable to global health security, but both deserve stronger strategic capacity support and institutional status under the WHO leadership granted by the IHR Treaty. Treaties are the most successful means the world has in preventing, preparing for, and controlling epidemics in an increasingly globalized world. Other options are not sustainable. Given the gravity of ongoing

  11. 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.

  12. Quality of prostate cancer screening information on the websites of nationally recognized cancer centers and health organizations.

    Science.gov (United States)

    Manole, Bogdan-Alexandru; Wakefield, Daniel V; Dove, Austin P; Dulaney, Caleb R; Marcrom, Samuel R; Schwartz, David L; Farmer, Michael R

    2017-12-24

    The purpose of this study was to survey the accessibility and quality of prostate-specific antigen (PSA) screening information from National Cancer Institute (NCI) cancer center and public health organization Web sites. We surveyed the December 1, 2016, version of all 63 NCI-designated cancer center public Web sites and 5 major online clearinghouses from allied public/private organizations (cancer.gov, cancer.org, PCF.org, USPSTF.org, and CDC.gov). Web sites were analyzed according to a 50-item list of validated health care information quality measures. Web sites were graded by 2 blinded reviewers. Interrater agreement was confirmed by Cohen kappa coefficient. Ninety percent of Web sites addressed PSA screening. Cancer center sites covered 45% of topics surveyed, whereas organization Web sites addressed 70%. All organizational Web pages addressed the possibility of false-positive screening results; 41% of cancer center Web pages did not. Forty percent of cancer center Web pages also did not discuss next steps if a PSA test was positive. Only 6% of cancer center Web pages were rated by our reviewers as "superior" (eg, addressing >75% of the surveyed topics) versus 20% of organizational Web pages. Interrater agreement between our reviewers was high (kappa coefficient = 0.602). NCI-designated cancer center Web sites publish lower quality public information about PSA screening than sites run by major allied organizations. Nonetheless, information and communication deficiencies were observed across all surveyed sites. In an age of increasing patient consumerism, prospective prostate cancer patients would benefit from improved online PSA screening information from provider and advocacy organizations. Validated cancer patient Web educational standards remain an important, understudied priority. Copyright © 2018. Published by Elsevier Inc.

  13. Mobile health applications for the most prevalent conditions by the World Health Organization: review and analysis.

    Science.gov (United States)

    Martínez-Pérez, Borja; de la Torre-Díez, Isabel; López-Coronado, Miguel

    2013-06-14

    New possibilities for mHealth have arisen by means of the latest advances in mobile communications and technologies. With more than 1 billion smartphones and 100 million tablets around the world, these devices can be a valuable tool in health care management. Every aid for health care is welcome and necessary as shown by the more than 50 million estimated deaths caused by illnesses or health conditions in 2008. Some of these conditions have additional importance depending on their prevalence. To study the existing applications for mobile devices exclusively dedicated to the eight most prevalent health conditions by the latest update (2004) of the Global Burden of Disease (GBD) of the World Health Organization (WHO): iron-deficiency anemia, hearing loss, migraine, low vision, asthma, diabetes mellitus, osteoarthritis (OA), and unipolar depressive disorders. Two reviews have been carried out. The first one is a review of mobile applications in published articles retrieved from the following systems: IEEE Xplore, Scopus, ScienceDirect, Web of Knowledge, and PubMed. The second review is carried out by searching the most important commercial app stores: Google play, iTunes, BlackBerry World, Windows Phone Apps+Games, and Nokia's Ovi store. Finally, two applications for each condition, one for each review, were selected for an in-depth analysis. Search queries up to April 2013 located 247 papers and more than 3673 apps related to the most prevalent conditions. The conditions in descending order by the number of applications found in literature are diabetes, asthma, depression, hearing loss, low vision, OA, anemia, and migraine. However when ordered by the number of commercial apps found, the list is diabetes, depression, migraine, asthma, low vision, hearing loss, OA, and anemia. Excluding OA from the former list, the four most prevalent conditions have fewer apps and research than the final four. Several results are extracted from the in-depth analysis: most of the apps

  14. Organization of school health education in obesity in children

    Directory of Open Access Journals (Sweden)

    Joanna Woźniak-Holecka

    2013-12-01

    Full Text Available Abnormal body weight poses a risk of the development of various health disorders, having a negative impact on the quality and length of life. The prevalence of overweight and obesity among European children is estimated to be 10–20%. In Poland this figure reaches 18%. A war on the epidemic obesity waged from the youngest age of the child is a strategy that brings long-term health benefits for the entire population. Apart from the family, the school is the second important educational environment responsible for conducting health education activities among children and teenagers. School health education programs should be implementing by teachers in collaboration with other school staff, parents and the broadly understood local community. Comprehensive health education aiming at combating obesity should cover the entire population of school children and teenagers, with special attention given to high risk groups. The school, undertaking health education activities aimed at preventing abnormal body weight, should implement nationwide programs for the prevention of obesity, and should also pursue its own health education program based on its curriculum. In most cases, development of obesity at children results from improper eating habits and insufficient physical activity, and therefore school health education programs aimed at the prevention of overweight and obesity should focus on these two most important modifiable risk factors of abnormal body weight.

  15. The Community Mental Health Center as a Matrix Organization.

    Science.gov (United States)

    White, Stephen L.

    1978-01-01

    This article briefly reviews the literature on matrix organizational designs and discusses the ways in which the matrix design might be applied to the special features of a community mental health center. The phases of one community mental health center's experience in adopting a matrix organizational structure are described. (Author)

  16. 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...

  17. 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.

  18. [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.

  19. Primary health care organizations - through a conceptual and a political lens.

    Science.gov (United States)

    Sturmberg, Joachim P

    2011-06-01

    Governments around the world are looking at means to improve health care services and health outcomes for their communities within a sustainable expenditure framework. There is a general agreement that strengthening primary health care is the way for the future. Primary health care organizations (PHCOs) are seen as a means to achieving more effective and efficient health care. This paper proposes a complex adaptive framework for PHCOs, taking account of health and illness being subjective experiences, health care being 'whole person'-focused, and PHCOs focusing on all of a community's health determinants and community-based health care needs. Such approach would foster building healthy local communities as much as seamless integration of health services for all. However, despite the expressed intensions towards patient-centred health care reform the bureaucratic mindset of Australian health policy makers risks true reform by imposing highly structured - rather than 'simple'- policy and operational rules. © 2011 Blackwell Publishing Ltd.

  20. Importance of health and environment as quality traits in the buying decision of organic products

    OpenAIRE

    Mondelaers, Koen; Verbeke, Wim; Van Huylenbroeck, Guido

    2009-01-01

    Purpose - This paper aims to explore consumer preference for fresh vegetables labelled as organic in combination with health and environment related quality traits. The study decomposes organic farming into its main quality aspects and measures consumers' preference structure for organic, in general, and for specific organic quality traits in particular. Design/methodology/approach - By means of stated choice preference modelling, the following hypotheses are tested: consumers prefer healt...

  1. The 2017 World Health Organization classification of tumors of the pituitary gland: a summary.

    Science.gov (United States)

    Lopes, M Beatriz S

    2017-10-01

    The 4th edition of the World Health Organization (WHO) classification of endocrine tumors has been recently released. In this new edition, major changes are recommended in several areas of the classification of tumors of the anterior pituitary gland (adenophypophysis). The scope of the present manuscript is to summarize these recommended changes, emphasizing a few significant topics. These changes include the following: (1) a novel approach for classifying pituitary neuroendocrine tumors according to pituitary adenohypophyseal cell lineages; (2) changes to the histological grading of pituitary neuroendocrine tumors with the elimination of the term "atypical adenoma;" and (3) introduction of new entities like the pituitary blastoma and re-definition of old entities like the null-cell adenoma. This new classification is very practical and mostly based on immunohistochemistry for pituitary hormones, pituitary-specific transcription factors, and other immunohistochemical markers commonly used in pathology practice, not requiring routine ultrastructural analysis of the tumors. Evaluation of tumor proliferation potential, by mitotic count and Ki-67 labeling index, and tumor invasion is strongly recommended on individual case basis to identify clinically aggressive adenomas. In addition, the classification offers the treating clinical team information on tumor prognosis by identifying specific variants of adenomas associated with an elevated risk for recurrence. Changes in the classification of non-neuroendocrine tumors are also proposed, in particular those tumors arising in the posterior pituitary including pituicytoma, granular cell tumor of the posterior pituitary, and spindle cell oncocytoma. These changes endorse those previously published in the 2016 WHO classification of CNS tumors. Other tumors arising in the sellar region are also reviewed in detail including craniopharyngiomas, mesenchymal and stromal tumors, germ cell tumors, and hematopoietic tumors. It is

  2. Advanced soft computing diagnosis method for tumour grading.

    Science.gov (United States)

    Papageorgiou, E I; Spyridonos, P P; Stylios, C D; Ravazoula, P; Groumpos, P P; Nikiforidis, G N

    2006-01-01

    To develop an advanced diagnostic method for urinary bladder tumour grading. A novel soft computing modelling methodology based on the augmentation of fuzzy cognitive maps (FCMs) with the unsupervised active Hebbian learning (AHL) algorithm is applied. One hundred and twenty-eight cases of urinary bladder cancer were retrieved from the archives of the Department of Histopathology, University Hospital of Patras, Greece. All tumours had been characterized according to the classical World Health Organization (WHO) grading system. To design the FCM model for tumour grading, three experts histopathologists defined the main histopathological features (concepts) and their impact on grade characterization. The resulted FCM model consisted of nine concepts. Eight concepts represented the main histopathological features for tumour grading. The ninth concept represented the tumour grade. To increase the classification ability of the FCM model, the AHL algorithm was applied to adjust the weights of the FCM. The proposed FCM grading model achieved a classification accuracy of 72.5%, 74.42% and 95.55% for tumours of grades I, II and III, respectively. An advanced computerized method to support tumour grade diagnosis decision was proposed and developed. The novelty of the method is based on employing the soft computing method of FCMs to represent specialized knowledge on histopathology and on augmenting FCMs ability using an unsupervised learning algorithm, the AHL. The proposed method performs with reasonably high accuracy compared to other existing methods and at the same time meets the physicians' requirements for transparency and explicability.

  3. 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.

  4. 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.

  5. How to create a health care organization that can succeed in an unpredictable future.

    Science.gov (United States)

    Olden, Peter C; Haynos, Jessika

    2013-01-01

    For those who manage organizations, it has been said that success does not come from predicting the future but instead comes from creating an organization that can succeed in an unpredictable future. Managers are responsible for creating such an organization. To do that, managers can apply management-related principles and methods. This article explains selected principles of organization structure, human resources, culture, decision making, and change management and how to apply them to health care organizations. If done well, that will help such organizations succeed in an unpredictable future.

  6. The World Health Organization's mechanisms for increasing the health sector budget: The South African context.

    Science.gov (United States)

    Venter, Fouche Hendrik Johannes; Wolfaardt, Jaqueline Elizabeth

    2016-07-04

    South Africa (SA) has limited scope for raising income taxes, and the proposed National Health Insurance (NHI) scheme will necessitate growth in the health sector budget. The NHI White Paper suggests five funding scenarios to meet the expected shortfall. 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 transaction levy, and taxes on tobacco, alcohol and unhealthy foods) were chosen based on their fund-raising potential and their mandatory element. A literature review provides the information for a discussion of the potential costs of each mechanism. Within specific assumptions, potential budgetary contribution is compared with the requirement. First, raising corporate tax rates could raise enough funds, but the losses due to capital flight might be too much for the local economy to bear. Second, a levy on currency transactions is unlikely to raise the required resources, even without a probable decrease in the number of transactions. Third, the increase in the tax on tobacco and alcohol would need to be very large, even assuming that consumption patterns would remain unchanged. Lastly, a tax on unhealthy food products is a new idea and could be explored as an option - especially as the SA Treasury has announced its future implementation. Implementing only one of the mechanisms is unlikely to increase available funding sufficiently, but if they are implemented together the welfare-maximising tax rate for each mechanism may be high enough to fulfil the NHI scheme's budgetary requirement, moderating the increases in the tax burden of the SA population.

  7. The framing of teenage health care: organizations, culture, and control.

    Science.gov (United States)

    Nader, L; González, R J

    2000-06-01

    Adolescent health is one of the most polemical health issues that has swept the United States in recent years. This study is about documenting the process of a project on teenage sex, drug, and alcohol abuse in a small rural California town. It illustrates a dynamic set of concerns that impinge on health issues: development and underdevelopment, experts and lay people, young and old, in a context of the transformation of a rural economy to a prison-based industry. It is also about covert forms of control, pacification, burnout, and teenagers caught in the crossfire between bureaucratic institutions and contradictory messages about adolescent health as they correspond to changing conditions between institutional power holders.

  8. Implications of the 2015 World Health Organization isoniazid ...

    African Journals Online (AJOL)

    Isoniazid preventive therapy (IPT) is a key strategy recommended by the World ... In its continued effort to attain its vision of a Namibia where TB is no longer a ... In its health budget planning, the government of Namibia needs ... STATEMENT.

  9. 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

  10. Health and social organization: towards a health policy for the twenty-first century

    National Research Council Canada - National Science Library

    Blane, David; Brunner, Eric

    1996-01-01

    ...: economic growth, income distribution, consumption, work organization, unemployment and job insecurity, social and family structure, education and deprivation, and they are all aspects of 'social organization...

  11. Animal health in organic livestock production systems: a review

    NARCIS (Netherlands)

    Kijlstra, A.; Eijck, I.A.J.M.

    2006-01-01

    Organic livestock production is a means of food production with a large number of rules directed towards a high status of animal welfare, care for the environment, restricted use of medical drugs and the production of a healthy product without residues (pesticides or medical drugs). The intentions

  12. 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

  13. 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.

  14. Health-related quality of life of cranial WHO grade I meningioma patients: are current questionnaires relevant?

    Science.gov (United States)

    Zamanipoor Najafabadi, Amir H; Peeters, Marthe C M; Lobatto, Daniel J; Broekman, Marieke L D; Smith, Timothy R; Biermasz, Nienke R; Peerdeman, Saskia M; Peul, Wilco C; Taphoorn, Martin J B; van Furth, Wouter R; Dirven, Linda

    2017-11-01

    The clinical relevance of Health-Related Quality of Life (HRQoL) in meningioma patients has been increasingly acknowledged in recent years. Various questionnaires have been used. However, almost none of these questionnaires has been particularly developed for and/or validated in this patient group. Therefore, the aim of this study was to assess the relevance and comprehensiveness of existing HRQoL questionnaires used in meningioma research and to assess the agreement between patients and health care professionals (HCPs) on the most relevant and important HRQoL issues. A systematic literature search, following the PRISMA statement, was conducted to identify all HRQoL questionnaires used in meningioma research. Semi-structured interviews were organized with patients and HCPs to (1) assess the relevance of all issues covered by the questionnaires (score 0-3: not relevant-highly relevant), (2) assess the ten most important issues, and (3) identify new relevant HRQoL issues. Fourteen different questionnaires were found in the literature, comprising 140 unique issues. Interviews were conducted with 20 patients (median age 57, 71% female) and 10 HCPs (4 neurosurgeons, 2 neurologists, 2 radiotherapists, 1 rehabilitation specialist, 1 neuropsychologist; median experience 13 years). Meningioma patients rated 17-80% of the issues in each of the questionnaires as relevant, HCPs 90-100%. Patients and HCPs agreed on the relevance of only 49 issues (35%, Cohen's kappa: 0.027). Both patients and HCPs considered lack of energy the most important issue. Patients and HCPs suggested five additional relevant issues not covered by current HRQoL questionnaires. Existing HRQoL questionnaires currently used in meningioma patients do not fully cover all relevant issues to these patients. Agreement between patients and HCPs on the relevance of issues was poor. Both findings support the need to develop and validate a meningioma-specific HRQoL questionnaire.

  15. Self-Contained versus Departmentalized School Organization and the Impact on Fourth and Fifth Grade Student Achievement in Reading and Mathematics as Determined by the Kentucky Core Content Test

    Science.gov (United States)

    Kent, Kimberly Penn

    2010-01-01

    The primary purpose of this study was to determine if there was a difference between self-contained and departmentalized classroom organization on the Kentucky Core Content Test (KCCT) in reading and mathematics for students in fourth and fifth grade. A secondary purpose of this study was to consider how these organizational structures affect the…

  16. The Economics of New Health Technologies Incentives, Organization, and Financing

    CERN Document Server

    Costa-Font, Joan; McGuire, Alistair

    2009-01-01

    Technological change in healthcare has led to huge improvements in health services and the health status of populations. It is also pinpointed as the main driver of healthcare expenditure. Although offering remarkable benefits, changes in technology are not free and often entail significant financial, as well as physical or social risks. These need to be balanced out in the setting of government regulations, insurance contracts, and individuals' decisions to use and consume certaintechnologies. With this in mind, this book addresses the following important objectives: to provide a detailed ana

  17. 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.

  18. 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.

  19. Armenia: Influences and Organization of Mental Health Services

    Science.gov (United States)

    McCarthy, John; Harutyunyan, Hasmik; Smbatyan, Meri; Cressley, Heidi

    2013-01-01

    Relatively little has been published on mental health care and counseling as they pertain to Armenia, a country of approximately three million residents that gained independence in 1991 from the former Soviet Union. Various influences, such as its history, economy, religious and family systems, and a major natural disaster in 1988, have affected…

  20. Offering-level strategy formulation in health service organizations.

    Science.gov (United States)

    Pointer, D D

    1990-01-01

    One of six different strategies must be selected for a health service offering to provide consumers with distinctive value and achieve sustainable competitive advantage in a market or market segment. Decisions must be made regarding objectives sought, market segmentation, market scope, and the customer-value proposition that will be pursued.

  1. 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...

  2. Mental disorders among college students in the World Health Organization World Mental Health Surveys.

    Science.gov (United States)

    Auerbach, R P; Alonso, J; Axinn, W G; Cuijpers, P; Ebert, D D; Green, J G; Hwang, I; Kessler, R C; Liu, H; Mortier, P; Nock, M K; Pinder-Amaker, S; Sampson, N A; Aguilar-Gaxiola, S; Al-Hamzawi, A; Andrade, L H; Benjet, C; Caldas-de-Almeida, J M; Demyttenaere, K; Florescu, S; de Girolamo, G; Gureje, O; Haro, J M; Karam, E G; Kiejna, A; Kovess-Masfety, V; Lee, S; McGrath, J J; O'Neill, S; Pennell, B-E; Scott, K; Ten Have, M; Torres, Y; Zaslavsky, A M; Zarkov, Z; Bruffaerts, R

    2016-10-01

    Although mental disorders are significant predictors of educational attainment throughout the entire educational career, most research on mental disorders among students has focused on the primary and secondary school years. The World Health Organization World Mental Health Surveys were used to examine the associations of mental disorders with college entry and attrition by comparing college students (n = 1572) and non-students in the same age range (18-22 years; n = 4178), including non-students who recently left college without graduating (n = 702) based on surveys in 21 countries (four low/lower-middle income, five upper-middle-income, one lower-middle or upper-middle at the times of two different surveys, and 11 high income). Lifetime and 12-month prevalence and age-of-onset of DSM-IV anxiety, mood, behavioral and substance disorders were assessed with the Composite International Diagnostic Interview (CIDI). One-fifth (20.3%) of college students had 12-month DSM-IV/CIDI disorders; 83.1% of these cases had pre-matriculation onsets. Disorders with pre-matriculation onsets were more important than those with post-matriculation onsets in predicting subsequent college attrition, with substance disorders and, among women, major depression the most important such disorders. Only 16.4% of students with 12-month disorders received any 12-month healthcare treatment for their mental disorders. Mental disorders are common among college students, have onsets that mostly occur prior to college entry, in the case of pre-matriculation disorders are associated with college attrition, and are typically untreated. Detection and effective treatment of these disorders early in the college career might reduce attrition and improve educational and psychosocial functioning.

  3. 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

  4. 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.

  5. Should Health Care Organizations Use Information Gleaned from Organization-Sponsored Patient Support Groups in Strategic Planning?

    Science.gov (United States)

    Nambisan, Priya

    2017-11-01

    Online forums and partnerships with patients have several benefits, such as the creation of new products and services. However, as with any such initiatives, there are risks as well as benefits. Through analysis of a case of misinformation being spread through a health care provider-sponsored online support group for patients dealing with obesity, this article outlines best practices and strategies to deploy in such organization-sponsored patient support groups. These strategies would enable organizations and patients to use such forums to the fullest extent while preventing or managing their potential risks as best as possible. © 2017 American Medical Association. All Rights Reserved.

  6. 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.

  7. [Prostate cancer. Part 2: Review of the various tumor grading systems over the years 1966-2015 and future perspectives of the new grading of the International Society of Urological Pathology (ISUP)].

    Science.gov (United States)

    Helpap, B; Bubendorf, L; Kristiansen, G

    2016-02-01

    The continued development of methods in needle biopsies and radical prostatectomy for treatment of prostate cancer has given special emphasis to the question of the prognostic relevance of the various systems of grading. The classical purely histological grading system of Gleason has been modified several times in the past decades and cleared the way for a new grading system by the prognostic grading of Epstein. Assessment of the old and also modified combined histological and cytological grading of Mostofi, the World health Organization (WHO) and the urologic-pathological working group of prostate cancer in connection with the Gleason grading (combined Gleason-Helpap grading), has led to considerably improved rates of concordance between biopsy and radical prostatectomy and to improved estimations of prognosis beside its contribution to the development of a more practicable grading system for clinical use.

  8. 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.

  9. 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

  10. Thermodynamic analysis and comparison between CO_2 transcritical power cycles and R245fa organic Rankine cycles for low grade heat to power energy conversion

    International Nuclear Information System (INIS)

    Li, L.; Ge, Y.T.; Luo, X.; Tassou, S.A.

    2016-01-01

    Highlights: • CO_2 is a promising working fluid to be applied in low-grade power generation systems. • Thermodynamic models of CO_2 transcritical power cycles (T-CO_2) and R245fa ORC were developed. • Energy and exergy analyses were carried out for T-CO_2 and R245fa ORC systems. • Optimal system designs are existed for both T-CO_2 and R245fa ORC systems. - Abstract: In this paper, a theoretical study is conducted to investigate and compare the performance of CO_2 transcritical power cycles (T-CO_2) and R245fa organic Rankine cycles (ORCs) using low-grade thermal energy to produce useful shaft or electrical power. Each power cycle consists of typical Rankine cycle components, such as a working fluid pump, gas generator or evaporator, turbine with electricity generator, air cooled condenser and recuperator (internal heat exchanger). The thermodynamic models of both cycles have been developed and are applied to calculate and compare the cycle thermal and exergy efficiencies at different operating conditions and control strategies. The simulation results show that the system performances for both cycles vary with different operating conditions. When the heat source (waste heat) temperature increases from 120 °C to 260 °C and heat sink (cooling air) temperature is reduced from 20 °C to 0 °C, both thermal efficiencies of R245fa ORC and T-CO_2 with recuperator can significantly increase. On the other hand, R245fa ORC and T-CO_2 exergy efficiencies increase with lower heat sink temperatures and generally decrease with higher heat source temperatures. In addition, with the same operating conditions and heat transfer assumptions, the thermal and exergy efficiencies of R245fa ORCs are both slightly higher than those of T-CO_2. However, the efficiencies of both cycles can be enhanced by installing a recuperator in each system at specified operating conditions. Ultimately, optimal operating states can be predicted, with particular focus on the working fluid expander

  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. Conceptions of authority within contemporary social work practice in managed mental health care organizations.

    Science.gov (United States)

    Bransford, Cassandra L

    2005-07-01

    This article examines how social workers may use their authority to create managed mental health care organizations that support the principles and values of professional social work practice. By exploring research and theoretical contributions from a multidisciplinary perspective, the author suggests ways that social workers may incorporate empowerment strategies into their organizational practices to create more socially responsible and humane mental health organizations. (c) 2005 APA, all rights reserved.

  13. Restaurant Industry. Grade Three. One in a Series of Career Development Curriculum Units for the Elementary Classroom. (Third Edition).

    Science.gov (United States)

    Briggs, Gail; And Others

    Focusing on the occupational clusters of health, hospitality and recreation, this unit entitled "Restaurant Industry" is one of four grade 3 units which are part of a total set of twenty-seven career development curriculum units for grades K-6. This unit is organized into four sections. Section 1 identifies two career…

  14. Airline Workers. Grade 3. One in a Series of Career Development Curriculum Units for the Elementary Classroom. (Second Edition).

    Science.gov (United States)

    Briggs, Gail; And Others

    Focusing on the occupational clusters of health, hospitality, recreation, clerical, technology, and research, this unit entitled "Airline Workers" is one of four grade 3 units which are part of a total set of twenty-seven career development curriculum units for grades K-6. This unit is organized into four sections. Section 1 identifies…

  15. 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.

  16. Determinants of information technology outsourcing among health maintenance organizations.

    Science.gov (United States)

    Wholey, D R; Padman, R; Hamer, R; Schwartz, S

    2001-09-01

    We analyze the determinants of HMO information technology outsourcing using two studies. Study 1 examines the effect of asset specificity on outsourcing for development and operation activities, using HMO specific fixed effects to control for differences between HMOs. Study 2 regresses the HMO specific fixed effects from Study 1, which measure an HMO's propensity to outsource, on HMO characteristics. The data comes from a 1995 InterStudy survey about information technology organization of HMOs. While HMOs split roughly equally in outsourcing information technology development activities, they are extremely unlikely to outsource the day-to-day operation of information systems. The greater an HMO's information technology capability and the complexity of information systems supported, the less likely is an HMO to outsource. While HMOs less than two years old, for-profit HMOs, local or Blue Cross-affiliated HMOs, and mixed HMOs are more likely to outsource, federally qualified HMOs are less likely to outsource. Policy and managerial implications for the adoption and diffusion of new ways of organizing information technology, such as application service providers (ASPs), are discussed.

  17. 77 FR 60996 - Office of the Assistant Secretary for Health, Statement of Organization, Functions, and...

    Science.gov (United States)

    2012-10-05

    ...-delegations of authority previously made to officials and employees of the affected organizational components... for Health, Statement of Organization, Functions, and Delegations of Authority Part A, Office of the Secretary, Statement of Organization, Function, and Delegation of Authority for the U.S. Department of...

  18. 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.

  19. Impacts of timber harvesting on soil organic matter, nitrogen, productivity, and health of inland northwest forests

    Science.gov (United States)

    M. F. Jurgensen; A. E. Harvey; R. T. Graham; D. S. Page-Dumroese; J. R. Tonn; M. J. Larsen; T. B. Jain

    1997-01-01

    Soil organic components are important factors in the health and productivity of Inland Northwest forests. Timber harvesting and extensive site preparation (piling, windrowing, or scalping) reduces the amount of surface organic material (woody residues and forest floor layers) over large areas. Some wildfires and severe prescribed burns can have similar consequences....

  20. The World Health Organization fetal growth charts: concept, findings, interpretation, and application.

    Science.gov (United States)

    Kiserud, Torvid; Benachi, Alexandra; Hecher, Kurt; Perez, Rogelio González; Carvalho, José; Piaggio, Gilda; Platt, Lawrence D

    2018-02-01

    Ultrasound biometry is an important clinical tool for the identification, monitoring, and management of fetal growth restriction and development of macrosomia. This is even truer in populations in which perinatal morbidity and mortality rates are high, which is a reason that much effort is put onto making the technique available everywhere, including low-income societies. Until recently, however, commonly used reference ranges were based on single populations largely from industrialized countries. Thus, the World Health Organization prioritized the establishment of fetal growth charts for international use. New fetal growth charts for common fetal measurements and estimated fetal weight were based on a longitudinal study of 1387 low-risk pregnant women from 10 countries (Argentina, Brazil, Democratic Republic of Congo, Denmark, Egypt, France, Germany, India, Norway, and Thailand) that provided 8203 sets of ultrasound measurements. The participants were characterized by median age 28 years, 58% nulliparous, normal body mass index, with no socioeconomic or nutritional constraints (median caloric intake, 1840 calories/day), and had the ability to attend the ultrasound sessions, thus essentially representing urban populations. Median gestational age at birth was 39 weeks, and birthweight was 3300 g, both with significant differences among countries. Quantile regression was used to establish the fetal growth charts, which also made it possible to demonstrate a number of features of fetal growth that previously were not well appreciated or unknown: (1) There was an asymmetric distribution of estimated fetal weight in the population. During early second trimester, the distribution was wider among fetuses 50th percentile. (2) Although fetal sex, maternal factors (height, weight, age, and parity), and country had significant influence on fetal weight (1-4.5% each), their effect was graded across the percentiles. For example, the positive effect of maternal height on fetal

  1. Organized Sport Participation Is Associated with Higher Levels of Overall Health-Related Physical Activity in Children (CHAMPS Study-DK)

    Science.gov (United States)

    Hebert, Jeffrey J.; Møller, Niels C.; Andersen, Lars B.; Wedderkopp, Niels

    2015-01-01

    Introduction Many children fail to meet international guideline recommendations for health-related activity (≥60 minutes/day of moderate-to-vigorous physical activity [MVPA]), and intervention studies to date have reported negligible effects. Objective Explore the associations of organized leisure-time sport participation with overall physical activity levels and health-related physical activity guideline concordance. Methods This prospective cohort study was nested in the Childhood Health, Activity, and Motor Performance School Study Denmark. Study participants were a representative sample of 1124 primary school students. Organized leisure-time sport participation was reported via text messaging and physical activity was objectively measured over seven days with accelerometry. Associations between sport participation and physical activity level were explored with multilevel mixed-effects regression models and reported with beta coefficients (b) and adjusted odds ratios (aOR). Results Participants were 53% female, with mean(SD) age = 8.4(1.4) years. Boys were more active than girls (psports (gymnastics, basketball, volleyball) were inconsistent. Conclusions Many children, particularly girls and those in higher grade levels do not adhere to health-related physical activity recommendations. Organized leisure-time sport participation may be a viable strategy to increase overall health-related physical activity levels and international guideline concordance in children. PMID:26262678

  2. 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.

  3. The World Health Organization's Clean Hands Save Lives

    DEFF Research Database (Denmark)

    Verwilghen, D.

    2018-01-01

    health and integrity as the first principle of good hand hygiene, using decontamination methods and products that are the least harmful to the skin is mandatory. This is why the currently accepted presurgical hand preparation methods do not involve aggressive brushing and disinfecting soaps anymore....... Rather, hands should be washed with a neutral pH friendly soap first before a hydroalcoholic solution is applied. Although the principles and benefits of proper hand hygiene have been recognised in the healthcare world, one of the major drawbacks remains the lack of compliance with established protocols...

  4. 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

  5. Ethnic disparities in children's oral health: findings from a population-based survey of grade 1 and 2 schoolchildren in Alberta, Canada.

    Science.gov (United States)

    Shi, Congshi; Faris, Peter; McNeil, Deborah A; Patterson, Steven; Potestio, Melissa L; Thawer, Salima; McLaren, Lindsay

    2018-01-04

    Although oral health has improved remarkably in recent decades, not all populations have benefited equally. Ethnic identity, and in particular visible minority status, has been identified as an important risk factor for poor oral health. Canadian research on ethnic disparities in oral health is extremely limited. The aim of this study was to examine ethnic disparities in oral health outcomes and to assess the extent to which ethnic disparities could be accounted for by demographic, socioeconomic and caries-related behavioral factors, among a population-based sample of grade 1 and 2 schoolchildren (age range: 5-8 years) in Alberta, Canada. A dental survey (administered during 2013-14) included a mouth examination and parent questionnaire. Oral health outcomes included: 1) percentage of children with dental caries; 2) number of decayed, extracted/missing (due to caries) and filled teeth; 3) percentage of children with two or more teeth with untreated caries; and 4) percentage of children with parental-ratings of fair or poor oral health. We used multivariable regression analysis to examine ethnic disparities in oral health, adjusting for demographic, socioeconomic and caries-related behavioral variables. We observed significant ethnic disparities in children's oral health. Most visible minority groups, particularly Filipino and Arab, as well as Indigenous children, were more likely to have worse oral health than White populations. In particular, Filipino children had an almost 5-fold higher odds of having severe untreated dental problems (2 or more teeth with untreated caries) than White children. Adjustment for demographic, socioeconomic, and caries-related behavior variables attenuated but did not eliminate ethnic disparities in oral health, with the exception of Latin American children whose outcomes did not differ significantly from White populations after adjustment. Significant ethnic disparities in oral health exist in Alberta, Canada, even when adjusting for

  6. 75 FR 55582 - National Institutes of Health Statement of Organization, Functions, and Delegations of Authority

    Science.gov (United States)

    2010-09-13

    ... authority statement: All delegations and redelegations of authority to officers and employees of NIH that..., Functions, and Delegations of Authority Part N, National Institutes of Health, of the Statement of Organization, Functions, and Delegations of Authority for the Department of Health and Human Services (40 FR...

  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. 76 FR 74788 - Patient Safety Organizations: Voluntary Relinquishment From HealthWatch, Inc.

    Science.gov (United States)

    2011-12-01

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Agency for Healthcare Research and Quality Patient Safety... relinquishment from HealthWatch, Inc. of its status as a Patient Safety Organization (PSO). The Patient Safety and Quality Improvement Act of 2005 (Patient Safety Act), Public Law 109-41, 42 U.S.C. 299b-21--b-26...

  9. World Health Organization Global Estimates and Regional Comparisons of the Burden of Foodborne Disease in 2010

    NARCIS (Netherlands)

    Havelaar, Arie H|info:eu-repo/dai/nl/072306122; Kirk, Martyn D; Torgerson, Paul R; Gibb, Herman J; Hald, Tine; Lake, Robin J; Praet, Nicolas; Bellinger, David C; de Silva, Nilanthi R; Gargouri, Neyla; Speybroeck, Niko; Cawthorne, Amy; Mathers, Colin; Stein, Claudia; Angulo, Frederick J; Devleesschauwer, Brecht

    2015-01-01

    Illness and death from diseases caused by contaminated food are a constant threat to public health and a significant impediment to socio-economic development worldwide. To measure the global and regional burden of foodborne disease (FBD), the World Health Organization (WHO) established the Foodborne

  10. Clocking in: The Organization of Work Time and Health in the United States

    Science.gov (United States)

    Kleiner, Sibyl; Pavalko, Eliza K.

    2010-01-01

    This article assesses the health implications of emerging patterns in the organization of work time. Using data from the National Longitudinal Survey of Youth 1979, we examine general mental and physical health (SF-12 scores), psychological distress (CESD score), clinical levels of obesity, and the presence of medical conditions, at age 40.…

  11. 75 FR 38112 - Organization, Functions, and Delegations of Authority; Part G; Indian Health Service; Proposed...

    Science.gov (United States)

    2010-07-01

    ... Ethics Staff (PIES) (GAL1) (1) Directs the fact-finding and resolution of allegations of impropriety such as mismanagement of resources, fraud, waste, and abuse, violations of the Standards of Ethical... DEPARTMENT OF HEALTH AND HUMAN SERVICES Indian Health Service Organization, Functions, and...

  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. Segmenting Consumers According to Their Purchase of Products with Organic, Fair-Trade, and Health Labels

    NARCIS (Netherlands)

    Verhoef, Peter C.; van Doorn, Jenny

    2016-01-01

    Using actual purchase data of food products with different labels, we examine Dutch consumers' purchases of organic, fair-trade, and health labels. Empirically, consumers' purchase behavior of labeled products can be categorized into two dimensions: a health-related and a sustainable dimension

  14. 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...

  15. Family health nurse project--an education program of the World Health Organization: the University of Stirling experience.

    Science.gov (United States)

    Murray, Ian

    2008-11-01

    This article outlines the delivery of the Family Health Nurse Education Programme of the World Health Organization (WHO) at the University of Stirling, Scotland, from 2001 to 2005. The program was part of the WHO European Family Health Nurse pilot project. The curriculum outlined by the WHO Curriculum Planning Group detailed the broad thrust of the Family Health Nurse Education Programme and was modified to be responsive to the context in which it was delivered, while staying faithful to general principles and precepts. The Family Health Nurse Education Programme is described in its evolving format over the two phases of the project; the remote and rural context occurred from 2001 to 2003, and the modification of the program for the urban phase of the project occurred during 2004 and 2005. The conceptual framework that was foundational to the development of the curriculum to prepare family health nurses will be described.

  16. Operation characteristic and performance comparison of organic Rankine cycle (ORC) for low-grade waste heat using R245fa, R123 and their mixtures

    International Nuclear Information System (INIS)

    Feng, Yong-qiang; Hung, Tzu-Chen; He, Ya-Ling; Wang, Qian; Wang, Shuang; Li, Bing-xi; Lin, Jaw-Ren; Zhang, Wenping

    2017-01-01

    Highlights: • Experimental comparison using R123, R245fa and their mixtures has been investigated. • The basic operation parameters and the detailed operation characteristics of pure and mixture working fluids are addressed. • The mixture owns a relatively higher pump power consumption, 10–50% higher than that of R245fa and 2–47% higher than that of R123. • The highest system generating efficiency of 4.53% is obtained by 0.67R245fa/0.33R123. - Abstract: The operation characteristic and performance comparison of low-grade organic Rankine cycle (ORC) using R245fa, R123 and their mixtures have been investigated. The heat source temperature is set to be 120 °C, while the mass flow rate is controlled by adjusting the pump frequency. The basic operation parameters are first examined, while the detailed operation characteristics of pure and mixture working fluids are addressed. The system overall performance, including thermal efficiency and system generating efficiency, for pure and mixture working fluids are explored. The experimental results show that the mixtures own a relatively higher pump power consumption and enhancing the pump performance is also significant for ORC application. Whether the mixtures exhibit better thermodynamic performance than the pure working fluids depend on the operation parameters and mass fraction of mixtures. 0.67R245fa/0.33R123 owns the highest maximum net electricity output of 1.67 kW, 4.38% higher than that of R245fa and 63.73% higher than that of R123. Compared to the pure working fluids, the mixture working fluids own a better thermodynamic performance and a moderate economic performance.

  17. Influence of health and environmental information on hedonic evaluation of organic and conventional bread.

    Science.gov (United States)

    Annett, L E; Muralidharan, V; Boxall, P C; Cash, S B; Wismer, W V

    2008-05-01

    Grain from paired samples of the hard red spring wheat cultivar "Park" grown on both conventionally and organically managed land was milled and baked into 60% whole wheat bread. Consumers (n= 384) rated their liking of the bread samples on a 9-point hedonic scale before (blind) and after (labeled) receiving information about organic production. Consumers liked organic bread more (P bread under blind and labeled conditions. Environmental information about organic production did not impact consumer preference changes for organic bread, but health information coupled with sensory evaluation increased liking of organic bread. Ordinary least squares (OLS) and binary response (probit) regression models identified that postsecondary education, income level, frequency of bread consumption, and proenvironmental attitudes played a significant role in preference changes for organic bread. The techniques used in this study demonstrate that a combination of sensory and econometric techniques strengthens the evaluation of consumer food choice.

  18. Health in the news: an analysis of magazines coverage of health issues in veterans and military service organizations.

    Science.gov (United States)

    Jitnarin, Nattinee; Poston, Walker S C; Haddock, Christopher K; Jahnke, Sara

    2015-05-01

    The purpose of this study was to conduct a content analysis of Veterans and Military Service Organizations (VMSOs) magazines to determine what health-related topics VMSOs target and how they inform their constituencies about health issues. Health-related topics in 288 VMSOs' magazines from 21 VMSOs published in 2011 and 2012 were coded by trained raters using a standardized manual. The top three most addressed health topics were Health Services (Health care, Insurance), Disability and Disability benefits, and post-traumatic stress disorder. Topics least frequently covered were Tobacco and Smoking cessation, Illegal drugs, Alcohol, Gulf War Syndrome, and Weight and Body composition. VMSOs are concerned about the health and well-being of their members given the considerable amount of content devoted to certain health topics such as health insurance concerns, disability, and post-traumatic stress disorder. However, other health concerns that affect a considerable number of both current military personnel and veterans and cost both the Department of Veterans Affairs and the Department of Defense millions annually, such as drug and alcohol problems, and tobacco use and smoking cessation, are infrequently covered. The results of this study improve our understanding of the health-related information that reaches the military and veteran populations through this important media outlet. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

  19. [Managment system in safety and health at work organization. An Italian example in public sector: Inps].

    Science.gov (United States)

    Di Loreto, G; Felicioli, G

    2010-01-01

    The Istituto Nazionale della Previdenza Sociale (Inps) is one of the biggest Public Sector organizations in Italy; about 30.000 people work in his structures. Fifteen years ago, Inps launched a long term project with the objective to create a complex and efficient safety and health at work organization. Italian law contemplates a specific kind of physician working on safety and health at work, called "Medico competente", and 85 Inps's physicians work also as "Medico competente". This work describes how IT improved coordination and efficiency in this occupational health's management system.

  20. Towards an organization with a memory: exploring the organizational generation of adverse events in health care.

    Science.gov (United States)

    Smith, Denis; Toft, Brian

    2005-05-01

    The role of organizational factors in the generation of adverse events, and the manner in which such factors can also inhibit an organization's abilities to learn, have become important agenda items within health care. The government report 'An organization with a memory' highlighted many of the problems facing health care and suggested changes that need to be made if the sector is to learn effective lessons and prevent adverse events from occurring. This paper seeks to examine some of these organizational factors in more detail and suggests issues that managers need to consider as part of their wider strategies for the prevention and management of risk. The paper sets out five core elements that are held to be importance in shaping the manner in which the potential for risk is incubated within organizations. Although the paper focuses its attention on health care, the points made have validity across the public sector and into private sector organizations.

  1. 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...

  2. Service quality and maturity of health care organizations through the lens of Complexity Leadership Theory.

    Science.gov (United States)

    Horvat, Ana; Filipovic, Jovan

    2018-02-01

    This research focuses on Complexity Leadership Theory and the relationship between leadership-examined through the lens of Complexity Leadership Theory-and organizational maturity as an indicator of the performance of health organizations. The research adopts a perspective that conceptualizes organizations as complex adaptive systems and draws upon a survey of opinion of 189 managers working in Serbian health organizations. As the results indicate a dependency between functions of leadership and levels of the maturity of health organizations, we propose a model that connects the two. The study broadens our understanding of the implications of complexity thinking and its reflection on leadership functions and overall organizational performance. The correlations between leadership functions and maturity could have practical applications in policy processing, thus improving the quality of outcomes and the overall level of service quality. © 2017 John Wiley & Sons, Ltd.

  3. Peripheral Reproductive Organ Health and Melatonin: Ready for Prime Time

    Directory of Open Access Journals (Sweden)

    Russel J. Reiter

    2013-04-01

    Full Text Available Melatonin has a wide variety of beneficial actions at the level of the gonads and their adnexa. Some actions are mediated via its classic membrane melatonin receptors while others seem to be receptor-independent. This review summarizes many of the published reports which confirm that melatonin, which is produced in the ovary, aids in advancing follicular maturation and preserving the integrity of the ovum prior to and at the time of ovulation. Likewise, when ova are collected for in vitro fertilization-embryo transfer, treating them with melatonin improves implantation and pregnancy rates. Melatonin synthesis as well as its receptors have also been identified in the placenta. In this organ, melatonin seems to be of particular importance for the maintenance of the optimal turnover of cells in the villous trophoblast via its ability to regulate apoptosis. For male gametes, melatonin has also proven useful in protecting them from oxidative damage and preserving their viability. Incubation of ejaculated animal sperm improves their motility and prolongs their viability. For human sperm as well, melatonin is also a valuable agent for protecting them from free radical damage. In general, the direct actions of melatonin on the gonads and adnexa of mammals indicate it is an important agent for maintaining optimal reproductive physiology.

  4. Peripheral Reproductive Organ Health and Melatonin: Ready for Prime Time

    Science.gov (United States)

    Reiter, Russel J.; Rosales-Corral, Sergio A.; Manchester, Lucien C.; Tan, Dun-Xian

    2013-01-01

    Melatonin has a wide variety of beneficial actions at the level of the gonads and their adnexa. Some actions are mediated via its classic membrane melatonin receptors while others seem to be receptor-independent. This review summarizes many of the published reports which confirm that melatonin, which is produced in the ovary, aids in advancing follicular maturation and preserving the integrity of the ovum prior to and at the time of ovulation. Likewise, when ova are collected for in vitro fertilization-embryo transfer, treating them with melatonin improves implantation and pregnancy rates. Melatonin synthesis as well as its receptors have also been identified in the placenta. In this organ, melatonin seems to be of particular importance for the maintenance of the optimal turnover of cells in the villous trophoblast via its ability to regulate apoptosis. For male gametes, melatonin has also proven useful in protecting them from oxidative damage and preserving their viability. Incubation of ejaculated animal sperm improves their motility and prolongs their viability. For human sperm as well, melatonin is also a valuable agent for protecting them from free radical damage. In general, the direct actions of melatonin on the gonads and adnexa of mammals indicate it is an important agent for maintaining optimal reproductive physiology. PMID:23549263

  5. 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.

  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. Diabetes HealthSense: Resources for Living Well

    Medline Plus

    Full Text Available ... managing your diabetes and preventing kidney disease. Player Controls Use these controls to control the play back ... school health professional K-8th grade Community health worker Community organization Age Select one: Child Teen and ...

  8. 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.

  9. [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.

  10. Veterinarians’ and agricultural advisors’ perception of calf health and welfare in organic dairy production in Norway

    DEFF Research Database (Denmark)

    Ellingsen, Kristian; Mejdell, C. M.; Hansen, B.

    2012-01-01

    and opinions on calf health and welfare in organic dairy farming. The response rate was 52 % for veterinarians and 54 % for advisors. In direct comparison, both groups thought that the calves’ overall health status and well-being did not differ in organic and conventional dairy farming systems. However...... of respondents considered the routine of keeping calves with their mothers and the good care of the calves by stockpersons as important welfare advantages. Among all factors related to health, welfare, morbidity and mortality, low calf mortality and adequate treatment of disease and injury received the best...... scores. Body condition and growth, as well as the use of calf health recording cards, received the worst scores. The two professions differed in their views on the most important welfare challenges for calves in an organic environment: while both groups agreed on poor feed quality, veterinarians...

  11. 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.

  12. 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.

  13. Organizational Climate and Employee Mental Health Outcomes -- A Systematic Review of Studies in Health Care Organizations

    NARCIS (Netherlands)

    Bronkhorst, B.A.C.; Tummers, L.G.|info:eu-repo/dai/nl/341028274; Steijn, A.J.; Vijverberg, D.

    2015-01-01

    Background: 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. Purposes: We conducted a

  14. 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.

  15. Oceans and Human Health: Linking Ocean, Organism, and Human Health for Sustainable Management of Coastal Ecosystems

    Science.gov (United States)

    Sandifer, P. A.; Trtanj, J.; Collier, T. K.

    2012-12-01

    Scientists and policy-makers are increasingly recognizing that sustainable coastal communities depend on healthy and resilient economies, ecosystems, and people, and that the condition or "health" of the coastal ocean and humans are intimately and inextricably connected. A wealth of ecosystem services provided by ocean and coastal environments are crucial for human survival and well being. Nonetheless, the health of coastal communities, their economies, connected ecosystems and ecosystem services, and people are under increasing threats from health risks associated with environmental degradation, climate change, and unwise land use practices, all of which contribute to growing burdens of naturally-occurring and introduced pathogens, noxious algae, and chemical contaminants. The occurrence, frequency, intensity, geographic range, and number and kinds of ocean health threats are increasing, with concomitant health and economic effects and eroding public confidence in the safety and wholesomeness of coastal environments and resources. Concerns in the research and public health communities, many summarized in the seminal 1999 NRC Report, From Monsoons to Microbes and the 2004 final report of the US Commission on Ocean Policy, resulted in establishment of a new "meta-discipline" known as Oceans and Human Health (OHH). OHH brings together practitioners in oceanography, marine biology, ecology, biomedical science, medicine, economics and other social sciences, epidemiology, environmental management, and public health to focus on water- and food-borne causes of human and animal illnesses associated with ocean and coastal systems and on health benefits of seafood and other marine products. It integrates information across multiple disciplines to increase knowledge of ocean health risks and benefits and communicate such information to enhance public safety. Recognizing the need for a comprehensive approach to ocean health threats and benefits, Congress passed the Oceans and

  16. Evidence-informed health policy 2 - survey of organizations that support the use of research evidence.

    Science.gov (United States)

    Lavis, John N; Paulsen, Elizabeth J; Oxman, Andrew D; Moynihan, Ray

    2008-12-17

    Previous surveys of organizations that support the development of evidence-informed health policies have focused on organizations that produce clinical practice guidelines (CPGs) or undertake health technology assessments (HTAs). Only rarely have surveys focused at least in part on units that directly support the use of research evidence in developing health policy on an international, national, and state or provincial level (i.e., government support units, or GSUs) that are in some way successful or innovative or that support the use of research evidence in low- and middle-income countries (LMICs). We drew on many people and organizations around the world, including our project reference group, to generate a list of organizations to survey. We modified a questionnaire that had been developed originally by the Appraisal of Guidelines, Research and Evaluation in Europe (AGREE) collaboration and adapted one version of the questionnaire for organizations producing CPGs and HTAs, and another for GSUs. We sent the questionnaire by email to 176 organizations and followed up periodically with non-responders by email and telephone. We received completed questionnaires from 152 (86%) organizations. More than one-half of the organizations (and particularly HTA agencies) reported that examples from other countries were helpful in establishing their organization. A higher proportion of GSUs than CPG- or HTA-producing organizations involved target users in the selection of topics or the services undertaken. Most organizations have few (five or fewer) full-time equivalent (FTE) staff. More than four-fifths of organizations reported providing panels with or using systematic reviews. GSUs tended to use a wide variety of explicit valuation processes for the research evidence, but none with the frequency that organizations producing CPGs, HTAs, or both prioritized evidence by its quality. Between one-half and two-thirds of organizations do not collect data systematically about

  17. 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.

  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. Grounding the Marketing Strategy of the Organizations in the Field of Health Care

    Directory of Open Access Journals (Sweden)

    Iuliana Cetina

    2009-03-01

    Full Text Available The application of marketing in the health services presents certain particularities determined by market characteristics, of the organizations, products, staff and consumers. The consumers of health services are different of those of other goods and services, due to the lack of information concerning the means of rendering a service and its price, the means of taking a decision, the purchase and consume conduit, the capacity limited by the assessment of the services’ and result quality. In addition, within the last years there have been registered major changes in the conduit of the consumer of health services pursuant to the significant modifications occurred at the demographic and social level.Under these conditions, the grounding of the strategies of the organizations which function in the health field, both at macroeconomic, and microeconomic level, cannot be performed without a deep knowledge of the consumer of health services, with its needs, preferences, and its conduit of purchase and consume.

  20. 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.

  1. 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.

  2. Self-reported temporomandibular joint disorder symptoms, oral health, and quality of life of children in kindergarten through grade 5: Do sex, race, and socioeconomic background matter?

    Science.gov (United States)

    Inglehart, Marita R; Patel, Manan H; Widmalm, Sven-Erik; Briskie, Daniel M

    2016-02-01

    The authors' objectives were to determine the percentage of children in kindergarten through grade 5 who reported symptoms of temporomandibular joint disorder (TMJD); to assess whether sex, race, and socioeconomic background mattered; and to explore the relationships between TMJD and children's oral health and oral health-related quality of life (OHRQoL). The research team conducted face-to-face interviews with 8,302 children in kindergarten through grade 5 (51% female, 49% male; 53% African American, 42% white). They conducted oral health screenings with 7,439 children. Overall, 23.6% of the children reported pain when chewing tough food, and 18.8% reported pain when opening their mouth wide; 23.2% reported hearing a sound (clicking) when opening their mouth wide. Female students were more likely than male students and African American children were more likely than white children to report TMJD symptoms. The prevalence of TMJD symptoms did not correlate with whether the children had a need for oral health care services or whether they had an abscess or carious teeth with pulpal involvement. TMJD symptoms were associated significantly with children's OHRQoL. Considerable percentages of 4- to 12-year-old children reported TMJD symptoms, with girls and African American children being more likely than their counterparts to be affected. Experiencing TMJD symptoms was associated significantly with poorer OHRQoL. Dental practitioners need to be aware that substantial percentages of kindergarten and elementary school-aged children experience TMJD symptoms. Taking a dental history and conducting an oral examination, therefore, should include assessments of the signs and symptoms of TMJD; treatment recommendations should be provided for affected children. Copyright © 2016 American Dental Association. Published by Elsevier Inc. All rights reserved.

  3. 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.

  4. 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.

  5. Facility location of organ procurement organisations in Indian health care supply chain management

    Directory of Open Access Journals (Sweden)

    Rajmohan, M.

    2017-05-01

    Full Text Available 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 centres in India is considered, and a solution is provided by facilitating the identification of locations where organs can be procured and distributed to the nearest transplant location. The location of the distribution centres of organs are identified, based on the p-median model. This model minimises the weighted distance of the organ recipients. Initially, the demand or the population density of organ recipients with respect to particular location is recognised. Then, based on the p-median model, the location of OPOs is effectively identified. Experimental analysis proves that the proposed model performs well in facilitating the location of OPOs. The robustness of the proposed work is validated using a sensitivity analysis of the differences in the selection of OPOs when the estimated demand for organs varies.

  6. Suicidal ideation among students of the 7th, 8th, and 9th grades in the State of Lara, Venezuela: the Global School Health Survey.

    Science.gov (United States)

    Granero, Ricardo; Poni, Esteban; Poni, Carolin

    2008-12-01

    Suicidal behavior among adolescents is not a well-explored public health problem. Health policy decision-making on suicidal behavior needs reliable information on the prevalence of suicidal ideation (SI) and its associated risk factors to produce health promotion and prevention programs. The Global School Health Survey is a self-administered survey done on a random probabilistic sample among students of the 7th, 8th, and 9th grades in the Lara State, Venezuela, school period 2003 to 2004. Point prevalence of SI and associated factors were included and the odds (OR) of having SI was calculated given selected factors. Two-thousand seventy (2070) respondents, of which 13.5 % reported having SI in the last 12 months, and in females more than males (14.6% vs. 11.7%). The OR for SI, according to an associated risk factor, were among (a) females: age > or = 14 years (2.2), worries (3.42), loneliness (8.8), ever had sexual intercourse (5.58), alcohol (8.43) and (b) males: having only one or non close friends (3.69), alcohol (12.36), ever had sexual intercourse (2.73). Behavioral risk factors are relatively new in the field of surveillance systems; therefore, results on SI should be cautiously taken into consideration and a wide discussion should be encouraged as we learn how to best use the results for health promotion and disease prevention.

  7. 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

  8. Primary tonsillar lymphomas according to the new World Health Organization classification: to report 87 cases and literature review and analysis.

    Science.gov (United States)

    Mohammadianpanah, Mohammad; Daneshbod, Yahya; Ramzi, Mani; Hamidizadeh, Nasrin; Dehghani, Seyed Javad; Bidouei, Farzad; Khademi, Bijan; Ahmadloo, Niloofar; Ansari, Mansour; Omidvari, Shapour; Mosalaei, Ahmad; Dehghani, Mehdi

    2010-10-01

    The present study aimed to define the natural history, World Health Organization (WHO) classification, prognostic factors, and treatment outcome of 87 patients with primary lymphoma of the palatine tonsil and literature review and analysis. Between 1990 and March 2008, 87 consecutive patients diagnosed with primary lymphoid malignancy of the palatine tonsil. All pathologic specimens were reviewed and reclassified according to the recent WHO classification. To investigate the association of tonsillar lymphomas with Epstein-Barr virus (EBV), in situ hybridization was performed for 24 tonsillar lymphomas (23 diffuse large B-cell lymphoma (DLBC) and one classic Hodgkin's disease) and ten normal tonsils as control group. In literature review, we found 26 major related series including 1,602 patients with primary tonsillar lymphoma. The median age of our patients was 52 years (range 11-86 years). There were 39 women and 48 men with a median follow-up of 67 months for living patients. The vast majority (95%) of patients had B-cell phenotype. DLBC was the most frequent histology. In situ hybridization revealed none of 23 DLBC to be positive for EBV. The 5-year disease-free and overall survival rates were 78.9% and 86%, respectively. In the literature review and by analyzing the data collection from 26 major reported series, the median age was 55 years and male/female ratio was 1.3:1. Intermediate grade tumors consisted of 72% of all tonsillar lymphomas and B-cell lymphomas constituted 82% of all cell immunophenotypes. The 5-year disease-free and overall survival rates were 61% and 67%, respectively. The vast majority of tonsillar lymphomas are of B-cell origin and with intermediate to high-grade histology. These neoplasms tend to present in early stage disease and to have favorable outcome. WHO classification predicts more accurately treatment outcome of patients with tonsillar lymphoma. The association of DLBC in the palatine tonsil with EBV infection is infrequent.

  9. A SWOT analysis of the organization and financing of the Danish health care system.

    Science.gov (United States)

    Christiansen, Terkel

    2002-02-01

    The organization and financing of the Danish health care system was evaluated within a framework of a SWOT analysis (analysis of Strengths, Weaknesses, Opportunities and Threats) by a panel of five members with a background in health economics. The present paper describes the methods and materials used for the evaluation: selection of panel members, structure of the evaluation task according to the health care triangle model, selection of background material consisting of documents and literature on the Danish health care system, and a 1-week study visit.

  10. Jumpin’ Jacks: Social Marketing Campaign Aimed to Increase Awareness of Healthful Behavior in South Dakota Fourth Grade Students

    Directory of Open Access Journals (Sweden)

    Megan N. Olesen

    2016-06-01

    Full Text Available This study investigated the influence of utilizing a collegiate mascot as a marketing tool for the promotion of fruit and vegetable intake and physical activity among 4th grade students. The program utilized service learning and formative research for the development of a social marketing campaign comprised of nutrition education and brand marketing. A pre-test/post-test design was used to measure fruit and vegetable intake and physical activity in participants in intervention and control schools. Awareness and understanding of the campaign was assessed post-intervention. There were no changes in fruit and vegetable intake or physical activity. However, 91% of the intervention students were able to correctly report understanding of the campaign messages, and approximately one-third of the participants were able to recall the campaign without any prompts. Results demonstrated how a social marketing campaign can utilize branding techniques to bring about awareness, which is an essential step in initiating behavior change.

  11. 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.

  12. 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.

  13. European organic dairy farmers' preference for animal health management within the farm management system.

    Science.gov (United States)

    van Soest, F J S; Mourits, M C M; Hogeveen, H

    2015-11-01

    The expertise and knowledge of veterinary advisors on improving animal health management is key towards a better herd health status. However, veterinary advisors are not always aware of the goals and priorities of dairy farmers. To dairy farmers animal health is only one aspect of farm management and resources may be allocated to other more preferred areas. Veterinary advisors may experience this as non-compliant with their advice. To explore the preferences of European Union (EU) organic dairy farmers for improved animal health management relative to other farm management areas an adaptive conjoint analysis (ACA) was performed. A total of 215 farmers participated originating from organic dairy farms in France (n = 70), Germany (n = 60), Spain (n = 28) and Sweden (n = 57). The management areas udder health and claw health represented animal health management whereas barn, calf and pasture management represented potential conflicting management areas. Results indicate that EU organic dairy farmers differ in their preferences for improved animal health management within the farming system. In general, improved calf management was the most preferred area and improved claw health management was found to be least preferred, the remaining areas were of intermediate interest. Cluster analyses on claw health measures and udder health measures resulted in respectively seven and nine distinct preference profiles. The results indicate a high degree of variation in farmers' preference, which cannot be explained by the typical herd characteristics. With the individual preferences revealed by ACA, a veterinary advisor can now find out whether his intended advice is directed at a favourable or unfavourable management area of the farmer. If the latter is the case the veterinarian should first create awareness of the problem to the farmer. Insights in individual farmers preferences will allow veterinary advisors to better understand why farmers were incompliant with their advice

  14. 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.

  15. Accumulation and health risk of heavy metals in vegetables from harmless and organic vegetable production systems of China.

    Science.gov (United States)

    Chen, Yong; Hu, Wenyou; Huang, Biao; Weindorf, David C; Rajan, Nithya; Liu, Xiaoxiao; Niedermann, Silvana

    2013-12-01

    Heavy metal accumulation in vegetables is a growing concern for public health. Limited studies have elucidated the heavy metal accumulation characteristics and health risk of different vegetables produced in different facilities such as greenhouses and open-air fields and under different management modes such as harmless and organic. Given the concern over the aforementioned factors related to heavy metal accumulation, this study selected four typical greenhouse vegetable production bases, short-term harmless greenhouse vegetable base (SHGVB), middle-term harmless greenhouse vegetable base (MHGVB), long-term harmless greenhouse vegetable base (LHGVB), and organic greenhouse vegetable base (OGVB), in Nanjing City, China to study heavy metal accumulation in different vegetables and their associated health risks. Results showed that soils and vegetables from SHGVB and OGVB apparently accumulated fewer certain heavy metals than those from other bases, probably due to fewer planting years and special management, respectively. Greenhouse conditions significantly increased certain soil heavy metal concentrations relative to open-air conditions. However, greenhouse conditions did not significantly increase concentrations of As, Cd, Cu, Hg, and Zn in leaf vegetables. In fact, under greenhouse conditions, Pb accumulation was effectively reduced. The main source of soil heavy metals was the application of large amounts of low-grade fertilizer. There was larger health risk for producers' children to consume vegetables from the three harmless vegetable bases than those of residents' children. The hazard index (HI) over a large area exceeded 1 for these two kinds of children in the MHGVB and LHGVB. There was also a slight risk in the SHGVB for producers' children solely. However, the HI of the whole area of the OGVB for two kinds of children was below 1, suggesting low risk of heavy metal exposure through the food chain. Notably, the contribution rate of Cu and Zn to the HI were

  16. 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.

  17. 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.

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

    NARCIS (Netherlands)

    B.A.C. Bronkhorst (Babette); L.G. Tummers (Lars); A.J. Steijn (Bram); D. Vijverberg (Dominique)

    2014-01-01

    markdownabstract__Abstract__ Background: 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

  20. Functional interactivity in social media: an examination of Chinese health care organizations' microblog profiles.

    Science.gov (United States)

    Jiang, Shaohai

    2017-09-08

    Social media hold enormous potentials as a communication tool for health care due to its interactive nature. However, prior research mainly focused on contingency interactivity of social media, by examining messages sent from health care organizations to audiences, while little is known about functional interactivity, which refers to social media's presence of functions for facilitating communication between users and its interface. That is, how health care organizations use interactive features on social media to communicate with the public. Thus, with a general basis of the functional interactivity framework proposed by Waters et al. (Engaging stakeholders through social networking: how nonprofit organizations are using Facebook. Pub Relat Rev 2009;35:102-106), the current study investigated three aspects of functional interactivity in microblogging, and its subsequent effects. Specifically, this study analyzed 500 Chinese hospitals' profiles on Sina Weibo, the most popular microblogging platform in China. The results showed that the most common functional interactivity feature was organization disclosure, followed by information dissemination, and audience involvement. These interactive features all positively predicted the number of followers. Also, Chinese private hospitals scored significantly higher than public hospitals to use interactive features offered by social media. The findings of this study provide important implications for health care organizations to understand new communicative functions available on social media, incorporate more functions into their profiles and thus provide audiences with greater opportunity to interact with them via social media. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  1. 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.

  2. 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.

  3. The evolution of human rights in World Health Organization policy and the future of human rights through global health governance.

    Science.gov (United States)

    Meier, B M; Onzivu, W

    2014-02-01

    The World Health Organization (WHO) was intended to serve at the forefront of efforts to realize human rights to advance global health, and yet this promise of a rights-based approach to health has long been threatened by political constraints in international relations, organizational resistance to legal discourses, and medical ambivalence toward human rights. Through legal research on international treaty obligations, historical research in the WHO organizational archives, and interview research with global health stakeholders, this research examines WHO's contributions to (and, in many cases, negligence of) the rights-based approach to health. Based upon such research, this article analyzes the evolving role of WHO in the development and implementation of human rights for global health, reviews the current state of human rights leadership in the WHO Secretariat, and looks to future institutions to reclaim the mantle of human rights as a normative framework for global health governance. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  4. 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.

  5. 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.

  6. Provider and Staff Perceptions and Experiences Implementing Behavioral Health Integration in Six Low-Income Health Care Organizations.

    Science.gov (United States)

    Farb, Heather; Sacca, Katie; Variano, Margaret; Gentry, Lisa; Relle, Meagan; Bertrand, Jane

    2018-01-01

    Behavioral health integration (BHI) is a proven, effective practice for addressing the joint behavioral health and medical health needs of vulnerable populations. As part of the New Orleans Charitable Health Fund (NOCHF) program, this study addressed a gap in literature to better understand factors that impact the implementation of BHI by analyzing perceptions and practices among staff at integrating organizations. Using a mixed-method design, quantitative results from the Levels of Integration Measure (LIM), a survey tool for assessing staff perceptions of BHI in primary care settings (n=86), were analyzed alongside qualitative results from in-depth interviews with staff (n=27). Findings highlighted the roles of strong leadership, training, and process changes on staff collaboration, relationships, and commitment to BHI. This study demonstrates the usefulness of the LIM in conjunction with in-depth interviews as an assessment tool for understanding perceptions and organizational readiness for BHI implementation.

  7. 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...

  8. Who's in charge here anyway? Managing the management split in mental health organizations.

    Science.gov (United States)

    Eilenberg, J; Townsend, E J; Oudens, E

    2000-05-01

    Most mental health organizations are run by chief executive officers (CEOs) who are not physicians, with medical directors reporting to the CEOs. In this article the historical and organizational origins of this arrangement are reviewed. The well known disadvantages of shared management are discussed, as are the less obvious advantages. Through case vignettes the authors illustrate how bifurcated leadership can promote productive and creative administrative decisions. Guidelines are offered for strengthening collaborations between non-medical and medical mental health program directors.

  9. Asian Americans: Diabetes Prevalence Across U.S. and World Health Organization Weight Classifications

    OpenAIRE

    Oza-Frank, Reena; Ali, Mohammed K.; Vaccarino, Viola; Narayan, K.M. Venkat

    2009-01-01

    OBJECTIVE To compare diabetes prevalence among Asian Americans by World Health Organization and U.S. BMI classifications. RESEARCH DESIGN AND METHODS Data on Asian American adults (n = 7,414) from the National Health Interview Survey for 1997–2005 were analyzed. Diabetes prevalence was estimated across weight and ethnic group strata. RESULTS Regardless of BMI classification, Asian Indians and Filipinos had the highest prevalence of overweight (34–47 and 35–47%, respectively, compared with 20–...

  10. 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.

  11. Alternative dispute resolution: methods to address workplace conflict in health services organizations.

    Science.gov (United States)

    DeSouza, J R

    1998-01-01

    As healthcare organizations become increasingly complex, healthcare administrators and human resource managers face the cost and challenges of employment-related disputes. Litigation and legal costs associated with employment disputes are escalating at a significant rate. Additionally, litigation procedures are drawn out and damage the employer-employee relationship. Alternative dispute resolution (ADR) programs such as mediation and arbitration alleviate the burden of litigation and preserve positive employment relationships between the organization and its employees. A proposed ADR program is presented is a guideline for health services organizations considering the adoption of such programs.

  12. Internal marketing within a health care organization: developing an implementation plan.

    Science.gov (United States)

    Hallums, A

    1994-05-01

    This paper discusses how the concept of internal marketing can be applied within a health care organization. In order to achieve a market orientation an organization must identify the needs and wants of its customers and how these may change in the future. In order to achieve this, internal marketing is a necessary step to the implementation of the organizations marketing strategy. An outline plan for the introduction of an internal marketing programme within an acute hospital trust is proposed. The plan identifies those individuals and departments who should be involved in the planning and implementation of the programme. The benefits of internal marketing to the Trust are also considered.

  13. Health spending, macroeconomics and fiscal space in countries of the World Health Organization South-East Asia Region.

    Science.gov (United States)

    Gupta, Indrani; Mondal, Swadhin

    2014-01-01

    The paper examines the issues around mobilization of resources for the 11 countries of the South-East Asia Region of the World Health Organization (WHO), by analysing their macroeconomic situation, health spending, fiscal space and other determinants of health. With the exception of a few, most of these countries have made fair progress on their own Millennium Development Goal (MDG) targets of maternal mortality ratio and mortality rate in children aged under 5 years. However, the achieved targets have been very modest - with the exception of Thailand and Sri Lanka - indicating the continued need for additional efforts to improve these indicators. The paper discusses the need for investment, by looking at evidence on economic growth, the availability of fiscal space, and improvements in "macroeconomic-plus" factors like poverty, female literacy, governance and efficiency of the health sector. The analysis indicates that, overall, the countries of the WHO South-East Asia Region are collectively in a position to make the transition from low public spending to moderate or even high health spending, which is required, in turn, for transition from lowcoverage-high out-of-pocket spending (OOPS) to highcoverage-low OOPS. However, explicit prioritization for health within the overall government budget for low spenders would require political will and champions who can argue the case of the health sector. Additional innovative avenues of raising resources, such as earmarked taxes or a health levy can be considered in countries with good macroeconomic fundamentals. With the exception of Thailand, this is applicable for all the countries of the region. However, countries with adverse macroeconomic-plus factors, as well as inefficient health systems, need to be alert to the possibility of overinvesting - and thereby wasting - resources for modest health gains, making the challenge of increasing health sector spending alongside competing demands for spending on other areas of

  14. Evaluation of the organization and financing of the Danish health care system.

    Science.gov (United States)

    Janssen, Richard

    2002-02-01

    The organization and financing of the Danish health care system was evaluated within a framework of a SWOT analysis (analysis of strengths, weaknesses, opportunities and threats) by a panel of five members with a background in health economics. The evaluation was based on the reading of an extensive range of documents and literature on the Danish health care system, and a 1-week visit to health care authorities, providers and key persons. The present paper describes the main findings of one of the panel members. A quality assessment approach is combined with the principles of a SWOT analysis to assess the main features of the Danish health care system. In addition, a public health perspective has been used in judging the coherence of the subsystems of the health systems. It is concluded that the macro-efficiency of the health care system could be increased by improving the cooperation between the subsystems. The relatively high mortality rates suggest that greater input into health education programs could significantly improve the health status of the Danish population. Finally, it is suggested that the steering power of the public board be strengthened by transferring ownership of health care institutions to other hands (privatization).

  15. Behavioral Health and Health Care Reform Models: Patient-Centered Medical Home, Health Home, and Accountable Care Organization

    OpenAIRE

    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 H...

  16. 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.

  17. 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.

  18. 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.

  19. 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

  20. Animal health organizations: roles to mitigate the impact of ecologic change on animal health in the tropics.

    Science.gov (United States)

    Acord, Bobby R; Walton, Thomas E

    2004-10-01

    Production of livestock across North and South America is extensive. The opportunities for production, commerce, and thriving economies related to animal agriculture are balanced against the devastating threats of disease. Commitment by livestock and poultry producers in exporting countries to production methods, herd health management, and biosecurity in their operations must be coupled with an animal health and marketing infrastructure that allows the industries to thrive and offers assurances to trading partners that their livestock industries will not be jeopardized. National and international animal health organizations play a key role in providing this infrastructure to the industries that they serve. The incentive for the successful World agricultural production economies to provide direction and support for improving animal health and conveying principles for competitive and safe production to lesser developed nations is the assurance that the expanding economies of these nations offer an eager and hungry market for the products of the other industries of an export-dependent economy. The World Trade Organization (WTO) was established after the Uruguay Round of the General Agreement on Tariffs and Trade (GATT). The WTO provides the permanent international multilateral institutional framework for implementing dispute resolution agreements and the agreement on the application of sanitary and phytosanitary (SPS) measures. The SPS agreements allow for the protection of animal and plant health.

  1. Information and communication technology: students' health education in 1st- to 6th-grade South Korea elementary schools.

    Science.gov (United States)

    Lee, Eunjoo; Park, Hyejin; Whyte, James; Jeong, Eunhoe

    2013-09-01

    The purposes of this study were to (1) identify school nurses' awareness of information and communication technology (ICT) use in students' health education and (2) explore the barriers or reasons for the adoption of ICT in school nursing practice, while (3) presenting strategies to speed ICT diffusion and dissemination into practice. For data collection, 209 primary school nurses in K province of Korea were selected and e-mailed the questionnaires. Collected data were analyzed as frequency, percentages, and chi-square tests. The major reasons to adopt ICT were increasing school nurses' confidence in providing health education and improving teaching methods using diverse multimedia. The major barriers to utilization of ICT were lack of time for preparation of educational materials, lack of software availability, and lack of computer skills of school nurses and students. Several strategies were suggested to speed the diffusion of ICT into students' health education, such as integrating a health education course into regular curriculum. It is important to identify barriers and reasons for adoption of ICT in school nursing. In addition, strategies should be emphasized that result in more rapid diffusion of these technologies in school nursing practice. © 2013, American School Health Association.

  2. Effect of graded inclusion of dietary soybean meal on nutrient digestibility, health, and metabolic indices of adult dogs.

    Science.gov (United States)

    Menniti, M F; Davenport, G M; Shoveller, A K; Cant, J P; Osborne, V R

    2014-05-01

    Two studies were conducted using adult dogs to evaluate the effect of increasing the inclusion of soybean meal (SBM) in an adult dog food on body composition, hematological and biochemical blood analyses, and total tract nutrient digestibility. Nutritionally complete and balanced diets were formulated with commercial-grade SBM (48% CP) to replace 0, 10, 20, or 30% of the protein provided by dried chicken protein resulting in final SBM inclusion of 0, 6.0, 11.5, and 17.0% (as-fed basis), respectively. In study 1, diets were fed during a 24-wk feeding trial using 36 female (spayed), adult hounds to evaluate food intake, BW, body composition, and blood measurements. There were no diet-related differences in food intake or BW. Body composition responded in a quadratic manner to increased dietary SBM inclusion with the percentage (%) of lean mass responding positively (P dogs. Serum concentrations of C-reactive protein and IGF-1 were similar among diets. In study 2, diets were evaluated in a digestibility study using 12 adult dogs in a 4 × 4 Latin square design. Increased SBM inclusion was associated with linear increases in the digestibility of CP (P dogs.

  3. Comprehensive, Integrative Genomic Analysis of Diffuse Lower-Grade Gliomas.

    Science.gov (United States)

    Brat, Daniel J; Verhaak, Roel G W; Aldape, Kenneth D; Yung, W K Alfred; Salama, Sofie R; Cooper, Lee A D; Rheinbay, Esther; Miller, C Ryan; Vitucci, Mark; Morozova, Olena; Robertson, A Gordon; Noushmehr, Houtan; Laird, Peter W; Cherniack, Andrew D; Akbani, Rehan; Huse, Jason T; Ciriello, Giovanni; Poisson, Laila M; Barnholtz-Sloan, Jill S; Berger, Mitchel S; Brennan, Cameron; Colen, Rivka R; Colman, Howard; Flanders, Adam E; Giannini, Caterina; Grifford, Mia; Iavarone, Antonio; Jain, Rajan; Joseph, Isaac; Kim, Jaegil; Kasaian, Katayoon; Mikkelsen, Tom; Murray, Bradley A; O'Neill, Brian Patrick; Pachter, Lior; Parsons, Donald W; Sougnez, Carrie; Sulman, Erik P; Vandenberg, Scott R; Van Meir, Erwin G; von Deimling, Andreas; Zhang, Hailei; Crain, Daniel; Lau, Kevin; Mallery, David; Morris, Scott; Paulauskis, Joseph; Penny, Robert; Shelton, Troy; Sherman, Mark; Yena, Peggy; Black, Aaron; Bowen, Jay; Dicostanzo, Katie; Gastier-Foster, Julie; Leraas, Kristen M; Lichtenberg, Tara M; Pierson, Christopher R; Ramirez, Nilsa C; Taylor, Cynthia; Weaver, Stephanie; Wise, Lisa; Zmuda, Erik; Davidsen, Tanja; Demchok, John A; Eley, Greg; Ferguson, Martin L; Hutter, Carolyn M; Mills Shaw, Kenna R; Ozenberger, Bradley A; Sheth, Margi; Sofia, Heidi J; Tarnuzzer, Roy; Wang, Zhining; Yang, Liming; Zenklusen, Jean Claude; Ayala, Brenda; Baboud, Julien; Chudamani, Sudha; Jensen, Mark A; Liu, Jia; Pihl, Todd; Raman, Rohini; Wan, Yunhu; Wu, Ye; Ally, Adrian; Auman, J Todd; Balasundaram, Miruna; Balu, Saianand; Baylin, Stephen B; Beroukhim, Rameen; Bootwalla, Moiz S; Bowlby, Reanne; Bristow, Christopher A; Brooks, Denise; Butterfield, Yaron; Carlsen, Rebecca; Carter, Scott; Chin, Lynda; Chu, Andy; Chuah, Eric; Cibulskis, Kristian; Clarke, Amanda; Coetzee, Simon G; Dhalla, Noreen; Fennell, Tim; Fisher, Sheila; Gabriel, Stacey; Getz, Gad; Gibbs, Richard; Guin, Ranabir; Hadjipanayis, Angela; Hayes, D Neil; Hinoue, Toshinori; Hoadley, Katherine; Holt, Robert A; Hoyle, Alan P; Jefferys, Stuart R; Jones, Steven; Jones, Corbin D; Kucherlapati, Raju; Lai, Phillip H; Lander, Eric; Lee, Semin; Lichtenstein, Lee; Ma, Yussanne; Maglinte, Dennis T; Mahadeshwar, Harshad S; Marra, Marco A; Mayo, Michael; Meng, Shaowu; Meyerson, Matthew L; Mieczkowski, Piotr A; Moore, Richard A; Mose, Lisle E; Mungall, Andrew J; Pantazi, Angeliki; Parfenov, Michael; Park, Peter J; Parker, Joel S; Perou, Charles M; Protopopov, Alexei; Ren, Xiaojia; Roach, Jeffrey; Sabedot, Thaís S; Schein, Jacqueline; Schumacher, Steven E; Seidman, Jonathan G; Seth, Sahil; Shen, Hui; Simons, Janae V; Sipahimalani, Payal; Soloway, Matthew G; Song, Xingzhi; Sun, Huandong; Tabak, Barbara; Tam, Angela; Tan, Donghui; Tang, Jiabin; Thiessen, Nina; Triche, Timothy; Van Den Berg, David J; Veluvolu, Umadevi; Waring, Scot; Weisenberger, Daniel J; Wilkerson, Matthew D; Wong, Tina; Wu, Junyuan; Xi, Liu; Xu, Andrew W; Yang, Lixing; Zack, Travis I; Zhang, Jianhua; Aksoy, B Arman; Arachchi, Harindra; Benz, Chris; Bernard, Brady; Carlin, Daniel; Cho, Juok; DiCara, Daniel; Frazer, Scott; Fuller, Gregory N; Gao, JianJiong; Gehlenborg, Nils; Haussler, David; Heiman, David I; Iype, Lisa; Jacobsen, Anders; Ju, Zhenlin; Katzman, Sol; Kim, Hoon; Knijnenburg, Theo; Kreisberg, Richard Bailey; Lawrence, Michael S; Lee, William; Leinonen, Kalle; Lin, Pei; Ling, Shiyun; Liu, Wenbin; Liu, Yingchun; Liu, Yuexin; Lu, Yiling; Mills, Gordon; Ng, Sam; Noble, Michael S; Paull, Evan; Rao, Arvind; Reynolds, Sheila; Saksena, Gordon; Sanborn, Zack; Sander, Chris; Schultz, Nikolaus; Senbabaoglu, Yasin; Shen, Ronglai; Shmulevich, Ilya; Sinha, Rileen; Stuart, Josh; Sumer, S Onur; Sun, Yichao; Tasman, Natalie; Taylor, Barry S; Voet, Doug; Weinhold, Nils; Weinstein, John N; Yang, Da; Yoshihara, Kosuke; Zheng, Siyuan; Zhang, Wei; Zou, Lihua; Abel, Ty; Sadeghi, Sara; Cohen, Mark L; Eschbacher, Jenny; Hattab, Eyas M; Raghunathan, Aditya; Schniederjan, Matthew J; Aziz, Dina; Barnett, Gene; Barrett, Wendi; Bigner, Darell D; Boice, Lori; Brewer, Cathy; Calatozzolo, Chiara; Campos, Benito; Carlotti, Carlos Gilberto; Chan, Timothy A; Cuppini, Lucia; Curley, Erin; Cuzzubbo, Stefania; Devine, Karen; DiMeco, Francesco; Duell, Rebecca; Elder, J Bradley; Fehrenbach, Ashley; Finocchiaro, Gaetano; Friedman, William; Fulop, Jordonna; Gardner, Johanna; Hermes, Beth; Herold-Mende, Christel; Jungk, Christine; Kendler, Ady; Lehman, Norman L; Lipp, Eric; Liu, Ouida; Mandt, Randy; McGraw, Mary; Mclendon, Roger; McPherson, Christopher; Neder, Luciano; Nguyen, Phuong; Noss, Ardene; Nunziata, Raffaele; Ostrom, Quinn T; Palmer, Cheryl; Perin, Alessandro; Pollo, Bianca; Potapov, Alexander; Potapova, Olga; Rathmell, W Kimryn; Rotin, Daniil; Scarpace, Lisa; Schilero, Cathy; Senecal, Kelly; Shimmel, Kristen; Shurkhay, Vsevolod; Sifri, Suzanne; Singh, Rosy; Sloan, Andrew E; Smolenski, Kathy; Staugaitis, Susan M; Steele, Ruth; Thorne, Leigh; Tirapelli, Daniela P C; Unterberg, Andreas; Vallurupalli, Mahitha; Wang, Yun; Warnick, Ronald; Williams, Felicia; Wolinsky, Yingli; Bell, Sue; Rosenberg, Mara; Stewart, Chip; Huang, Franklin; Grimsby, Jonna L; Radenbaugh, Amie J; Zhang, Jianan

    2015-06-25

    Diffuse low-grade and intermediate-grade gliomas (which together make up the lower-grade gliomas, World Health Organization grades II and III) have highly variable clinical behavior that is not adequately predicted on the basis of histologic class. Some are indolent; others quickly progress to glioblastoma. The uncertainty is compounded by interobserver variability in histologic diagnosis. Mutations in IDH, TP53, and ATRX and codeletion of chromosome arms 1p and 19q (1p/19q codeletion) have been implicated as clinically relevant markers of lower-grade gliomas. We performed genomewide analyses of 293 lower-grade gliomas from adults, incorporating exome sequence, DNA copy number, DNA methylation, messenger RNA expression, microRNA expression, and targeted protein expression. These data were integrated and tested for correlation with clinical outcomes. Unsupervised clustering of mutations and data from RNA, DNA-copy-number, and DNA-methylation platforms uncovered concordant classification of three robust, nonoverlapping, prognostically significant subtypes of lower-grade glioma that were captured more accurately by IDH, 1p/19q, and TP53 status than by histologic class. Patients who had lower-grade gliomas with an IDH mutation and 1p/19q codeletion had the most favorable clinical outcomes. Their gliomas harbored mutations in CIC, FUBP1, NOTCH1, and the TERT promoter. Nearly all lower-grade gliomas with IDH mutations and no 1p/19q codeletion had mutations in TP53 (94%) and ATRX inactivation (86%). The large majority of lower-grade gliomas without an IDH mutation had genomic aberrations and clinical behavior strikingly similar to those found in primary glioblastoma. The integration of genomewide data from multiple platforms delineated three molecular classes of lower-grade gliomas that were more concordant with IDH, 1p/19q, and TP53 status than with histologic class. Lower-grade gliomas with an IDH mutation either had 1p/19q codeletion or carried a TP53 mutation. Most

  4. The association between mental health problems and inflammatory conditions across gender and immigrant status: a population-based cross-sectional study among 10th-grade students.

    Science.gov (United States)

    Lien, Lars

    2008-06-01

    The aim of this study was to describe the prevalence of and investigate the association between mental health problems, asthma, allergy and eczema in Norwegian and immigrant youths. A cross-sectional study was performed of all 10th-grade students in Oslo, Norway, in two school years; 1999-2000 and 2000-2001. Of the 8316 eligible students, 7345 (88.3%) participated. Internalized mental problems were measured using the Hopkins Symptom Check List 10-version, and two subscales of the Strength and Difficulties Questionnaire were used to study externalizing mental health problems. All questions are based on self-report, and 25% of the sample had an immigrant background. Immigrant boys had higher scores on internalizing problems than Norwegian boys. First-generation immigrants reported less asthma and eczema than Norwegians. The strongest association between mental health problems and inflammatory conditions was for allergy and internalizing problems for boys (odds ratio (OR)=2.5 for immigrants and OR=1.8 for Norwegians). For girls, it was allergy in Norwegians (OR=1.6) and asthma for immigrants (OR=2.2). For externalizing problems, the association was strongest for asthma in boys and eczema in girls. Immigrant boys had stronger associations between number of inflammatory conditions and internalizing mental health problems than Norwegians (OR=3.2 vs. OR=2.4). Among girls, the figures were 1.7 for Norwegians and 1.8 for immigrants. There is a strong association between number of inflammatory conditions and internalizing mental health problems, especially among boys with an immigrant background. The association with externalizing mental health problems was less prominent.

  5. Social media use by community-based organizations conducting health promotion: a content analysis.

    Science.gov (United States)

    Ramanadhan, Shoba; Mendez, Samuel R; Rao, Megan; Viswanath, Kasisomayajula

    2013-12-05

    Community-based organizations (CBOs) are critical channels for the delivery of health promotion programs. Much of their influence comes from the relationships they have with community members and other key stakeholders and they may be able to harness the power of social media tools to develop and maintain these relationships. There are limited data describing if and how CBOs are using social media. This study assesses the extent to which CBOs engaged in health promotion use popular social media channels, the types of content typically shared, and the extent to which the interactive aspects of social media tools are utilized. We assessed the social media presence and patterns of usage of CBOs engaged in health promotion in Boston, Lawrence, and Worcester, Massachusetts. We coded content on three popular channels: Facebook, Twitter, and YouTube. We used content analysis techniques to quantitatively summarize posts, tweets, and videos on these channels, respectively. For each organization, we coded all content put forth by the CBO on the three channels in a 30-day window. Two coders were trained and conducted the coding. Data were collected between November 2011 and January 2012. A total of 166 organizations were included in our census. We found that 42% of organizations used at least one of the channels of interest. Across the three channels, organization promotion was the most common theme for content (66% of posts, 63% of tweets, and 93% of videos included this content). Most organizations updated Facebook and Twitter content at rates close to recommended frequencies. We found limited interaction/engagement with audience members. Much of the use of social media tools appeared to be uni-directional, a flow of information from the organization to the audience. By better leveraging opportunities for interaction and user engagement, these organizations can reap greater benefits from the non-trivial investment required to use social media well. Future research should

  6. 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.

  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. [[The Devil in the Details: Women's Right to Abortion and Health Organization].

    Science.gov (United States)

    Pioggia, Alessandra

    Often a woman's right to terminate a pregnancy for health reasons is considered as achieved by simply performing the intervention. But today isn't in doubt that the effective protection of health requires that health organizations carrying out performance which also affect other aspects: taking charge of women, information on services, respect for the dignity and autonomy of women, etc ... You could say that these are details, compared to the final performance. But, as we know, often the devil is in the details.

  9. Organized Sport Participation Is Associated with Higher Levels of Overall Health-Related Physical Activity in Children (CHAMPS Study-DK).

    Science.gov (United States)

    Hebert, Jeffrey J; Møller, Niels C; Andersen, Lars B; Wedderkopp, Niels

    2015-01-01

    Many children fail to meet international guideline recommendations for health-related activity (≥60 minutes/day of moderate-to-vigorous physical activity [MVPA]), and intervention studies to date have reported negligible effects. Explore the associations of organized leisure-time sport participation with overall physical activity levels and health-related physical activity guideline concordance. This prospective cohort study was nested in the Childhood Health, Activity, and Motor Performance School Study Denmark. Study participants were a representative sample of 1124 primary school students. Organized leisure-time sport participation was reported via text messaging and physical activity was objectively measured over seven days with accelerometry. Associations between sport participation and physical activity level were explored with multilevel mixed-effects regression models and reported with beta coefficients (b) and adjusted odds ratios (aOR). Participants were 53% female, with mean(SD) age = 8.4(1.4) years. Boys were more active than girls (p<0.001), and physical activity levels and guideline concordance decreased with age (p<0.001). Soccer participation at any frequency was associated with greater overall MVPA (b[95% CI] = 0.66[0.20,1.13] to 2.44[1.44,3.44]). Depending on participation frequency, this equates to 5-20 minutes more MVPA on the average day and 3 to 15 fold increased odds of achieving recommended levels of health-related physical activity (aOR[95%CI] = 3.04[1.49,6.19] to 14.49[1.97,106.56]). Similar associations were identified among children playing handball at least twice per week. Relationships with other sports (gymnastics, basketball, volleyball) were inconsistent. Many children, particularly girls and those in higher grade levels do not adhere to health-related physical activity recommendations. Organized leisure-time sport participation may be a viable strategy to increase overall health-related physical activity levels and international

  10. Information and Communication Technology: Students' Health Education in 1st- to 6th-Grade South Korea Elementary Schools

    Science.gov (United States)

    Lee, Eunjoo; Park, Hyejin; Whyte, James; Jeong, Eunhoe

    2013-01-01

    Background: The purposes of this study were to (1) identify school nurses' awareness of information and communication technology (ICT) use in students' health education and (2) explore the barriers or reasons for the adoption of ICT in school nursing practice, while (3) presenting strategies to speed ICT diffusion and dissemination into practice.…

  11. Positioning radiation safety in occupational safety and health programme in an organization

    International Nuclear Information System (INIS)

    Abed Bin Onn

    2000-01-01

    The Atomic Energy Licensing Act 1984, which is under purview of the Ministry of Science, Technology and Environment, and Occupational Safety and Health Act, OSHA 1994, under Ministry of Human Resources were discussed. RPO responsibilities were discussed in detailed. As the conclusion, organization which complies with the provisions of the AELA 1984 are well on the way to complying the requirements of OSHA 1994

  12. Methodological framework for World Health Organization estimates of the global burden of foodborne disease

    NARCIS (Netherlands)

    B. Devleesschauwer (Brecht); J.A. Haagsma (Juanita); F.J. Angulo (Frederick); D.C. Bellinger (David); D. Cole (Dana); D. Döpfer (Dörte); A. Fazil (Aamir); E.M. Fèvre (Eric); H.J. Gibb (Herman); T. Hald (Tine); M.D. Kirk (Martyn); R.J. Lake (Robin); C. Maertens De Noordhout (Charline); C. Mathers (Colin); S.A. McDonald (Scott); S.M. Pires (Sara); N. Speybroeck (Niko); M.K. Thomas (Kate); D. Torgerson; F. Wu (Felicia); A.H. Havelaar (Arie); N. Praet (Nicolas)

    2015-01-01

    textabstractBackground: The Foodborne Disease Burden Epidemiology Reference Group (FERG) was established in 2007 by the World Health Organization to estimate the global burden of foodborne diseases (FBDs). This paper describes the methodological framework developed by FERG's Computational Task Force

  13. The 2016 revision of the World Health Organization classification of lymphoid neoplasms | Center for Cancer Research

    Science.gov (United States)

    A revision of the nearly 8-year-old World Health Organization classification of the lymphoid neoplasms and the accompanying monograph is being published. It reflects a consensus among hematopathologists, geneticists, and clinicians regarding both updates to current entities as well as the addition of a limited number of new provisional entities.

  14. Vision of Dutch organic dairy farmers on animal health and welfare

    NARCIS (Netherlands)

    Smolders, E.A.A.; Bestman, M.W.P.; Eijck, I.A.J.M.

    2009-01-01

    Dutch organic dairy farmers expressed their opinions on animal health and welfare in order to be able to communicate it internally (within the dairy sector) and externally (to consumers). A healthy animal in their opinion is free of physical and psychological discomfort, survives in a herd, takes

  15. When children play, they feel better : organized activity participation and health in adolescents

    NARCIS (Netherlands)

    Badura, Petr; Geckova, Andrea Madarasova; Sigmundova, Dagmar; van Dijk, Jitse P.; Reijneveld, Sijmen A.

    2015-01-01

    Background: Participation in organized leisure-time activities (OLTA) has been linked to healthy youth development. This study aimed to assess whether participation in OLTA is associated with both physical and mental health in adolescents, and whether this association differs by pattern of activity

  16. Health-related quality of life in pediatric patients with functional and organic gastrointestinal diseases

    Science.gov (United States)

    The objective of our study was to compare health-related quality of life (HRQOL) in pediatric patients with functional gastrointestinal disorders (FGIDs) and organic gastrointestinal (GI) diseases with an age-, sex-, and race/ethnicity-matched healthy sample across GI diagnostic groups and with one ...

  17. 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.

  18. 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.

  19. Volatile compounds emission and health risk assessment during composting of organic fraction of municipal solid waste

    DEFF Research Database (Denmark)

    Mustafa, Muhammad Farooq; Liu, Yanjun; Duan, Zhenhan

    2017-01-01

    Degradation of mechanically sorted organic fraction (MSOF) of municipal solid waste in composting facilities is among the major contributors of volatile compounds (VCs) generation and emission, causes nuisance problems and health risks on site as well as in the vicinages. The aim of current study...

  20. Construction of the World Health Organization child growth standards: Selection of methods for attained growth curves

    NARCIS (Netherlands)

    Borghi, E.; Onis, M. de; Garza, C.; Broeck, J. van den; Frongillo, E.A.; Grummer-Strawn, L.; Buuren, S. van; Pan, H.; Molinari, L.; Martorell, R.; Onyango, A.W.; Martines, J.C.; Pinol, A.; Siyam, A.; Victoria, C.G.; Bhan, M.K.; Araújo, C.L.; Lartey, A.; Owusu, W.B.; Bhandari, N.; Norum, K.R.; Bjoerneboe, G.-E.Aa.; Mohamed, A.J.; Dewey, K.G.; Belbase, K.; Chumlea, C.; Cole, T.; Shrimpton, R.; Albernaz, E.; Tomasi, E.; Cássia Fossati da Silveira, R. de; Nader, G.; Sagoe-Moses, I.; Gomez, V.; Sagoe-Moses, C.; Taneja, S.; Rongsen, T.; Chetia, J.; Sharma, P.; Bahl, R.; Baerug, A.; Tufte, E.; Alasfoor, D.; Prakash, N.S.; Mabry, R.M.; Al Rajab, H.J.; Helmi, S.A.; Nommsen-Rivers, L.A.; Cohen, R.J.; Heinig, M.J.

    2006-01-01

    The World Health Organization (WHO), in collaboration with a number of research institutions worldwide, is developing new child growth standards. As part of a broad consultative process for selecting the best statistical methods, WHO convened a group of statisticians and child growth experts to

  1. Soil health: a comparison between organically and conventionally managed arable soils in the Netherlands

    NARCIS (Netherlands)

    Diepeningen, van A.D.; Blok, W.J.; Korthals, G.W.; Bruggen, van A.H.C.; Ariena, H.C.

    2005-01-01

    A comparative study of 13 organic and 13 neighboring conventional arable farming systems was conducted in the Netherlands to determine the effect of management practices on chemical and biological soil properties and soil health. Soils were analyzed using a polyphasic approach combining traditional

  2. 76 FR 7853 - Patient Safety Organizations: Voluntary Delisting From HealthDataPSO

    Science.gov (United States)

    2011-02-11

    ... Medical Error Management, LLC, of its status as a Patient Safety Organization (PSO). The Patient Safety and Quality Improvement Act of 2005 (Patient Safety Act), Public Law 109-41, 42 U.S.C. 299b-21--b-26... DEPARTMENT OF HEALTH AND HUMAN SERVICES Agency for Healthcare Research and Quality Patient Safety...

  3. How should health service organizations respond to diversity? A content analysis of six approaches

    NARCIS (Netherlands)

    Seeleman, C.; Essink-Bot, M.-L.; Stronks, K.; Ingleby, D.

    2015-01-01

    Background Health care organizations need to be responsive to the needs of increasingly diverse patient populations. We compared the contents of six publicly available approaches to organizational responsiveness to diversity. The central questions addressed in this paper are: what are the most

  4. An overview of Uganda's mental health care system: results from an assessment using the world health organization's assessment instrument for mental health systems (WHO-AIMS

    Directory of Open Access Journals (Sweden)

    Cooper Sara

    2010-01-01

    Full Text Available Abstract Background The Ugandan government recognizes mental health as a serious public health and development concern, and has of recent implemented a number of reforms aimed at strengthening the country's mental health system. The aim of this study was to provide a profile of the current mental health policy, legislation and services in Uganda. Methods A survey was conducted of public sector mental health policy and legislation, and service resources and utilisation in Uganda, in the year 2005, using the World Health Organization's Assessment Instrument for Mental Health Systems (WHO-AIMS Version 2.2. Results Uganda's draft mental health policy encompasses many positive reforms, including decentralization and integration of mental health services into Primary Health Care (PHC. The mental health legislation is however outdated and offensive. Services are still significantly underfunded (with only 1% of the health expenditure going to mental health, and skewed towards urban areas. Per 100,000 population, there were 1.83 beds in mental hospitals, 1.4 beds in community based psychiatric inpatient units, and 0.42 beds in forensic facilities. The total personnel working in mental health facilities were 310 (1.13 per 100,000 population. Only 0.8% of the medical doctors and 4% of the nurses had specialized in psychiatry. Conclusion Although there have been important developments in Uganda's mental health policy and services, there remains a number of shortcomings, especially in terms of resources and service delivery. There is an urgent need for more research on the current burden of mental disorders and the functioning of mental health programs and services in Uganda.

  5. No correlation between ultrasound placental grading at 31-34 weeks of gestation and a surrogate estimate of organ function at term obtained by stereological analysis.

    Science.gov (United States)

    Yin, T T; Loughna, P; Ong, S S; Padfield, J; Mayhew, T M

    2009-08-01

    We test the experimental hypothesis that early changes in the ultrasound appearance of the placenta reflect poor or reduced placental function. The sonographic (Grannum) grade of placental maturity was compared to placental function as expressed by the morphometric oxygen diffusive conductance of the villous membrane. Ultrasonography was used to assess the Grannum grade of 32 placentas at 31-34 weeks of gestation. Indications for the scans included a history of previous fetal abnormalities, previous fetal growth problems or suspicion of IUGR. Placentas were classified from grade 0 (most immature) to grade III (most mature). We did not exclude smokers or complicated pregnancies as we aimed to correlate the early appearance of mature placentas with placental function. After delivery, microscopical fields on formalin-fixed, trichrome-stained histological sections of each placenta were obtained by multistage systematic uniform random sampling. Using design-based stereological methods, the exchange surface areas of peripheral (terminal and intermediate) villi and their fetal capillaries and the arithmetic and harmonic mean thicknesses of the villous membrane (maternal surface of villous trophoblast to adluminal surface of vascular endothelium) were estimated. An index of the variability in thickness of this membrane, and an estimate of its oxygen diffusive conductance, were derived secondarily as were estimates of the mean diameters and total lengths of villi and fetal capillaries. Group comparisons were drawn using analysis of variance. We found no significant differences in placental volume or composition or in the dimensions or diffusive conductances of the villous membrane. Subsequent exclusion of smokers did not alter these main findings. Grannum grades at 31-34 weeks of gestation appear not to provide reliable predictors of the functional capacity of the term placenta as expressed by the surrogate measure, morphometric diffusive conductance.

  6. Implementing health information exchange for public health reporting: a comparison of decision and risk management of three regional health information organizations in New York state

    Science.gov (United States)

    Phillips, Andrew B; Wilson, Rosalind V; Kaushal, Rainu; Merrill, Jacqueline A

    2014-01-01

    Health information exchange (HIE) is a significant component of healthcare transformation strategies at both the state and national levels. HIE is expected to improve care coordination, and advance public health, but implementation is massively complex and involves significant risk. In New York, three regional health information organizations (RHIOs) implemented an HIE use case for public health reporting by demonstrating capability to deliver accurate responses to electronic queries via a set of services called the Universal Public Health Node. We investigated process and outcomes of the implementation with a comparative case study. Qualitative analysis was structured around a decision and risk matrix. Although each RHIO had a unique operational model, two common factors influenced risk management and implementation success: leadership capable of agile decision-making and commitment to a strong organizational vision. While all three RHIOs achieved certification for the public health reporting, only one has elected to deploy a production version. PMID:23975626

  7. Tobacco and oral health--the role of the world health organization

    DEFF Research Database (Denmark)

    Petersen, Poul Erik

    2003-01-01

    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......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...... 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...

  8. [Governance of primary health-care-based health-care organization].

    Science.gov (United States)

    Báscolo, Ernesto

    2010-01-01

    An analytical framework was developed for explaining the conditions for the effectiveness of different strategies promoting integrated primary health-care (PHC) service-based systems in Latin-America. Different modes of governance (clan, incentives and hierarchy) were characterised from a political economics viewpoint for representing alternative forms of regulation promoting innovation in health-service-providing organisations. The necessary conditions for guaranteeing the modes of governance's effectiveness are presented, as are their implications in terms of posts in play. The institutional construction of an integrated health system is interpreted as being a product of a social process in which different modes of governance are combined, operating with different ways of resolving normative aspects for regulating service provision (with the hierarchical mode), resource distribution (with the incentives mode) and on the social values legitimising such process (with the clan mode).

  9. Normal Health-Related Quality of Life and Ability to Work Twenty-nine Years After in Situ Arthrodesis for High-Grade Isthmic Spondylolisthesis.

    Science.gov (United States)

    Joelson, Anders; Hedlund, Rune; Frennered, Karin

    2014-06-18

    The purpose of this mixed prospective and retrospective case series was to evaluate the long-term health-related quality of life and physical disability after in situ arthrodesis for high-grade isthmic spondylolisthesis. Thirty-five of forty consecutive patients who had in situ spinal arthrodesis for high-grade isthmic spondylolisthesis at a mean age of fifteen years (range, nine to twenty-five years) completed validated questionnaires (Short Form-36 [SF-36], EuroQol-5 Dimensions [EQ-5D], Zung depression scale, Oswestry disability index [ODI], Million score, and back and leg pain visual analog scale [VAS]) and underwent physical examination twenty-nine years (range, twenty-three to thirty-five years) after surgery. The mean age at the time of follow-up was forty-three years (range, thirty-seven to fifty-one years). In the absence of a formal control group, the scores on the SF-36 and EQ-5D were compared with Swedish normative data. The proportion of patients at work was compared with an age-matched control group derived from official statistics of Sweden. The Million score at the long-term follow-up was compared with the corresponding results at the mid-term follow-up of the same patients at a mean age of twenty-two years. The scores on the SF-36 and EQ-5D were similar to the scores of the general Swedish population. The mean Zung depression scale score was 30 (range, 20 to 52), the mean ODI score was 10 (range, 0 to 34), the mean back pain VAS score was 13 (range, 0 to 72), and the mean leg pain VAS score was 9 (range, 0 to 60). The Million score averaged 28 (range, 0 to 109) and was slightly worsened compared with the score of 19 (range, 0 to 94) at the mid-term follow-up (p = 0.034). The proportion of patients at work was the same as that for the age-matched general Swedish population. Our study shows good outcomes in health-related quality of life, disability, pain, and ability to work at up to twenty-nine years after in situ lumbar spine arthrodesis for high-grade

  10. [Imaginary dimension and intersubjectivity in public health organizations: implications to managerial work and organizational change].

    Science.gov (United States)

    Azevedo, Creuza da Silva

    2010-06-01

    This paper deals with organization management in a new perspective, stressing the micro-social aspects and the role of individuals in the process of implementing change in public health organizations such as hospitals. Following the paths of French psychosociology, the article approaches the imaginary, intersubjective and collective dimensions of these organizations, highlighting the ways hospitals' directors and employees engage themselves in a struggle for power, affiliation and recognition. An essentially interactive and intersubjective activity, management is examined in the light of psychoanalysis's leadership function. It seems crucial to take into account the directors' potential structuring role in order to understand the organizational changing processes. Nevertheless, the mounting crisis in Rio de Janeiro public health services does not favor change and the building of personal bonds, but disruption, dismantle of institutional affiliations. In this scenario, the management structuring function and the director's social and psychological mediating role lose ground.

  11. A retrospective evaluation of the Perfecting Patient Care University training program for health care organizations.

    Science.gov (United States)

    Morganti, Kristy Gonzalez; Lovejoy, Susan; Beckjord, Ellen Burke; Haviland, Amelia M; Haas, Ann C; Farley, Donna O

    2014-01-01

    This study evaluated how the Perfecting Patient Care (PPC) University, a quality improvement (QI) training program for health care leaders and clinicians, affected the ability of organizations to improve the health care they provide. This training program teaches improvement methods based on Lean concepts and principles of the Toyota Production System and is offered in several formats. A retrospective evaluation was performed that gathered data on training, other process factors, and outcomes after staff completed the PPC training. A majority of respondents reported gaining QI competencies and cultural achievements from the training. Organizations had high average scores for the success measures of "outcomes improved" and "sustainable monitoring" but lower scores for diffusion of QI efforts. Total training dosage was significantly associated with the measures of QI success. This evaluation provides evidence that organizations gained the PPC competencies and cultural achievements and that training dosage is a driver of QI success.

  12. Impact of termogidroprocedure to the physical health and functional capacity of student's organism

    Directory of Open Access Journals (Sweden)

    Agoshkov V.V.

    2012-11-01

    Full Text Available The aspects of the use are considered athletic-health-improvement technologies of termogidrotrenings for the increase of functional possibilities and somatic health of students. 12 boys and 16 girls took part in research. Testing of physical development, functional trained, physical preparedness and somatic health of students is conducted. The health swimming was used in combination with the dosed contrasting shower. Also bath-house procedures with dousing cold water. The increase of level of general physical capacity of students is set. It is marked that the use of technology of termogidrotrenings is instrumental in the increase of level of adaptation possibilities of organism of students. The optimum variant of the use of technology is recommended: 32 planned employment after a physical culture with the health swimming; 16 additional bath-house procedures with dousing; 16 independent employments.

  13. Management of health and safety in the organization of worktime at the local level.

    Science.gov (United States)

    Jeppesen, H J; Bøggild, H

    1998-01-01

    This study examined the consideration of health and safety issues in the local process of organizing worktime within the framework of regulations. The study encompassed all 7 hospitals in one region of Denmark. Twenty-three semi-structured interviews were carried out with 2 representatives from the different parties involved (management, cooperation committees, health and safety committees from each hospital, and 2 local unions). Furthermore, a questionnaire was sent to all 114 wards with day and night duty. The response rate was 84%. Data were collected on alterations in worktime schedules, responsibilities, reasons for the present design of schedules, and use of inspection reports. The organization of worktime takes place in single wards without external interference and without guidelines other than the minimum standards set in regulations. At the ward level, management and employees were united in a mutual desire for flexibility, despite the fact that regulations were not always followed. No interaction was found in the management of health and safety factors between the parties concerned at different levels. The demands for flexibility in combination with the absence of guidelines and the missing dynamics between the parties involved imply that the handling of health and safety issues in the organization of worktime may be accidental and unsystematic. In order to consider the health and safety of night and shift workers within the framework of regulations, a clarification of responsibilities, operational levels, and cooperation is required between the parties concerned.

  14. Key Element Performance In Occupational Safety And Health Management System In Organization (A Literature

    Directory of Open Access Journals (Sweden)

    Agus Salim Nuzaihan Aras

    2016-01-01

    Full Text Available Setting an effective safety and health management system is crucial in order to reduce problem relating to accident and ill in management organizational. It is involve with multiple level of management and stakeholders who empower the organization to the management in handling the safety and health cases and issues in organizational. It is necessary to prepare a well knowledge about safety and health management systems and preparing the framework for setting a certain scale in measuring its performance in this area. The successful or failure of management does showing the capability of the organization in delivering the responsible to management levels [1]. The problem in safe work issues and practices cause by the management commitment and involvement that create improper safety program and procedures, and this crisis keep continuing till present [2]. This paper describes about key element of safety and health management system and measuring the performance in order to get an effective management system in organization that describes the process in achieving effectiveness in management. The literature review will be conducted through the data collection from research findings and defined the strong character of key element in which focusing on measuring performance. A guide on key element performance in occupational safety and health management system is specifically drawn to prepare for a future research.

  15. The 2014 International Society of Urological Pathology (ISUP) Consensus Conference on Gleason Grading of Prostatic Carcinoma: Definition of Grading Patterns and Proposal for a New Grading System.

    Science.gov (United States)

    Epstein, Jonathan I; Egevad, Lars; Amin, Mahul B; Delahunt, Brett; Srigley, John R; Humphrey, Peter A

    2016-02-01

    of 10, it implies that their prognosis is intermediate and contributes to their fear of having a more aggressive cancer. Also, in the literature and for therapeutic purposes, various scores have been incorrectly grouped together with the assumption that they have a similar prognosis. For example, many classification systems consider Gleason score 7 as a single score without distinguishing 3+4 versus 4+3, despite studies showing significantly worse prognosis for the latter. The basis for a new grading system was proposed in 2013 by one of the authors (J.I.E.) based on data from Johns Hopkins Hospital resulting in 5 prognostically distinct Grade Groups. This new system was validated in a multi-institutional study of over 20,000 radical prostatectomy specimens, over 16,000 needle biopsy specimens, and over 5,000 biopsies followed by radiation therapy. There was broad (90%) consensus for the adoption of this new prostate cancer Grading system in the 2014 consensus conference based on: (1) the new classification provided more accurate stratification of tumors than the current system; (2) the classification simplified the number of grading categories from Gleason scores 2 to 10, with even more permutations based on different pattern combinations, to Grade Groups 1 to 5; (3) the lowest grade is 1 not 6 as in Gleason, with the potential to reduce overtreatment of indolent cancer; and (4) the current modified Gleason grading, which forms the basis for the new grade groups, bears little resemblance to the original Gleason system. The new grades would, for the foreseeable future, be used in conjunction with the Gleason system [ie. Gleason score 3+3=6 (Grade Group 1)]. The new grading system and the terminology Grade Groups 1-5 have also been accepted by the World Health Organization for the 2016 edition of Pathology and Genetics: Tumours of the Urinary System and Male Genital Organs.

  16. 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

  17. Reducing health risk assigned to organic emissions from a chemical weapons incinerator.

    Science.gov (United States)

    Laman, David M; Weiler, B Douglas; Skeen, Rodney S

    2013-03-01

    Organic emissions from a chemical weapons incinerator have been characterized with an improved set of analytical methods to reduce the human health risk assigned to operations of the facility. A gas chromatography/mass selective detection method with substantially reduced detection limits has been used in conjunction with scanning electron microscopy/energy dispersive X-ray spectrometry and Fourier transform infrared microscopy to improve the speciation of semi-volatile and non-volatile organics emitted from the incinerator. The reduced detection limits have allowed a significant reduction in the assumed polycyclic aromatic hydrocarbon (PAH) and aminobiphenyl (ABP) emission rates used as inputs to the human health risk assessment for the incinerator. A mean factor of 17 decrease in assigned human health risk is realized for six common local exposure scenarios as a result of the reduced PAH and ABP detection limits.

  18. Work organization, health, and obesity in urban transit operators: A qualitative study.

    Science.gov (United States)

    Dobson, Marnie; Choi, BongKyoo; Schnall, Peter L

    2017-11-01

    Urban transit operators have high rates of obesity, hypertension, and other cardiovascular risk-factors compared to other occupations. There have been few qualitative studies exploring the interrelationships between the organization of transit work, stress, and health including obesity, from the perspective of operators. Five focus groups were conducted at five Divisions in a transit authority in Southern California and included 65 bus and rail operators. Operators reported a great deal of stress related to their work, including 1) time pressures and lack of recovery time; 2) long work shifts and overtime; 3) feeling unsafe when dealing with the public; 4) lack of respect from supervisors and management. Operators believed stressful working conditions negatively impacted their health and weight. This qualitative study yielded new as well as confirmatory data about stress and transit work organization, health, and weight in operators. This study will add to future survey research and interventions in this population. © 2017 Wiley Periodicals, Inc.

  19. 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.

  20. How Should Organizations Promote Equitable Distribution of Benefits from Technological Innovation in Health Care?

    Science.gov (United States)

    Nambisan, Satish; Nambisan, Priya

    2017-11-01

    Technological innovations typically benefit those who have good access to and an understanding of the underlying technologies. As such, technology-centered health care innovations are likely to preferentially benefit users of privileged socioeconomic backgrounds. Which policies and strategies should health care organizations adopt to promote equitable distribution of the benefits from technological innovations? In this essay, we draw on two important concepts-co-creation (the joint creation of value by multiple parties such as a company and its customers) and digitalization (the application of new digital technologies and the ensuing changes in sociotechnical structures and relationships)-and propose a set of policies and strategies that health care organizations could adopt to ensure that benefits from technological innovations are more equitably distributed among all target populations, including resource-poor communities and individuals. © 2017 American Medical Association. All Rights Reserved.

  1. Asylum seekers in Denmark--a study of health status and grade of traumatization of newly arrived asylum seekers.

    Science.gov (United States)

    Masmas, Tania Nicole; Møller, Eva; Buhmannr, Caecilie; Bunch, Vibeke; Jensen, Jean Hald; Hansen, Trine Nørregård; Jørgensen, Louise Møller; Kjaer, Claes; Mannstaedt, Maiken; Oxholm, Annemette; Skau, Jutta; Theilade, Lotte; Worm, Lise; Ekstrøm, Morten

    2008-01-01

    An unknown number of asylum seekers arriving in Denmark have been exposed to torture or have experienced other traumatising events in their country of origin. The health of traumatised asylum seekers, both physically and mentally, is affected upon arrival to Denmark, and time in asylum centres leads to further deterioration in health. One hundred forty-two (N=142) newly arrived asylum seekers were examined at Center Sandholm by Amnesty International Danish Medical Group from the 1st of September until the 31st of December 2007. The asylum seekers came from 33 different countries, primarily representing Afghanistan, Iraq, Iran, Syria, and Chechnya. Of the asylum seekers, 45 percent had been exposed to torture--approximately one-third within the year of arrival to Denmark. Unsystematic blows, personal threats or threats to family, degrading treatment, isolation, and witnessing torture of others were the main torture methods reported. The majority of the asylum seekers had witnessed armed conflict, persecution, and imprisonment. The study showed that physical symptoms were approximately twice as frequent and psychological symptoms were approximately two to three times as frequent among torture survivors as among non-tortured asylum seekers. However, even the health of non-tortured asylum seekers was affected. Among the torture survivors, 63 percent fulfilled the criteria for post-traumatic stress disorder, and 30-40 percent of the torture survivors were depressed, in anguish, anxious, and tearful in comparison to 5-10 percent of the non-tortured asylum seekers. Further, 42 percent of torture survivors had torture-related scars. Torture survivors amid newly arrived asylum seekers are an extremely vulnerable group, hence examination and inquiry about the torture history is extremely important in order to identify this population to initiate the necessary medical treatment and social assistance. Amnesty International Danish Medical group is currently planning a follow

  2. 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.

  3. Co-Exposure with Fullerene May Strengthen Health Effects of Organic Industrial Chemicals

    DEFF Research Database (Denmark)

    Lehto, M.; Karilainen, T.; Rog, T.

    2014-01-01

    In vitro toxicological studies together with atomistic molecular dynamics simulations show that occupational co-exposure with C-60 fullerene may strengthen the health effects of organic industrial chemicals. The chemicals studied are acetophenone, benzaldehyde, benzyl alcohol, m-cresol, and toluene...... which can be used with fullerene as reagents or solvents in industrial processes. Potential co-exposure scenarios include a fullerene dust and organic chemical vapor, or a fullerene solution aerosolized in workplace air. Unfiltered and filtered mixtures of C-60 and organic chemicals represent different...... co-exposure scenarios in in vitro studies where acute cytotoxicity and immunotoxicity of C-60 and organic chemicals are tested together and alone by using human THP-1-derived macrophages. Statistically significant co-effects are observed for an unfiltered mixture of benzaldehyde and C-60 that is more...

  4. Consumer health consciousness and the organic foods boom: Fact or fiction?

    DEFF Research Database (Denmark)

    Brunsø, Karen; Scholderer, Joachim

    2001-01-01

    scales (three items each) assessed the importance of organic foods, healthiness, freshness, novelty, and the price/quality relation to consumers' food choices. Trends in the importance of these aspects were modeled using multi-sample confirmatory factor analysis with structured means. Results indicate...... that, contrary to widespread expectations, the importance of healthy/unprocessed foods, organic foods, and fresh foods has been declining in all three countries since the early 1990s. The pattern suggests that the actual consumer trend to organic foods already peaked several years ago......Sales of organic foods have tremendously increased over the last years. The conclusion seems obvious: European consumers have become more health-conscious. Or have they? In fact, it is not quite clear from previous research whether rising market shares reflect changes in consumer attitudes, changes...

  5. Consumer health consciousness and the organic foods boom: Fact or fiction?

    DEFF Research Database (Denmark)

    Brunsø, Karen; Scholderer, Joachim

    scales (three items each) assessed the importance of organic foods, healthiness, freshness, novelty, and the price/quality relation to consumers' food choices. Trends in the importance of these aspects were modeled using multi-sample confirmatory factor analysis with structured means. Results indicate...... that, contrary to widespread expectations, the importance of healthy/unprocessed foods, organic foods, and fresh foods has been declining in all three countries since the early 1990s. The pattern suggests that the actual consumer trend to organic foods already peaked several years ago......Sales of organic foods have tremendously increased over the last years. The conclusion seems obvious: European consumers have become more health-conscious. Or have they? In fact, it is not quite clear from previous research whether rising market shares reflect changes in consumer attitudes, changes...

  6. 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.

  7. Organizational coherence in health care organizations: conceptual guidance to facilitate quality improvement and organizational change.

    Science.gov (United States)

    McAlearney, Ann Scheck; Terris, Darcey; Hardacre, Jeanne; Spurgeon, Peter; Brown, Claire; Baumgart, Andre; Nyström, Monica E

    2014-01-01

    We sought to improve our understanding of how health care quality improvement (QI) methods and innovations could be efficiently and effectively translated between settings to reduce persistent gaps in health care quality both within and across countries. We aimed to examine whether we could identify a core set of organizational cultural attributes, independent of context and setting, which might be associated with success in implementing and sustaining QI systems in health care organizations. We convened an international group of investigators to explore the issues of organizational culture and QI in different health care contexts and settings. This group met in person 3 times and held a series of conference calls to discuss emerging ideas over 2 years. Investigators also conducted pilot studies in their home countries to examine the applicability of our conceptual model. We suggest that organizational coherence may be a critical element of QI efforts in health care organizations and propose that there are 3 key components of organizational coherence: (1) people, (2) processes, and (3) perspectives. Our work suggests that the concept of organizational coherence embraces both culture and context and can thus help guide both researchers and practitioners in efforts to enhance health care QI efforts, regardless of organizational type, location, or context.

  8. Health maintenance organizations: critical issues raised by restructuring delivery for health systems reform.

    Science.gov (United States)

    Gold, M

    1993-10-01

    In sum, the potential that managed care will grow under health systems reform creates an opportunity for the HMO industry but also serves as a challenge and a threat. Faced with greater scrutiny and growing demands, HMOs increasingly are being forced to demonstrate their potential and live up to their expectation. At the same time, the changing nature of the health care system creates a challenge for HMOs. Cost pressures create needs to review the entire delivery system, including the ambulatory component, with a focus on enhancing cost-effectiveness. Greater visibility also creates demands; growing market penetration argues for the creation of a new paradigm to define an appropriate structure for public accountability and management. Finally, the transformation of an HMO industry into a managed care industry is not without its risks as HMO performance becomes evaluated not only against itself but as part of the performance of the broader managed care industry in which HMOs have become embedded.

  9. World Health Organization, radiofrequency radiation and health - a hard nut to crack (Review)

    OpenAIRE

    Hardell, Lennart

    2017-01-01

    In May 2011 the International Agency for Research on Cancer (IARC) evaluated cancer risks from radiofrequency (RF) radiation. Human epidemiological studies gave evidence of increased risk for glioma and acoustic neuroma. RF radiation was classified as Group 2B, a possible human carcinogen. Further epidemiological, animal and mechanistic studies have strengthened the association. In spite of this, in most countries little or nothing has been done to reduce exposure and educate people on health...

  10. World Health Organization, radiofrequency radiation and health - a hard nut to crack (Review).

    Science.gov (United States)

    Hardell, Lennart

    2017-08-01

    In May 2011 the International Agency for Research on Cancer (IARC) evaluated cancer risks from radiofrequency (RF) radiation. Human epidemiological studies gave evidence of increased risk for glioma and acoustic neuroma. RF radiation was classified as Group 2B, a possible human carcinogen. Further epidemiological, animal and mechanistic studies have strengthened the association. In spite of this, in most countries little or nothing has been done to reduce exposure and educate people on health hazards from RF radiation. On the contrary ambient levels have increased. In 2014 the WHO launched a draft of a Monograph on RF fields and health for public comments. It turned out that five of the six members of the Core Group in charge of the draft are affiliated with International Commission on Non-Ionizing Radiation Protection (ICNIRP), an industry loyal NGO, and thus have a serious conflict of interest. Just as by ICNIRP, evaluation of non-thermal biological effects from RF radiation are dismissed as scientific evidence of adverse health effects in the Monograph. This has provoked many comments sent to the WHO. However, at a meeting on March 3, 2017 at the WHO Geneva office it was stated that the WHO has no intention to change the Core Group.

  11. The new frontier of strategic alliances in health care: New partnerships under accountable care organizations.

    Science.gov (United States)

    Lewis, Valerie A; Tierney, Katherine I; Colla, Carrie H; Shortell, Stephen M

    2017-10-01

    Accountable care organizations (ACOs) and similar reforms aim to improve coordination between health care providers; however, due to the fragmented nature of the US health care system, successful coordination will hinge in large part on the ability of health care organizations to successfully partner across organizational boundaries. Little is known about new partnerships formed under the ACO model. We use mixed methods data from the National Survey of ACOs, Medicare ACO performance data and interviews with executive leaders across 31 ACOs to examine the prevalence, characteristics, and capabilities of partnership ACOs and why