Sample records for health protection administration

  1. Administration and environmental protection

    Milkov, Dragan


    Environmental protection is a very important task of the state. The state in this area deals in a preventative manner, and at the same time controls the application of laws and regulations. The aim of this paper is to carry out the identification of administrative bodies dealing with environmental protection at the national, provincial and local levels. There are administrative bodies dealing directly with matters of environmental protection. On the other hand, within the scope of some admini...

  2. TUESDAY: EPA Administrator to Discuss Historic Clean Power Plan to Cut U.S. Carbon Pollution and Protect Public Health

    WASHINGTON - On Tuesday, August 11, EPA Administrator Gina McCarthy will be discussing the Clean Power Plan at the Resources for the Future (RFF) Leadership Forum. The Clean Power Plan will protect public health, spur clean energy investments and st

  3. Veterans Health Administration

    ... code here VA » Veterans Health Administration Veterans Health Administration Robotic Brace for Veterans of Spinal Cord Injury ... Read more » VA Medical Centers The Veterans Health Administration is home to the United States’ largest integrated ...

  4. Health Ethics Education for Health Administration Chaplains

    Porter, Russell; Broussard, Amelia; Duckett, Todd


    It is imperative for divinity and health administration programs to improve their level of ethics education for their graduates who work as health administration chaplains. With an initial presentation of the variation of ethical dilemmas presented in health care facilities covering social, organizational, and patient levels, we indicate the need…

  5. Veterans Health Administration (VHA)

    Social Security Administration — The purpose of this agreement is for SSA to verify SSNs and other identifying information for the Department of Veterans Affairs, VHA. DVA will use the information...

  6. Environmental Protection Agency, Protecting Children's Environmental Health

    ... Agency Search Search Contact Us Share Protecting Children's Environmental Health Children are often more vulnerable to pollutants ... during development. Learn more about children's health, the environment, and what you can do. Basic Information Children ...

  7. Phytochemicals: Health Protective Effects.

    Craig, Winston; Beck, Leslie


    Consuming a diet rich in plant foods will provide a milieu of phytochemicals, non-nutritive substances in plants that possess health-protective benefits. Vegetables, fruits, whole grains, herbs, nuts and seeds contain an abundance of phenolic compounds, terpenoids, sulfur compounds, pigments, and other natural antioxidants that have been associated with protection from and/or treatment of conditions such as cardiovascular disease and cancer. The foods and herbs with the highest anticancer activity include garlic, soybeans, cabbage, ginger, licorice root, and the umbelliferous vegetables. Citrus, in addition to providing an ample supply of vitamin C, folic acid, potassium, and soluble fibre, contains a host of active phytochemicals. Clinical trials have not yet been able to demonstrate the same protective effects from taking supplements. It is difficult to estimate how many Canadians achieve an adequate level of consumption, but it seems reasonable to assume that many Canadians could benefit from substantially increasing their intake of vegetables and fruit.

  8. Protecting the delivery of heart failure: Regenerative Medicine/Stem Cell Therapeutics: Potential protections afforded by the Department of Health and Human Services and Health Resources Service Administration's Bureau of Special Programs

    Gary S Friedman; John S. Tomicki; Neil Cohen; Robert Marshall; Philip Lowry; Jeffrey Warsh


    malpractice liability have not impeded the development and growth of organ/cell/tissue transplantation despite increased risks of infection, malignancy and cardiovascular disease in transplant recipients. Currently, human transplantation is only performed using FDA/CBER-approved, non-embryonic stem cells from peripheral blood, bone marrow or umbilical cord blood. Federal legislation passed in 2005 (HR2520 and S1317: The Bone Marrow and Cord Blood Cell Transplantation Program) authorizes the Secretary of Health and Human Services acting through the Director of HRSA to ensure uniform stem cell units distribution and outcomes monitoring via the federally-designated C.W. Bill Young Cell Transplant Program.Historically in the U.S., human biological therapies (vaccines, organ transplant and stem cell transplant) have required federal protections to ensure continued distribution, fair access and avoidance of inhibitory product liability via protections afforded under the "stewardship" of the Secretary of Health and Human Services. The National Childhood Vaccine Injury Act of 1986 established the NVICP to equitably and expeditiously compensate individuals, or families of individuals, who have been declared injured by vaccines, thereby stabilizing a once imperiled vaccine supply by substantially reducing the threat of liability for vaccine companies, physicians, and other health care professionals who administer vaccines. Vaccines were the first biologics administered to U.S. citizens en masse and presage stem cell therapeutics(which may similarly be administered to millions) will similarly necessitate that a Stem Cell Injury Compensation Program(SCICP) will also need to be in place to demonstrate an intention to do good, an understanding that industry may do well,but that the health care consumer has a right of protection-all recognized from the outset. The Federal Tort Claims Act(FTCA) addresses liability claims via the Executive, Judicial and Legislative branches of Government


    N. I. Zhdanova


    Full Text Available The article describes actions of the Administration of the Federal Service for Surveillance on Consumer Rights Protection and Human Well-being in KamchatskyKrai and the Federal Health Organization "Center of Hygiene and Epidemiology in the Kamchatsky Krai" to ensure radiation protection of the population in conditions of the radiation accident at Fukushima nuclear power plant and their co-operation with other regional administrations in solution of this problem. The article also presents results of radiation monitoring in the region and shows absence of any significant radiation exposure to the population of the region resulting from the Fukushima nuclear power plant accident.

  10. Health Protection Products Are Hot



    FooDS and beverages that are made from natural ingredients and advertised as therapies are sweeping the consumer market. The health protection products I’ve seen can be divided into five categories. They include: 1. Beverages: tea, haw juice, mineral water; 2. Medicinal liquids: royal jelly, black-boned chicken essence, softshelled turtle essence; 3. Health protection foods: brown rice powder, rice vinegar, asparagus juice, egg-white candy;

  11. Definition and scope of health services administration.

    Begun, James W; Kaissi, Amer


    The definition and scope of health services administration are important to public policy, educational programs, new entrants to the field, and practitioners. Formal definition of the field of health services administration has not received concerted attention since 1975. Significant changes in the field have occurred since that time, widening opportunities for graduates of educational programs and increasing interdependencies between health services organizations and public policy organizations, supplier organizations, insurers, and other businesses that are not involved directly in health services delivery. Stakeholders in the field of health services administration should consider a broadened definition of the field that would institutionalize and build on those increased opportunities and interdependencies.

  12. Radiation protection policies to protect public health

    Muckerheide, J. [Commonwealth Massachusetts, Needham, MA (United States)


    Scientific data from plant, animal, and human populations more strongly find radiation essential to life, i.e., suppressing background radiation is debilitating and that moderately enhanced radiation doses have positive effects, than that low-moderate radiation dose has adverse effects. {close_quote} Federal radiation protection policy will be in the public interest and save hundreds of billions of dollars at no public health cost when known dose effects to exposed populations are applied to ensure no adverse health effects, with safety margins, and when appropriate research is funded (and public benefits from new radiation and nuclear science and technology applications are enabled) at the sole cost of reduced federal power and influence.

  13. Occupational Safety and Health Administration

    ... Indonesian Irish Italian Japanese Javanese Kannada Kazakh Khmer Korean Kurdish (Kurmanji) Kyrgyz Lao Latin Latvian Lithuanian Luxembourgish ... New Recommended practices for safety and health programs Learn how a strong workplace safety and health program ...

  14. Veterans Health Administration Behavioral Health Data

    U.S. Department of Health & Human Services — A list of VHA hospitals with behavioral health measure data. VHA reports data on a set of core performance measures for Hospital-Based Inpatient Psychiatric Services...

  15. Care for the Person, Protection of Health and Respect for the will of the Patient in Italy: Support Administration as a Tool to Jointly Promote Health and Respect for Autonomy in Incompetent Patients

    Delbon, Paola; Ricci, Giovanna; Gandolfini, Massimo; Conti1, Adelaide


    In Italy, advance health care directives are a subject of considerable debate in both legal theory and practice. This debate focuses in particular not only on the appropriateness of approving ad hoc statutory regulations but also on the extent to which similar advance indications of a person’s wishes are applicable under the existing legal system, albeit in the absence of a law regulating them. The authors of this paper consider, in particular, guidelines relating to the possible use of the mechanism of support administration (amministrazione di sostegno) (Law No. 6/2004) as a procedure to be used for the legal recognition of advance health care directives, particularly in the light of the legal provision for the possible designation in advance of a support administrator by a beneficiary in anticipation of an eventual situation of incapacity. This underlines how the concept of health does not only exist in the abstract, but must be measured in relation to the particular patient in the particular situation and how beneficence and respect for autonomy are both essential elements in the choices aimed at promoting the health and the wellbeing of its citizens. Significance for public health The concept of health includes not only the physical, but also the psychosocial dimension in accordance with the will of people. The reference to the personal concept of quality of life, values, ethical and religious opinions of each subject are key components underlying the decision-making process concerning a given patient in a given clinical condition: the concept of health does not only exist in the abstract, but must be measured in relation to the specific patient in the specific situation. The authors analyse the Italian debate about the possible designation in advance of the support administrator on the part of the beneficiary in anticipation of a potential situation of incapacity, as a tool to enforce advance care directives, to show how beneficence and respect for autonomy

  16. [Chile: social protection in health].

    Urriola, Rafael


    This piece begins with a brief discussion of the concepts leading to the social right to health protection. Special emphasis is placed on the principle of social cohesion, which has influenced social health protection in European countries. Chile's experience in this field from the 1990s to the present is described, as exemplified in three dimensions. In the first place, social security coverage is presented as a means to achieve universal (horizontal) coverage. A discussion follows on vertical coverage, where the author identifies health problems for which insured persons have guaranteed rights of access to medical care. This section describes available emergency care, primary health care, and the special plan for Universal Access to Explicit Guarantees (Acceso Universal de Garantías Explícitas de salud, or AUGE). Thirdly, the discussion covers the funding sources supporting the Chilean health care system: Government subsidies, contributions to social security, and out-of-pocket disbursements for private care. Chile's public health system has various special programs. One of them is catastrophic insurance, which covers 100% of the care needed for complex and very costly treatments. Older persons (over 65) have coverage for 100% of the cost of eyeglasses and hearing aids, and for 50% of the cost of home care. If life expectancy is an appropriate indicator of health system results, it is worth noting that Chile and the United States of America have both achieved a life expectancy of 77 years, even though Chile spends only 5.9% of its gross domestic product on health care, as compared to the 15% spent by the United States.

  17. 77 FR 76052 - Health Resources and Services Administration


    ... HUMAN SERVICES Health Resources and Services Administration Agency Information Collection Activities... and Services Administration (HRSA) publishes periodic summaries of proposed projects being developed...: The Health Resources and Services Administration (HRSA) plans to conduct a survey of the...

  18. 78 FR 14806 - Health Resources and Services Administration


    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Statement of Organization, Functions and Delegations of Authority; Correction AGENCY: Health Resources and Services Administration (HRSA), HHS....

  19. Occupational Safety and Health Administration (OSHA) Technical Support Committee


    0575 N5-95-1 Occupational Safety & Health Administration (OSHA) Technical Support Committee U.S. DEPARTMENT OF THE NAVY CARDEROCK DIVISION, NAVAL...4. TITLE AND SUBTITLE The National Shipbuilding Research Program, Occupational Safety & Health Administration (OSHA) Technical Support...SPECIFICALLY DISCLAIMED. Sp-5 Safety and Health Final Report Occupational Safety & Health Administration (OSHA) Technical Support Committee Task No

  20. 77 FR 62243 - Health Resources and Services Administration


    ... No: 2012-25192] DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration... Resources and Services Administration (HRSA), Parklawn Building (and via audio conference call), 5600... Service, Health Resources and Services Administration, Parklawn Building, Room 13-64, 5600 Fishers...

  1. 19 CFR 206.66 - Limited disclosure of certain confidential business information under administrative protective...


    ... business information under administrative protective order. 206.66 Section 206.66 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION NONADJUDICATIVE INVESTIGATIONS INVESTIGATIONS RELATING TO GLOBAL... certain confidential business information under administrative protective order. In an investigation...

  2. Protecting the Health of Family Caregivers


    This podcast discusses role of family caregivers and the importance of protecting their health. It is primarily targeted to public health and aging services professionals.  Created: 12/23/2009 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 12/23/2009.

  3. The New Epidemiology--A Challenge to Health Administration. Issues in Epidemiology for Administration.

    Crichton, Anne, Ed.; Neuhauser, Duncan, Ed.

    The role of epidemiology in health administration is considered in 11 articles, and three course descriptions and a bibliography are provided. Titles and authors include the following: "The Need for Creative Managerial Epidemiology" (Gary L. Filerman); "The Growing Role of Epidemiology in Health Administration" (Maureen M.…

  4. 75 FR 2890 - OSHA Listens: Occupational Safety and Health Administration Stakeholder Meeting


    ... Occupational Safety and Health Administration OSHA Listens: Occupational Safety and Health Administration Stakeholder Meeting AGENCY: Occupational Safety and Health Administration (OSHA), Labor. ACTION: Notice of public meeting. SUMMARY: The Occupational Safety and Health Administration (OSHA) is announcing a...

  5. Administrative-judicial protection of electoral right: With analysis of the judicature of the Administrative Court of Serbia

    Vučetić, Dejan; Janićijević, Dejan; Ranđelović, Nebojša


    The subject of analysis in this paper are regulations that govern the judicial protection of electoral right, especially the cases brought before the Serbian Administrative Court during the parliamentary and local elections of 2012 and 2014, the former of which are remembered by a number of alleged irregularities. We used a standard legal methodological apparatus to analyze the normative framework for administrative and judicial protection of electoral right. The paper analyzes the jurisprude...

  6. On-Orbit Health Monitoring and Repair Assessment of Thermal Protection Systems Project

    National Aeronautics and Space Administration — This SBIR project delivers On-orbit health MoNItoring and repair assessment of THERMal protection systems (OMNI_THERM). OMNI_THERM features impedance-based...

  7. 76 FR 25342 - Children's Health Protection Advisory Committee; Request for Nominations to the Children's Health...


    ... AGENCY Children's Health Protection Advisory Committee; Request for Nominations to the Children's Health... for appointment to its Children's Health Protection Advisory Committee. Vacancies are anticipated to... solicit nominees. Background: The Children's Health Protection Advisory Committee is a Federal advisory...

  8. 45 CFR 164.522 - Rights to request privacy protection for protected health information.


    ... Health Information § 164.522 Rights to request privacy protection for protected health information. (a)(1... 45 Public Welfare 1 2010-10-01 2010-10-01 false Rights to request privacy protection for protected health information. 164.522 Section 164.522 Public Welfare DEPARTMENT OF HEALTH AND HUMAN...

  9. Health Equity in a Trump Administration.

    Stone, Deborah


    Donald Trump's rhetoric and leadership are destroying the "culture of community" necessary for progress on health equity. His one-line promises to provide "quality health care at a fraction of the cost" smack of neoliberal nostrums that shifted ever more costs onto patients, thereby preventing many people from getting care. The dangers of Trump go far beyond health policy, however; Trump's presidency threatens the political and cultural institutions that make any good policy possible. Copyright © 2017 by Duke University Press.

  10. Health care change: challenge for nurse administrators.

    Bonalumi, N; Fisher, K


    Nursing administrators facing reorganization understand the difficulties and resistance that accompany organizational change. This article discusses resilience, a critical character trait for successfully managing change. Understanding the change process can assist those charged with the challenge of leading organizational change to manage the journey more effectively.


    A. A. Rubtsova


    Full Text Available The article presents results of activities of the Administration of the Federal Service for Surveillance on Consumer Rights Protection and Human Well-being in Magadan region and the Federal Health Organization "Center of Hygiene and Epidemiology in Magadan region" in the context of monitoring of the radiation situation in the Magadan region from 12.03.2011 in connection with the Fukushima accident in Japan. The authors present the data on radiological laboratory studies, the analysis of performed organizational activities, the results of co-operation with the state and other regulatory authorities.

  12. 78 FR 59121 - Basic Health Program: State Administration of Basic Health Programs; Eligibility and Enrollment...


    ... 42 CFR Part 600 Office of the Secretary 45 CFR Part 144 Basic Health Program: State Administration of... Standard Health Plans; Performance Standards for Basic Health Programs; Premium and Cost Sharing for Basic... CFR Part 144 RIN 0938-AR93 Basic Health Program: State Administration of Basic Health...

  13. Veterans Health Administration Readmissions and Deaths Data

    U.S. Department of Health & Human Services — A list of VHA hospitals with data on readmissions and deaths. These data show how often patients who are hospitalized for certain conditions experience serious...

  14. Veterans Health Administration Patient Safety Indicators Data

    U.S. Department of Health & Human Services — A list of VHA hospitals with data on the Agency for Healthcare Research and Quality (AHRQ) Patient Safety Indicators (PSIs). These indicators provide information on...

  15. Oral Administration of Probiotics Inhibits Absorption of the Heavy Metal Cadmium by Protecting the Intestinal Barrier.

    Zhai, Qixiao; Tian, Fengwei; Zhao, Jianxin; Zhang, Hao; Narbad, Arjan; Chen, Wei


    The heavy metal cadmium (Cd) is an environmental pollutant that causes adverse health effects in humans and animals. Our previous work demonstrated that oral administration of probiotics can significantly inhibit Cd absorption in the intestines of mice, but further evidence is needed to gain insights into the related protection mode. The goal of this study was to evaluate whether probiotics can inhibit Cd absorption through routes other than the Cd binding, with a focus on gut barrier protection. In the in vitro assay, both the intervention and therapy treatments of Lactobacillus plantarum CCFM8610 alleviated Cd-induced cytotoxicity in the human intestinal cell line HT-29 and protected the disruption of tight junctions in the cell monolayers. In a mouse model, probiotics with either good Cd-binding or antioxidative ability increased fecal Cd levels and decreased Cd accumulation in the tissue of Cd-exposed mice. Compared with the Cd-only group, cotreatment with probiotics also reversed the disruption of tight junctions, alleviated inflammation, and decreased the intestinal permeability of mice. L. plantarum CCFM8610, a strain with both good Cd binding and antioxidative abilities, exhibited significantly better protection than the other two strains. These results suggest that along with initial intestinal Cd sequestration, probiotics can inhibit Cd absorption by protecting the intestinal barrier, and the protection is related to the alleviation of Cd-induced oxidative stress. A probiotic with both good Cd-binding and antioxidative capacities can be used as a daily supplement for the prevention of oral Cd exposure. The heavy metal cadmium (Cd) is an environmental pollutant that causes adverse health effects in humans and animals. For the general population, food and drinking water are the main sources of Cd exposure due to the biomagnification of Cd within the food chain; therefore, the intestinal tract is the first organ that is susceptible to Cd contamination

  16. Education in health administration: an assessment of the Brazilian case.

    Kisil, M


    This discussion presents an overview of the health service system and its programs in Brazil, emphasizing current policies; sketches out what is being done about education in health administration; and examines some of the more innovative programs and activities within this field. Brazil's bealth service system is characterized by a multiplicity of public agencies that often compete and overlap, and by concentration of its resources in high-income urban core areas. 3 main groups of health care providers exist in Brazil. These work within the private subsector, which covers about 23 million people or 20% of the population; the official subsector, which covers about 25 million people; and the social security system, which covers about 50 million people. About 20 million people are not covered by any institutional health care services. There is no effective agency planning, despite the existence of planning units in all agencies, and, consequently, there is no national health development planning in Brazil. The negative impact of this on health care is compounded by a lack of managerially oriented information systems and a lack of monitoring and evaluation agencies. At present there are essentially 3 types of health administration education in Brazil -- one emphasizing the health component, one emphasizing the administrative component, and one seeking to balance these 2 elements. Historically, the health dominated type of health administration education emerged first, followed by the administration-dominated type, and then by the more balanced type. Regarding innovative developments, since 1975 the National School of Public Health in Rio de Janeiro has been working with state health agencies and local universities in many parts of the country in an effort to decentralize its basic public health course. Another program has promoted teaching and research in health administration and has provided technical assistance to promote the delivery of health administration

  17. Strategy for Coordinated EPA/Occupational Safety and Health Administration (OSHA) Implementation of the Chemical Accident Prevention Requirements of the Clean Air Act Amendments of 1990

    EPA and the Occupational Safety and Health Administration (OSHA) share responsibility for prevention: OSHA has the Process Safety Management Standard to protect workers, and EPA the Risk Management Program to protect the general public and environment.

  18. 77 FR 22358 - Occupational Safety and Health Administration


    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF LABOR Occupational Safety and Health Administration Preparations for the 23rd Session of the UN Sub-Committee of... Administration (OSHA), Labor. ACTION: Notice of public meeting. SUMMARY: OSHA invites interested parties...

  19. Mary Wakefield: Health Resources and Services Administrator. Interview.

    Wakefield, Mary


    Dr. Mary Wakefield is the administrator of the Health Resources and Services Administration. She came from the University of North Dakota, where she directed the Center for Rural Health. She has served as director of the Center for Health Policy, Research and Ethics at George Mason University and has worked with the World Health Organization's Global Programme on AIDS in Geneva, Switzerland. She is a fellow in the American Academy of Nursing and was elected to the Institute of Medicine of the National Academies. A native of North Dakota, Wakefield holds a doctoral degree in nursing from the University of Texas.

  20. Brazilian union actions for workers' health protection

    Rodolpho Repullo Junior

    Full Text Available CONTEXT: Many authors have emphasized the importance of worker strength through unionized organizations, in relation to the improvement of working procedures, and have reported on the decisiveness of labor movement actions in achieving modifications within the field of work and health. OBJECTIVE: To describe the ways in which Brazilian unions have tried to intervene in health-illness and work processes, identifying the existence of commonality in union actions in this field. TYPE OF STUDY: Qualitative study. SETTING: Postgraduate Program, Environmental Health Department, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil. METHODS: Union health advisers and directors were interviewed. Documents relating to union action towards protecting workers' health were collected and analyzed. RESULTS: Unions articulate actions regarding workers' health of a technical and political nature that involve many aspects and high complexity. These have been divided into thematic categories for better analysis. DISCUSSION: Union actions regarding workers' health in Brazil are restricted to some unions, located mainly in the southern, southeastern and northeastern regions of the country. Nonetheless, the unions undertaking such actions represent many professions of great economic and political importance. CONCLUSIONS: The recent changes in health and safety at work regulations, recognition of professional diseases, creation of workers' health services and programs within the unified health system, and operational improvements in companies' specialized safety and occupational medicine services, all basically result from union action. There is commonality of union action in this field in its seeking of technical and political strengthening for all workers and their general and local representation. This has the objective of benefiting collective bargaining between employers and workers. Inter-institutional action on behalf of workers' rights

  1. Indigenous populations health protection: A Canadian perspective

    Richardson Katya L


    Full Text Available Abstract The disproportionate effects of the 2009 H1N1 pandemic on many Canadian Aboriginal communities have drawn attention to the vulnerability of these communities in terms of health outcomes in the face of emerging and reemerging infectious diseases. Exploring the particular challenges facing these communities is essential to improving public health planning. In alignment with the objectives of the Pandemic Influenza Outbreak Research Modelling (Pan-InfORM team, a Canadian public health workshop was held at the Centre for Disease Modelling (CDM to: (i evaluate post-pandemic research findings; (ii identify existing gaps in knowledge that have yet to be addressed through ongoing research and collaborative activities; and (iii build upon existing partnerships within the research community to forge new collaborative links with Aboriginal health organizations. The workshop achieved its objectives in identifying main research findings and emerging information post pandemic, and highlighting key challenges that pose significant impediments to the health protection and promotion of Canadian Aboriginal populations. The health challenges faced by Canadian indigenous populations are unique and complex, and can only be addressed through active engagement with affected communities. The academic research community will need to develop a new interdisciplinary framework, building upon concepts from ‘Communities of Practice’, to ensure that the research priorities are identified and targeted, and the outcomes are translated into the context of community health to improve policy and practice.

  2. 78 FR 61367 - Health Resources and Services Administration


    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Agency Information Collection Activities... development of a technical assistance tracker for RWHAP grantees to monitor and assess changes in the mix...

  3. Improving Performance through Knowledge Translation in the Veterans Health Administration

    Francis, Joseph; Perlin, Jonathan B.


    The Veterans Health Administration (VA) provides a case study for linking performance measurement, information technology, and aligned research efforts to facilitate quality improvement in a large, complex health system. Dialogue between clinical researchers and VA leaders occurs through structured activities (e.g., the Quality Enhancement…

  4. The accuracy and completeness for receipt of colorectal cancer care using Veterans Health Administration administrative data

    Sherer, Eric A.; Fisher, Deborah A; Barnd, Jeffrey; Jackson, George L.; Provenzale, Dawn; Haggstrom, David A.


    Background The National Comprehensive Cancer Network and the American Society of Clinical Oncology have established guidelines for the treatment and surveillance of colorectal cancer (CRC), respectively. Considering these guidelines, an accurate and efficient method is needed to measure receipt of care. Methods The accuracy and completeness of Veterans Health Administration (VA) administrative data were assessed by comparing them with data manually abstracted during the Colorectal Cancer Care...

  5. Delegated affairs of state administration in the area of environmental protection

    Loncar, Zoran


    In legal system of the Republic of Serbia there are numerous affairs of the state administration in the field of environmental protection which are, as delegated affairs, performed by the authorities...

  6. Administrative data for public health surveillance and planning.

    Virnig, B A; McBean, M


    Electronically available administrative data are increasingly used by public health researchers and planners. The validity of the data source has been established, and its strengths and weaknesses relative to data abstracted from medical records and obtained via survey are documented. Administrative data are available from a variety of state, federal, and private sources and can, in many cases, be combined. As a tool for planning and surveillance, administrative data show great promise: They contain consistent elements, are available in a timely manner, and provide information about large numbers of individuals. Because they are available in an electronic format, they are relatively inexpensive to obtain and use. In the United States, however, there is no administrative data set covering the entire population. Although Medicare provides health care for an estimated 96% of the elderly, age 65 years and older, there is no comparable source for those under 65.

  7. Complying with Occupational Safety and Health Administration regulations: a guide for compounding pharmacists.

    Mixon, Bill; Nain, John


    In the compounding pharmacy, compliance with Occupational Safety and Health Administration regulations is essential to protect employees and customers from exposure to hazardous substances and a dangerous environment, to avert heavy fines and penalties levied for noncompliance, and to fulfill the moral obligation of pharmacists to do no harm. Without adequate vigilance, compounders are vulnerable to lapses in adherence to Occupational Safety and Health Administration requirements, the results of which can be dire in a climate of increased scrutiny about the safety and integrity of pharmaceutical compounding. Proactively addressing necessary compliance with essential safety regulations can only benefit compounders and their staff and clients, and guidance from an expert in Occupational Safety and Health Administration requirements can be a key factor in accomplishing that goal.

  8. Identifying individuals with physcian diagnosed COPD in health administrative databases.

    Gershon, A S; Wang, C; Guan, J; Vasilevska-Ristovska, J; Cicutto, L; To, T


    Chronic Obstructive Pulmonary Disease (COPD) is a common chronic respiratory disease responsible for significant morbidity and mortality. Population-based health administrative databases provide a powerful and unbiased way of studying COPD in the population, however, their ability to accurately identify patients with this disease must first be confirmed. The objective was to validate population-based health administrative definitions of COPD. Previously abstracted medical records of adults over the age of 35 randomly selected from primary care practices in Ontario, Canada were reviewed by an expert panel to establish if an individual did or did not have a diagnosis of COPD. These reference designations were then linked to each individual's respective health administrative database record and compared with predefine health administrative data definitions of COPD. Concepts of diagnostic test evaluation were used to calculate and compare their test characteristics. The most sensitive health administrative definition of COPD was 1 or more ambulatory claims and/or 1 or more hospitalizations for COPD that yielded a sensitivity of 85.0% (95% confidence interval 77.0 to 91.0) and a specificity of 78.4% (95% confidence interval 73.6 to 82.7). As number of ambulatory claims in the definition increased, sensitivity decreased and specificity increased. Individuals with COPD can be accurately identified in health administrative data, and therefore it may be used to create an unbiased population cohort for surveillance and research. This offers a powerful means of generating evidence to inform strategies that optimize the prevention and management of COPD.

  9. Recommendations for European health data protection legislation.

    Callens, S; Nys, H


    In year 1 of the SEISMED project, the Katholieke Universiteit Leuven coordinated the inventory and analysis of medical personal data protection legislation in Europe. A report on legal issues of medical data protection legislation in Europe was written by the Vrije Universiteit Amsterdam, the Centre National pour la Recherche Scientifique (Paris) and the University College Dublin. This report served as a basis for a second important legal deliverable, i.e. the Health Informatics Deontology Code. In this third and final report, we take into account the results of the other two legal reports and we formulate recommendations for the national and European legislator. This report analyses critically the upcoming privacy directive. We propose several recommendations which should be taken into account by the European and national legislator. We focused quite extensively on the use of medical data for research purposes. We had several reasons to do this. One of them is the fact that the use of medical data for research purposes is very popular, in particular now the health care sector is becoming more and more 'standardized' by using computers, networksystems and telematics. Legislation is therefore needed. Moreover, the use of medical data for research purposes involves the transfer of data from one Member State to another. Therefore, a harmonized legislation is really needed. We hope that the recommendations we propose, will be taken into consideration by the European legislator.

  10. An Overview Study of Performance Evaluation of Intellectual Property Administrative and Judicial Protection in China

    Xu Xingxiang; Luo Juan


    Whether IP Administrative and judicial Protection in China is good or bad depends on the evaluation of protection effects of administrative and judicial organs. In China the evaluation system of IP protection performance consists of evaluation principles, evaluation elements and evaluation methods, evaluation principles includes the principle of designing two sets of indicators, the principle of closely linking with China' s national intellectual property strategy, the principle of openness and flexibility of performance evaluation indicators,the principle of standardability of the determination of performance evaluation indicators; evaluation elements consist of evaluator, evaluation tools and objects evaluated; evaluation methods here refers to the Delphi method and the method of network questionary survey.

  11. Applying radiation health effects data to radiation protection policies

    Muckerheide, James [Center for Nuclear Technology and Society at WPI, Worcester Polytechnic Institute, Worcester, MA (United States)


    Data from the peer-reviewed scientific literature establish a sound basis to define a low-dose, low-dose-rate, dose-response. These data include human health dose-response studies; immunologically 'whole' animal studies; and cellular and molecular biological studies of complete biological systems for the relevant immunological and physiological responses. Initiatives are required to constructively apply these data to both radiation research and radiation protection policies. First, current low level radiation health effects research must apply existing data to define research projects to integrate and confirm existing dose-response data, with specific emphasis on the biological bases that exist in definitive and reproducible cellular and biological dose-response. Second, dose-response assessment must identify and incorporate all existing substantial and confirmed data, including natural radiation sources, to establish the bases for radiation protection policy for interventions to protect public health and safety. A preliminary assessment of these data is applied to: 1) Specify research that can be constructively applied to describe radiation health effects dose-response. 2) Apply health effects dose-response to radiation and radioactivity applications policies to maximize radiation health effects interventions for occupational applications, medical applications, and other radiation and radioactive materials applications controls to cost-effectively assure public health and safety. An assessment of the proposed revisions to ICRP radiation protection policies is provided that associates the basis for administrative limits with the previous proposal of the US NRC for a 'Below Regulatory Concern' (BRC) policy. This proposal ignores the context of the fact that very low levels of radiation exposure are far within the variations of natural radiation exposures, and therefore can have no gross net consequences. The equivalent failure of the BRC proposal


    Ovidia Janina IONESCU


    Full Text Available According to the relevant Romanian legislation, i.e. Law no. 129/1992 on the protection of drawings and patterns and Government Decision no. 211/2008 for the approval of the Regulation enforcing Law no. 129/1992, rights over drawings or patterns may also be protected via administrative law. Administrative law means ensure the recognition of the right during the procedure of registering the drawings and patterns and of issuing the drawing or pattern registration certificate, which, as mentioned above, represents the protection title granted by OSIM for registered drawings and patterns. This category of means includes the opposition and challenge, which may be filed with the administrative authority ensuring the protection of drawings and patterns, i.e. the State Office for Inventions and Trademarks.


    Ovidia Janina IONESCU


    Full Text Available According to the relevant Romanian legislation, i.e. Law no. 129/1992 on the protection of drawings and patterns and Government Decision no. 211/2008 for the approval of the Regulation enforcing Law no. 129/1992, rights over drawings or patterns may also be protected via administrative law. Administrative law means ensure the recognition of the right during the procedure of registering the drawings and patterns and of issuing the drawing or pattern registration certificate, which, as mentioned above, represents the protection title granted by OSIM for registered drawings and patterns. This category of means includes the opposition and challenge, which may be filed with the administrative authority ensuring the protection of drawings and patterns, i.e. the State Office for Inventions and Trademarks.

  14. Health protection in the USA: Right or privilege?

    Vidojević, Jelena


    The paper deals with the system of health protection in the USA, its key features, problems it faces and attempts for improvement of its functioning. Corresponding to the manner in which (residual) social state is organized, the American health protection system is rather rudimental, characterized by high costs and inequality in approach to and quality of health protection. Accordingly, general health situation of the nation is comparatively poorer than in developed market economy countries. ...

  15. Replacement-ready? Succession planning tops health care administrators' priorities.

    Husting, P M; Alderman, M


    Nurses' increasing age coupled with health care's rapidly changing environment moves succession planning, originally only a business sector tool, to a top administrative priority. Through active support of your facility's executive leadership and a clear linkage to long range organization objectives, you can implement this progressive procedure.

  16. 78 FR 44574 - Third Annual Food and Drug Administration Health Professional Organizations Conference


    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Third Annual Food and Drug Administration Health.... The Food and Drug Administration (FDA) is announcing a conference for representatives of...

  17. 76 FR 55928 - Food and Drug Administration Health Professional Organizations Conference


    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Food and Drug Administration Health Professional... Food and Drug Administration (FDA) is announcing a conference for representatives of...

  18. The Veterans Health Administration: an American success story?

    Oliver, Adam


    The Veterans Health Administration (VHA) provides health care for U.S. military veterans. By the early 1990s, the VHA had a reputation for delivering limited, poor-quality care, which led to health care reforms. By 2000, the VHA had substantially improved in terms of numerous indicators of process quality, and some evidence shows that its overall performance now exceeds that of the rest of U.S. health care. Recently, however, the VHA has started to become a victim of its own success, with increased demands on the system raising concerns from some that access is becoming overly restricted and from others that its annual budget appropriations are becoming excessive. Nonetheless, the apparent turnaround in the VHA's performance offers encouragement that health care that is both financed and provided by the public sector can be an effective organizational form.

  19. 45 CFR 164.526 - Amendment of protected health information.


    ... RELATED REQUIREMENTS SECURITY AND PRIVACY Privacy of Individually Identifiable Health Information § 164.526 Amendment of protected health information. (a) Standard: Right to amend. (1) Right to amend. An... 45 Public Welfare 1 2010-10-01 2010-10-01 false Amendment of protected health information. 164.526...

  20. Role and tasks of the Mine Safety and Health Administration

    Bradecki, W. (Wyzszy Urzad Gorniczy, Katowice (Poland))


    Discusses the visit of 2 representatives of the Mine Safety and Health Administration and the West Mining Company from the United States to Poland in November 1991. During the visit, occupational safety in underground coal mines in Upper Silesia was evaluated. Selected aspects of experience and organization schemes of the Mine Safety and Health Administration are evaluated from the point of view of their use in Poland to increase occupational safety in coal mining. The following aspects are discussed: Mine Safety and Health Administration and its budget (US$ 186 million), personnel (2,700), research institutes that specialize in mine safety (the National Institute of Occupational Safety and Health, Bureau of Mines), natural hazards associated with mining, mine safety in underground and surface coal mines in the USA in relation to number of coal miners and coal output, job safety analysis as a key to the success of the MSHA, increased hazards in small mines (Pennsylvania, West Virginia, Virginia and Kentucky), problems of drug addiction and alcoholism among coal miners.

  1. Expectations and outcome skills of a generalist health care administrator.

    Jones, V B; Taylor, L C


    The question of the degree of technical versus managerial competence to be found in future graduates from health administration programs is not easily resolved. In the HIMSS 1988 survey of CIOs the attributes needed for success are listed in descending rank order as follows: leadership ability, vision/imagination, knowledge of hospital systems, business acumen, decisiveness, and technical competence. CIOs ranked technical competence as less important than other attributes associated with general management success. The expectations for attitudes, knowledge, and skills presented in this article support the greater importance of management abilities relative to pure technical competence. However, it is vital that an appropriate level of technical knowledge and skill be maintained to enable future alumni of health administration programs to function effectively as administrators. Depending on their role in a health care organization, greater or lesser technical knowledge may be needed. Those pursuing a career path toward CIO must, of necessity, have greater technical knowledge and skill. We have discussed necessary and expected attitudes, knowledge, and skills that will be needed by the generalist health administration graduate in the future. It will be important to develop and maintain an attitude that MIS is a strategic tool, that health care technology is a corporate asset, and that information is power. Graduates must recognize the necessity of maintaining and enhancing their knowledge and skills through continuing education. The knowledge base of MIS education should focus on determining information needs to support strategic goals, understanding of general systems theory, principles of systems analysis, design, implementation and maintenance, awareness and exposure to standard application software, and an awareness of external sources of data.(ABSTRACT TRUNCATED AT 250 WORDS)

  2. Health promotion versus health protection? Employees' perceptions and concerns.

    Walsh, D C; Jennings, S E; Mangione, T; Merrigan, D M


    The "second public health revolution" targets factors in the environment, together with lifestyle, to prevent illness and untimely death. Yet the growth of the "wellness movement" has driven a wedge between public health advocates who argue for environmental solutions and those whose major focus is individual behavior. This tension is nowhere more evident than in the workplace, where the new wellness professionals are at odds with specialists in occupational health and industrial hygiene. This paper reports findings from a cross-sectional survey of a sizeable sample of workers at six New England facilities of a very large American manufacturing firm, assessing their perceptions of risk in the two domains: environmental exposures and lifestyle risks. Multiple regression analyses reveal that both job risks and life risks are associated with a variety of potentially costly and disruptive health problems, even after controlling for demographic and occupational factors. This analysis suggests that wellness programs in the workplace will be more effective if they integrate environmental protection with efforts to reduce lifestyle risk.

  3. Employee Health in the Mental Health Workplace: Clinical, Administrative, and Organizational Perspectives.

    Shah, Jai L; Kapoor, Reena; Cole, Robert; Steiner, Jeanne L


    Issues of mental health and employee health have risen to increasing prominence in recent years. However, there have been few explorations of the clinical and administrative challenges that these issues raise, particularly in settings that are themselves mental health workplaces. In order to identify and understand such challenges, a brief case of acute employee illness in a mental health workplace is described followed by a discussion of salient clinical, administrative, and organizational considerations. The case raises questions about medicolegal responsibilities and relationships between clinicians and patients in mental health settings, illuminates tensions between clinical staff and human resources processes, and draws attention to the need for illness prevention and mental health promotion initiatives in the workplace. Increased awareness of these issues, complications, and potential solutions would benefit clinicians, administrators, and mental health institutions.

  4. Insights from advanced analytics at the Veterans Health Administration.

    Fihn, Stephan D; Francis, Joseph; Clancy, Carolyn; Nielson, Christopher; Nelson, Karin; Rumsfeld, John; Cullen, Theresa; Bates, Jack; Graham, Gail L


    Health care has lagged behind other industries in its use of advanced analytics. The Veterans Health Administration (VHA) has three decades of experience collecting data about the veterans it serves nationwide through locally developed information systems that use a common electronic health record. In 2006 the VHA began to build its Corporate Data Warehouse, a repository for patient-level data aggregated from across the VHA's national health system. This article provides a high-level overview of the VHA's evolution toward "big data," defined as the rapid evolution of applying advanced tools and approaches to large, complex, and rapidly changing data sets. It illustrates how advanced analysis is already supporting the VHA's activities, which range from routine clinical care of individual patients--for example, monitoring medication administration and predicting risk of adverse outcomes--to evaluating a systemwide initiative to bring the principles of the patient-centered medical home to all veterans. The article also shares some of the challenges, concerns, insights, and responses that have emerged along the way, such as the need to smoothly integrate new functions into clinical workflow. While the VHA is unique in many ways, its experience may offer important insights for other health care systems nationwide as they venture into the realm of big data.

  5. Data Protection Compliance in the Age of Digital Health.

    Hordern, Victoria


    Advances in technology are transforming the way that health data is collected and used. This includes improvements in existing technology as well as innovations in mobile technology such as smartphone apps and wearables. Health data is strictly regulated under the EU Data Protection Directive 95/46/EC. Under current data protection rules, health data is broadly interpreted and will, in most circumstances not connected to the provision of healthcare, require organisations to obtain explicit consent from individuals for its collection and use. Further data protection compliance issues arise such as identifying who is a controller, ensuring transparency, using health data for research purposes and keeping health data secure. As the EU data protection landscape is due to change in the next few years and will affect the collection and use of health data, the forthcoming Data Protection Regulation also deserves attention.

  6. Intraintestinal administration of ulinastatin protects against sepsis by relieving intestinal damage.

    Yang, Bingchang; Gao, Min; Wang, Kangkai; Jiang, Yu; Peng, Yue; Zhang, Huali; Yang, Mingshi; Xiao, Xianzhong


    Intravenous administration of ulinastatin (UTI), a broad spectral protease inhibitor, has been used on an experimental basis with severe sepsis patients in Asia. However, the effects of intraintestinal administration of UTI on intestinal and multiple organ damage in sepsis have not been reported. In this study, we established a sepsis model in rats using cecal ligation and puncture and compared the effects of intraintestinal administration of UTI through an artificial fistula of duodenum and intraperitoneal administration of UTI on the pathophysiological changes of sepsis. It was found that intraintestinal administration of UTI (1) significantly improved the survival of septic rats, (2) significantly reduced the serum levels of tumor necrosis factor-α, interleukin-1β, interleukin-6 as well as intestinal injury biomarkers diamine oxidase, D-lactic acid, and fluorescein isothiocyanate-dextran 4, and (3) significantly reduced intestinal microscopic and ultrastructural damage of septic rats. In addition, the protective effects of intraintestinal administration of UTI were significantly better than those of intraperitoneal administration of UTI. Overall, the present study for the first time revealed that intraintestinal administration of protease inhibitor UTI could reduce systemic inflammatory responses and multiple organ dysfunction in rats with sepsis by inhibiting autodigestion of intestinal wall due to proteases and provided new research ideas and experimental evidences for treatment of sepsis by intraintestinal administration of UTI. Copyright © 2016. Published by Elsevier Inc.

  7. TOMORROW: EPA Administrator to Focus on Protecting Clean Water in Travel to Minnesota, Texas and Illinois

    WASHINGTON - Tomorrow, EPA Administrator Gina McCarthy is hitting the road to focus on the important need to protect the critical streams and wetlands that provide 1 in 3 Americans their drinking water and that are currently vulnerable to pollution

  8. 19 CFR 206.17 - Limited disclosure of certain confidential business information under administrative protective...


    ... Investigations Relating to Global Safeguard Actions § 206.17 Limited disclosure of certain confidential business... business information under administrative protective order. 206.17 Section 206.17 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION NONADJUDICATIVE INVESTIGATIONS INVESTIGATIONS RELATING TO...

  9. Radon in the Workplace: the Occupational Safety and Health Administration (OSHA) Ionizing Radiation Standard.

    Lewis, Robert K


    On 29 December 1970, the Occupational Safety and Health Act of 1970 established the Occupational Safety and Health Administration (OSHA). This article on OSHA, Title 29, Part 1910.1096 Ionizing Radiation standard was written to increase awareness of the employer, the workforce, state and federal governments, and those in the radon industry who perform radon testing and radon mitigation of the existence of these regulations, particularly the radon relevant aspect of the regulations. This review paper was also written to try to explain what can sometimes be complicated regulations. As the author works within the Radon Division of the Pennsylvania Department of Environmental Protection, Bureau of Radiation Protection, the exclusive focus of the article is on radon. The 1910.1096 standard obviously covers many other aspects of radiation and radiation safety in the work place.

  10. Historical Precedents on the Protection or Defense of Natural Resources and salubritas in Rome. Towards an Administrative Environmental Roman Law

    Salvador Ruiz-Pino


    Full Text Available This article discusses certain situations involving the protection of natural resources by the Roman Law itself, some of which contain ancient environmental protections that today fall under a branch of Administrative Law, now known as Environmental Law.

  11. Epidemiology in a health services administration curriculum: what topics are important to practicing healthcare administrators?

    Hooker, Edmond A


    There is no published empirical research into what topics should be covered in a managerial epidemiology course for graduate students in health services administration (HSA). The goal of the research described here was to identify epidemiologic topics seen as important to healthcare executives. A survey was conducted of a convenience sample of alumni the Graduate program in Health Services Administration of Xavier University in Cincinnati Ohio. Alumni were asked to rank 68 epidemiologic topics on a likert-type scale: 1 = Not important; 2 = Slightly Important; 3 = Important; 4 = Very Important; 5 = Not applicable. Demographic characteristics were collected including: age of respondents, gender, years since graduation, and current position. All responses of important (3) and very important (4) were grouped together. Topics were then ranked based on the percent of respondents who answered the question and ranked the topic as a 3 or 4. A total of 858 surveys were mailed to alumni, and 177 completed surveys were returned for a 21% response rate. Respondents were 64% male, and there were similar number of graduates from all age groups and from year of graduation. The largest groups of respondents were CEOs and Managers. Clinical guidelines, Quality and Satisfaction, and Benchmarking ranked highest for number or respondents ranking the topic as important or very important. The majority of graduates indicated that almost all epidemiologic topics are important or very important. Topics dealing with quality were ranked highest by the graduates.

  12. Hospital administrator's perspectives regarding the health care industry.

    McDermott, D R; Little, M W


    Based on responses from 52 hospital administrators, four areas of managerial concern have been addressed, including: (1) decision-making factors; (2) hospital service offerings: current and future; (3) marketing strategy and service priorities; and (4) health care industry challenges. Of the total respondents, 35 percent indicate a Director of Marketing has primary responsibility for making marketing-related decisions in their hospital, and 19 percent, a Vice-President of Marketing, thus demonstrating the increased priority of the marketing function. The continued importance of the physician being the primary market target is highlighted by 70 percent of the administrators feeling physician referrals will be more important regarding future admissions than in the past, compared to only two percent feeling the physicians' role will be less important. Of primary importance to patients selecting a hospital, as perceived by the administrators, are the physician's referral, the patient's previous experience, the hospital's reputation, and the courtesy of the staff. The clear majority of the conventional-care hospitals surveyed offer out-patient surgery, a hospital pharmacy, obstetrics/maternity care, and diabetic services. The future emphasis on expanding services is evidenced by some 50 percent of the hospital administrators indicating they either possibly or definitely plan to offer long-term nursing care, out-patient substance abuse programs, and cancer clinics by 1990. In addition, some one-third of the respondents are likely to expand their offerings to include wellness/fitness centers, in-patient substance abuse programs, remote or satellite primary care clinics, and diabetic services. Other areas having priority for future offerings include services geared specifically toward women and the elderly. Perceived as highest in priority by the administrators regarding how their hospital can achieve its goals in the next three years are market development strategies

  13. Public health service administration and academia. A joint venture.

    Campbell, B F; King, J B


    Joint ventures between service and academia are designed to enhance the quality of client services, enrich faculty teaching experiences and skills, and strengthen communication channels. The joint venture described in this article is an example of how public health nursing services and academia can be united through faculty participation in administration. Included in the discussion are the impetus for the project, the contract negotiations, the positive outcomes and disadvantages of the venture, and questions that should be raised when a similar venture is considered.


    V. A. Ott


    Full Text Available The article analyzes activities of the Administration of Federal Service for Surveillance on Consumer Rights Protection and Human Well-being in Khabarovsky Krai and the Federal Health Organization "Center of Hygiene and Epidemiology in Khabarovsky Krai" in the situation related to the Fukushima accident in Japan

  15. Protect Childrens Health with EPA School App

    DALLAS - (Aug. 24, 2015) Are you looking for ways to promote a healthier learning environment, reduce absenteeism, improve test scores or enhance student or staff productivity? The U.S. Environmental Protection Agency (EPA) recently launched a new m

  16. Administrative judge control over the activities of the tax administration: between the need for taxation and protection of tax payers

    Jérôme Michell


    Full Text Available Among the main principles of constitutional values of taxation law (the principle of freedom, legality, equality, annual postulate the principle of necessity of taxation can be found in the fundamentals of the great powers of the Taxation Department responsible for establishing and charging all legally founded taxes. Due to the declarative principle of numerous taxes (income tax, tax on profit, VAT tax, administration justifiably has at its disposal a range of methods for controlling the honesty of taxpayers and repressive powers to combat taxation fraud in any form. In a state with the rule of law, the judge for taxation has two tasks: to combat fraud or tax evasion and to protect the taxpayer from misuse of powers by public administration authorities. In this sense, the judge for taxation is constantly seeking to achieve a balance, given the current legal regulations, between (1 the contradictory imperatives regarding the efficiency of taxation controls on the one hand, and (2 respecting guarantees for the taxpayer on the other. After that, the judge controls the loyalty of Taxation Department activity and whether it respects the fundamentals of the rule of law.

  17. Substance Abuse and Mental Health Services Administration (SAMHSA) Behavioral Health Disaster Response App.

    Seligman, Jamie; Felder, Stephanie S; Robinson, Maryann E


    The Substance Abuse and Mental Health Services Administration (SAMHSA) in the Department of Health and Human Services offers extensive disaster behavior health resources to assist disaster survivors in preparing for, responding to, and recovering from natural and manmade disasters. One of SAMHSA's most innovative resources is the SAMHSA Behavioral Health Disaster Response App (SAMHSA Disaster App). The SAMHSA Disaster App prepares behavioral health responders for any type of traumatic event by allowing them to access disaster-related materials and other key resources right on their phone, at the touch of a button. The SAMHSA Disaster App is available on iPhone, Android, and BlackBerry devices.

  18. Electronic Health Record in Italy and Personal Data Protection.

    Bologna, Silvio; Bellavista, Alessandro; Corso, Pietro Paolo; Zangara, Gianluca


    The present article deals with the Italian Electronic Health Record (hereinafter EHR), recently introduced by Act 221/2012, with a specific focus on personal data protection. Privacy issues--e.g., informed consent, data processing, patients' rights and minors' will--are discussed within the framework of recent e-Health legislation, national Data Protection Code, the related Data Protection Authority pronouncements and EU law. The paper is aimed at discussing the problems arising from a complex, fragmentary and sometimes uncertain legal framework on e-Health.

  19. Health research and systems' governance are at risk: should the right to data protection override health?

    Di Iorio, C T; Carinci, F; Oderkirk, J


    The European Union (EU) Data Protection Regulation will have profound implications for public health, health services research and statistics in Europe. The EU Commission's Proposal was a breakthrough in balancing privacy rights and rights to health and healthcare. The European Parliament, however, has proposed extensive amendments. This paper reviews the amendments proposed by the European Parliament Committee on Civil Liberties, Justice and Home Affairs and their implications for health research and statistics. The amendments eliminate most innovations brought by the Proposal. Notably, derogation to the general prohibition of processing sensitive data shall be allowed for public interests such as the management of healthcare services,but not health research, monitoring, surveillance and governance. The processing of personal health data for historical, statistical or scientific purposes shall be allowed only with the consent of the data subject or if the processing serves an exceptionally high public interest, cannot be performed otherwise and is legally authorised. Research, be it academic, government,corporate or market research, falls under the same rule.The proposed amendments will make difficult or render impossible research and statistics involving the linkage and analysis of the wealth of data from clinical,administrative, insurance and survey sources, which have contributed to improving health outcomes and health systems performance and governance; and may illegitimise efforts that have been made in some European countries to enable privacy-respectful data use for research and statistical purposes. If the amendments stand as written, the right to privacy is likely to override the right to health and healthcare in Europe.

  20. Social protection in Brazil: universalism and targeting in the FHC and Lula administrations.

    Costa, Nilson do Rosário


    This article analyzes the organization of Brazil's social protection system after the Federal Constitution of 1998 (CF 1988). It also demonstrates that 1988 Federal Constitution favored the institutionalization of universalist public policies. This institutionalization took place amidst conflict with the stabilization goals of the Real Plan. The paper argues that such an institutionalization protected public spending in the social area of the macroeconomic management's minimalist project. It also identifies the implementation of social programs targeting the poor during the 1980's decade. Targeting is an innovation directly associated with the adjustment agenda. It reveals that under the FHC and Lula administrations there was an identical adoption of targeted social programs. The targeting of social protection did not possess power of veto over the universalist proposals arising from the democratization in the 1980's. It demonstrates that the Bolsa Família Program (Family Grant Program - PBF), the main mark of the Lula administration, is a large scale adaptation of the targeted programs of direct transfer of income in the FHC administration. The combination of universalism and targeting expanded the scope of social policy. However, the significant growth in social public spending has not been producing broad social results, although the poor in Brazil have benefited from the PBF's targeting.

  1. Fundamentals of health physics for the radiation-protection officer

    Murphy, B.L.; Traub, R.J.; Gilchrist, R.L.; Mann, J.C.; Munson, L.H.; Carbaugh, E.H.; Baer, J.L.


    The contents of this book on health physics include chapters on properties of radioactive materials, radiation instrumentation, radiation protection programs, radiation survey programs, internal exposure, external exposure, decontamination, selection and design of radiation facilities, transportation of radioactive materials, radioactive waste management, radiation accidents and emergency preparedness, training, record keeping, quality assurance, and appraisal of radiation protection programs. (ACR)

  2. Contracts under administrative law in the areas of emission control and water protection law; Verwaltungsrechtliche Vertraege im Immissions- und Gewaesserschutzrecht

    Ahlhaus, Jens


    Using the fields of emission control and water protection as an example the author investigates how environmental law is executed by way of contracts between the citizen and the administration. The study encompasses fundamental theoretical deliberations as well as practical experiences. It undertakes a discussion in legal theory on the instrument of an administrative contract, taking into consideration the results of a survey among 100 companies. The study identifies application fields for administrative contracts in the field of emission control and water protection law. It carves out and illustrates by way of examples the advantages and drawbacks of the use of administrative contracts as compared with regulation through administrative acts.

  3. [Correlation between legal protection of the environment and health].

    Giraldi, Guglielmo; Rinaldi, Alessandro; D'Andrea, Elvira; Lucchetti, Pietro; Messano, Giuseppe Alessio; d'Alessandro, Eugenia De Luca


    Health promotion is a priority of our time and planning and the evaluation of health and hygiene should be directed towards strategies to improve the well-being and lifestyles of the community. At the legislative level in Italy, the Ministry of Health, was established in 1958 with the task of providing for the collective health of the whole nation and in 1978, with Law 833, the National Health Service (NHS) was created which secured assistance and healthcare to all Italian citizens. The most important component of the entire health system is the Local Health Unit (USL) which has responsibility for prevention, treatment and rehabilitation, and highlights the importance of safeguarding the health, hygiene and safely at home and at work and the "hygiene of urban settlements and communities", ie environmental protection. One of the reasons for the delays in the promotion of environmental protection initiatives in Italy is to be found in the referendums of 1993, including the one which removed the tasks regarding environmental controls from the NHS. The temporary skills gap in the environmental field was filled with the 'National Agency for Environmental Protection (ANPA), which later became the Agency for Environmental Protection and Technical Services (APAT), and the regional level, the Regional Agencies Environmental Protection Agency (ARPA). Law 61/21 January 1994 joined the ARPA to the National Institute for Environmental Research and Protection (ISPRA). It is now necessary to implement a program that takes account of the damage caused to the environment and consequently the individual, which is totally committed the combination of the environment and human health and not, as in the recent past, as two distinct entities. In this sense, it is of fundamental importance the role of prevention departments to promote the organization networking and of individual companies' and individuals' skills, in fact. The integration of planning processes, environmental monitoring

  4. State of health protection and self-protection: the history and nowadays

    Оксана Михайлівна Юрченко


    Full Text Available The author of the article determined the essence of the concept of "self-protection technology"; main directions of views of the human to their life and health in the context of the historical process. Relevant ideas of improvement of teachers’ work using self-protection technologies in educational space are defined. It is noted that education and health are mutually reinforcing components of successful everyday life of participants of the educational process

  5. Burnout among psychiatrists in the Veterans Health Administration

    Hector A. Garcia


    Full Text Available Research suggests that mental health workers are at high risk for burnout, and that burnout can increase staff turnover and reduce quality of care. The Veterans Administration (VA employs over 3000 psychiatrists across the United States, but little is known about burnout in this population. This study was conducted to examine predictors of burnout and intent to leave the VA among a national sample of VA psychiatrists. Participants (N = 125 responded to an anonymous online survey. Regression analyses were used to examine relationships between workplace variables, patient characteristics, and burnout as measured by the Maslach Burnout Inventory-General Survey – which includes sub-scales for cynicism, exhaustion, and professional efficacy – as well as intent to leave the VA. Based on established cut-off scores, 90% of the sample reported high cynicism, 86% reported high exhaustion, and 74% reported high professional efficacy. High cynicism predicted the intent to leave the VA (p = .004. Not feeling part of a coherent team predicted greater cynicism (p = .01, and patient characteristics such as suspected malingering showed a positive trend with cynicism (p = .05. Workplace characteristics such as unfair treatment by supervisors (p = .03 and insufficient resources (p = .001 predicted greater exhaustion. The current findings suggest that burnout is prevalent in the VA psychiatry workforce. Specific administrative measures to reduce burnout may have potential to improve the emotional health of that workforce and ensure high quality of care for the veteran population it serves. The size of both the VA psychiatry workforce and patient population underscores the importance of greater understanding of burnout as it occurs in the VA.

  6. Cataract surgery practices in the United States Veterans Health Administration.

    Havnaer, Annika G; Greenberg, Paul B; Cockerham, Glenn C; Clark, Melissa A; Chomsky, Amy


    To describe current cataract surgery practices within the United States Veterans Health Administration (VHA). Veterans Health Administration hospitals in the U.S. Retrospective data analysis. An initial e-mail containing a link to an anonymous 32-question survey of cataract surgery practices was sent to participants in May 2016. Two reminder e-mails were sent to nonresponders 1 week and 2 weeks after the initial survey was sent; the remaining nonresponders were called twice over a 2-week period. The data were analyzed using descriptive statistics. The response rate was 75% (67/89). Cataract surgeons routinely ordered preoperative testing in 29 (45%) of 65 sections and preoperative consultations in 26 (39%) of 66 sections. In 22 (33%) of 66 sections, cataract surgeons administered intracameral antibiotics. In 61 (92%) of 66 sections, cataract surgeons used toric intraocular lenses (IOLs). In 20 (30%) of 66 sections, cataract surgeons used multifocal IOLs. Cataract surgeons in 6 (9%) of 66 sections performed femtosecond laser-assisted cataract surgery. In 6 (9%) of 66 sections, cataract surgeons performed immediate sequential bilateral cataract surgery. Forty-nine (74%) ophthalmology chiefs reported a high level of satisfaction with Veterans Affairs ophthalmology. The survey results indicate that in cataract surgery in the VHA, routine preoperative testing is commonly performed and emerging practices, such as femtosecond laser-assisted cataract surgery and immediate sequential bilateral cataract surgery, have limited roles. The results of this survey could benchmark future trends in U.S. cataract surgery practices, especially in teaching hospital settings. Copyright © 2017 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  7. Protect the Health of Women and Children


    CHINA has reached its present standard of maternal and child health by constant effort. Before the founding of New China in 1949, Chinese women’s life expectancy was only 37.6 years. A girl born today can expect to live an average of 72 years. Hygienic practices barely existed for mother and children in the early 1950s, said a health worker who remembers that period. Maternal mortality was high as a result of traditional midwifery practices, which often caused childbed fever. Infant

  8. Health Protection Features of Student Youth in Research University

    Antonova, Tatyana V.; Kozhanov, Vladimir V.; Kolodovsky, Alexander A.; Shivrinskaya, Svetlana E.; Kudyashev, Nail K.


    The relevance of the study is conditioned by the adverse dynamics of students' physical and mental health, which creates objective obstacles to the development of research universities. The article aims to find out particular health protection features of student youth in research universities. The leading approach of the study is the systematic…

  9. What Your Can Do to Protect Your Health Information

    ... store health information on your personal computer or mobile device, exchange emails about it, or participate in health-related online communities, here are a few things you should know: While the HIPAA Privacy and Security Rules are in place to protect and secure ...

  10. Administrative "health courts" for medical injury claims: the federal constitutional issues.

    Elliott, E Donald; Narayan, Sanjay A; Nasmith, Moneen S


    Our article analyzes whether the federal government may constitutionally supplant a traditional system of common-law trials before state judges and juries with new federal institutions designed by statute for compensating victims of medical injuries. Specifically, this article examines the federal constitutional issues raised by various proposals to replace traditional medical malpractice litigation in state courts with a federal system of administrative "health courts." In doing so, we address the following constitutional issues: 1. Is there federal authority to preempt state law (the commerce clause and spending clause issues)? 2. May jurisdiction be created in non-article 3 tribunals, and may claims be decided without trial by jury (the separation of powers and Seventh Amendment issues)? 3. Would pilot programs that require some claims to be pursued in a federal administrative forum while other claimants are left to pursue traditional state tort law remedies be constitutional (the equal protection issue)? The article concludes that a federal compensation system through administrative health courts should be constitutional provided the statute is appropriately drafted and that appropriate factual findings are made concerning the benefits to patients and the public as well as to doctors and their insurers.

  11. 292 The State of Administration of Health Services among ...



    Jan 18, 2011 ... health services, nursing services, and health education. Other areas ... (2001) sees school health services to be those services that take care of the health needs ..... Network, Family Health International 14:2:30. Chisango, T.

  12. Administration

    Bogen handler om den praksis, vi kalder administration. Vi er i den offentlige sektor i Danmark hos kontorfolkene med deres sagsmapper, computere, telefoner,, lovsamlinger,, retningslinier og regneark. I bogen udfoldes en mangfoldighed af konkrete historier om det administrative arbejde fra...... forskellige områder i den offentlige sektor. Hensigten er at forstå den praksis og faglighed der knytter sig til det administrative arbejde...

  13. Administrative Challenges to the Integration of Oral Health With Primary Care

    Maxey, Hannah L.; Randolph, Courtney; Gano, Laura; Kochhar, Komal


    Inadequate access to preventive oral health services contributes to oral health disparities and is a major public health concern in the United States. Federally Qualified Health Centers play a critical role in improving access to care for populations affected by oral health disparities but face a number of administrative challenges associated with implementation of oral health integration models. We conducted a SWOT (strengths, weaknesses, opportunities, and threats) analysis with health care executives to identify strengths, weaknesses, opportunities, and threats of successful oral health integration in Federally Qualified Health Centers. Four themes were identified: (1) culture of health care organizations; (2) operations and administration; (3) finance; and (4) workforce. PMID:27218701

  14. Health Economics Studies Information Exchange; Reports of Current Research in Health Economics, and Medical Care Administration. Publication No. 1719.

    Public Health Service (DHEW), Arlington, VA. Home Economics Branch.

    The first volume of a continuing series reporting research in progress in health economics and medical care organization and administration was compiled by contacting (1) graduate schools offering degrees in the health professions, sociology, economics, public administration, and public health, (2) charitable foundations indicating an interest in…

  15. Health Insecurity and Social Protection: Pathways, Gaps, and Their Implications on Health Outcomes and Poverty.

    Gama, Elvis


    Health insecurity has emerged as a major concern among health policy-makers particularly in low- and middle-income countries (LMICs). It includes the inability to secure adequate healthcare today and the risk of being unable to do so in the future as well as impoverishing healthcare expenditure. The increasing health insecurity among 150 million of the world's poor has moved social protection in health (SPH) to the top of the agenda among health policy-makers globally. This paper aims to provide a debate on the potential of social protection contribution to addressing health insecurity, poverty, and vulnerability brought by healthcare expenditure in low-income countries, to explore the gaps in current and proposed social protection measures in healthcare and provide suggestions on how social protection intervention aimed at addressing health insecurity, poverty, and vulnerability may be effectively implemented.

  16. Administration of kefir-fermented milk protects mice against Giardia intestinalis infection.

    Franco, Mariana Correa; Golowczyc, Marina A; De Antoni, Graciela L; Pérez, Pablo F; Humen, Martín; Serradell, María de los Angeles


    Giardiasis, caused by the protozoan Giardia intestinalis, is one of the most common intestinal diseases worldwide and constitutes an important problem for the public health systems of various countries. Kefir is a probiotic drink obtained by fermenting milk with 'kefir grains', which consist mainly of bacteria and yeasts that coexist in a complex symbiotic association. In this work, we studied the ability of kefir to protect mice from G. intestinalis infection, and characterized the host immune response to this probiotic in the context of the intestinal infection. Six- to 8-week-old C75BL/6 mice were separated into four groups: controls, kefir mice (receiving 1 : 100 dilution of kefir in drinking water for 14 days), Giardia mice (infected orally with 4×10(7) trophozoites of G. intestinalis at day 7) and Giardia-kefir mice (kefir-treated G. intestinalis-infected mice), and killed at 2 or 7 days post-infection. Kefir administration was able to significantly reduce the intensity of Giardia infection at 7 days post-infection. An increase in the percentage of CD4(+) T cells at 2 days post-infection was observed in the Peyer's patches (PP) of mice belonging to the Giardia group compared with the control and kefir groups, while the percentage of CD4(+) T cells in PP in the Giardia-kefir group was similar to that of controls. At 2 days post-infection, a reduction in the percentage of B220-positive major histocompatibility complex class II medium cells in PP was observed in infected mice compared with the other groups. At 7 days post-infection, Giardia-infected mice showed a reduction in RcFcε-positive cells compared with the control group, suggesting a downregulation of the inflammatory response. However, the percentages of RcFcε-positive cells did not differ from controls in the kefir and Giardia-kefir groups. An increase in IgA-positive cells was observed in the lamina propria of the kefir group compared with controls at 2 days post-infection. Interestingly, the

  17. The glass ceiling in academe: health administration is no exception.

    Stoskopf, C H; Xirasagar, S


    This paper reviews gender issues in academe and presents findings of a limited survey of ACEHSA-accredited health administration graduate programs. The survey shows gender ratios adverse to women at the full, associate, and assistant professor levels. Men to women ratio among faculty was 1.98, among full-time faculty it was 2.24, and among tenured/tenure-track faculty it was 2.69, despite an excess of female students over male students in graduate programs, and despite equal proportions of women and men faculty holding doctoral degrees. Distribution by rank showed 48.5 percent full professors, 27.8 percent associate professors, and, 20.1 percent assistant professors among men, vs. 27.4 percent, 41.1 percent, and 31.5 percent respectively among women. In other academic fields similar gender ratios prevail, and many researchers have documented evidence of continuing gender inequities in tenure, promotion and salary, given comparable performance, despite the enactment of Title IX in 1972. Gender disparities are rooted in a complex web of gender-specific constraints interwoven with secular human capital and structural variables, and confounded by sexist discriminatory factors. In light of these issues, recommendations are made toward creating an equitable academic climate without compromising the ideal of meritocracy, through gender-sensitive initiatives and vigilance mechanisms to bring policies to fruition.

  18. Characteristics of Veterans Health Administration chiropractors and chiropractic clinics.

    Lisi, Anthony J; Goertz, Christine; Lawrence, Dana J; Satyanarayana, Preeti


    Chiropractic services have been delivered on station at select Veterans Health Administration (VHA) medical facilities since late 2004. No published data describing the characteristics of VHA chiropractic physicians (chiropractors) and chiropractic clinics exist at a national level. This study was designed to examine elements of the structures of chiropractic services in VHA settings. Web-based survey methods were used to question all chiropractors in VHA facilities (N = 36). Data were obtained from 33 providers, yielding a 91.6% response rate. Most respondents were full-time VHA employees, while others were part-time employees or contractors. Differences were found in prior training, integrated practice, and academic or research experience. Of the respondents, 88% ranked low back pain as the most common patient complaint seen in practice and 79% ranked cervical pain the second most common complaint. Of the new patient consultations, 67.6% originated from primary care, 9.4% from pain management, and 6.2% from physiatry. Most respondents were similar in their reported use of diagnostic and therapeutic procedures, but their reported rates of participation in various facility activities were different. Further work is needed for researchers and policy makers to more fully understand the integration and delivery of chiropractic services in VHA settings.

  19. Veterans Health Administration: Management Attention Is Needed to Address Systemic, Long standing Human Capital Challenges


    required by the Choice Act: the Independent Assessment of the Health Care Delivery Systems and Management Processes of the Department of Veterans...VETERANS HEALTH ADMINISTRATION Management Attention Is Needed to Address Systemic, Long-standing Human Capital...Government Accountability Office Highlights of GAO-17-30, a report to congressional requesters December 2016 VETERANS HEALTH ADMINISTRATION

  20. New Law Protects the Health of Mothers and Infants


    CHINA celebrates International Children’s Day this year with the implementation of a law protecting the health of the country’s mothers and infants. The Law of the P.R.C. on the Protection of Mothers and Infants, passed on October 27, 1994, during the 10th Session of the 8th Standing Committee of National People’s Congress, was publicly issued on the No.33 Command of the President of the P.R.C. and will go into effect June 1, 1995. This first law specifically concerned with the protection of the health of women and children is expected to play an important role in the overall improvement of the health of the Chinese people, the quality of the population, the advancement of the society, and the overall happiness among families. The law stresses the promotion of maternal and child hygiene

  1. The American Association of Occupational Health Nurses' Respiratory Protection Education Program and Resources Webkit for Occupational Health Professionals.

    Pompeii, Lisa; Byrd, Annette; Delclos, George L; Conway, Sadie H


    Organizations are required to adhere to the Occupational Safety and Health Administration's (OSHA) Respiratory Protection Standard (29 CFR 1910.134) if they have workers that wear a respirator on the job. They must also have an employee "suitably trained" to administer their program. The National Institute for Occupational Safety and Health and its National Personal Protective Technology Laboratory have worked to champion the occupational health nurse in this role by collaborating with the American Association of Occupational Health Nurses to develop free, online respiratory protection training and resources (RPP Webkit). This article describes the development, content, and success of this training. To date, 724 participants have completed the training, 32.6% of whom lead their organization's respiratory protection program, 15.3% who indicated they will lead a program in the near future, and 52% who did not lead a program, but indicated that the training was relevant to their work. The majority "strongly agreed" the training was applicable to their work and it enhanced their professional expertise. © 2016 The Author(s).

  2. Systemic Administration of Proteoglycan Protects BALB/c Retired Breeder Mice from Experimental Arthritis

    Larissa Lumi Watanabe Ishikawa


    Full Text Available This study was undertaken to evaluate the prophylactic potential of proteoglycan (PG administration in experimental arthritis. Female BALB/c retired breeder mice received two (2xPG50 and 2xPG100 groups or three (3xPG50 group intraperitoneal doses of bovine PG (50 μg or 100 μg every three days. A week later the animals were submitted to arthritis induction by immunization with three i.p. doses of bovine PG associated with dimethyldioctadecylammonium bromide adjuvant at intervals of 21 days. Disease severity was daily assessed after the third dose by score evaluation. The 3xPG50 group showed significant reduction in prevalence and clinical scores. This protective effect was associated with lower production of IFN-γ and IL-17 and increased production of IL-5 and IL-10 by spleen cells restimulated in vitro with PG. Even though previous PG administration restrained dendritic cells maturation this procedure did not alter the frequency of regulatory Foxp3+ T cells. Lower TNF-α and IL-6 levels and higher expression of ROR-γ and GATA-3 were detected in the paws of protected animals. A delayed-type hypersensitivity reaction confirmed specific tolerance induction. Taken together, these results indicate that previous PG inoculation determines a specific tolerogenic effect that is able to decrease severity of subsequently induced arthritis.

  3. Ginseng administration protects skeletal muscle from oxidative stress induced by acute exercise in rats.

    Voces, J; Cabral de Oliveira, A C; Prieto, J G; Vila, L; Perez, A C; Duarte, I D G; Alvarez, A I


    Enzymatic activity was analyzed in the soleus, gastrocnemius (red and white) and plantaris muscles of acutely exercised rats after long-term administration of Panax ginseng extract in order to evaluate the protective role of ginseng against skeletal muscle oxidation. Ginseng extract (3, 10, 100, or 500 mg/kg) was administered orally for three months to male Wistar rats weighing 200 +/- 50 g before exercise and to non-exercised rats (N = 8/group). The results showed a membrane stabilizing capacity of the extract since mitochondrial function measured on the basis of citrate synthase and 3-hydroxyacyl-CoA dehydrogenase activities was reduced, on average, by 20% (P < 0.05) after exercise but the activities remained unchanged in animals treated with a ginseng dose of 100 mg/kg. Glutathione status did not show significant changes after exercise or treatment. Lipid peroxidation, measured on the basis of malondialdehyde levels, was significantly higher in all muscles after exercise, and again was reduced by about 74% (P < 0.05) by the use of ginseng extract. The administration of ginseng extract was able to protect muscle from exercise-induced oxidative stress irrespective of fiber type.

  4. Ginseng administration protects skeletal muscle from oxidative stress induced by acute exercise in rats

    J. Voces


    Full Text Available Enzymatic activity was analyzed in the soleus, gastrocnemius (red and white and plantaris muscles of acutely exercised rats after long-term administration of Panax ginseng extract in order to evaluate the protective role of ginseng against skeletal muscle oxidation. Ginseng extract (3, 10, 100, or 500 mg/kg was administered orally for three months to male Wistar rats weighing 200 ± 50 g before exercise and to non-exercised rats (N = 8/group. The results showed a membrane stabilizing capacity of the extract since mitochondrial function measured on the basis of citrate synthase and 3-hydroxyacyl-CoA dehydrogenase activities was reduced, on average, by 20% (P < 0.05 after exercise but the activities remained unchanged in animals treated with a ginseng dose of 100 mg/kg. Glutathione status did not show significant changes after exercise or treatment. Lipid peroxidation, measured on the basis of malondialdehyde levels, was significantly higher in all muscles after exercise, and again was reduced by about 74% (P < 0.05 by the use of ginseng extract. The administration of ginseng extract was able to protect muscle from exercise-induced oxidative stress irrespective of fiber type.

  5. Ghana's National Health Insurance Scheme: insights from members, administrators and health care providers.

    Barimah, Kofi Bobi; Mensah, Joseph


    The Ghana National Health Insurance Scheme (NHIS) was established as part of a poverty reduction strategy to make health care more affordable to Ghanaians. It is envisaged that it will eventually replace the existing cash-and-carry system. This paper examines the views of NHIS administrators, members/enrollees, and health care providers on how the Scheme operates in practice. It is part of a larger evaluation project on Ghana's NHIS, sponsored by the Bill and Melinda Gates Foundation and the Global Development Network as part of a two-year global research. We rely primarily on qualitative data from focus group discussion in the Brong Ahafo and the Upper East regions respectively. Our findings suggest that the NHIS has improved access to affordable health care services and prescription drugs to many people in Ghana. However, there are concerns about fraud and corruption that must be addressed if the Scheme is to be financially viable.

  6. Veterans Health Care: Veterans Health Administration Processes for Responding to Reported Adverse Events


    evaluation, a clinician is given an opportunity to improve his or her clinical competence over a period of time as determined by the VAMC director. At... competence by a peer. GAO-12-827R Veterans Health Administration Response to Reported Adverse Events 8 concerns about clinical competence remain...the discretion of the VAMC director, this evaluation can include progressive training or proctoring aimed at helping the clinician improve clinical


    Marcos César Botelho


    Full Text Available It is argued in the present article about the possibility of a health discursive administration. The starting point is the theoretical ideas from the theory of the discourse, the concept of discursive democracy and its distinction from the deliberative idea. We seek to demonstrate that the Brazilian constitutional model to the health, while social fundamental right, allows the development of an administration based on the Habermas’ discursive model. From our bibliographic research, it was concluded that the health administrative model in the Federal Constitution allows the application of the Habermas’ discursive theory premises resulting in an effective improvement of the democratic participation in health administration.

  8. Apollo experience report: Protection of life and health

    Wooley, B. C.


    The development, implementation, and effectiveness of the Apollo Lunar Quarantine Program and the Flight Crew Health Stabilization Program are discussed as part of the broad program required for the protection of the life and health of U.S. astronauts. Because the goal of the Apollo Program has been the safe transport of men to the moon and back to earth, protection of the astronauts and of the biosphere from potentially harmful lunar contaminants has been required. Also, to ensure mission success, the continuing good health of the astronauts before and during a mission has been necessary. Potential applications of specific aspects of the health and quarantine programs to possible manned missions to other planets are discussed.

  9. Proposal for a European Public Health Research Infrastructure for Sharing of health and Medical administrative data (PHRIMA).

    Burgun, Anita; Oksen, Dina V; Kuchinke, Wolfgang; Prokosch, Hans-Ulrich; Ganslandt, Thomas; Buchan, Iain; van Staa, Tjeerd; Cunningham, James; Gjerstorff, Marianne L; Dufour, Jean-Charles; Gibrat, Jean-Francois; Nikolski, Macha; Verger, Pierre; Cambon-Thomsen, Anne; Masella, Cristina; Lettieri, Emanuele; Bertele, Paolo; Salokannel, Marjut; Thiebaut, Rodolphe; Persoz, Charles; Chêne, Geneviève; Ohmann, Christian


    In Europe, health and medical administrative data is increasingly accumulating on a national level. Looking further than re-use of this data on a national level, sharing health and medical administrative data would enable large-scale analyses and European-level public health projects. There is currently no research infrastructure for this type of sharing. The PHRIMA consortium proposes to realise the Public Health Research Infrastructure for Sharing of health and Medical Administrative data (PHRIMA) which will enable and facilitate the efficient and secure sharing of healthcare data.

  10. Does social capital protect mental health among migrants in Sweden?

    Lecerof, Susanne Sundell; Stafström, Martin; Westerling, Ragnar; Östergren, Per-Olof


    Poor mental health is common among migrants. This has been explained by migration-related and socio-economic factors. Weak social capital has also been related to poor mental health. Few studies have explored factors that protect mental health of migrants in the post-migration phase. Such knowledge could be useful for health promotion purposes. Therefore, this study aimed to analyse associations between financial difficulties, housing problems and experience of discrimination and poor mental health; and to detect possible effect modification by social capital, among recently settled Iraqi migrants in Sweden. A postal questionnaire in Arabic was sent to recently settled Iraqi citizens. The response rate was 51% (n = 617). Mental health was measured by the GHQ-12 instrument and social capital was defined as social participation and trust in others. Data were analysed by means of logistic regression. Poor mental health was associated with experience of discrimination (OR 2.88, 95% CI 1.73-4.79), housing problems (OR 2.79, 95% CI 1.84-4.22), and financial difficulties (OR 2.14, 95% CI 1.44-3.19), after adjustments. Trust in others seemed to have a protective effect for mental health when exposed to these factors. Social participation had a protective effect when exposed to experience of discrimination. Social determinants and social capital in the host country play important roles in the mental health of migrants. Social capital modifies the effect of risk factors and might be a fruitful way to promote resilience to factors harmful to mental health among migrants, but must be combined with policy efforts to reduce social inequities.

  11. Health, Education and Economic Crisis : Protecting the Poor in Indonesia

    Sparrow, R.A.


    When an economic crisis hits, a primary policy concern in developing countries is how social services can be protected and, in particular, how access to health and education for the poor can be maintained. Using the Indonesian Social Safety Net (SSN) as case study, this dissertation investigates

  12. Health, Education and Economic Crisis : Protecting the Poor in Indonesia

    Sparrow, R.A.


    When an economic crisis hits, a primary policy concern in developing countries is how social services can be protected and, in particular, how access to health and education for the poor can be maintained. Using the Indonesian Social Safety Net (SSN) as case study, this dissertation investigates th

  13. Protecting health from climate change: Preparedness of medical interns

    Majra Jai


    Full Text Available Context : Climate change is a significant and emerging threat to public health and to meet the challenge, health systems require qualified staff. Aims : To study the preparedness of medical interns to meet the challenge of protecting health from climate change. Settings and Design: Medical colleges in a coastal town. Cross-sectional study. Materials and Methods: A proportionate number of medical interns from five medical colleges were included in the study. Level of awareness was used as a criterion to judge the preparedness. A self-administered, pretested, open-ended questionnaire was used. Responses were evaluated and graded. Statistical Analysis Used: Proportions, percentage, Chi-test. Results : About 90% of the medical interns were aware of the climate change and human activities that were playing a major role. Ninety-four percent were aware of the direct health impacts due to higher temperature and depletion in ozone concentration, and about 78% of the respondents were aware about the change in frequency / distribution of vector-borne diseases, water borne / related diseases, malnutrition, and health impact of population displacement. Knowledge regarding health protection was limited to mitigation of climate change and training / education. Options like adaptation, establishing / strengthening climate and disease surveillance systems, and health action in emergency were known to only nine (7%, eight (6%, and 17 (13%, respectively. Collegewise difference was statistically insignificant. Extra / co-curricular activities were the major source of knowledge. Conclusions : Majority of medical interns were aware of the causes and health impacts of climate change, but their knowledge regarding health protection measures was limited.

  14. Older Adult Participation in Health Promotion Programs: Perspectives of Facility Administrators

    Wright, Tim; Hyner, Gerald C.


    Administrators of older adult-centered facilities must identify barriers to the planning and implementation of health promotion programs. In this qualitative research those barriers were identified through in-depth interviews with administrators of older adult-centered facilities. As identified by administrators, the predominant barriers to the…

  15. It is not on Medicines that Protecting-health Depend

    CHEN Han-ping


    @@ What should people depend on for pursuing the health and longevity? It is first on one's own efforts according to my viewpoint, such as rationalizing daily diet, making an appropriate exercises and a mental balance, giving up smoking while moderating liquor, etc. Then one turns to the medical measure for help if necessary. Even though in this case it is not imperative to select medicinal simply, because acupuncture therapy,as well as Tuina one, both called "alternative medicine" in Western medical sector, is also able to play an important role in protecting health and treating illness. This is what expected to be expressed by this paper, in the light of the therapies' properties of efficiency in treating disorder as well as in protecting health, while no complicated toxicity and other side-effects, therefore they are called "green-therapy" and deeply concerned by medical scientists and the publics in the world, especially when the drug-evil runs wild worldwide.

  16. Radiation Protection and Dosimetry An Introduction to Health Physics

    Stabin, Michael G


    This comprehensive text provides an overview of all relevant topics in the field of radiation protection (health physics). Radiation Protection and Dosimetry serves as an essential handbook for practicing health physics professionals, and is also ideal as a teaching text for courses at the university level. The book is organized to introduce the reader to basic principles of radiation decay and interactions, to review current knowledge and historical aspects of the biological effects of radiation, and to cover important operational topics such as radiation shielding and dosimetry. In addition to presenting the most up to date treatment of the topics and references to the literature, most chapters contain numerical problems with their solutions for use in teaching or self assessment. One chapter is devoted to Environmental Health Physics, which was written in collaboration with leading professionals in the area.

  17. Psychoneuroimmunology and health psychology: inflammation and protective factors.

    Bertini, M; Conti, C M; Fulcheri, M


    A common clinical observation is the adverse relationship between stress and human diseases. The attention of scientific research on health has been disproportionately focused on risk factors that predict the onset of certain health outcomes, in particular there has been an increasing interest in the role of inflammation as a common mechanism of disease in a number of medical and neuropsychiatric diseases. Despite the importance of such research being undisputed, it is necessary to emphasize what the protective factors are that promote psychosocial recovery processes and increased survival rates in a biopsychosocial perspective. This article aims to understand the relationship between psychosocial factors and immune system in the interests of health psychology, highlighting the protective factors that promote recovery, resiliency and resistance to disease.

  18. Large-scale Health Information Database and Privacy Protection*1

    YAMAMOTO, Ryuichi


    Japan was once progressive in the digitalization of healthcare fields but unfortunately has fallen behind in terms of the secondary use of data for public interest. There has recently been a trend to establish large-scale health databases in the nation, and a conflict between data use for public interest and privacy protection has surfaced as this trend has progressed. Databases for health insurance claims or for specific health checkups and guidance services were created according to the law that aims to ensure healthcare for the elderly; however, there is no mention in the act about using these databases for public interest in general. Thus, an initiative for such use must proceed carefully and attentively. The PMDA*2 projects that collect a large amount of medical record information from large hospitals and the health database development project that the Ministry of Health, Labour and Welfare (MHLW) is working on will soon begin to operate according to a general consensus; however, the validity of this consensus can be questioned if issues of anonymity arise. The likelihood that researchers conducting a study for public interest would intentionally invade the privacy of their subjects is slim. However, patients could develop a sense of distrust about their data being used since legal requirements are ambiguous. Nevertheless, without using patients’ medical records for public interest, progress in medicine will grind to a halt. Proper legislation that is clear for both researchers and patients will therefore be highly desirable. A revision of the Act on the Protection of Personal Information is currently in progress. In reality, however, privacy is not something that laws alone can protect; it will also require guidelines and self-discipline. We now live in an information capitalization age. I will introduce the trends in legal reform regarding healthcare information and discuss some basics to help people properly face the issue of health big data and privacy

  19. Large-scale Health Information Database and Privacy Protection.

    Yamamoto, Ryuichi


    Japan was once progressive in the digitalization of healthcare fields but unfortunately has fallen behind in terms of the secondary use of data for public interest. There has recently been a trend to establish large-scale health databases in the nation, and a conflict between data use for public interest and privacy protection has surfaced as this trend has progressed. Databases for health insurance claims or for specific health checkups and guidance services were created according to the law that aims to ensure healthcare for the elderly; however, there is no mention in the act about using these databases for public interest in general. Thus, an initiative for such use must proceed carefully and attentively. The PMDA projects that collect a large amount of medical record information from large hospitals and the health database development project that the Ministry of Health, Labour and Welfare (MHLW) is working on will soon begin to operate according to a general consensus; however, the validity of this consensus can be questioned if issues of anonymity arise. The likelihood that researchers conducting a study for public interest would intentionally invade the privacy of their subjects is slim. However, patients could develop a sense of distrust about their data being used since legal requirements are ambiguous. Nevertheless, without using patients' medical records for public interest, progress in medicine will grind to a halt. Proper legislation that is clear for both researchers and patients will therefore be highly desirable. A revision of the Act on the Protection of Personal Information is currently in progress. In reality, however, privacy is not something that laws alone can protect; it will also require guidelines and self-discipline. We now live in an information capitalization age. I will introduce the trends in legal reform regarding healthcare information and discuss some basics to help people properly face the issue of health big data and privacy

  20. [Bavarian mental health reform 1851. An instrument of administrative modernization].

    Burgmair, Wolfgang; Weber, Matthias M


    By 1850 the reformation of institutional psychiatric care in Bavaria was given the highest priority by monarchy and administration. Cooperating with experts, especially the psychiatrist Karl August von Solbrig, they provided for new asylums to be established throughout Bavaria in a surprisingly short period of time. It was, however, only at personal intervention of King Max II. that the administrative and financial difficulties which had existed since the beginning of the 19th century could be overcome. The planning of asylums done by each administrative district of Bavaria vividly reflects rivalry as well as cooperation between all governmental and professional agencies involved. Modernization of psychiatry was publicly justified by referring to scientism, the need for a more progressive restructuring of administration, and the paternalistic care of the monarchy, whereas, from an administrative point of view, aspects of psychiatric treatment, like what kind of asylum would be best, were rather insignificant. The structures established by means of the alliance between state administration and psychiatric care under the rule of King Max II. had a lasting effect on the further development of Bavaria.

  1. Veterans Health Administration Survey of Healthcare Experiences of Patients (SHEP)

    U.S. Department of Health & Human Services — A list of VHA hospitals with inpatient experience of care survey data. The VA SHEP uses the same questions as the Hospital Consumer Assessment of Health Providers...

  2. The National Aeronautics and Space Administration's Earth Science Applications Program: Exploring Partnerships to Enhance Decision Making in Public Health Practice

    Vann, Timi S.; Venezia, Robert A.


    The National Aeronautics and Space Administration (NASA), Earth Science Enterprise is engaged in applications of NASA Earth science and remote sensing technologies for public health. Efforts are focused on establishing partnerships with those agencies and organizations that have responsibility for protecting the Nation's Health. The program's goal is the integration of NASA's advanced data and technology for enhanced decision support in the areas of disease surveillance and environmental health. A focused applications program, based on understanding partner issues and requirements, has the potential to significantly contribute to more informed decision making in public health practice. This paper intends to provide background information on NASA's investment in public health and is a call for partnership with the larger practice community.

  3. Sustainability in primary care and Mental Health Integration projects in Veterans Health Administration.

    Ford, James H; Krahn, Dean; Oliver, Karen Anderson; Kirchner, JoAnn


    To explore staff perceptions about sustainability, commitment to change, participation in change process, and information received about the change project within the Veterans Administration Primary Care and Mental Health Integration (PC-MHI) initiative and to examine differences from the Veterans Health Administration Mental Health Systems Redesign (MHSR) initiative. Surveys of change team members involved in the Veterans Affairs PC-MHI and MHSR initiatives. One-way analysis of variance examined the relationship between commitment, participation and information, and sustainability. Differences in PC-MHI sustainability were explored by location and job classification. Staff sustainability perceptions were compared with MHSR results. Sustainability differed by staff discipline. Difference between MHSR and PC-MHI existed by job function and perceptions about the change benefits. Participation in the change process and information received about the change process were positively correlated with sustainability. Staff commitment to change was positively associated with staff perceptions about the benefits of change and staff attitudes toward change. Sustainability is an important part of organizational change efforts. Change complexity seems to influence perception about sustainability and impacts staff perceptions about the benefits of change. These perceptions seem to be driven by the information received and opportunities to participate in the change process. Further research is needed to understand how information and participation influence sustainability and affect employee commitment to change.

  4. Financial protection in health: updates for Mexico to 2014

    Felicia Marie Knaul


    Full Text Available Objetive. Document financial protection in health in Mexico up to 2014. Materials and methods. We update the measures of impoverishing and catastrophic health expenditure to 2014, to analyse shifts since the implementation of the System for Social Protection in Health and the Seguro Popular using time series data from the Household Income and Expenditure Survey. Results. Between 2004 and 2014 there has been a continued improvement in levels of financial protection. Excessive expenditure reached its lowest point: –2.0% in 2012 and 2.1% in 2014. Impoverishing expenditure dropped to 1.3% in 2004, compared to 0.5% in 2014, and catastrophic expenditures from 2.7% to 2.1%. Conclusions. The time series of data on financial protection show a clear pattern of improvement between 2000 and 2014 and level off and low levels in 2012 and 2014. Still, levels continue to be relatively high for households in the poorest quintile, in rural areas and with an elderly person.

  5. Integrating occupational health protection and health promotion: theory and program application.

    Blix, A


    1. The worksite offers an excellent setting to focus on both health protection and health promotion. Collaboration between health professionals concerned with health protection and health promotion would achieve common goals of risk reduction related to job risks and life risks. 2. Workers who experience "double jeopardy" because they are exposed to job risks and life risks would benefit most. 3. Benefits of integration include lower health risks, joint responsibility to promote health and safety shared between management and workers, and cost effectiveness. 4. The social ecological model is useful in developing an integrated program as it is multidimensional, interdisciplinary, and includes the dynamic interplay between the environment and personal factors impacting the health outcome.

  6. Therapeutic administration of recombinant Paracoccin confers protection against paracoccidioides brasiliensis infection: involvement of TLRs.

    Ana Claudia Paiva Alegre-Maller


    Full Text Available Paracoccin (PCN is an N-acetylglucosamine-binding lectin from the human pathogenic fungus Paracoccidioides brasiliensis. Recombinant PCN (rPCN induces a T helper (Th 1 immune response when prophylactically administered to BALB/c mice, protecting them against subsequent challenge with P. brasiliensis. In this study, we investigated the therapeutic effect of rPCN in experimental paracoccidioidomycosis (PCM and the mechanism accounting for its beneficial action.Four distinct regimens of rPCN administration were assayed to identify which was the most protective, relative to vehicle administration. In all rPCN-treated mice, pulmonary granulomas were less numerous and more compact. Moreover, fewer colony-forming units were recovered from the lungs of rPCN-treated mice. Although all therapeutic regimens of rPCN were protective, maximal efficacy was obtained with two subcutaneous injections of 0.5 µg rPCN at 3 and 10 days after infection. The rPCN treatment was also associated with higher pulmonary levels of IL-12, IFN-γ, TNF-α, nitric oxide (NO, and IL-10, without IL-4 augmentation. Encouraged by the pulmonary cytokine profile of treated mice and by the fact that in vitro rPCN-stimulated macrophages released high levels of IL-12, we investigated the interaction of rPCN with Toll-like receptors (TLRs. Using a reporter assay in transfected HEK293T cells, we verified that rPCN activated TLR2 and TLR4. The activation occurred independently of TLR2 heterodimerization with TLR1 or TLR6 and did not require the presence of the CD14 or CD36 co-receptors. The interaction between rPCN and TLR2 depended on carbohydrate recognition because it was affected by mutation of the receptor's N-glycosylation sites. The fourth TLR2 N-glycan was especially critical for the rPCN-TLR2 interaction.Based on our results, we propose that PCN acts as a TLR agonist. PCN binds to N-glycans on TLRs, triggers regulated Th1 immunity, and exerts a therapeutic effect against P

  7. Administrative Challenges to the Integration of Oral Health With Primary Care: A SWOT Analysis of Health Care Executives at Federally Qualified Health Centers.

    Norwood, Connor W; Maxey, Hannah L; Randolph, Courtney; Gano, Laura; Kochhar, Komal

    Inadequate access to preventive oral health services contributes to oral health disparities and is a major public health concern in the United States. Federally Qualified Health Centers play a critical role in improving access to care for populations affected by oral health disparities but face a number of administrative challenges associated with implementation of oral health integration models. We conducted a SWOT (strengths, weaknesses, opportunities, and threats) analysis with health care executives to identify strengths, weaknesses, opportunities, and threats of successful oral health integration in Federally Qualified Health Centers. Four themes were identified: (1) culture of health care organizations; (2) operations and administration; (3) finance; and (4) workforce.

  8. Ascertainment of chronic diseases using population health data: a comparison of health administrative data and patient self-report

    Muggah Elizabeth; Graves Erin; Bennett Carol; Manuel Douglas G


    Abstract Background Health administrative data is increasingly being used for chronic disease surveillance. This study explored agreement between administrative and survey data for ascertainment of seven key chronic diseases, using individually linked data from a large population of individuals in Ontario, Canada. Methods All adults who completed any one of three cycles of the Canadian Community Health Survey (2001, 2003 or 2005) and agreed to have their responses linked to provincial health ...

  9. Combined administration of taurine and monoisoamyl DMSA protects arsenic induced oxidative injury in rats.

    Flora, Swaran J S; Chouhan, Swapnila; Kannan, Gurusamy M; Mittal, Megha; Swarnkar, Harimohan


    Arsenic is a naturally occurring element that is ubiquitously present in the environment. High concentration of naturally occurring arsenic in drinking water is a major health problem in different parts of the world. Despite arsenic being a health hazard and a well documented carcinogen, no safe, effective and specific preventive or therapeutic measures are available. Among various recent strategies adopted, administration of an antioxidant has been reported to be the most effective. The present study was designed to evaluate the therapeutic efficacy of monoisoamyl dimercaptosuccinic acid (MiADMSA), administered either individually or in combination with taurine post chronic arsenic exposure in rats. Arsenic exposed male rats (25 ppm, sodium arsenite in drinking water for 24 weeks) were treated with taurine (100 mg/kg, i.p., once daily), monoisoamyl dimercaptosuccinic acid (MiADMSA) (50 mg/kg, oral, once daily) either individually or in combination for 5 consecutive days. Biochemical variables indicative of oxidative stress along-with arsenic concentration in blood, liver and kidney were measured. Arsenic exposure significantly reduced blood delta-aminolevulinic acid dehydratase (ALAD) activity, a key enzyme involved in the heme biosynthesis and enhanced zinc protoporphyrin (ZPP) level. Clinical hematological variables like white blood cells (WBC), mean cell hemoglobin (MCH), and mean cell hemoglobin concentration (MCHC) showed significant decrease with a significant elevation in platelet (PLT) count. These changes were accompanied by significant decrease in superoxide dismutase (SOD) activity and increased catalase activity. Arsenic exposure caused a significant decrease in hepatic and renal glutathione (GSH) level and an increase in oxidized glutathione (GSSG). These biochemical changes were correlated with an increased uptake of arsenic in blood, liver and kidney. Administration of taurine significantly reduced hepatic oxidative stress however co-administration

  10. Combined Administration of Taurine and Monoisoamyl Dmsa Protects Arsenic Induced Oxidative Injury in Rats

    Swaran J. S. Flora


    Full Text Available Arsenic is a naturally occurring element that is ubiquitously present in the environment. High concentration of naturally occurring arsenic in drinking water is a major health problem in different parts of the world. Despite arsenic being a health hazard and a well documented carcinogen, no safe, effective and specific preventive or therapeutic measures are available. Among various recent strategies adopted, administration of an antioxidant has been reported to be the most effective. The present study was designed to evaluate the therapeutic efficacy of monoisoamyl dimercaptosuccinic acid (MiADMSA, administered either individually or in combination with taurine post chronic arsenic exposure in rats. Arsenic exposed male rats (25 ppm, sodium arsenite in drinking water for 24 weeks were treated with taurine (100 mg/kg, i.p., once daily, monoisoamyl dimercaptosuccinic acid (MiADMSA (50 mg/kg, oral, once daily either individually or in combination for 5 consecutive days. Biochemical variables indicative of oxidative stress along-with arsenic concentration in blood, liver and kidney were measured. Arsenic exposure significantly reduced blood δ-aminolevulinic acid dehydratase (ALAD activity, a key enzyme involved in the heme biosynthesis and enhanced zinc protoporphyrin (ZPP level. Clinical hematological variables like white blood cells (WBC, mean cell hemoglobin (MCH, and mean cell hemoglobin concentration (MCHC showed significant decrease with a significant elevation in platelet (PLT count. These changes were accompanied by significant decrease in superoxide dismutase (SOD activity and increased catalase activity. Arsenic exposure caused a significant decrease in hepatic and renal glutathione (GSH level and an increase in oxidized glutathione (GSSG. These biochemical changes were correlated with an increased uptake of arsenic in blood, liver and kidney. Administration of taurine significantly reduced hepatic oxidative stress however co-administration


    Yermolenko V. V.


    Full Text Available The article heads a series of the publications devoted to the solution of an actual problem of modern health care - a management problem at the regional level. The contradiction between expectations and needs of the population for high-quality medical services and quality of management of the medical organizations is shown in the Russian health system. This contradiction is shown at the micro and meso (regional level in poor quality of not medical part of medical services and in total generates a dissatisfaction of patients with quality of medical services in general. At this stage of reforming of health system in Russia, economic and administrative problems are main issues. It is necessary to master and quickly to introduce in work practice modern economic methods and administrative technologies for their decision. Network creation of the companies belongs to a remarkable trend of development modern societies and economics. The cluster campaign was widely adopted. Studying of network forms of the organizations is based on interdisciplinary researches on ecological, economic, administrative and relational approaches. Application of network structures in health sector is based on the new organizational and administrative principles, from which are main: principle of systems; principle of a synergy of material and immaterial resources; principle of trust; principle of reciprocity; principle of formation of network culture and ideological coordination of actors of a network; principle of economy of the valid human capital; accession of the network management and its actors to business services in relation to the diagnostic and treatment process; professionalizing of activity of infrastructure service of a network and its participants

  12. Space toxicology: protecting human health during space operations.

    Khan-Mayberry, Noreen; James, John T; Tyl, Rochelle; Lam, Chiu-wing


    Space toxicology is a unique and targeted discipline for spaceflight, space habitation, and occupation of celestial bodies including planets, moons, and asteroids. Astronaut explorers face distinctive health challenges and limited resources for rescue and medical care during space operation. A central goal of space toxicology is to protect the health of the astronaut by assessing potential chemical exposures during spaceflight and setting safe limits that will protect the astronaut against chemical exposures while in a physiologically altered state. In order to maintain sustained occupation in space on the International Space Station (ISS), toxicological risks must be assessed and managed within the context of isolation, continuous exposures, reuse of air and water, limited rescue options, and the need to use highly toxic compounds for propulsion and other purposes. As we begin to explore other celestial bodies, in situ toxicological risks, such as inhalation of reactive mineral dusts, must also be managed.

  13. Symposium on Economic Change, Scarcity and Mental Health Administration.

    Feldman, Saul, ed.


    Discusses challenges to the mental health field as a result of severe economic change. The six articles deal with reindustrialization, the effect of the labor market on mental hospital and prison use, retrenchment strategies, mental health problems in energy boomtowns, and economic issues of public policy. (JAC)


    V.G. Fotynyuk


    Full Text Available Purpose: to assess health protection and health related physical culture trainings of first year students. Material: in the research first year students (n=121; 86 boys and 35girls of age 16 - 19 years, participated. Results: components of students’ individual health were found. Situation with health related physical culture trainings, ensuring students’ sound health and optimal functional potentials of their organisms were determined. It was found that leading role shall be played by formation of health world vision values, knowledge about formation of practical skills in healthy life style. Motivation tendency for realization of intentions and practicing of health related physical culture trainings were found in students. Conclusions: the received results prove students’ tendency to pay insufficient attention to individual health. It was found that health related physical culture trainings require modern renewal of education’s content, forms and methods of physical education. The basis of such trainings shall be health related orientation.

  15. The Data Protection Act (1998): implications for health researchers.

    Redsell, S A; Cheater, F M


    This paper reports on the methods used in two studies to obtain access to subjects to comply with the common law duty of confidence laid out in the Data Protection Act (1998) and discusses the researchers' problems in interpreting the procedures. The amendments to the United Kingdom (UK) Data Protection Act (1998) are causing confusion within the health service and academic institutions. There is a need to balance patient confidentiality with the requirement to conduct vital, unbiased research in which health service professionals are not subject to ethical dilemmas. This paper examines the recruitment methods used in two studies in which the researchers' attempts to adhere to the requirements lengthened the study costs and may have produced less reliable results. The methodological difficulties in two studies are presented. In Study 1, the difficulties encountered when the Multicentre Research Ethics Committee refused permission for researchers to recruit patients directly to a multicentre randomized controlled trial are discussed. In Study 2, the method used to compile a sampling frame for a national questionnaire survey following the eight principles of the Act are described. Our experience has shown that health care professionals are increasingly required to recruit patients to intervention trials, and that researchers are not allowed access to the names of patients or other subjects to ask them for consent to participate in a study. The requirement for researchers to use "intermediaries" to obtain consent from and recruit subjects to studies increases the risk of selection bias, may expose the practitioner to ethical difficulties and may compromise the external validity of trial results. There is also a danger that research costs will soar when the Data Protection Act (1998) is fully realized. The Data Protection Act (1998) is currently being interpreted in a number of different ways. We conclude there is an urgent need for consensus within the health service

  16. [Gender inequalities in the Spanish Public Health and Health Administration Society (2000-2009)].

    Morrison, Joana; Borrell, Carme; Marí-Dell'Olmo, Marc; Ruiz Cantero, María Teresa; Benach, Joan; Fernández, Esteve; Pasarín, M Isabel; Pérez, Glòria; Cascant, Lorena; Alvarez-Dardet, Carlos; Artazcoz, Lucía; Pérez, Katherine; García-Calvente, María Del Mar; Ruiz, Isabel


    To describe gender inequalities in positions of leadership and scientific recognition in activities carried out by the Spanish Public Health and Health Administration Society (SESPAS), the Spanish Epidemiology Society (SEE) and the Health Economics Association (AES) for 2000-2009. We performed a descriptive study of the gender distribution of the boards of directors, scientific and conference organization committees and chairpersons of the SESPAS, SEE and AES. The gender distribution of the editorial board of Gaceta Sanitaria, and of the authors of editorials published in the journal, as well as that of the editors of SESPAS Reports, was also analyzed. Between 2000 and 2009, there was a slight increase in women's participation in the SESPAS and there was greater gender parity in the SEE. However, representation of women in the AES was low. The causes of gender inequalities in public health professional societies should continue to be analyzed and actions should be taken to change the present situation. Copyright © 2009 SESPAS. Published by Elsevier Espana. All rights reserved.

  17. Administrative judge control over the activities of the tax administration: between the need for taxation and protection of tax payers

    Jérôme Michell


    Among the main principles of constitutional values of taxation law (the principle of freedom, legality, equality, annual postulate) the principle of necessity of taxation can be found in the fundamentals of the great powers of the Taxation Department responsible for establishing and charging all legally founded taxes. Due to the declarative principle of numerous taxes (income tax, tax on profit, VAT tax), administration justifiably has at its disposal a range of methods for controlling the ho...

  18. Constitutional rights to health, public health and medical care: the status of health protections in 191 countries.

    Heymann, Jody; Cassola, Adèle; Raub, Amy; Mishra, Lipi


    United Nations (UN) member states have universally recognised the right to health in international agreements, but protection of this right at the national level remains incomplete. This article examines the level and scope of constitutional protection of specific rights to public health and medical care, as well as the broad right to health. We analysed health rights in the constitutions of 191 UN countries in 2007 and 2011. We examined how rights protections varied across the year of constitutional adoption; national income group and region; and for vulnerable groups within each country. A minority of the countries guaranteed the rights to public health (14%), medical care (38%) and overall health (36%) in their constitutions in 2011. Free medical care was constitutionally protected in 9% of the countries. Thirteen per cent of the constitutions guaranteed children's right to health or medical care, 6% did so for persons with disabilities and 5% for each of the elderly and the socio-economically disadvantaged. Valuable next steps include regular monitoring of the national protection of health rights recognised in international agreements, analyses of the impact of health rights on health outcomes and longitudinal multi-level studies to assess whether specific formulations of the rights have greater impact.

  19. Oral Administration of Lipopolysaccharide of Acetic Acid Bacteria Protects Pollen Allergy in a Murine Model.

    Amano, Satoko; Inagawa, Hiroyuki; Nakata, Yoko; Ohmori, Masaki; Kohchi, Chie; Soma, Gen-Ichiro


    Lipopolysaccharide (LPS), a major component of the cell wall of Gram-negative bacteria, is known to possess strong immune-regulatory activity. We have found and reported the existence of biologically-active LPS in acetic acid bacteria. The LPS shows Limulus-positive activity and activation of macrophages to produce nitric oxide and tumor necrosis factor. In this study, we investigated the anti-allergic effect of an orally-administrated acetic acid bacteria extract containing LPS; the cedar pollinosis model was used. Acetic acid bacteria were isolated from various fruits by Nodai kaihen medium. Then, the anti-allergic effect of acetic acid bacteria extracts was investigated. BALB/c mice were immunized with a mixture of cedar pollen and alum into their peritoneal cavity; they also received additional immunizations of pollen to nasal cavity. After immunizing the mice with pollen into their nasal cavity to trigger an allergic reaction, the frequency of nose scratching was counted for 5 min. The bacteria were cultured and prepared and the water-extract contained about 1-10 mg/ml of Limulus positive substances. The extract of acetic acid bacteria induced higher levels of interleukin (IL)-10 and FOXP3 mRNA expression in macrophages (RAW246.7 cell), as assessed by DNA microarray analysis. Oral administration of the acetic acid bacteria extract demonstrated significantly less scratching numbers than control water group with pollen immunization. These results showed that LPS in acetic acid bacteria has the potential to protect from an allergic reaction, especially from cedar pollinosis. Copyright© 2015 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  20. Veterans Health Administration Timely and Effective Care Data

    U.S. Department of Health & Human Services — A list of VHA hospitals with timely and effective care (process of care) measure data. VHA collects this information through a Quality Improvement Organization...

  1. Protective immunity against Megalocytivirus infection in rock bream (Oplegnathus fasciatus) following CpG ODN administration.

    Jung, Myung-Hwa; Lee, Jehee; Ortega-Villaizan, M; Perez, Luis; Jung, Sung-Ju


    Rock bream iridovirus (RBIV) disease in rock bream (Oplegnathus fasciatus) remains an unsolved problem in Korea aquaculture farms. CpG ODNs are known as immunostimulant, can improve the innate immune system of fish providing resistance to diseases. In this study, we evaluated the potential of CpG ODNs to induce anti-viral status protecting rock bream from different RBIV infection conditions. We found that, when administered into rock bream, CpG ODN 1668 induces better antiviral immune responses compared to other 5 CpG ODNs (2216, 1826, 2133, 2395 and 1720). All CpG ODN 1668 administered fish (1/5µg) at 2days before infection (1.1×10(7)) held at 26°C died even though mortality was delayed from 8days (1µg) and 4days (5µg). Similarly, CpG ODN 1668 administered (5µg) at 2days before infection (1.2×10(6)) held at 23/20°C had 100% mortality; the mortality was delayed from 9days (23°C) and 11days (20°C). Moreover, when CpG ODN 1668 administered (1/5/10µg) at 2/4/7days before infection or virus concentration was decreased to 1.1×10(4) and held at 20°C had mortality rates of 20/60/30% (2days), 30/40/60% (4days) and 60/60/20% (7days), respectively, for the respective administration dose, through 100 dpi. To investigate the development of a protective immune response, survivors were re-infected with RBIV (1.1×10(7)) at 100 and 400 dpi, respectively. While 100% of the previously unexposed fish died, 100% of the previously infected fish survived. The high survival rate of fish following re-challenge with RBIV indicates that protective immunity was established in the surviving rock bream. Our results showed the possibility of developing preventive measures against RBIV using CpG ODN 1668 by reducing RBIV replication speed (i.e. water temperature of 20°C and infection dose of 1.1×10(4)). Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Veterans Health Administration: Actions Needed to Better Recruit and Retain Clinical and Administrative Staff


    VHA’s HR operations and its ability to improve delivery of health care services to veterans. Long-standing, Systemic Human Capital Challenges Limit...veterans. GAO’s prior work has found that VHA faces long- standing, systemic human capital challenges that limit its ability to improve delivery of...Still, the care is inconsistent from facility to facility. Our prior work has described the human capital challenges facing VHA, including

  3. Conundrums in the legal protection of migrant workers' health rights and relative resolutions: implications from the case of Tseng Hei-tao.

    Liu, Kai


    The deteriorating situation of migrant workers' health rights protection was once again highlighted in the case of Tseng Hei-tao. This case explicitly and implicitly showed that four conundrums--the Employment Restriction Conundrum, the Occupational Safety and Health (OSH) Legal Conundrum, the Morality Conundrum and the Identity Conundrum--are barriers to migrant workers' right protection. The health rights of migrant workers could be safeguarded by abolishing the outdated household registration system designed in the planned economy era, improving the rule of law, and strengthening administrative supervisions. This would fundamentally remove these barriers and thus contribute to migrant workers' health rights protection.

  4. Early Administration of Glutamine Protects Cardiomyocytes from Post-Cardiac Arrest Acidosis.

    Lin, Yan-Ren; Li, Chao-Jui; Syu, Shih-Han; Wen, Cheng-Hao; Buddhakosai, Waradee; Wu, Han-Ping; Hsu Chen, Cheng; Lu, Huai-En; Chen, Wen-Liang


    Postcardiac arrest acidosis can decrease survival. Effective medications without adverse side effects are still not well characterized. We aimed to analyze whether early administration of glutamine could improve survival and protect cardiomyocytes from postcardiac arrest acidosis using animal and cell models. Forty Wistar rats with postcardiac arrest acidosis (blood pH < 7.2) were included. They were divided into study (500 mg/kg L-alanyl-L-glutamine, n = 20) and control (normal saline, n = 20) groups. Each of the rats received resuscitation. The outcomes were compared between the two groups. In addition, cardiomyocytes derived from human induced pluripotent stem cells were exposed to HBSS with different pH levels (7.3 or 6.5) or to culture medium (control). Apoptosis-related markers and beating function were analyzed. We found that the duration of survival was significantly longer in the study group (p < 0.05). In addition, in pH 6.5 or pH 7.3 HBSS buffer, the expression levels of cell stress (p53) and apoptosis (caspase-3, Bcl-xL) markers were significantly lower in cardiomyocytes treated with 50 mM L-glutamine than those without L-glutamine (RT-PCR). L-glutamine also increased the beating function of cardiomyocytes, especially at the lower pH level (6.5). More importantly, glutamine decreased cardiomyocyte apoptosis and increased these cells' beating function at a low pH level.

  5. Early Administration of Glutamine Protects Cardiomyocytes from Post-Cardiac Arrest Acidosis

    Yan-Ren Lin


    Full Text Available Postcardiac arrest acidosis can decrease survival. Effective medications without adverse side effects are still not well characterized. We aimed to analyze whether early administration of glutamine could improve survival and protect cardiomyocytes from postcardiac arrest acidosis using animal and cell models. Forty Wistar rats with postcardiac arrest acidosis (blood pH < 7.2 were included. They were divided into study (500 mg/kg L-alanyl-L-glutamine, n=20 and control (normal saline, n=20 groups. Each of the rats received resuscitation. The outcomes were compared between the two groups. In addition, cardiomyocytes derived from human induced pluripotent stem cells were exposed to HBSS with different pH levels (7.3 or 6.5 or to culture medium (control. Apoptosis-related markers and beating function were analyzed. We found that the duration of survival was significantly longer in the study group (p<0.05. In addition, in pH 6.5 or pH 7.3 HBSS buffer, the expression levels of cell stress (p53 and apoptosis (caspase-3, Bcl-xL markers were significantly lower in cardiomyocytes treated with 50 mM L-glutamine than those without L-glutamine (RT-PCR. L-glutamine also increased the beating function of cardiomyocytes, especially at the lower pH level (6.5. More importantly, glutamine decreased cardiomyocyte apoptosis and increased these cells’ beating function at a low pH level.

  6. A Health Services Research Agenda for Bariatric Surgery Within the Veterans Health Administration.

    Funk, L M; Gunnar, W; Dominitz, J A; Eisenberg, D; Frayne, S; Maggard-Gibbons, M; Kalarchian, M A; Livingston, E; Sanchez, V; Smith, B R; Weidenbacher, H; Maciejewski, Matthew L


    In 2016, the Veterans Health Administration (VHA) held a Weight Management State of the Art conference to identify evidence gaps and develop a research agenda for population-based weight management for veterans. Included were behavioral, pharmacologic, and bariatric surgery workgroups. This article summarizes the bariatric surgery workgroup (BSWG) findings and recommendations for future research. The BSWG agreed that there is evidence from randomized trials and large observational studies suggesting that bariatric surgery is superior to medical therapy for short- and intermediate-term remission of type 2 diabetes, long-term weight loss, and long-term survival. Priority evidence gaps include long-term comorbidity remission, mental health, substance abuse, and health care costs. Evidence of the role of endoscopic weight loss options is also lacking. The BSWG also noted the limited evidence regarding optimal timing for bariatric surgery referral, barriers to bariatric surgery itself, and management of high-risk bariatric surgery patients. Clinical trials of pre- and post-surgery interventions may help to optimize patient outcomes. A registry of overweight and obese veterans and a workforce assessment to determine the VHA's capacity to increase bariatric surgery access were recommended. These will help inform policy modifications and focus the research agenda to improve the ability of the VHA to deliver population-based weight management.

  7. [Children's health protection in the state political system].

    Baranov, A A; Iakovleva, T V; Lapin, Iu E


    The system of children's health protection in this country still lacks an adequate legal basis. Its improvement should be considered as a function of the state realized through legal regulation of public relations for the benefit of each child based on the legislatively fixed government policy in the sphere of children's health care. Such an approach may strengthen the role of this sphere in the intersectoral relations and implies the extension of pediatrics toward interaction with the spheres of politics and law. It reflects the understanding that physiological processes behind regulation of the functioning of the child's organism in the course of its development need an adequate support from the outside through regulation of public relations on behalf of children. The definition of state policy in the sphere of children's health care is proposed and its basic principles are considered.

  8. An Adult Protective Services' view of collaboration with Mental Health Services.

    Teaster, Pamela B; Stansbury, Kim L; Nerenberg, Lisa; Stanis, Patricia


    Mental Health Services (MHS) meet mental health needs of older adults through active, outpatient, community-based care. Adult Protective Services (APS) are involved with needs of older adults who have mental disability and mental illness. Adult Protective Services and MHS staff may to work together when they respond to the needs of victims and adults at risk for abuse, neglect, self-neglect, and exploitation. The purpose of this study was to understand effective APS-MHS collaborations (e.g., leadership, organizational culture, administration, and resources in predicting success). A survey that was sent to members of the National Adult Protective Services Association (NAPSA) revealed that both APS and MHS have strong commitments to protecting clients' rights and autonomy, but there appear to be differences between the two with regard to implementation, apparent in cases involving clients with diminished mental capacity who are at imminent risk, but who refuse help. Strengths of APS-MHS collaborations included improved communication and better service for at-risk clients.

  9. Philosophy in medical education: a means of protecting mental health.

    Keller, Eric J


    This study sought to identify and examine less commonly discussed challenges to positive mental health faced by medical students, residents, and physicians with hopes of improving current efforts to protect the mental health of these groups. Additionally, this work aimed to suggest an innovative means of preventing poor mental health during medical education. Literature on medical student, resident, and physician mental health was carefully reviewed and a number of psychiatrists who treat physician-patients were interviewed. The culture of medicine, medical training, common physician psychology and identity, and conflicting professional expectations all seem to contribute to poor mental health among medical students, residents, and physicians. Many current efforts may be more successful by better addressing the negative effects of these characteristics of modern medicine. Programs aimed at promoting healthy mental lifestyles during medical education should continue to be developed and supported to mitigate the deleterious effects of the challenging environment of modern medicine. To improve these efforts, educators may consider incorporating philosophical discussions on meaning and fulfillment in life between medical students and faculty. Through medical school faculty members sharing and living out their own healthy outlooks on life, students may emulate these habits and the culture of medicine may become less challenging for positive mental health.

  10. Are we preparing health services administration students to respond to bioterrorism and mass casualty management?

    Houser, Shannon H; Houser, Howard W


    Bioterrorism/natural disaster events add significant specialized demands and disrupt normal operation of the health system, often for an indefinite period of time. Health administration leaders should be educationally prepared for and informed about these potential events, but few receive this knowledge via their academic preparation in health administration. This study examined the existence of coverage of bioterrorism topics in health administration curricula and characteristics of bioterrorism coverage in current health administration programs through a self-completed survey among AUPHA graduate and undergraduate program members. Of the total survey respondents, only 32% of programs have current coverage of bioterrorism. The main reasons for nothavingbioterrorism coverage were not having enough resources; not having enough time to develop course/materials; and not thinking it is necessary to add these courses/materials. To prepare better and to inform future health administrators regarding major disruptive circumstances, advocacy and documentation are important to develop and implement bioterrorism awareness. Possibly, suggested minimum curricular requirements, content, and mechanisms for inclusion can be developed in the near future. Health administration educators should address the new reality and demonstrate that their graduates can function and lead in crises and situations disruptive to normal commerce.

  11. Contract law for the hospital and health administrator.

    Bates, P W


    The author discusses the concept of a legal 'contract' and gives many examples of its application in hospitals and health settings. He describes the main features of a contract and gives special attention to personnel and clinical ramifications and to the role of agents in making contracts on behalf of hospitals.

  12. Environmental health needs and launching of an environmental health protection unit in Pakistan.

    Khan, M Z A; Kazi, B M; Bile, K M; Magan, M; Nasir, J A


    Pakistan is seriously confronted by many complex and difficult environmental challenges related to air, water, soil, forests and food including issues such as climate change. The close link between environment and health is neither well understood nor appreciated. The annual cost of environmental degradation in Pakistan has been estimated to be around US $4.0 billion orat least 6% of the country's GDP. Up to 35% of the burden of disease is attributable to environmental hazards and risk factors and most of this burden is preventable. A systematic process for identifying environmental health needs and issues as well as the efforts made by the government of Pakistan and the World Health Organization in establishing and launching an environmental health protection unit are described. Also presented are the mission, functions, structure (operational and logistical) and technical requirements as well as sustainability aspects of the environmental health protection unit.

  13. The academic elite in health services administration: linkages among top-ranked graduate programs.

    Bair, J H; Barrons, J C


    The eleven top-ranked graduate programs in health services administration, based on a national survey of deans, top administrators, and senior faculty, were linked to one another by hiring one another's graduates. It is suggested that this linkage helps these programs maintain and enhance their prestige.

  14. Protection of carbon monoxide intraperitoneal administration from rat intestine injury induced by lipopolysaccharide

    LIU Shao-hua; MA Ke; XU Bing; XU Xin-rong


    Background Treatment with inhaled carbon monoxide (CO) has been shown to ameliorate intestinal injury in experimental animals induced by lipopolysaccharide (LPS) or ischemia-reperfusion. We hypothesized that CO intraperitoneal administration (i.p.) might provide similar protection to inhaled gas. This study aimed to investigate the effects of continuous 2 L/min of 250 ppm CO i.p. on rat intestine injury induced by LPS and to try to develop a more practical means of delivering the gas.Methods A total of 72 male Sprague-Dawley rats were randomly assigned to 4 groups: control group, CO i.p. group, LPS group and LPS+CO i.p. group. One hour after intravenously received 5 mg/kg LPS, the rats in LPS group and LPS+CO i.p. group were exposed to room air and 2 L/min of 250 ppm CO i.p., respectively, and the rats of control group and CO i.p. group intravenously received an equal volume of 0.9% NaClI and 1 hour later, were exposed to room air and 2 L/min of 250 ppm CO i.p., respectively. One, 3 and 6 hour of each group after treated with room air or CO i.p., the animals (n=6 for each time point) were sacrificed and intestinal tissues were collected for determinating the levels of platelet activator factor (PAF) and intercellular adhesion molecule-1 (ICAM-1) with enzyme-lined immunosorbent assays. The maleic dialdehyde (MDA) content and the myeloperoxidase (MPO) activity were determined with a chemical method. The phosphorylated p38 mitogen activated protein kinase (MAPK) expression was assayed with Western blotting and the cell apoptotic rate with flow cytometery. The arterial oxygenation was measured by blood gas analysis, and the pathology determined by light microscope.Results After treatment with 2 L/min of 250 ppm CO i.p., the increase of PAF, ICAM-1, MDA, MPO, and cell apoptotic rate induced by LPS was markedly reduced (P<0.05 or 0.01), and accompanied by ameliorating intestine injury. Western blotting showed that these effects of CO i.p. were mediated by p38 MAPK

  15. Ascertainment of chronic diseases using population health data: a comparison of health administrative data and patient self-report

    Muggah Elizabeth


    Full Text Available Abstract Background Health administrative data is increasingly being used for chronic disease surveillance. This study explored agreement between administrative and survey data for ascertainment of seven key chronic diseases, using individually linked data from a large population of individuals in Ontario, Canada. Methods All adults who completed any one of three cycles of the Canadian Community Health Survey (2001, 2003 or 2005 and agreed to have their responses linked to provincial health administrative data were included. The sample population included 85,549 persons. Previously validated case definitions for myocardial infarction, asthma, diabetes, chronic lung disease, stroke, hypertension and congestive heart failure based on hospital and physician billing codes were used to identify cases in health administrative data and these were compared with self-report of each disease from the survey. Concordance was measured using the Kappa statistic, percent positive and negative agreement and prevalence estimates. Results Agreement using the Kappa statistic was good or very good (kappa range: 0.66-0.80 for diabetes and hypertension, moderate for myocardial infarction and asthma and poor or fair (kappa range: 0.29-0.36 for stroke, congestive heart failure and COPD. Prevalence was higher in health administrative data for all diseases except stroke and myocardial infarction. Health Utilities Index scores were higher for cases identified by health administrative data compared with self-reported data for some chronic diseases (acute myocardial infarction, stroke, heart failure, suggesting that administrative data may pick up less severe cases. Conclusions In the general population, discordance between self-report and administrative data was large for many chronic diseases, particularly disease with low prevalence, and differences were not easily explained by individual and disease characteristics.

  16. [Telematics in the public health sector. Where is the protection of health data?].

    Voßhoff, Andrea; Raum, Bertram; Ernestus, Walter


    There is a long history of telematics in the German health system. Apart from the growing technical possibilities in the field, it is important to concentrate on the protection of health data in telematics applications. Health data in the hands of service providers or other third parties entails certain risks for the patient's personality rights, because these institutions may not be bound by the practice of medical confidentiality. In addition, big data processing risks make the individual lives of patients and insured persons totally transparent. Measures to reduce these risks have to be taken by the providers as well as by the users of telematics infrastructure; they are the ones who should explicitly address the relevant risks and dangers in a data protection and IT-security concept and develop adequate strategies to cope with these dangers. Additionally, the German legislator remains obliged to create a regulatory framework for the protection of patients' rights.

  17. Dual use of Medicare and the Veterans Health Administration: are there adverse health outcomes?

    Brezinski Paul R


    Full Text Available Abstract Background Millions of veterans are eligible to use the Veterans Health Administration (VHA and Medicare because of their military service and age. This article examines whether an indirect measure of dual use based on inpatient services is associated with increased mortality risk. Methods Data on 1,566 self-responding men (weighted N = 1,522 from the Survey of Assets and Health Dynamics among the Oldest Old (AHEAD were linked to Medicare claims and the National Death Index. Dual use was indirectly indicated when the self-reported number of hospital episodes in the 12 months prior to baseline was greater than that observed in the Medicare claims. The independent association of dual use with mortality was estimated using proportional hazards regression. Results 96 (11% of the veterans were classified as dual users. 766 men (50.3% had died by December 31, 2002, including 64.9% of the dual users and 49.3% of all others, for an attributable mortality risk of 15.6% (p Conclusion An indirect measure of veterans' dual use of the VHA and Medicare systems, based on inpatient services, was associated with an increased risk of death. Further examination of dual use, especially in the outpatient setting, is needed, because dual inpatient and dual outpatient use may be different phenomena.

  18. Burnout in Veterans Health Administration mental health providers in posttraumatic stress clinics.

    Garcia, Hector A; McGeary, Cindy A; McGeary, Donald D; Finley, Erin P; Peterson, Alan L


    The purpose of this study was to conduct the first assessment of burnout among Veterans Health Administration (VHA) mental health clinicians providing evidence-based posttraumatic stress disorder (PTSD) care. This study consisted of 138 participants and the sample was mostly female (67%), Caucasian (non-Hispanic; 81%), and married (70%) with a mean age of 44.3 years (SD = 11.2). Recruitment was directed through VHA PTSD Clinical Teams (PCT) throughout the United States based on a nationwide mailing list of PCT Clinic Directors. Participants completed an electronic survey that assessed demographics, organizational work factors, absenteeism, and burnout (assessed through the Maslach Burnout Inventory-General Survey, MBI-GS). Twelve percent of the sample reported low Professional Efficacy, 50% reported high levels of Exhaustion, and 47% reported high levels of Cynicism as determined by the MBI-GS cut-off scores. Only workplace characteristics were significantly associated with provider scores on all 3 scales. Exhaustion and Cynicism were most impacted by perceptions of organizational politics/bureaucracy, increased clinical workload, and control over how work is done. Organizational factors were also significantly associated with provider absenteeism and intent to leave his or her job. Findings suggest that providers in VHA specialty PTSD-care settings may benefit from programs or supports aimed at preventing and/or ameliorating burnout. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  19. Protecting the environment and public health from rare earth mining

    Huang, Xiang; Zhang, Guochun; Pan, An; Chen, Fengying; Zheng, Chunli


    As increasing demand for green energy and high-tech devices grows, so does the rising prospecting of rare earth metals required for their production. Protecting the environment and public health from rare earth element (REE) mining as well as emerging pollutants is urgently required to achieve sustainable development. This study mapped Earth's hidden REE deposits to identify potential contamination hotspots with the aim of preventing its deleterious effects on the environment. We worry that there would be widespread tailing facilities concomitant with serious pollutions, such as the Bayan Obo tailings site, and argue that a tradeoff between the underground REE exploration and environment conservation should be reached as soon as possible.

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


    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

  1. Public Administration Efficiency and the Aggravation of Public Health Issues

    Vladimir Aleksandrovich Ilyin


    Full Text Available December 3, 2015, the President of Russia Vladimir Putin delivered his annual Address to the Federal Assembly. Having analyzed the Address, experts pointed out the President’s worries and concerns about the efficiency of execution of development priorities he had set out. Vladimir Putin repeatedly urged the Government to implement effective measures on specific issues in the shortest time possible. However, it has not been done so far; therefore, we think that the President’s concern is reasonable. Recent research carried out by ISEDT RAS reveals certain alarming trends in the social health of the regional society

  2. Promoting and protecting the health of children and young people.

    Licence, K


    The health-related behaviours adopted by children and young people can have both immediate and long-term health effects. Health promotion interventions that target children and young people can lay the foundations of a healthy lifestyle that may be sustained into adulthood. This paper is based on a selective review of evidence relating to health promotion in childhood, carried out to support the external working group on the 'Healthy Child' module of the Children's National Service Framework. This is a selective review of mainly secondary research. It focuses on injury prevention, support for parenting and the promotion of good mental health, and promoting a healthy diet and physical activity amongst children and young people. In many areas, the quality of primary research into health promotion interventions aimed at children and young people is poor. Interventions are heterogeneous and not described in sufficient detail. Sample sizes tend to be small, and there are commonly problems of bias. Despite these difficulties, there is good evidence for a range of interventions, including (1) area road safety schemes; (2) combining a variety of approaches to the promotion of the use of safety equipment, including legislation and enforcement, loan/assisted purchase/giveaway schemes, education, fitting and maintenance of safety equipment; (3) school-based mental health promotion; (4) parenting support; (5) interventions that promote and facilitate 'lifestyle' activity for children, such as walking and cycling to school, and those that aim to reduce sedentary behaviours such as parent education to reduce the time children spend watching TV and using computers; and (6) controlling advertising of unhealthy food that is aimed at children. There are effective interventions to promote and protect the health of children and young people that require action across the five areas described in the Ottawa Charter. Health, social care and education services have a direct role in the

  3. [Protective action figurations for superoxide dismutase - chondroitin sulfate - catalase bienzyme conjugate after its medicative administration in endotoxin shock].

    Maksimenko, A V; Vavaeva, A V; Zvyagintseva, M A; Abramov, A A; Timoshin, A A; Vavaev, A V; Lakomkin, V L


    Previously it found that the bienzymatic conjugate superoxide dismutase-chondroitin sulfate, catalase (SOD-CHS-CAT) increased the survival rate of rats with endotoxic shock caused by the administration of lipopolysaccharide (LPS). This effect was observed both in preventive (before LPS) and therapeutic conjugate administration (after the administration of LPS). This study shows that the development of endotoxic shock is accompanied by increased levels of NO in the liver, lungs, kidneys, heart; administration of the SOD-CHS-CAT conjugate insignificantly influenced this parameter. At the same time, the changes in blood urea and creatinine suggest the protective effect of the conjugate on renal function, while diverse changes in biochemical parameters studied complicate the formation of the agreed conclusions on the state of other organs.

  4. Promoting employee health by integrating health protection, health promotion, and continuous improvement: a longitudinal quasi-experimental intervention study.

    von Thiele Schwarz, Ulrica; Augustsson, Hanna; Hasson, Henna; Stenfors-Hayes, Terese


    To test the effects of integrating health protection and health promotion with a continuous improvement system (Kaizen) on proximal employee outcomes (health promotion, integration, and Kaizen) and distal outcomes (workability, productivity, self-rated health and self-rated sickness absence). Twelve units in a county hospital in Sweden were randomized to control or intervention groups using a quasiexperimental study design. All staff (approximately 500) provided self-ratings in questionnaires at baseline, and a 12- and 24-month follow-up (response rate, 79% to 87.5%). There was a significant increase in the proximal outcomes over time in the intervention group compared with the control group, and a trend toward improvement in the distal outcomes workability and productivity. Integration seems to promote staff engagement in health protection and promotion, as well as to improve their understanding of the link between work and health.

  5. Protecting unauthorized immigrant mothers improves their children's mental health.

    Hainmueller, Jens; Lawrence, Duncan; Martén, Linna; Black, Bernard; Figueroa, Lucila; Hotard, Michael; Jiménez, Tomás R; Mendoza, Fernando; Rodriguez, Maria I; Swartz, Jonas J; Laitin, David D


    The United States is embroiled in a debate about whether to protect or deport its estimated 11 million unauthorized immigrants, but the fact that these immigrants are also parents to more than 4 million U.S.-born children is often overlooked. We provide causal evidence of the impact of parents' unauthorized immigration status on the health of their U.S. citizen children. The Deferred Action for Childhood Arrivals (DACA) program granted temporary protection from deportation to more than 780,000 unauthorized immigrants. We used Medicaid claims data from Oregon and exploited the quasi-random assignment of DACA eligibility among mothers with birthdates close to the DACA age qualification cutoff. Mothers' DACA eligibility significantly decreased adjustment and anxiety disorder diagnoses among their children. Parents' unauthorized status is thus a substantial barrier to normal child development and perpetuates health inequalities through the intergenerational transmission of disadvantage. Copyright © 2017 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works.

  6. Forest management practices and the occupational safety and health administration logging standard

    John R. Myers; David Elton Fosbroke


    The Occupational Safety and Health Administration (OSHA) has established safety and health regulations for the logging industry. These new regulations move beyond the prior OSHA pulpwood harvesting standard by including sawtimber harvesting operations. Because logging is a major tool used by forest managers to meet silvicultural goals, managers must be aware of what...

  7. Occupational Safety and Health Program Guidelines for Colleges and Universities. An Administrative Resource Manual.

    Godbey, Frank W.; Hatch, Loren L.

    Designed as an aid for establishing and strengthening occupational safety and health programs on college and university campuses, this administrator guide is divided into four chapters. The first chapter defines and gives background information on the Occupational Safety and Health Act (OSHA). In addition, it presents a discussion of what the OSHA…

  8. Evolution of Medication Administration Workflow in Implementing Electronic Health Record System

    Huang, Yuan-Han


    This study focused on the clinical workflow evolutions when implementing the health information technology (HIT). The study especially emphasized on administrating medication when the electronic health record (EHR) systems were adopted at rural healthcare facilities. Mixed-mode research methods, such as survey, observation, and focus group, were…

  9. New managerial roles in multiorganizational systems: implications for health administration education.

    Hoare, G


    It is difficult to discuss the expertise needed to effectively manage multiunit health care corporations without examining the different work settings that comprise these organizations. This paper presents a framework to systematically describe the necessary tasks in multiunit corporations. Specific skills and knowledge areas are then described that may be missing from health administration programs' curricula.

  10. 77 FR 76518 - Summary of Commission Practice Relating to Administrative Protective Orders


    ... Attorney; (3) In the case of an attorney, accountant, or other professional, referral to the ethics panel of the appropriate professional association; (4) Such other administrative sanctions as...

  11. 19 CFR 207.7 - Limited disclosure of certain business proprietary information under administrative protective...


    ... an attorney, accountant, or other professional, referral to the ethics panel of the appropriate professional association; (4) Such other administrative sanctions as the Commission determines to...

  12. Health protection at the Savannah River Site: A guide to records series of the Department of Energy and its contractors



    As part of the Department of Energy`s (DOE) Epidemiologic Records Inventory Project, History Associates Incorporated (HAI) prepared this guide to the records series pertaining to health protection activities at the DOE`s Savannah River Site (SRS). Since its inception in the early 1950s, the SRS, formerly known as the Savannah River Plant (SRP), has demonstrated significant interest in safeguarding facilities, protecting employees` health, and monitoring the environment. The guide describes records that concern health protection program administration, radiological monitoring of the plant and the environment, calibration and maintenance of monitoring instruments, internal and external dosimetry practices, medical surveillance of employees, occupational safety and training measures, site visitation, and electronic information systems. The introduction to the guide describes the Epidemiologic Records Inventory Project and HAI`s role in the project. It provides brief histories of the DOE, SRS, and the SRS organizational units responsible for health protection activities. This introduction also summarizes HAI`s methodology in developing criteria and conducting its verification of the SRS inventory of active and inactive SRS Health Protection records. Furthermore, it furnishes information on the production of the guide, the content of the records series descriptions, the location of the records, and the procedures for accessing records repositories.

  13. Linking Canadian population health data: maximizing the potential of cohort and administrative data.

    Doiron, Dany; Raina, Parminder; Fortier, Isabel


    Linkage of data collected by large Canadian cohort studies with provincially managed administrative health databases can offer very interesting avenues for multidisciplinary and cost-effective health research in Canada. Successfully co-analyzing cohort data and administrative health data (AHD) can lead to research results capable of improving the health and well-being of Canadians and enhancing the delivery of health care services. However, such an endeavour will require strong coordination and long-term commitment between all stakeholders involved. The challenges and opportunities of a pan-Canadian cohort-to-AHD data linkage program have been considered by cohort study investigators and data custodians from each Canadian province. Stakeholders acknowledge the important public health benefits of establishing such a program and have established an action plan to move forward.

  14. Health sector employment: a tracer indicator for universal health coverage in national Social Protection Floors.

    Scheil-Adlung, Xenia; Behrendt, Thorsten; Wong, Lorraine


    Health sector employment is a prerequisite for availability, accessibility, acceptability and quality (AAAQ) of health services. Thus, in this article health worker shortages are used as a tracer indicator estimating the proportion of the population lacking access to such services: The SAD (ILO Staff Access Deficit Indicator) estimates gaps towards UHC in the context of Social Protection Floors (SPFs). Further, it highlights the impact of investments in health sector employment equity and sustainable development. The SAD is used to estimate the share of the population lacking access to health services due to gaps in the number of skilled health workers. It is based on the difference of the density of the skilled health workforce per population in a given country and a threshold indicating UHC staffing requirements. It identifies deficits, differences and developments in access at global, regional and national levels and between rural and urban areas. In 2014, the global UHC deficit in numbers of health workers is estimated at 10.3 million, with most important gaps in Asia (7.1 million) and Africa (2.8 million). Globally, 97 countries are understaffed with significantly higher gaps in rural than in urban areas. Most affected are low-income countries, where 84 per cent of the population remains excluded from access due to the lack of skilled health workers. A positive correlation of health worker employment and population health outcomes could be identified. Legislation is found to be a prerequisite for closing access as gaps. Health worker shortages hamper the achievement of UHC and aggravate weaknesses of health systems. They have major impacts on socio-economic development, particularly in the world's poorest countries where they act as drivers of health inequities. Closing the gaps by establishing inclusive multi-sectoral policy approaches based on the right to health would significantly increase equity, reduce poverty due to ill health and ultimately contribute

  15. 75 FR 26759 - Health Care Integrity and Protection Data Bank (HIPDB) and National Practitioner Data Bank (NPDB...


    ... Administration Health Care Integrity and Protection Data Bank (HIPDB) and National Practitioner Data Bank (NPDB...: ``Government agencies,'' as defined in section 1128E(g)(3) of the Social Security Act (42 U.S.C. 1320a-7e(g)(3... in a report on the HRSA and Data Bank Web sites ( and http://www.npdb-hipdb.hrsa...

  16. Public vs private administration of rural health insurance schemes: a comparative study in Zhejiang of China.

    Zhou, Xiaoyuan; Mao, Zhengzhong; Rechel, Bernd; Liu, Chaojie; Jiang, Jialin; Zhang, Yinying


    Since 2003, China has experimented in some of the country's counties with the private administration of the New Cooperative Medical Scheme (NCMS), a publicly subsidized health insurance scheme for rural populations. Our study compared the effectiveness and efficiency of private vs public administration in four counties in one of China's most affluent provinces in the initial stage of the NCMS's implementation. The study was undertaken in Ningbo city of Zhejiang province. Out of 10 counties in Ningbo, two counties with private administration for the NCMS (Beilun and Ninghai) were compared with two others counties with public administration (Zhenhai and Fenghua), using the following indicators: (1) proportion of enrollees who were compensated for inpatient care; (2) average reimbursement-expense ratio per episode of inpatient care; (3) overall administration cost; (4) enrollee satisfaction. Data from 2004 to 2006 were collected from the local health authorities, hospitals and the contracted insurance companies, supplemented by a randomized household questionnaire survey covering 176 households and 479 household members. In our sample counties, private administration of the NCMS neither reduced transaction costs, nor improved the benefits of enrollees. Enrollees covered by the publicly administered NCMS were more likely to be satisfied with the insurance scheme than those covered by the privately administered NCMS. Experience in the selected counties suggests that private administration of the NCMS did not deliver the hoped-for results. We conclude that caution needs to be exercised in extending private administration of the NCMS.

  17. Industrial hygiene programs for workers' health protection in Italy.

    Cecchetti, G; Peruzzo, G F; Sordelli, D


    The recent Health and Safety Act devolves the management of workers' health protection to new local authorities named "Local Sanitary Units." The specific program is framed in the existing state regulations and is in agreement with European community politics regarding health risks arising from the industrial use of particular substances like lead, asbestos, benzene, PCBs and others. The rapid industrial growth during recent years put into evidence completely new and numerous risks with the result of both qualitative and quantitative modifications of occupational diseases which existed in the years preceding the second world war. This rapid and remarkable change required a general adjustment in the country, which involved universities, government and industry. At the same time, the need of new relationships between occupational risks and insurance management rose. Beginning in the seventies, the Italian Industrial Hygiene Association [Associazione Italiana Degli Igienisti Industriali (A.I.D.I.I.)] promoted the progress of industrial hygiene in Italy through national and international conferences, continuous educational activities and participation with government standard-setting committees. The trend in A.I.D.I.I. future activities embraces the development of standard evaluation and control procedures and the improvement of research following European guidelines in strict cooperation with correlated European and American organizations.

  18. Health protection of health care workers from the prospective of ethics, science and good medical practice. Opinions from stakeholders in health care settings.

    Porru, S; Cannatelli, P; Cerioli, Beloyanna; Flor, L; Gramegna, Maria; Polato, R; Rodriguez, D


    Fitness for work (FFW) in health care workers poses multidisciplinary challenges because of management problems scientific and ethical implications and the implementation of preventive interventions in health care settings. All the relevant stakeholders, including the General Manager, Medical Director, worker's representative, the person responsible for prevention and protection, forensic medicine expert, the person responsible for prevention and health safety at public administration level, commented on: danger to third parties; FFW formulation; human resource management; stress; professional independence; role of the person responsible for prevention and protection and of the person responsible for prevention at public administration level; professional responsibilities. Opinions are reported regarding the main problems related to the role of the Occupational Physician in FFW formulation, such as the difficult balance between autonomy and independence, limited turnover and aging of workforce, need of confidentiality and respect for professional status of the HCW prevalence of susceptibility conditions, rights and duties of stakeholders. The most significant result was the request by the Lombardy Region for more quality in risk assessment and health surveillance; to maintain uniform conduct over all the local health authorities, to allow the board in charge of examining appeals against FFW to fully cooperate with the occupational physician; due attention to the person/worker; the opportunity to convene referral boards for complex FFW management; the challenge of stress management and the need for an observatory for psychological discomforts; the importance of the ICOH Code of Ethics and avoidance of conflicts of interests; the need for individual risk assessment and risk management; the concept of sharing responsibilities and of a real multidisciplinary approach.

  19. Evaluating current automatic de-identification methods with Veteran’s health administration clinical documents

    Ferrández Oscar


    Full Text Available Abstract Background The increased use and adoption of Electronic Health Records (EHR causes a tremendous growth in digital information useful for clinicians, researchers and many other operational purposes. However, this information is rich in Protected Health Information (PHI, which severely restricts its access and possible uses. A number of investigators have developed methods for automatically de-identifying EHR documents by removing PHI, as specified in the Health Insurance Portability and Accountability Act “Safe Harbor” method. This study focuses on the evaluation of existing automated text de-identification methods and tools, as applied to Veterans Health Administration (VHA clinical documents, to assess which methods perform better with each category of PHI found in our clinical notes; and when new methods are needed to improve performance. Methods We installed and evaluated five text de-identification systems “out-of-the-box” using a corpus of VHA clinical documents. The systems based on machine learning methods were trained with the 2006 i2b2 de-identification corpora and evaluated with our VHA corpus, and also evaluated with a ten-fold cross-validation experiment using our VHA corpus. We counted exact, partial, and fully contained matches with reference annotations, considering each PHI type separately, or only one unique ‘PHI’ category. Performance of the systems was assessed using recall (equivalent to sensitivity and precision (equivalent to positive predictive value metrics, as well as the F2-measure. Results Overall, systems based on rules and pattern matching achieved better recall, and precision was always better with systems based on machine learning approaches. The highest “out-of-the-box” F2-measure was 67% for partial matches; the best precision and recall were 95% and 78%, respectively. Finally, the ten-fold cross validation experiment allowed for an increase of the F2-measure to 79% with partial matches

  20. 45 CFR 164.502 - Uses and disclosures of protected health information: general rules.


    ...) Standard. A covered entity may not use or disclose protected health information, except as permitted or.... A covered entity is permitted to use or disclose protected health information as follows: (i) To the... entity that has agreed to a restriction pursuant to § 164.522(a)(1) may not use or disclose the protected...

  1. Assessment of administrative claims data for public health reporting of Salmonella in Tennessee.

    Marder, Ellyn; Garman, Katie; Jones, Timothy F; Dunn, John; Jones, Stephen


    In the USA, approximately 4% of the estimated 1 million Salmonella infections occurring annually are reported to public health. Administrative claims data from large health insurance companies capture disease-specific data which could potentially enhance public health surveillance. To determine the utility of medical claims data for public health reporting of Salmonella, we assessed medical claims data from BlueCross BlueShield of Tennessee (BCBST) members compared to Tennessee Department of Health (TDH) surveillance data. BCBST Salmonella cases diagnosed during 2007-2011 were matched to TDH Salmonella cases reported during the same time period. Matches and non-matches were validated using medical records. Of the 450 BCBST cases identified, 72% matched TDH cases. All culture-confirmed BCBST cases were reported to TDH. Non-matched BCBST cases included clinical diagnoses which were culture negative or not tested. Our findings indicate administrative claims data are not currently a viable mechanism for enhancing routine reporting of Salmonella infections.

  2. Automatic detection of protected health information from clinic narratives.

    Yang, Hui; Garibaldi, Jonathan M


    This paper presents a natural language processing (NLP) system that was designed to participate in the 2014 i2b2 de-identification challenge. The challenge task aims to identify and classify seven main Protected Health Information (PHI) categories and 25 associated sub-categories. A hybrid model was proposed which combines machine learning techniques with keyword-based and rule-based approaches to deal with the complexity inherent in PHI categories. Our proposed approaches exploit a rich set of linguistic features, both syntactic and word surface-oriented, which are further enriched by task-specific features and regular expression template patterns to characterize the semantics of various PHI categories. Our system achieved promising accuracy on the challenge test data with an overall micro-averaged F-measure of 93.6%, which was the winner of this de-identification challenge.

  3. A privacy protection for an mHealth messaging system

    Aaleswara, Lakshmipathi; Akopian, David; Chronopoulos, Anthony T.


    In this paper, we propose a new software system that employs features that help the organization to comply with USA HIPAA regulations. The system uses SMS as the primary way of communication to transfer information. Lack of knowledge about some diseases is still a major reason for some harmful diseases spreading. The developed system includes different features that may help to communicate amongst low income people who don't even have access to the internet. Since the software system deals with Personal Health Information (PHI) it is equipped with an access control authentication system mechanism to protect privacy. The system is analyzed for performance to identify how much overhead the privacy rules impose.

  4. Health research and the Data Protection Act 1998.

    Boyd, Phil


    The 1998 Data Protection Act in the UK largely restates existing good practice: individuals have a right to know what data are held about them and why; and those processing data have a duty to proceed with fairness and transparency, maintain high data quality and keep data secure. Some health researchers have criticised the Act, seeing it as a legal minefield, unnecessary bureaucracy and interference from the European Union. This is largely based on misconceptions. Recent guidance from the Information Commissioner aims to assist researchers by advising how legal requirements can be met through anonymisation of data, attention to data-processing methods and fair collection of data. The Act provides a clear framework of rights and responsibilities that should be embraced with enthusiasm rather than with the reluctance of a person forced to carry out a meaningless chore.

  5. Perceived impact by administrators of psychiatric emergency services after changes in a state's mental health system.

    Arfken, Cynthia L; Zeman, Lori Lackman; Koch, Alison


    As a safety net, psychiatric emergency services are sensitive to system changes. To determine the impact of a state's changes in its mental health system, administrators of publicly funded psychiatric emergency services were surveyed. They reported few (M=0.8) negative changes in coordination of care but 77% endorsed change in administrative burden (54% saying it negatively affected quality of services). Reporting negative effect of administrative burden was associated with treating more persons with substance abuse problems and greater challenge posed by distance to local providers. These results suggest that impact of state-level changes was not uniform but associated with local characteristics.

  6. A civic engagement paradigm for reforming health administration education and recreating the community.

    Renick, Oren; Metzler, Leanne; Murray, Jennifer; Renick, Judy


    The education of students of health administration has traditionally combined both the theoretical and practical to enhance and balance the learning experience. Classroom exposure to the principles of management, law, organizations, and finance is coupled with problem solving, practicum, internship, and administrative residency experiences. However, just as recent years have seen the developmentof courses from managed care and alternative delivery systems to total quality management and continuous quality improvement, there is also emerging an awareness of the need to enhance the practical side of the learning equation. Perhaps this need is finding expression in curricular opportunities for students to learn from a participatory model known as civic engagement (CE). CE is a way of integrating academic study and community service to strengthen learning while promoting civic and personal responsibility to strengthen communities. Based on experiences with graduate and undergraduate students spanning the last ten years at Texas State University--San Marcos (Texas State), it is suggested that a CE paradigm has been developed within the Department of Health Administration that merits consideration by other programs of health administration. As a model for change, it has the potential for reforming both health administration education and most other higher education disciplines as well.


    Taylor, Mark J


    The disclosure of confidential patient data without an individual's explicit consent should be for purposes that persons have reason to both expect and accept. We do not currently have the required level of clarity or consistency in understanding regarding the disclosure of confidential patient information for public health purposes to support effective public dialogue. The Health Service (Control of Patient Information) Regulations 2002 establish a legal basis in England and Wales for data to be disclosed for public health purposes without patient consent. Under the Regulations, there is more than one potential route towards lawful processing: Data may be processed for public health purposes under both Regulations 3 and 5. The alternatives have different safeguards and conditions attached, and their respective applicability to processing for purposes of public health improvement is currently unclear and subject to review. Beyond the need for clarity regarding the safeguards applicable to processing for particular public health purposes, there are reasons to prefer recognition that Regulation 5 is the most appropriate legal basis for disclosure when the purpose is public health improvement rather than public health protection. Where health improvement, rather than protection, is the aim, there is no justification for discarding the additional safeguards associated with processing under Regulation 5.

  8. Development of a respiratory protection survey instrument for occupational health nurses: an educational project.

    Taormina, Deborah; Burgel, Barbara J


    The Institute of Medicine (2011) report Occupational Health Nurses and Respiratory Protection: Improving Education and Training outlined seven recommendations to improve the competency of occupational health nurses in respiratory protection. An advisory group was convened in December 2011, with stakeholder representation from the Centers for Disease Control and Prevention/National Institute for Occupational Safety and Health/National Personal Protective Technology Laboratory, American Association of Occupational Health Nurses, Inc., American Board for Occupational Health Nurses, Inc., Association of Occupational Health Professionals in Healthcare, American Nurses Association, and Institute of Medicine Standing Committee on Personal Protective Equipment for Workplace Safety and Health. The initial work of the advisory group included developing and administering a survey to assess current occupational health nurse roles and responsibilities relevant to respiratory protection. Development of the survey was led by a master's student and advisor who worked with the advisory group. The process of tool development and preliminary findings are presented in this article.

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

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


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

  10. Radiation. Protection. Health. Proceedings; Strahlen. Schutz. Gesundheit. Tagungsband

    Hajek, Michael [International Atomic Energy Agency, Wien (Austria); Maringer, Franz Josef; Steurer, Andreas [Bundesamt fuer Eich- und Vermessungswesen, Wien (Austria); Schwaiger, Martina [Seibersdorf Labor GmbH, Seibersdorf (Austria); Timal, Guenter (ed.) [Bundesministerium fuer Inneres, Wien (Austria)


    The topics of the meeting are the diagnostic and therapeutic application of ionizing radiations, the application of radiation in research, industry and engineering and radiation protection. The volume includes the following chapters: Radiation protection and society, radiation protection infrastructure, population and environment, metrology and measuring techniques, 1. Workshop on population and environment, NORM and radon, 2. Update: dose - extent of damage - limiting value definition, radiation protection for personnel (except medicine), radiation protection in medicine.

  11. 42 CFR 495.364 - Review and assessment of administrative activities and expenses of Medicaid provider health...


    ... 42 Public Health 5 2010-10-01 2010-10-01 false Review and assessment of administrative activities... administrative activities and expenses of Medicaid provider health information technology adoption and operation... its approved HIT planning advance planning document and health information technology...

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


    organization. All of our resources— high -quality and safe health care, disability compensation and pensions, education and training, home mortgages, life...Leadership Development, Leadership Theory, RN, VA, VHA, Veterans Health Administration, Succession Planning, Development Strategies, Education and Training...59 Veterans Health Administration Leadership Competencies ......................................... 63 High Performance Development Model

  13. Continued administration of ciliary neurotrophic factor protects mice from inflammatory pathology in experimental autoimmune encephalomyelitis

    Kuhlmann, Tanja; Remington, Leah; Cognet, Isabelle;


    Multiple sclerosis is an inflammatory disease of the central nervous system that leads to loss of myelin and oligodendrocytes and damage to axons. We show that daily administration (days 8 to 24) of murine ciliary neurotrophic factor (CNTF), a neurotrophic factor that has been described as a surv...

  14. What Role for Administrative Courts in Granting Effective Legal Protection in the Energy Sector?

    Lavrijssen, S.


    This article develops a normative framework for assessing the role of the national administrative courts in reviewing regulatory decisions involving complex legal and economic assessments in the energy sector. It elaborates in a detailed way the requirements that follow from the EU law principle of

  15. Co-occurrence of protective health behaviours and perceived psychosocial job characteristics

    Vera J.C. Mc Carthy


    Full Text Available Little is known about the association between positive job characteristics of older workers and the co-occurrence of protective health behaviours. This study aims to investigate the association between perceived psychosocial job characteristics and the adoption of protective health behaviours. A population-based cross-sectional study was performed on a sample of 1025 males and females (age-range 50–69-years attending a primary healthcare clinic. Perceived job characteristics (job demands: quantitative and cognitive demands; resources: possibility for development and influence at work were determined using the Copenhagen Psychosocial Questionnaire. Each scale is presented in tertiles. Protective health behaviours were; consumption of five or more portions of fruit and vegetables a day, moderate alcohol, non/ex-smoker, and high and moderate physical activity. Each participant was scored 0–4 protective health behaviours. The majority of the sample had three protective health behaviours. Higher levels of influence at work and cognitive demands were associated with higher self-reported physical activity, but not with any number of protective health behaviours. Conversely, higher quantitative and higher cognitive demands were associated with reporting any number of protective health behaviours or above average number of protective health behaviours respectively. The findings on protective health behaviours were inconsistent in relation to the different measures of perceived psychosocial job characteristics and were largely confined to physical activity and diet.

  16. Integrating hospital administrative data to improve health care efficiency and outcomes: "the socrates story".

    Lawrence, Justin; Delaney, Conor P


    Evaluation of health care outcomes has become increasingly important as we strive to improve quality and efficiency while controlling cost. Many groups feel that analysis of large datasets will be useful in optimizing resource utilization; however, the ideal blend of clinical and administrative data points has not been developed. Hospitals and health care systems have several tools to measure cost and resource utilization, but the data are often housed in disparate systems that are not integrated and do not permit multisystem analysis. Systems Outcomes and Clinical Resources AdministraTive Efficiency Software (SOCRATES) is a novel data merging, warehousing, analysis, and reporting technology, which brings together disparate hospital administrative systems generating automated or customizable risk-adjusted reports. Used in combination with standardized enhanced care pathways, SOCRATES offers a mechanism to improve the quality and efficiency of care, with the ability to measure real-time changes in outcomes.

  17. An Integrated Health Care Model in Medical Education: Interviews with Faculty and Administrators.

    Tresolini, Carol P.; Shugars, Daniel A.


    Faculty and administrators of 22 medical schools were interviewed for their insights into development of an approach to health care and medical education that integrates psychosocial and biomedical perspectives. Results suggest medical curricula should address development of physicians' knowledge, attitudes, and skills in relationships with both…

  18. Validated methods for identifying tuberculosis patients in health administrative databases: systematic review.

    Ronald, L A; Ling, D I; FitzGerald, J M; Schwartzman, K; Bartlett-Esquilant, G; Boivin, J-F; Benedetti, A; Menzies, D


    An increasing number of studies are using health administrative databases for tuberculosis (TB) research. However, there are limitations to using such databases for identifying patients with TB. To summarise validated methods for identifying TB in health administrative databases. We conducted a systematic literature search in two databases (Ovid Medline and Embase, January 1980-January 2016). We limited the search to diagnostic accuracy studies assessing algorithms derived from drug prescription, International Classification of Diseases (ICD) diagnostic code and/or laboratory data for identifying patients with TB in health administrative databases. The search identified 2413 unique citations. Of the 40 full-text articles reviewed, we included 14 in our review. Algorithms and diagnostic accuracy outcomes to identify TB varied widely across studies, with positive predictive value ranging from 1.3% to 100% and sensitivity ranging from 20% to 100%. Diagnostic accuracy measures of algorithms using out-patient, in-patient and/or laboratory data to identify patients with TB in health administrative databases vary widely across studies. Use solely of ICD diagnostic codes to identify TB, particularly when using out-patient records, is likely to lead to incorrect estimates of case numbers, given the current limitations of ICD systems in coding TB.

  19. Psychological Research With Administrative Data Sets: An Underutilized Strategy for Mental Health Services Research.

    Walkup, James T; Yanos, Philip T


    A key element in the identity of professional psychologists is their commitment to base practice on the best knowledge available about a problem being tackled. Although administrative data (e.g., records of provider billing and procedures) can often shed light on the dark areas of the complex U.S. health care system, psychologists make notably little use of them. Experience teaches that decisions must often be made despite the absence of "gold standard" knowledge from the well-designed, controlled studies learned in graduate school. Increased involvement of psychologists in work using administrative data can improve service provision but requires that psychologists adopt unaccustomed approaches to research. The authors discuss administrative data's strengths and limitations, recent progress made in using them, how psychologists can acquire and use low-cost information from administrative data, and examples of questions that can be answered.

  20. Optimizing the electronic health record to standardize administration and documentation of nutritional supplements.

    Citty, Sandra W; Kamel, Amir; Garvan, Cynthia; Marlowe, Lee; Westhoff, Lynn


    Malnutrition in hospitalized patients is a major cause for hospital re-admission, pressure ulcers and increased hospital costs. Methods to improve the administration and documentation of nutritional supplements for hospitalized patients are needed to improve patient care, outcomes and resource utilization. Staff at a medium-sized academic health science center hospital in the southeastern United States noted that nutritional supplements ordered for patients at high risk for malnutrition were not offered or administered to patients in a standardized manner and/or not documented clearly in the electronic health record as per prescription. This paper reports on a process improvement project that redesigned the ordering, administration and documentation process of oral nutritional supplements in the electronic health record. By adding nutritional products to the medication order sets and adding an electronic nutrition administration record (ENAR) tab, the multidisciplinary team sought to standardize nutritional supplement ordering, documentation and administration at prescribed intervals. This process improvement project used a triangulated approach to evaluating pre- and post-process change including: medical record reviews, patient interviews, and nutrition formula room log reports. Staff education and training was carried out prior to initiation of the system changes. This process change resulted in an average decrease in the return of unused nutritional formula from 76% returned at baseline to 54% post-process change. The process change resulted in 100% of nutritional supplement orders having documentation about nutritional medication administration and/or reason for non-administration. Documentation in the ENAR showed that 41% of ONS orders were given and 59% were not given. Significantly more patients reported being offered the ONS product (p=0.0001) after process redesign and more patients (5% before ENAR and 86% after ENAR reported being offered the correct

  1. Optimizing the electronic health record to standardize administration and documentation of nutritional supplements

    Citty, Sandra W.; Kamel, Amir; Garvan, Cynthia; Marlowe, Lee; Westhoff, Lynn


    Malnutrition in hospitalized patients is a major cause for hospital re-admission, pressure ulcers and increased hospital costs. Methods to improve the administration and documentation of nutritional supplements for hospitalized patients are needed to improve patient care, outcomes and resource utilization. Staff at a medium-sized academic health science center hospital in the southeastern United States noted that nutritional supplements ordered for patients at high risk for malnutrition were not offered or administered to patients in a standardized manner and/or not documented clearly in the electronic health record as per prescription. This paper reports on a process improvement project that redesigned the ordering, administration and documentation process of oral nutritional supplements in the electronic health record. By adding nutritional products to the medication order sets and adding an electronic nutrition administration record (ENAR) tab, the multidisciplinary team sought to standardize nutritional supplement ordering, documentation and administration at prescribed intervals. This process improvement project used a triangulated approach to evaluating pre- and post-process change including: medical record reviews, patient interviews, and nutrition formula room log reports. Staff education and training was carried out prior to initiation of the system changes. This process change resulted in an average decrease in the return of unused nutritional formula from 76% returned at baseline to 54% post-process change. The process change resulted in 100% of nutritional supplement orders having documentation about nutritional medication administration and/or reason for non-administration. Documentation in the ENAR showed that 41% of ONS orders were given and 59% were not given. Significantly more patients reported being offered the ONS product (p=0.0001) after process redesign and more patients (5% before ENAR and 86% after ENAR reported being offered the correct

  2. Pesticide assessment: Protecting public health on the home turf.

    Sears, Meg; Walker, C Robin; van der Jagt, Richard Hc; Claman, Paul


    Pesticide regulation is examined in the context of Health Canada's Pest Management Regulatory Agency's assessment of the chlorophenoxy herbicide 2,4-dichlorophenoxyacetic acid (2,4-D) for turf. 2,4-D is the most common herbicide used to kill weeds in grass.The medical literature does not uniformly indicate harms from herbicides. However, the balance of epidemiological research suggests that 2,4-D can be persuasively linked to cancers, neurological impairment and reproductive problems. These may arise from 2,4-D itself, from breakdown products or dioxin contamination, or from a combination of chemicals.Regulators rely largely on toxicology, but experiments may not replicate exposures from 2,4-D application to lawns because environmental breakdown products (eg, 2,4-dichlorophenol) may not accumulate and selected herbicides are possibly less contaminated. Dioxins are bioaccumulative chemicals that may cause cancer, harm neurological development, impair reproduction, disrupt the endocrine system and alter immune function. No dioxin analyses were submitted to the Pest Management Regulatory Agency, and the principal contaminants of 2,4-D are not among the 17 congeners covered in pesticide regulation. Independent assessment of all dioxins is needed, in tissues and in the environment.The 2,4-D assessment does not approach standards for ethics, rigour or transparency in medical research. Canada needs a stronger regulator for pesticides. Potentially toxic chemicals should not be registered when more benign solutions exist, risks are not clearly quantifiable or potential risks outweigh benefits. Until landscaping pesticides are curtailed nationally, local bylaws and Quebec's Pesticide Code are prudent measures to protect public health. Physicians have a role in public education regarding pesticides.

  3. Response to health inequity: the role of social protection in reducing poverty and achieving equity.

    Scheil-Adlung, Xenia


    Health inequities are determined by multiple factors within the health sector and beyond. While gaps in social health protection coverage and effective access to health care are among the most prominent causes of health inequities, social and economic inequalities existing beyond the health sector contribute greatly to barriers to access affordable and acceptable health care. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email:

  4. Understanding administrative evidence-based practices: Findings from a survey of local health department leaders

    Brownson, Ross C.; Reis, Rodrigo S.; Allen, Peg; Duggan, Kathleen; Fields, Robert; Stamatakis, Katherine A.; Erwin, Paul C.


    Background There are sparse data showing the extent to which evidence-based public health is occurring among local health departments. Purpose The purpose of the study was to describe the patterns and predictors of administrative evidence-based practices (structures and activities that are associated with performance measures) in a representative sample of local health departments in the United States. Methods A cross-sectional study of 517 local health department directors was conducted from October through December 2012 (analysis in January through March 2013). The questions on administrative evidence-based practices included 19 items based on a recent literature review (five broad domains: workforce development, leadership, organizational climate and culture, relationships and partnerships, financial processes). Results There was a wide range in performance among the 19 individual administrative evidence-based practices, ranging from 35% for access to current information on evidence-based practices to 96% for funding via a variety of sources Among the five domains, values were generally lowest for organizational climate and culture (mean for the domain = 49.9%) and highest for relationships and partnerships (mean for the domain = 77.1%). Variables associated with attaining the highest tertile of administrative evidence-based practices included having a population jurisdiction of 25,000 or larger (adjusted odds ratios (aORs) ranging from 4.4 to 7.5) and state governance structure (aOR=3.1). Conclusions This report on the patterns and predictors of administrative evidence-based practices in health departments begins to provide information on gaps and areas for improvement that can be linked with ongoing quality improvement processes. PMID:24355671

  5. [Human habitats and the protection of health in Islam].

    Hadrović, A


    Architecture is an expression so wide in its dimensions and meanings, that it can be compared to expression "life". Architecture is a synthesis and an expression of all rational and irrational that attributes a man, family, community in general, or mankind at all-im one hand; and rational expression of physical structure given by architects, in other hand. Thus, architecture comes down from the highest spheres of philosophy, sociology, discussions on ethics etc., to life. That is the way how architecture becomes defining frame of human life. Human habitude and health protection in islam could be elaborated through theoretical concept of architecturally defined space (ADS), that considers (treats) architecture as a complex system, consisting of four fundamental elements: man, environment, limits and perspectives. Each of these elements, when looking from the perspective of islam, has its specific characteristics, that author discusses in this paper. No doubt, in islamic sphere of life there is a wide spectrum of architectural programmes, that follows natural environment, and has a goal to confirm human and general social values.

  6. Using linked electronic data to validate algorithms for health outcomes in administrative databases.

    Lee, Wan-Ju; Lee, Todd A; Pickard, Alan Simon; Shoaibi, Azadeh; Schumock, Glen T


    The validity of algorithms used to identify health outcomes in claims-based and administrative data is critical to the reliability of findings from observational studies. The traditional approach to algorithm validation, using medical charts, is expensive and time-consuming. An alternative method is to link the claims data to an external, electronic data source that contains information allowing confirmation of the event of interest. In this paper, we describe this external linkage validation method and delineate important considerations to assess the feasibility and appropriateness of validating health outcomes using this approach. This framework can help investigators decide whether to pursue an external linkage validation method for identifying health outcomes in administrative/claims data.

  7. Sublingual administration of Lactobacillus rhamnosus affects respiratory immune responses and facilitates protection against influenza virus infection in mice.

    Lee, Yu-Na; Youn, Ha-Na; Kwon, Jung-Hoon; Lee, Dong-Hun; Park, Jae-Keun; Yuk, Seong-Su; Erdene-Ochir, Tseren-Ochir; Kim, Ki-Taek; Lee, Joong-Bok; Park, Seung-Yong; Choi, In-Soo; Song, Chang-Seon


    The extensive morbidity and mortality caused by influenza A viruses worldwide prompts the need for a deeper understanding of the host immune response and novel therapeutic and/or prophylactic interventions. In this study, we assessed the sublingual route as an effective means of delivering probiotics against influenza virus in mice. In addition, IgA levels, NK cell activity, T cell activation, and cytokine profiles in the lungs were examined to understand the mechanism underlying this protective effect. Sublingual administration of Lactobacillus rhamnosus provided enhanced protection against influenza virus infection by enhancing mucosal secretory IgA production, and T and NK cell activity. Moreover, interleukin (IL)-12 levels in the lungs increased significantly. Conversely, IL-6 and tumor necrosis factor alpha levels in the lungs decreased significantly. On the basis of these promising findings, we propose that the sublingual mucosal route is an attractive alternative to mucosal routes for administering probiotics against influenza virus.

  8. Health service utilization in IBD: comparison of self-report and administrative data


    Background The reliability of self-report regarding health care utilization in inflammatory bowel disease (IBD) is unknown. If proven reliable, it could help justify self-report as a means of determining health care utilization and associated costs. Methods The Manitoba IBD Cohort Study is a population-based longitudinal study of participants diagnosed within 7 years of enrollment. Health care utilization was assessed through standardized interview. Participants (n = 352) reported the total number of nights hospitalized, frequency of physician contacts in the prior 12 months and whether the medical contacts were for IBD-related reasons or not. Reports of recent antibiotic use were also recorded. Actual utilization was drawn from the administrative database of Manitoba Health, the single comprehensive provincial health insurer. Results According to the administrative data, 15% of respondents had an overnight hospitalization, while 10% had an IBD-related hospitalization. Self-report concordance was highly sensitive (92%; 82%) and specific (96%; 97%, respectively). 97% of participants had contact with a physician in the previous year, and 69% had IBD-related visits. Physician visits were significantly under-reported and there was a trend to over-report the number of nights in hospital. Conclusions Self-report data can be helpful in evaluating health service utilization, provided that the researcher is aware of the systematic sources of bias. Outpatient visits are well identified by self-report. The discordance for the type of outpatient visit may be either a weakness of self-report or a flaw in diagnosis coding of the administrative data. If administrative data are not available, self-report information may be a cost-effective alternative, particularly for hospitalizations. PMID:21627808

  9. Health service utilization in IBD: comparison of self-report and administrative data

    Walker John R


    Full Text Available Abstract Background The reliability of self-report regarding health care utilization in inflammatory bowel disease (IBD is unknown. If proven reliable, it could help justify self-report as a means of determining health care utilization and associated costs. Methods The Manitoba IBD Cohort Study is a population-based longitudinal study of participants diagnosed within 7 years of enrollment. Health care utilization was assessed through standardized interview. Participants (n = 352 reported the total number of nights hospitalized, frequency of physician contacts in the prior 12 months and whether the medical contacts were for IBD-related reasons or not. Reports of recent antibiotic use were also recorded. Actual utilization was drawn from the administrative database of Manitoba Health, the single comprehensive provincial health insurer. Results According to the administrative data, 15% of respondents had an overnight hospitalization, while 10% had an IBD-related hospitalization. Self-report concordance was highly sensitive (92%; 82% and specific (96%; 97%, respectively. 97% of participants had contact with a physician in the previous year, and 69% had IBD-related visits. Physician visits were significantly under-reported and there was a trend to over-report the number of nights in hospital. Conclusions Self-report data can be helpful in evaluating health service utilization, provided that the researcher is aware of the systematic sources of bias. Outpatient visits are well identified by self-report. The discordance for the type of outpatient visit may be either a weakness of self-report or a flaw in diagnosis coding of the administrative data. If administrative data are not available, self-report information may be a cost-effective alternative, particularly for hospitalizations.

  10. Patents and the obligation to protect health: examining the significance of human rights considerations in the protection of pharmaceutical patents.

    Owoeye, Olasupo Ayodeji


    This article discusses the human right to health in the context of patent protection and access to medicines. It considers the limitations in international human rights law, especially in relation to socioeconomic rights, that make it difficult for the right to health to be a potent justification for derogation from trade or intellectual property agreements. It concludes by taking the view that while the right to health may be somewhat unenforceable in international law, its close association with enforceable rights such as the right to life can be a legitimate basis for making maximum use of the flexibilities in the international intellectual property regime to protect public health. The article takes the view that trade and intellectual property agreements must be interpreted in a way that endeavours as much as possible to resolve any seeming inconsistency with the right to health.

  11. Delayed administration of darbepoetin or erythropoietin protects against ischemic acute renal injury and failure.

    Johnson, D W; Pat, B; Vesey, D A; Guan, Z; Endre, Z; Gobe, G C


    Administration of human recombinant erythropoietin (EPO) at time of acute ischemic renal injury (IRI) inhibits apoptosis, enhances tubular epithelial regeneration, and promotes renal functional recovery. The present study aimed to determine whether darbepoetin-alfa (DPO) exhibits comparable renoprotection to that afforded by EPO, whether pro or antiapoptotic Bcl-2 proteins are involved, and whether delayed administration of EPO or DPO 6 h following IRI ameliorates renal dysfunction. The model of IRI involved bilateral renal artery occlusion for 45 min in rats (N = 4 per group), followed by reperfusion for 1-7 days. Controls were sham-operated. Rats were treated at time of ischemia or sham operation (T0), or post-treated (6 h after the onset of reperfusion, T6) with EPO (5000 IU/kg), DPO (25 mug/kg), or appropriate vehicle by intraperitoneal injection. Renal function, structure, and immunohistochemistry for Bcl-2, Bcl-XL, and Bax were analyzed. DPO or EPO at T0 significantly abrogated renal dysfunction in IRI animals (serum creatinine for IRI 0.17 +/- 0.05 mmol/l vs DPO-IRI 0.08 +/- 0.03 mmol/l vs EPO-IRI 0.04 +/- 0.01 mmol/l, P = 0.01). Delayed administration of DPO or EPO (T6) also significantly abrogated subsequent renal dysfunction (serum creatinine for IRI 0.17 +/- 0.05 mmol/l vs DPO-IRI 0.06 +/- 0.01 mmol/l vs EPO-IRI 0.03 +/- 0.03 mmol/l, P = 0.01). There was also significantly decreased tissue injury (apoptosis, P EPO at T0 or T6. These results reaffirm the potential clinical application of DPO and EPO as novel renoprotective agents for patients at risk of ischemic acute renal failure or after having sustained an ischemic renal insult.

  12. Managing transition: guidelines for mental health administrators facing services retrenchment due to funding cuts.

    Raymond, J S


    This piece of writing is one part of a four part series on managing transition in turbulent times. The series is written for mental health administrators and is a product of the author's direct experience as chief administrator of addiction treatment facilities and programs for The Salvation Army in Hawaii. Despite the loss of several hundred thousands of dollars, the agency was able to manage its own transition to emerge stronger and with two full years of accreditation as a psychiatric facility by the prestigious Joint Commission on the Accreditation of Hospitals.

  13. 78 FR 44947 - Children's Health Protection Advisory Committee


    ..., pediatricians, obstetrics, occupational medicine, community nurses, environmental groups, health groups, health... exposures, chemical exposures, public health information tracking, knowledge of EPA regulation development... communication; Water quality, regulations, policies, outreach and communication; Prenatal exposures and...

  14. Do differences in the administrative structure of populations confound comparisons of geographic health inequalities?

    Jackson, Andrew L


    Abstract Background Geographical health inequalities are naturally described by the variation in health outcomes between areas (e.g. mortality rates). However, comparisons made between countries are hampered by our lack of understanding of the effect of the size of administrative units, and in particular the modifiable areal unit problem. Our objective was to assess how differences in geographic and administrative units used for disseminating data affect the description of health inequalities. Methods Retrospective study of standard populations and deaths aggregated by administrative regions within 20 European countries, 1990-1991. Estimated populations and deaths in males aged 0-64 were in 5 year age bands. Poisson multilevel modelling was conducted of deaths as standardised mortality ratios. The variation between regions within countries was tested for relationships with the mean region population size and the unequal distribution of populations within each country measured using Gini coefficients. Results There is evidence that countries whose regions vary more in population size show greater variation and hence greater apparent inequalities in mortality counts. The Gini coefficient, measuring inequalities in population size, ranged from 0.1 to 0.5 between countries; an increase of 0.1 was accompanied by a 12-14% increase in the standard deviation of the mortality rates between regions within a country. Conclusions Apparently differing health inequalities between two countries may be due to differences in geographical structure per se, rather than having any underlying epidemiological cause. Inequalities may be inherently greater in countries whose regions are more unequally populated.

  15. Applying the Recovery Approach to the Interface between Mental Health and Child Protection Services

    Duffy, Joe; Davidson, Gavin; Kavanagh, Damien


    There is a range of theoretical approaches which may inform the interface between child protection and adult mental health services. These theoretical perspectives tend to be focused on either child protection or mental health with no agreed integrating framework. The interface continues to be identified, in research, case management reviews and…

  16. Applying the Recovery Approach to the Interface between Mental Health and Child Protection Services

    Duffy, Joe; Davidson, Gavin; Kavanagh, Damien


    There is a range of theoretical approaches which may inform the interface between child protection and adult mental health services. These theoretical perspectives tend to be focused on either child protection or mental health with no agreed integrating framework. The interface continues to be identified, in research, case management reviews and…

  17. Indian community health insurance schemes provide partial protection against catastrophic health expenditure

    Ranson Kent


    Full Text Available Abstract Background More than 72% of health expenditure in India is financed by individual households at the time of illness through out-of-pocket payments. This is a highly regressive way of financing health care and sometimes leads to impoverishment. Health insurance is recommended as a measure to protect households from such catastrophic health expenditure (CHE. We studied two Indian community health insurance (CHI schemes, ACCORD and SEWA, to determine whether insured households are protected from CHE. Methods ACCORD provides health insurance cover for the indigenous population, living in Gudalur, Tamil Nadu. SEWA provides insurance cover for self employed women in the state of Gujarat. Both cover hospitalisation expenses, but only upto a maximum limit of US$23 and US$45, respectively. We reviewed the insurance claims registers in both schemes and identified patients who were hospitalised during the period 01/04/2003 to 31/03/2004. Details of their diagnoses, places and costs of treatment and self-reported annual incomes were obtained. There is no single definition of CHE and none of these have been validated. For this research, we used the following definition; "annual hospital expenditure greater than 10% of annual income," to identify those who experienced CHE. Results There were a total of 683 and 3152 hospital admissions at ACCORD and SEWA, respectively. In the absence of the CHI scheme, all of the patients at ACCORD and SEWA would have had to pay OOP for their hospitalisation. With the CHI scheme, 67% and 34% of patients did not have to make any out-of-pocket (OOP payment for their hospital expenses at ACCORD and SEWA, respectively. Both CHI schemes halved the number of households that would have experienced CHE by covering hospital costs. However, despite this, 4% and 23% of households with admissions still experienced CHE at ACCORD and SEWA, respectively. This was related to the following conditions: low annual income, benefit

  18. Commentary: Personalized health planning and the Patient Protection and Affordable Care Act: an opportunity for academic medicine to lead health care reform.

    Dinan, Michaela A; Simmons, Leigh Ann; Snyderman, Ralph


    The Patient Protection and Affordable Care Act of 2010 (PPACA) mandates the exploration of new approaches to coordinated health care delivery--such as patient-centered medical homes, accountable care organizations, and disease management programs--in which reimbursement is aligned with desired outcomes. PPACA does not, however, delineate a standardized approach to improve the delivery process or a specific means to quantify performance for value-based reimbursement; these details are left to administrative agencies to develop and implement. The authors propose that coordinated care can be implemented more effectively and performance quantified more accurately by using personalized health planning, which employs individualized strategic health planning and care relevant to the patient's specific needs. Personalized health plans, developed by providers in collaboration with their patients, quantify patients' health and health risks over time, identify strategies to mitigate risks and/or treat disease, deliver personalized care, engage patients in their care, and measure outcomes. Personalized health planning is a core clinical process that can standardize coordinated care approaches while providing the data needed for performance-based reimbursement. The authors argue that academic health centers have a significant opportunity to lead true health care reform by adopting personalized health planning to coordinate care delivery while conducting the research and education necessary to enable its broad clinical application.

  19. [Historical reflections on health protection and the condom].

    Forrai, J


    The condom was first mentioned in a 1564 writing by Gabriel Fallopius as a means of protection against syphilis describing his tests on 1100 people. The name itself has been ascribed to the Latin word condere, Cum Domino, the French city of Condom, and doctor Quondom, the physician of the English King Charles II. The Marquis de Sade and Casanova used it to avoid venereal diseases (VDs). In London condom manufacturing started in the 18th century. Later it became a symbol of prostitution and immorality. The material used consisted of fish bladder or animal intestines (calf, sheep). The discovery of the rubber tree and the invention of vulcanization by the American technician Goodyear in 1840 made possible large-scale production. In Hungary the 1st rubber manufacturing plant EMERGE started production in 1893 along with toys and other wares. IN 1895 the HUngarian medial association warned about the spread of syphilis facilitated by the activities of 15,400 syphilitic prostitutes in the country. 30% of hospital patients had syphilis. The use of the condom was limited, and illegitimate births increased by 10.5% during the millennium celebrations of Hungary's existence in 1896. EMERGE manufactured condoms called Nono which were mostly distributed to soldiers during World War I, yet they had little popularity. US soldiers did not use the condoms either, as 7 million active days were lost due to VDs during World War II. In the 1950's Anna Ratko was Minister of Health in Hungary who opposed promotion of condoms to increase the population. The invention of penicillin in 1942 also pushed the condom to the background, but in the 1980's the epidemic of AIDS has made its use widespread.

  20. Administration of defined microbiota is protective in a murine Salmonella infection model.

    Martz, Sarah-Lynn E; McDonald, Julie A K; Sun, Jun; Zhang, Yong-Guo; Gloor, Gregory B; Noordhof, Curtis; He, Shu-Mei; Gerbaba, Teklu K; Blennerhassett, Michael; Hurlbut, David J; Allen-Vercoe, Emma; Claud, Erika C; Petrof, Elaine O


    Salmonella typhimurium is a major cause of diarrhea and causes significant morbidity and mortality worldwide, and perturbations of the gut microbiota are known to increase susceptibility to enteric infections. The purpose of this study was to investigate whether a Microbial Ecosystem Therapeutic (MET-1) consisting of 33 bacterial strains, isolated from human stool and previously used to cure patients with recurrent Clostridium difficile infection, could also protect against S. typhimurium disease. C57BL/6 mice were pretreated with streptomycin prior to receiving MET-1 or control, then gavaged with S. typhimurium. Weight loss, serum cytokine levels, and S. typhimurium splenic translocation were measured. NF-κB nuclear staining, neutrophil accumulation, and localization of tight junction proteins (claudin-1, ZO-1) were visualized by immunofluorescence. Infected mice receiving MET-1 lost less weight, had reduced serum cytokines, reduced NF-κB nuclear staining, and decreased neutrophil infiltration in the cecum. MET-1 also preserved cecum tight junction protein expression, and reduced S. typhimurium translocation to the spleen. Notably, MET-1 did not decrease CFUs of Salmonella in the intestine. MET-1 may attenuate systemic infection by preserving tight junctions, thereby inhibiting S. typhimurium from gaining access to the systemic circulation. We conclude that MET-1 may be protective against enteric infections besides C. difficile infection.

  1. 75 FR 25869 - The National Institutes of Health and the Food and Drug Administration Joint Leadership Council...


    ... HUMAN SERVICES Food and Drug Administration The National Institutes of Health and the Food and Drug Administration Joint Leadership Council: Stakeholders Meeting; Request for Comments AGENCY: Food and Drug Administration, HHS. ACTION: Notice of public meeting; request for comments. SUMMARY: The Food and...

  2. Reproducibility, reliability and validity of population-based administrative health data for the assessment of cancer non-related comorbidities

    Fowler, Helen


    Background Patients with comorbidities do not receive optimal treatment for their cancer, leading to lower cancer survival. Information on individual comorbidities is not straightforward to derive from population-based administrative health datasets. We described the development of a reproducible algorithm to extract the individual Charlson index comorbidities from such data. We illustrated the algorithm with 1,789 laryngeal cancer patients diagnosed in England in 2013. We aimed to clearly set out and advocate the time-related assumptions specified in the algorithm by providing empirical evidence for them. Methods Comorbidities were assessed from hospital records in the ten years preceding cancer diagnosis and internal reliability of the hospital records was checked. Data were right-truncated 6 or 12 months prior to cancer diagnosis to avoid inclusion of potentially cancer-related comorbidities. We tested for collider bias using Cox regression. Results Our administrative data showed weak to moderate internal reliability to identify comorbidities (ICC ranging between 0.1 and 0.6) but a notably high external validity (86.3%). We showed a reverse protective effect of non-cancer related Chronic Obstructive Pulmonary Disease (COPD) when the effect is split into cancer and non-cancer related COPD (Age-adjusted HR: 0.95, 95% CI:0.7–1.28 for non-cancer related comorbidities). Furthermore, we showed that a window of 6 years before diagnosis is an optimal period for the assessment of comorbidities. Conclusion To formulate a robust approach for assessing common comorbidities, it is important that assumptions made are explicitly stated and empirically proven. We provide a transparent and consistent approach useful to researchers looking to assess comorbidities for cancer patients using administrative health data. PMID:28263996

  3. Establishment of an International Information Network for International Health Development: a survey of public health administration and management courses.

    Loos, G P


    The purpose of the present study was to examine the content emphasis of courses of public health administration and management (A & M) among member institutions of the Asia-Pacific Academic Consortium for Public Health (APACPH), to determine comparability of curricula across campuses. A survey of course syllabi from APACPH schools was conducted by three separate reviewers to identify topical subject matter presented in general and specialty A & M courses delivered to graduate students at each campus. Based on this review, three synthetic general content A & M courses, and one specialty A & M course (i.e. Hospital Administration) were created as a basis for intercampus cross-institutional comparisons conducted by the author. Despite the number of courses provided by the different APACPH institutions, specific content areas consistently appeared across institutions, suggesting possible foundational A & M content for public health students. In general, there was much better coverage of similar topics at the introductory level of instruction, and much greater consistency was observed across institutions that provided course work addressing the administration of hospitals. Several recommendations are made for further studies of other content areas, and for the development of minimum training content areas as a basis for cross-institutional studies.

  4. Dietary and Intraperitoneal Administration of Selenium Provide Comparable Protection in the 6-Hydroxydopamine Lesion Rat Model of Parkinson's Disease

    Cecilia M. Fox


    Full Text Available Significant research implicates the involvement of free radicals in the manifestation of Parkinson's disease. The antioxidant, selenium is a vital dietary component for mammals. It is present in the active center of glutathione peroxidase, an antioxidant enzyme that scavenges peroxides and protects membrane lipids and macromolecules from oxidative insult. The purpose of this research was to determine an effective means of delivering selenium as well as an appropriate time frame for antioxidant administration that would elicit a protective response in rats challenged with an intranigral 6-hydroxydopamine (6-OHDA lesion. In the first part of this study, Fischer 344 rats were placed into one of four groups: selenium enhanced diet, control diet, intraperitoneal injection of selenium as Na2SeO3 or intraperitoneal injection of distilled water. All treatments were delivered prior to an intranigral 6-OHDA lesion. Animals were euthanized two weeks post lesion and their brains processed for tyrosine hydroxylase (TH immunocytochemistry. Average dopamine neuron survival in the substantia nigra of control animals was less than 22%; whereas nigral dopamine neuron survival in the selenium fed group was 49.7% and 56.0% in the selenium injected group. Based on these results, a subsequent study was designed utilizing the selenium enhanced diet method of antioxidant administration. To examine the neuroprotective effect of long-term selenium treatment, pregnant Fischer 344 rats were exposed to either selenium enhanced or control rat chow. Their pups were treated with the same diet as their mothers and lesioned with 6-OHDA at two months of age. Animals were euthanized and their brains were processed for TH immunocytochemistry. Nigral dopamine neuron survival for the selenium treated animals was significantly protective (59% when compared to the control chow fed animals (29.6%. However, when compared to the short-term exposure of selenium rat chow in the previous

  5. 77 FR 41418 - Statement of Cooperation Between the Food and Drug Administration and the Secretaria of Health of...


    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Statement of Cooperation Between the Food and Drug Administration and the Secretaria of Health of the United Mexican States: Safety and Sanitary Quality of...

  6. Oral administration of a recombinant attenuated Yersinia pseudotuberculosis strain elicits protective immunity against plague.

    Sun, Wei; Sanapala, Shilpa; Rahav, Hannah; Curtiss, Roy


    A Yersinia pseudotuberculosis PB1+ (Yptb PB1+) mutant strain combined with chromosome insertion of the caf1R-caf1A-caf1M-caf1 operon and deletions of yopJ and yopK, χ10068 [pYV-ω2 (ΔyopJ315 ΔyopK108) ΔlacZ044::caf1R-caf1M-caf1A-caf1] was constructed. Results indicated that gene insertion and deletion did not affect the growth rate of χ10068 compared to wild-type Yptb cultured at 26 °C. In addition, the F1 antigen in χ10068 was synthesized and secreted on the surface of bacteria at 37 °C (mammalian body temperature), not at ambient culture temperature (26 °C). Immunization with χ10068 primed antibody responses and specific T-cell responses to F1 and YpL (Y. pestis whole cell lysate). Oral immunization with a single dose of χ10068 provided 70% protection against a subcutaneous (s.c.) challenge with ∼ 2.6 × 10(5) LD50 of Y. pestis KIM6+ (pCD1Ap) (KIM6+Ap) and 90% protection against an intranasal (i.n.) challenge with ∼ 500 LD50 of KIM6+Ap in mice. Our results suggest that χ10068 can be used as an effective precursor to make a safe vaccine to prevent plague in humans and to eliminate plague circulation among humans and animals. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. The use of logistic regression to enhance risk assessment and decision making by mental health administrators.

    Menditto, Anthony A; Linhorst, Donald M; Coleman, James C; Beck, Niels C


    Development of policies and procedures to contend with the risks presented by elopement, aggression, and suicidal behaviors are long-standing challenges for mental health administrators. Guidance in making such judgments can be obtained through the use of a multivariate statistical technique known as logistic regression. This procedure can be used to develop a predictive equation that is mathematically formulated to use the best combination of predictors, rather than considering just one factor at a time. This paper presents an overview of logistic regression and its utility in mental health administrative decision making. A case example of its application is presented using data on elopements from Missouri's long-term state psychiatric hospitals. Ultimately, the use of statistical prediction analyses tempered with differential qualitative weighting of classification errors can augment decision-making processes in a manner that provides guidance and flexibility while wrestling with the complex problem of risk assessment and decision making.

  8. Beyond the Iron Triangle: Implications for the Veterans Health Administration in an Uncertain Policy Environment


    VAMC VA Medical Center VBA Veterans Benefits Administration VFW Veterans of Foreign War of the United States VHA Veterans Health...However, this model is not necessarily applicable to HVAC, because few Members seek to serve on it and even fewer elect to remain on it as they accrue...Said C. Ibrahim, David S. Macpherson, and Michael E. Moreland, “VA Healthcare System: A Potential Model for a National Plan,” in The Praeger Handbook

  9. Co-administration of Apelin and T4 Protects Inotropic and Chronotropic Changes Occurring in Hypothyroid Rats

    Zahra Akhondali


    Full Text Available Abstract Background: One of the most important thyroid hormone targets is the cardiovascular system. Hemodynamic changes, such as decreased resting heart rate (HR, myocardial contractility, and cardiac output, and increased diastolic pressure and systemic vascular resistance, have been observed in hypothyroid patients. Moreover, in these patients, ECG changes include sinus bradycardia and low voltage complexes (P waves or QRS complexes. Objective: This study aimed at evaluating the prophylactic effect of apelin on HR changes and QRS voltage that occur in propylthiouracil (PTU-induced hypothyroid rats. Method: In this study, 48 adult male Wistar rats weighing 170-235g were randomly divided into 6 groups: Control group (normal saline ip injection + tap water gavage; P group (PTU 0.05%, in drinking water; A group (apelin 200 µ, ip; PA group [co-administration of PTU and apelin]; PT group [co-administration of PTU + T4 (0.2 mg/g per day, gavage]; and PAT group (co-administration of PTU, apelin and T4. All experiments were performed for 28 consecutive days, and then the animals were anesthetized with an ip injection of ketamine (80 mg/kg and xylazine (12 mg/kg. Lead II electrocardiogram was recorded to calculate HR and QRS voltage. Results: Heart rate and QRS voltage increased more significantly in the hypothyroid group that consumed both apelin and T4 (201 ± 4 beat/min, 0.71 ± 0.02 mv vs. hypothyroid 145 ± 9 beat/min, 0.563 ± 0.015 mv; respectively. Conclusion: The co-administration of apelin and T4 showed a protective effect on QRS voltage and HR in PTU‑induced hypothyroid rats.

  10. Co-administration of Apelin and T4 Protects Inotropic and Chronotropic Changes Occurring in Hypothyroid Rats

    Akhondali, Zahra; Badavi, Mohammad; Dianat, Mahin, E-mail:; Faraji, Farzaneh [Physiology Research Center and Department of Physiology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz (Iran, Islamic Republic of)


    One of the most important thyroid hormone targets is the cardiovascular system. Hemodynamic changes, such as decreased resting heart rate (HR), myocardial contractility, and cardiac output, and increased diastolic pressure and systemic vascular resistance, have been observed in hypothyroid patients. Moreover, in these patients, ECG changes include sinus bradycardia and low voltage complexes (P waves or QRS complexes). This study aimed at evaluating the prophylactic effect of apelin on HR changes and QRS voltage that occur in propylthiouracil (PTU)-induced hypothyroid rats. In this study, 48 adult male Wistar rats weighing 170-235g were randomly divided into 6 groups: Control group (normal saline ip injection + tap water gavage); P group (PTU 0.05%, in drinking water); A group (apelin 200 µ{sup -1}.day{sup -1}, ip); PA group [co-administration of PTU and apelin]; PT group [co-administration of PTU + T4 (0.2 mg/g per day, gavage)]; and PAT group (co-administration of PTU, apelin and T4). All experiments were performed for 28 consecutive days, and then the animals were anesthetized with an ip injection of ketamine (80 mg/kg) and xylazine (12 mg/kg). Lead II electrocardiogram was recorded to calculate HR and QRS voltage. Heart rate and QRS voltage increased more significantly in the hypothyroid group that consumed both apelin and T4 (201 ± 4 beat/min, 0.71 ± 0.02 mv vs. hypothyroid 145 ± 9 beat/min, 0.563 ± 0.015 mv; respectively). The co-administration of apelin and T4 showed a protective effect on QRS voltage and HR in PTU‑induced hypothyroid rats.

  11. Protective effects of sildenafil citrate administration on cisplatin-induced ovarian damage in rats.

    Taskin, Mine Islimye; Yay, Arzu; Adali, Ertan; Balcioglu, Esra; Inceboz, Umit


    The aim of this study is to evaluate the effects of sildenafil citrate on cisplatin-induced ovarian toxicity. Thirty-two female rats were divided into four groups. Group 1: saline control; group 2: cisplatin; group 3: sildenafil citrate; and group 4: cisplatin plus sildenafil citrate group. In groups 2 and 4, the rats were injected with 5 mg/kg cisplatin intraperitoneally (i.p.). In groups 3 and 4, the rats were injected with 1.4 mg/kg sildenafil citrate i.p. The ovaries were removed two weeks later in all groups. Histopathologic examination, follicle counting and classification were performed. The expression of anti-Müllerian hormone (AMH) was detected immunohistochemically in the ovarian tissues. Sildenafil alleviated cisplatin-induced histopathological changes in the ovarian tissue. Primordial, secondary and tertiary follicles were diminished in group 2 compared with group 1 (p sildenafil citrate preserved primordial follicle count in group 4 compared with group 2, and the difference was statistically significant (p sildenafil citrate is beneficial for protecting the ovaries from cisplatin-induced damage. Sildenafil citrate can be a choice for fertility preservation.

  12. Ginger extract protects rat's kidneys against oxidative damage after chronic ethanol administration.

    Shirpoor, Aireza; Rezaei, Farzaneh; Fard, Amin Abdollahzade; Afshari, Ali Taghizadeh; Gharalari, Farzaneh Hosseini; Rasmi, Yousef


    Chronic alcohol ingestion is associated with pronounced detrimental effects on the renal system. In the current study, the protective effect of ginger extract on ethanol-induced damage was evaluated through determining 8-OHdG, cystatin C, glomerular filtration rate, and pathological changes such as cell proliferation and fibrosis in rats' kidneys. Male wistar rats were randomly divided into three groups and were treated as follows: (1) control, (2) ethanol and (3) ginger extract treated ethanolic (GETE) groups. After a six weeks period of treatment, the results revealed proliferation of glomerular and tubular cells, fibrosis in glomerular and peritubular and a significant rise in the level of 8-OHdG, cystatin C, plasma urea and creatinine. Moreover, compared to the control group, the ethanol group showed a significant decrease in the urine creatinine and creatinine clearance. In addition, significant amelioration of changes in the structure of kidneys, along with restoration of the biochemical alterations were found in the ginger extract treated ethanolic group, compared to the ethanol group. These findings indicate that ethanol induces kidneys abnormality by oxidative DNA damage and oxidative stress, and that these effects can be alleviated using ginger as an antioxidant and anti-inflammatory agent.

  13. The microbiome in early life: self-completion and microbiota protection as health priorities.

    Dietert, Rodney R


    This minireview considers the benefits of refocusing attention away from treating the patient as a mammalian human to managing the complete patient: a majority microbial superorganism. Under the "completed self" model for formation of the human-microbial superorganism, the single, most pivotal sign in distinguishing a life course of health versus that filled with disease is self-completion (i.e., seeding of the minority mammalian human by the majority microbial portion of the symbiont). From a disease prevention perspective, microbial seeding at birth and subsequent nurturing of the microbiota are significant steps to reduce the risk of both noncommunicable diseases (e.g., type 1 diabetes) and certain infectious diseases. Management of the microbiome during pregnancy, birth, and shortly thereafter appears to be the most significant critical window for healthy superorganism formation. However, the bolus for microbiota seeding at birth and the nurturing process are subject to environmental influences and disruption, such as exposure to toxic chemicals and drugs, infections, and other physical and psychological stressors. Additionally, childhood and adult corrective measures, such as fecal transplantation and administration of prebiotics and probiotics, while potentially useful, may have limitations that are yet to be fully defined. This minireview considers (1) basic features of management of the microbiome to facilitate self-completion, (2) protection of the microbiota from environmental hazards, and (3) the benefits of using a superorganism focus for health management beginning with pregnancy and extending throughout childhood and adult life.

  14. Protection motivation theory and adolescent drug trafficking: relationship between health motivation and longitudinal risk involvement.

    Wu, Ying; Stanton, Bonita F; Li, Xiaoming; Galbraith, Jennifer; Cole, Matthew L


    To assess health protection motivation as explained by the constructs of protection motivation theory (PMT) and its association with drug trafficking over 2 years. The sample included 817 African American youth (13-16 years old) participating in an adolescent risk-reduction program. We developed an instrument measuring the level of health protection motivation (LHPM) using factor analysis. Changes in LHPM over time were examined among drug traffickers, abstainers, initiators, and nonrisk youths. In sum, 151 participants reported selling and/or delivering drugs during the study period. The significant inverse correlation between drug-trafficking intention and health protection motivation was consistent with PMT. Changes in LHPM were strongly associated with the dynamics of behavior over 2 years. Adolescent drug trafficking can be predicted by an overall level of health protection motivation. PMT and related theories should be considered in the design of drug-trafficking prevention intervention.

  15. Delayed administration of interleukin-1 receptor antagonist protects against transient cerebral ischaemia in the rat.

    Mulcahy, Nicholas J; Ross, Jerard; Rothwell, Nancy J; Loddick, Sarah A


    The cytokine interleukin-1 (IL-1) has been implicated in ischaemic, excitotoxic and traumatic brain damage in rodents. The naturally occurring IL-1 receptor antagonist (IL-1ra) markedly reduces neuronal injury in these conditions. However, the effects of IL-1ra on focal, transient cerebral ischaemia in the rat, which is of major clinical relevance, have not been reported. The objectives of this study were to test the effects of IL-1ra on cell death after temporary cerebral ischaemia, and to investigate the therapeutic time window for IL-1ra treatment. Ischaemia was induced by temporary (60 min) occlusion of the middle cerebral artery (MCAO) in rats, via surgical insertion (and subsequent removal) of a thread into the internal carotid artery. Damage was quantified at various times after MCAO to investigate the temporal progression of damage and establish an appropriate time to assess the effects of IL-1ra on cell death. Cell death was complete 18-24 h after temporary MCAO. Intracerebroventricular injection of IL-1ra (10 microg) at the time of MCAO and 60 min later reduced the lesion volume measured 24 h (57% reduction) or 48 h (52% reduction) after MCAO. Cell death was also significantly reduced when IL-1ra (20 microg) was administered as a single injection, 1 h (47%), 2 h (57%) or 3 h (46%) after MCAO, when compared to vehicle. These data show that IL-1ra markedly reduces cell death even when administration is delayed until 3 h after induction of reversible, focal cerebral ischaemia in the rat, and support our proposal that IL-1ra may be of therapeutic benefit in stroke.

  16. Administrative Coding and Clinician Documentation of Mental Health Issues for Hospitalized Heart Failure Patients: Is There Agreement

    Bender, M


    Purpose Previous research suggests an association between depression and poorer clinical outcomes for heart failure patients. Administrative ICD-9 coding is used extensively in health services research to capture variables of interest for outcomes studies, such as mental health issues. However, there is limited evidence of the accuracy of administrative ICD-9 coding for identifying patient-level mental health issues. The purpose of this study was to determine the agreement between ICD-9 co...

  17. Attenuation of inflammatory response phenomena in periparturient dairy cows by the administration of an ω3 rumen protected supplement containing vitamin E

    Giuseppe Bertoni


    Full Text Available The aim of this research was to study the consequences of ω3 fatty acids (FA administration around calving on inflammatory response and on productive performances. In this period dairy cows undergo a metabolic challenge, coming with an inflammatory-like status triggering the release of pro-inflammatory mediators (e.g. eicosanoids, cytokines. Eicosanoids synthesis may be modulated by altering the ratio of their precursors (ω3 and ω6 FA. Ten cows received 22 g/d of rumen-protected ω3 FA from -21 to +21 days from calving (OPT, while 10 (CTR received no supplement. Cows were frequently monitored for health status, body condition score (BCS, blood (metabolic, inflammatory and FA profiles, milk yield. OPT (vs CTR showed a similar milk production, a numerically smaller BCS drop, lower postpartum levels of non-esterified fatty acids (P<0.05, β-hydroxybutyric acid (P<0.1 and creatinine (P<0.05, suggesting a milder post-calving reserves mobilization. All cows underwent an inflammatory condition around calving, but OPT showed a milder response, as suggested by lower levels of bilirubin (P<0.05, and by the higher level of Liver Functionality Index (P<0.09. Plasma concentration of ω3 FA (eicosapentaenoic and docosahexaenoic acids increased in OPT during treatment (P<0.01 vs CTR. Since ω3 FA are the main replacers of arachidonic acid in membrane phospholipids, their increased levels in plasma of OPT cows may have cut the formation of arachidonic-derivatives (pro-inflammatory mediators, countering the beginning of the inflammation. Hence, the administration of rumen-protected ω3 FA in transition period seems to attenuate the effects of subclinical inflammations and to improve the energy balance.

  18. Protection against atypical Aeromonas salmonicida infection in carp (Cyprinus carpio L.) by oral administration of humus extract.

    Kodama, Hiroshi; Denso; Nakagawa, Tsuyoshi


    Humic substances are formed during the decomposition of organic matter in humus, and are found in many natural environments in which organic materials and microorganisms have been present. In the present study, oral administration of humus extract to common carp (Cyprinus carpio L.) induced effective protection against experimental atypical Aeromonas salmonicida infection. Mortality of fish and development of skin lesions such as hemorrhages and ulcers were significantly suppressed in carp treated with 10%, 5% or 1% humus extract adsorbed on dry feeding pellets. The median surviving days was also greater in fish treated with 10% or 5% humus extract than in untreated fish. Atypical A. salmonicida was isolated from ulcerative lesions of part of dead fish, but Aeromonas hydrophila and Flavobacterium sp. were also isolated from these fish, verifying bacterial population changes during the progression of skin lesions. These results clearly show that treatment of fish with humus extract is effective in preventing A. salmonicida disease.

  19. Protection against dengue virus infection in mice by administration of antibodies against modified nonstructural protein 1.

    Shu-Wen Wan

    Full Text Available BACKGROUND: Infection with dengue virus (DENV may cause life-threatening disease with thrombocytopenia and vascular leakage which are related to dysfunction of platelets and endothelial cells. We previously showed that antibodies (Abs against DENV nonstructural protein 1 (NS1 cross-react with human platelets and endothelial cells, leading to functional disturbances. Based on sequence homology analysis, the C-terminal region of DENV NS1 protein contains cross-reactive epitopes. For safety in vaccine development, the cross-reactive epitopes of DENV NS1 protein should be deleted or modified. METHODOLOGY/PRINCIPAL FINDINGS: We tested the protective effects of Abs against full-length DENV NS1, NS1 lacking the C-terminal amino acids (a.a. 271-352 (designated ΔC NS1, and chimeric DJ NS1 consisting of N-terminal DENV NS1 (a.a. 1-270 and C-terminal Japanese encephalitis virus NS1 (a.a. 271-352. The anti-ΔC NS1 and anti-DJ NS1 Abs showed a lower binding activity to endothelial cells and platelets than that of anti-DENV NS1 Abs. Passive immunization with anti-ΔC NS1 and anti-DJ NS1 Abs reduced DENV-induced prolonged mouse tail bleeding time. Treatment with anti-DENV NS1, anti-ΔC NS1 and anti-DJ NS1 Abs reduced local skin hemorrhage, controlled the viral load of DENV infection in vivo, synergized with complement to inhibit viral replication in vitro, as well as abolished DENV-induced macrophage infiltration to the site of skin inoculation. Moreover, active immunization with modified NS1 protein, but not with unmodified DENV NS1 protein, reduced DENV-induced prolonged bleeding time, local skin hemorrhage, and viral load. CONCLUSIONS/SIGNIFICANCE: These results support the idea that modified NS1 proteins may represent an improved strategy for safe and effective vaccine development against DENV infection.

  20. Intracranial administration of P gene siRNA protects mice from lethal Chandipura virus encephalitis.

    Satyendra Kumar

    Full Text Available BACKGROUND: In parts of India, Chandipura Virus (CHPV has emerged as an encephalitis causing pathogen in both epidemic and sporadic forms. This pediatric disease follows rapid course leading to 55-75% mortality. In the absence of specific treatment, effectiveness of RNA interference (RNAi was evaluated. METHODS AND FINDINGS: Efficacy of synthetic short interfering RNA (siRNA or short hairpin RNA (shRNA in protecting mice from CHPV infection was assessed. The target genes were P and M genes primarily because important role of the former in viral replication and lethal nature of the latter. Real time one step RT-PCR and plaque assay were used for the assessment of gene silencing. Using pAcGFP1N1-CHPV-P, we showed that P-2 siRNA was most efficient in reducing the expression of P gene in-vitro. Both quantitative assays documented 2 logs reduction in the virus titer when P-2, M-5 or M-6 siRNAs were transfected 2 hr post infection (PI. Use of these siRNAs in combination did not result in enhanced efficiency. P-2 siRNA was found to tolerate four mismatches in the center. As compared to five different shRNAs, P-2 siRNA was most effective in inhibiting CHPV replication. An extended survival was noted when mice infected intracranially with 100 LD50 CHPV were treated with cationic lipid complexed 5 microg P-2 siRNA simultaneously. Infection with 10LD50 and treatment with two doses of siRNA first, simultaneously and second 24 hr PI, resulted in 70% survival. Surviving mice showed 4 logs less CHPV titers in brain without histopathological changes or antibody response. Gene expression profiles of P-2 siRNA treated mice showed no interferon response. First dose of siRNA at 2 hr or 4 hr PI with second dose at 24hr resulted in 40% and 20% survival respectively suggesting potential application in therapy. CONCLUSIONS: The results highlight therapeutic potential of siRNA in treating rapid and fatal Chandipura encephalitis.

  1. Overview of the Veterans Health Administration (VHA) Quality Enhancement Research Initiative (QUERI)

    McQueen, Lynn; Mittman, Brian S.; Demakis, John G.


    The U.S. Veterans Health Administration (VHA)'s Quality Enhancement Research Initiative (QUERI) is an innovative integration of health services research, policy, and clinical care delivery designed to improve the quality, outcomes, and efficiency of VHA health care through the identification and implementation of evidence-based practices in routine care settings. A total of eight condition-specific QUERI centers are currently in operation, each pursuing an integrated portfolio of activities designed to identify and correct gaps in clinical quality and performance and to derive generalizable scientific knowledge regarding quality improvement processes and methods and their effectiveness. This overview article describes QUERI's mission, history, structure, and activities and provides a brief summary of key findings and impacts. PMID:15187071

  2. Sex differences in chronic pain management practices for patients receiving opioids from the Veterans Health Administration.

    Oliva, Elizabeth M; Midboe, Amanda M; Lewis, Eleanor T; Henderson, Patricia T; Dalton, Aaron L; Im, Jinwoo J; Seal, Karen; Paik, Meenah C; Trafton, Jodie A


    Women experience chronic pain and use pain-related health care at higher rates than men. It is not known whether the pain-related health care female veterans receive is consistent with clinical practice guideline recommendations or whether receipt of this care differs between men and women. The aim of this study was to identify whether sex differences in chronic pain management care exist for patients served by the Veterans Health Administration (VHA). Data on patient demographics, diagnostic criteria, and health care utilization were extracted from VHA administrative databases for fiscal year 2010 (FY10). Patients in this study included all VHA patients (excluding metastatic cancer patients) who received more than 90 days of a short-acting opioid medication or a long-acting opioid medication prescription in FY10 study. Multilevel logistic regressions were conducted to identify sex differences in receipt of guideline-recommended chronic pain management. A total of 480,809 patients met inclusion criteria. Female patients were more likely to receive most measures of guideline-recommended care for chronic pain including mental health assessments, psychotherapy, rehabilitation therapy, and pharmacy reconciliation. However, women were more likely to receive concurrent sedative prescriptions, which is inconsistent with guideline recommendations. Most of the observed sex differences persisted after controlling for key demographic and diagnostic differences. Findings suggest that female VHA patients are more likely to receive an array of pain management practices than male patients, including both contraindicated and recommended polypharmacy. Quality improvement efforts to address underutilization of mental health and rehabilitative services for pain by male patients and polypharmacy in female patients should be considered. Wiley Periodicals, Inc.

  3. Use of administrative databases for health-care planning in CKD.

    Bello, Aminu; Hemmelgarn, Brenda; Manns, Braden; Tonelli, Marcello


    Good-quality information is required to plan healthcare services for patients with chronic diseases. Such information includes measures of disease burden, current care patterns and gaps in care based on quality-of-care indicators and clinical outcomes. Administrative data have long been used as a source of information for policy decisions related to the management of chronic diseases including cardiovascular disease, diabetes and hypertension. More recently, chronic kidney disease (CKD) has been acknowledged as a significant public health issue. Administrative data, particularly when supplemented by the use of routine laboratory data, have the potential to inform the development of optimal CKD care strategies, generate hypotheses about how to slow disease progression and identify risk factors for adverse outcomes. Available data may allow case identification and assessment of rates and patterns of disease progression, evaluation of risk and complications, including current gaps in care, and an estimation of associated costs. In this article, we use the example of the Alberta Kidney Disease Network to describe how researchers and policy makers can collaborate, using administrative data sources to guide health policy for the care of CKD patients.

  4. Development and validation of a case definition for epilepsy for use with administrative health data.

    Reid, Aylin Y; St Germaine-Smith, Christine; Liu, Mingfu; Sadiq, Shahnaz; Quan, Hude; Wiebe, Samuel; Faris, Peter; Dean, Stafford; Jetté, Nathalie


    The objective of this study was to develop and validate coding algorithms for epilepsy using ICD-coded inpatient claims, physician claims, and emergency room (ER) visits. 720/2049 charts from 2003 and 1533/3252 charts from 2006 were randomly selected for review from 13 neurologists' practices as the "gold standard" for diagnosis. Epilepsy status in each chart was determined by 2 trained physicians. The optimal algorithm to identify epilepsy cases was developed by linking the reviewed charts with three administrative databases (ICD 9 and 10 data from 2000 to 2008) including hospital discharges, ER visits and physician claims in a Canadian health region. Accepting chart review data as the gold standard, we calculated sensitivity, specificity, positive, and negative predictive value for each ICD-9 and ICD-10 administrative data algorithm (case definitions). Of 18 algorithms assessed, the most accurate algorithm to identify epilepsy cases was "2 physician claims or 1 hospitalization in 2 years coded" (ICD-9 345 or G40/G41) and the most sensitive algorithm was "1 physician clam or 1 hospitalization or 1 ER visit in 2 years." Accurate and sensitive case definitions are available for research requiring the identification of epilepsy cases in administrative health data.

  5. Organizational correlates of implementation of colocation of mental health and primary care in the Veterans Health Administration.

    Guerrero, Erick G; Heslin, Kevin C; Chang, Evelyn; Fenwick, Karissa; Yano, Elizabeth


    This study explored the role of organizational factors in the ability of Veterans Health Administration (VHA) clinics to implement colocated mental health care in primary care settings (PC-MH). The study used data from the VHA Clinical Practice Organizational Survey collected in 2007 from 225 clinic administrators across the United States. Clinic degree of implementation of PC-MH was the dependent variable, whereas independent variables included policies and procedures, organizational context, and leaders' perceptions of barriers to change. Pearson bivariate correlations and multivariable linear regression were used to test hypotheses. Results show that depression care training for primary care providers and clinics' flexibility and participation were both positively correlated with implementation of PC-MH. However, after accounting for other factors, regressions show that only training primary care providers in depression care was marginally associated with degree of implementation of PC-MH (p = 0.051). Given the importance of this topic for implementing integrated care as part of health care reform, these null findings underscore the need to improve theory and testing of more proximal measures of colocation in future work.

  6. Protection of Macrobrachium rosenbergii against white tail disease by oral administration of bacterial expressed and encapsulated double-stranded RNA.

    Naveen Kumar, Singaiah; Karunasagar, Indrani; Karunasagar, Iddya


    White tail disease (WTD) of cultured Macrobrachium rosenbergii is caused by M. rosenbergii nodavirus (MrNV) and an extra small virus (XSV), both present together, and the mortality rate can be as high as 100% within 2 or 3 days of infection. Possible protection of M. rosenbergii against WTD by oral administration of bacterial expressed and encapsulated double-stranded RNA (dsRNA) was studied. Juvenile M. rosenbergii were fed with the feed coated with inactivated bacteria encapsulated dsRNA of MrNV and XSV genes individually and in combination for 7 days followed by challenge with WTD causing agents at 24 h and 72 h post-feeding. Test animals fed with a combination of dsRNA of MrNV and XSV capsid genes showed the highest relative percent survival (RPS) when compared to other treatments with RPS of 80% and 75% at 24 and 72 h respectively. One hundred percent mortality was observed in test animals fed with control dsRNA coated feed. Although in the literature, injection is the most common method used to deliver dsRNA, this study shows that oral administration is effective, feasible and economical.

  7. Chronic dietary administration of valproic acid protects neurons of the rat nucleus basalis magnocellularis from ibotenic acid neurotoxicity.

    Eleuteri, Simona; Monti, Barbara; Brignani, Sara; Contestabile, Antonio


    Valproic acid (VPA) has been used for many years as a drug of choice for epilepsy and mood disorders. Recently, evidence has been proposed for a wide spectrum of actions of this drug, including antitumoral and neuroprotective properties. Valproic acid-mediated neuroprotection in vivo has been so far demonstrated in a limited number of experimental models. In this study, we have tested the neuroprotective potential of chronic (4 + 1 weeks) dietary administration of VPA on degeneration of cholinergic and GABAergic neurons of the rat nucleus basalis magnocellularis (NBM), injected with the excitotoxin, ibotenic acid (IBO), an animal models that is relevant for Alzheimer's disease-like neurodegeneration. We show that VPA treatment significantly protects both cholinergic and GABAergic neurons present in the injected area from the excitotoxic insult. A significant level of neuroprotection, in particular, is exerted towards the cholinergic neurons of the NBM projecting to the cortex, as demonstrated by the substantially higher levels of cholinergic markers maintained in the target cortical area of VPA-treated rats after IBO injection in the NBM. We further show that chronic VPA administration results in increased acetylation of histone H3 in brain, consistent with the histone deacetylase inhibitory action of VPA and putatively linked to a neuroprotective action of the drug mediated at the epigenetic level.

  8. Administration of nucleoside-modified mRNA encoding broadly neutralizing antibody protects humanized mice from HIV-1 challenge

    Pardi, Norbert; Secreto, Anthony J.; Shan, Xiaochuan; Debonera, Fotini; Glover, Joshua; Yi, Yanjie; Muramatsu, Hiromi; Ni, Houping; Mui, Barbara L.; Tam, Ying K.; Shaheen, Farida; Collman, Ronald G.; Karikó, Katalin; Danet-Desnoyers, Gwenn A.; Madden, Thomas D.; Hope, Michael J.; Weissman, Drew


    Monoclonal antibodies are one of the fastest growing classes of pharmaceutical products, however, their potential is limited by the high cost of development and manufacturing. Here we present a safe and cost-effective platform for in vivo expression of therapeutic antibodies using nucleoside-modified mRNA. To demonstrate feasibility and protective efficacy, nucleoside-modified mRNAs encoding the light and heavy chains of the broadly neutralizing anti-HIV-1 antibody VRC01 are generated and encapsulated into lipid nanoparticles. Systemic administration of 1.4 mg kg−1 of mRNA into mice results in ∼170 μg ml−1 VRC01 antibody concentrations in the plasma 24 h post injection. Weekly injections of 1 mg kg−1 of mRNA into immunodeficient mice maintain trough VRC01 levels above 40 μg ml−1. Most importantly, the translated antibody from a single injection of VRC01 mRNA protects humanized mice from intravenous HIV-1 challenge, demonstrating that nucleoside-modified mRNA represents a viable delivery platform for passive immunotherapy against HIV-1 with expansion to a variety of diseases. PMID:28251988

  9. Protection against Flavobacterium psychrophilum infection (cold water disease) in Ayu fish (Plecoglossus altivelis) by oral administration of humus extract.

    NAKAGAWA, Jun; IWASAKI, Tadashi; KODAMA, Hiroshi


    Humic substances are formed during the decomposition of organic matter in humus, and are found in many natural environments in which organic materials and microorganisms have been present. In the present study, oral administration of humus extract to ayu fish (Plecoglossus altivelis) induced effective protection against experimental Flavobacterium psychrophilum infection (cold water disease). Mortality of fish and development of skin lesions, such as erosion and hemorrhages on the skin, gill cover or mouth, were significantly suppressed in fish treated with 10%, 5% or 1% humus extract adsorbed on dry pellets. Although F. psychrophilum was not re-isolated from gills and erosion lesions of the skin of dead fish, bacterial gyrB DNA could be amplified in these specimens from dead fish and surviving control fish using the polymerase chain reaction. The protective effect of the extract was not the results of direct killing of bacteria or antibiotic activity of the extract since no obvious reduction in the bacterial number was observed at 5 times to 5,000 times dilution of the humus extract having pH 5.45 to 7.40. These results clearly show that treating fish with humus extract is effective in preventing cold water disease.

  10. Federal administrative health courts are unconstitutional: a reply to Elliott, Narayan, and Nasmith.

    Widman, Amy; Hochberg, Francine A


    This commentary responds to the essay by Elliott, Narayan, and Nasmith wherein they propose that the federal government may preclude plaintiffs with medically inflicted injuries from bringing state common-law tort claims against those whose negligence caused their injury. The administrative system championed by Elliott and other proponents is a radical departure from the current civil justice system. Specifically, we argue that the administrative health courts, as proposed, violate the commerce clause, the spending clause, the Seventh Amendment, and separation of powers principles. The commentary concludes that such a system is fatally flawed and cannot withstand constitutional scrutiny. Moreover, we are not persuaded that Congress will be able to ground such a radical constitutional restructuring in any sound public policy, as the majority of studies do not evidence Elliott, Narayan, and Nasmith's presumption that the civil justice system has failed in the medical malpractice context.

  11. Exploring the link between ambulatory care and avoidable hospitalizations at the Veteran Health Administration.

    Pracht, Etienne E; Bass, Elizabeth


    This paper explores the link between utilization of ambulatory care and the likelihood of rehospitalization for an avoidable reason in veterans served by the Veteran Health Administration (VA). The analysis used administrative data containing healthcare utilization and patient characteristics stored at the national VA data warehouse, the Corporate Franchise Data Center. The study sample consisted of 284 veterans residing in Florida who had been hospitalized at least once for an avoidable reason. A bivariate probit model with instrumental variables was used to estimate the probability of rehospitalization. Veterans who had at least 1 ambulatory care visit per month experienced a significant reduction in the probability of rehospitalization for the same avoidable hospitalization condition. The findings suggest that ambulatory care can serve as an important substitute for more expensive hospitalization for the conditions characterized as avoidable.

  12. 论行政强制法对行政相对人程序性权利的保护及完善%The Protection and Perfection of Administrative Counterparts'Procedural Rights Under Administrative Coercion Law



    行政强制法实施中具有保障行政相对人程序性权利的必要性,行政强制的单向性特征弱化和损益性特质,以及程序正义的要求,彰显了相对人程序性权利保障的重要意义。我国应在行政强制的设定、决定与实施,行政强制权利救济与监督等方面,全面保护行政相对人的程序性权利。%It is necessary to protect the procedural rights of administrative counterparts during the implementa-tion of the Administrative Coercion Law.Both the weakening of the one-way characteristic of the administrative law and the requirements to realize the procedural justice highlight the importance of protecting administrative counter-parts'procedural rights.Therefore, we should improve the design and implementation of administrative coercion, as well as its relief and the supervision, in order to completely protect administrative counterparts'procedural rights.

  13. Financial risk protection and universal health coverage: evidence and measurement challenges.

    Saksena, Priyanka; Hsu, Justine; Evans, David B


    Financial risk protection is a key component of universal health coverage (UHC), which is defined as access to all needed quality health services without financial hardship. As part of the PLOS Medicine Collection on measurement of UHC, the aim of this paper is to examine and to compare and contrast existing measures of financial risk protection. The paper presents the rationale behind the methodologies for measuring financial risk protection and how this relates to UHC as well as some empirical examples of the types of measures. Additionally, the specific challenges related to monitoring inequalities in financial risk protection are discussed. The paper then goes on to examine and document the practical challenges associated with measurement of financial risk protection. This paper summarizes current thinking on the area of financial risk protection, provides novel insights, and suggests future developments that could be valuable in the context of monitoring progress towards UHC.

  14. Financial risk protection and universal health coverage: evidence and measurement challenges.

    Priyanka Saksena


    Full Text Available Financial risk protection is a key component of universal health coverage (UHC, which is defined as access to all needed quality health services without financial hardship. As part of the PLOS Medicine Collection on measurement of UHC, the aim of this paper is to examine and to compare and contrast existing measures of financial risk protection. The paper presents the rationale behind the methodologies for measuring financial risk protection and how this relates to UHC as well as some empirical examples of the types of measures. Additionally, the specific challenges related to monitoring inequalities in financial risk protection are discussed. The paper then goes on to examine and document the practical challenges associated with measurement of financial risk protection. This paper summarizes current thinking on the area of financial risk protection, provides novel insights, and suggests future developments that could be valuable in the context of monitoring progress towards UHC.


    A. N. Liberman


    Full Text Available An article presents an analysis of the results of research aimed at clarifying the possible shortand long-term effects of exposure from electromagnetic fields (EMF of mobile radio communication – mobile (cellularand wireless (home phones on children and adolescents. Measures are considered to protect them from exposure to EMF, directions for further researches are formulated.

  16. opinion maternal and infant health is protected by antiretroviral drug ...


    Mar 1, 2012 ... stricter legislation to protect the rights of breastfeeding mothers. They objected to ... formula for HIV-positive women, and lamented that there has been hardly ... newborns against disease and support the maturation of their own immune ... two types of 'exceptionalism': (i) HIV exceptionalism and (ii) South.

  17. Community nurses' child protection role: views of public health nurses in Ireland.

    Kent, Susan


    Public health nurses in Ireland are generalist practitioners with a wide range of roles that address the needs of clients in the community across their lifespan. Child protection is one of many of the roles of Irish public health nurses. However, with increasing caseloads, birth rates and aging populations, their child protection role is becoming more difficult to define and practise safely. This paper presents a key finding of a qualitative study that explored the views of a group of public health nurses (n = 10) regarding their role with pre-school children. A significant theme following analysis of the interviews were the nurses\\' expressed concerns on their role in child protection. There is a need to define the role practised by public health nurses in child protection and to achieve a standard for this nationally.

  18. Health Promoting Behaviors and the Expectations for the Environment of the Hospital Administrative Staff

    Hilal Ozcebe


    Full Text Available Amac: It is important to learn how the people perceive their environment to promote health and to improve their perspectives. This study is aimed to determine the behaviors of smoking, physical activity, stres management and healthy eating of the administrative hospital staff and evaluate their perspectives about hospital environment. Gerec ve Yontem: The universe of the study was the administrative staffs working at a hospital. The questionnarie developed by the researchers .were used to collect data. The official permission was taken from hospital management, and the verbal permission was from the staff. Bulgular: The mean age of the participants was 34.4±7.43 and the mean year of working in this hospital was 10.7±7.1 years. The most common nutritional habit seen among all staff was drinking excess amount of tea, coffee, coke. Among the participants, 51.8% of the participants did not do any physical activity. The people interviewed in the study pointed out that the most given information among all topics was tobacco control (36.7%. Hospital staff declared the first desired expectations for their workplace as “having a seperate place to rest”, “professional support on communication skills”, “professional support on stress management”. The least expectation declared by the staff was "removing salt from the table". Sonuc: It is found that the hospital administrative staff interviewed in our study did not have enough awareness about health promoting behaviors and their accessibility to health promoting environment. The interventions should be developed to improve institutional policies, environmental infrastructure and also the level of awareness of staff. [TAF Prev Med Bull 2012; 11(6.000: 707-716

  19. 78 FR 48683 - National Institute for Occupational Safety and Health (NIOSH) Personal Protective Technology (PPT...


    ... Health (NIOSH) Personal Protective Technology (PPT) Program; Framework Document for the Healthcare Worker... availability of a document titled ``Framework for Setting the NIOSH PPT Program Action Plan for Healthcare... ). SUPPLEMENTARY INFORMATION: The NIOSH personal protective technology (PPT) program publishes and periodically...

  20. 77 FR 18309 - Patient Protection and Affordable Care Act; Establishment of Exchanges and Qualified Health Plans...


    ... Protection and Affordable Care Act; Establishment of Exchanges and Qualified Health Plans; Exchange Standards..., 156, and 157 RIN 0938-AQ67 Patient Protection and Affordable Care Act; Establishment of Exchanges and... collectively as the Affordable Care Act. The Exchanges will provide competitive marketplaces for...

  1. 76 FR 41865 - Patient Protection and Affordable Care Act; Establishment of Exchanges and Qualified Health Plans


    ... Protection and Affordable Care Act; Establishment of Exchanges and Qualified Health Plans; Proposed Rule #0... Exchanges (``Exchanges''), consistent with title I of the Patient Protection and Affordable Care Act of 2010...-152), referred to collectively as the Affordable Care Act. The Exchanges will provide...

  2. Veterinarians in Environmental Health: Opportunities for Veterinarians at the Environmental Protection Agency

    The United States Environmental Protection Agency (EPA) was created in 1970 partially in response to widespread public concern about environmental degradation. The EPA mission is to protect human health and the environment and the Agency is tasked with enforcing our nation's envi...

  3. Social work in the Veterans Health Administration (VA) System: rewards, challenges, roles and interventions.

    Beder, Joan; Postiglione, Paul


    For the social worker in the Veterans Health Administration (VA) System, numerous challenges are faced and met while serving the nation's Veterans. As part of the multidisciplinary team, social workers perform a variety of tasks and function in diverse roles. The qualitative survey research reported in this article sought to detail what social workers identified about the impact and rewards of their work and what they saw as the challenges and frustrations. In addition the social workers were asked to clarify their role with the patient and the family. Intervention strategies used in the course of the social workers interaction with the Veterans was also ascertained.

  4. The evolving role of advanced practice nursing within the new Veteran's Health Administration.

    Lynn, M M; Achtmeyer, C; Chavez, C; Zicafoose, B; Therien, J


    The Veteran's Health Administration (VHA) is experiencing profound change in focus and organization of service delivery. The focus of the evolving VHA system includes improvements in performance outcomes, such as actual costs, better access, higher levels of customer satisfaction, and improved functional status of patients. Given the changing nature of service delivery in the VHA system and the contributions of the Advanced Practices Nurses (APNs), this article explores the expanding role of the APN within the VHA and presents a best practice model for achieving the full potential of advanced nursing practice.

  5. Screening tool development for health impact assessment of large administrative structural changes

    Ravn, Anne Katrine; Nicolaisen, Henriette; Linnrose, Karina


    available on the Internet and in the scientific literature, in many cases lack of access to those tools creates a barrier to the use of HIA. RESULTS: Denmark is undergoing a major structural change in state administration, moving many responsibilities from the state to the local level. Newly constructed...... councils are faced with challenges regarding their responsibilities in health promotion and other fields, and this has opened a window for the introduction of HIA at a local level. Owing to the lack of experience with HIA in Denmark, screening tools are lacking and are frequently requested by councils...

  6. [Concept of personal data relating to health in the law of personal data protection].

    Navarrete, Jesús Rubí


    The Law on the Protection of Data states that health data are sensible data and therefore subject to a strengthened system of guarantees. In order to apply this, the information must make reference to physical persons and must be susceptible of being included within the concept of health data. The resolutions of the Spanish Agency for Data Protection and the rulings of the Courts provide very valuable elements to clarify both concepts.

  7. Evaluation of a Physiologically Based Pharmacokinetic (PBPK) Model Used to Develop Health Protective Levels for Trichloroethylene


    AFRL-RH-WP-TR-2017-0014 EVALUATION OF A PHYSIOLOGICALLY-BASED PHARMACOKINETIC (PBPK) MODEL USED TO DEVELOP HEALTH PROTECTIVE LEVELS FOR...Pharmacokinetic (PBPK) Model Used to Develop Health Protective Levels for Trichloroethylene 5a. CONTRACT NUMBER FA8650-15-2-6608 5b. GRANT...Anita Meyer, Army Corps of Engineers (CEHNC-EMS) and Shannon S. Garcia, AFCEC/CZTE for their efforts to obtain the required funding. The authors also

  8. Protecting Pakistan's health during the global economic crisis.

    Jooma, R; Khan, A; Khan, A A


    The world is facing an unprecedented global economic crisis, with many countries needing to reconsider their level of health care spending. This paper explores the many consequences of the global economic turndown on Pakistan's health, including reduced government and donor spending and increased poverty with the consequent diversion of funds away from health. Nevertheless, these challenges may provide opportunities not only to mitigate the adverse effects of the economic crisis but also to institute some much-needed reforms that may not receive political support during more affluent times. Our suggestions focus on setting priorities based on the national disease burden, prioritizing prevention interventions, demanding results, curbing corruption, experimenting with innovative funding mechanisms, advocating for increased funding by presenting health spending as an investment rather than an expense and by selected recourse to civil society interventions and philanthropy to bridge the gap between available and needed resources.

  9. Will the new Australian health privacy law provide adequate protection?

    Bomba, David; Hallit, George


    Amendments to the original Privacy Act (1988) come at a key point in time, as a national medical record system looms on the Australian horizon. Changes to The Privacy Act have the potential to define a level of information privacy prior to the implementation of such a system. We have therefore collected expert opinions on the ability of the Health Privacy Guidelines (enacted in December 2001 under The Privacy Act and hereafter more specifically known as Health Privacy Legislation) to ensure the privacy and security of patient information. We conclude that the legislation is flawed in its capacity to withstand an increasingly corporatised health sector. Deficiencies in consent requirements, together with feeble enforcement capabilities, mean The Legislation cannot effectively ensure that personally identifiable information will not end up in corporate third party hands. To significantly bolster the new legislation, we argue that it should be supplemented with explicit health data legislation and privacy auditing.

  10. Health care administration in the year 2000: practitioners' views of future issues and job requirements.

    Hudak, R P; Brooke, P P; Finstuen, K; Riley, P


    This research identifies the most important domains in health care administration (HCA) from now to the year 2000 and differentiates job skill, knowledge, and ability requirements necessary for successful management. Fellows of the American College of Healthcare Executives from about half of the United States responded to two iterations of a Delphi mail inquiry. Fellows identified 102 issues that were content-analyzed into nine domains by an HCA expert panel. Domains, in order of ranked importance, were cost/finance, leadership, professional staff interactions, health care delivery concepts, accessibility, ethics, quality/risk management, technology, and marketing. In the second Delphi iteration, Fellows reviewed domain results and rated job requirements on required job importance. Results indicated that while a business orientation is needed for organizational survival, an equal emphasis on person-oriented skills, knowledge, and abilities is required.

  11. The Adoption of Information and Communications Technology in the Administration of Health Insurance Schemes in Ghana

    Jeffrey Mingle


    Full Text Available This study evaluated the level of information andcommunications technologies (ICTs adoption in theadministration of the National Health Insurance Scheme (NHISin Ghana within the context of the Activity Theory. The studyused the mixed methods which involved the survey of 104 staffusing questionnaires and an interview with the Regional ICTCoordinator of the NHIS in Accra. The study revealed that theNHIS’ in the Region did not have an ICT policy of their ownderived from the national ICT policy. Also, the level of adoptionin ICTs was not satisfactory as essential processes in the schemesadministration were still being done manually. ICT usage in theschemes was not adequate and effective. The majority of the staffhad basic-intermediate ICT skills; and training in ICTs for staffwere not adequate. The study concluded that even though ICTshold great potential for health insurance scheme administration,these benefits for now remains an illusion in Ghana’s NHISsetup. A policy driven and training led strategies wererecommended.

  12. Indicators of "avoidable" mortality in health administrative areas in Sweden 1974-1985.

    Westerling, R


    When comparing health administrative areas in Sweden the variation in death rates for 13 suggested indicators of avoidable mortality was analysed for the time periods 1974-79 and 1980-85. For most indicators the variation was significant. The level of systematic (nonrandom) variance differed between the sexes for certain conditions. According to the theory of mass-significance it would be appropriate to use a sharpened significance test of high SMRs. For certain health policy indicators it was possible to detect areas accounting for nearly all the deviation above the national standard using a sharpened test (p positive warning signals. Epidemiological surveillance of indicators of avoidable mortality should be the starting point for in-depth studies.

  13. Using geographic information system tools to improve access to MS specialty care in Veterans Health Administration.

    Culpepper, William J; Cowper-Ripley, Diane; Litt, Eric R; McDowell, Tzu-Yun; Hoffman, Paul M


    Access to appropriate and timely healthcare is critical to the overall health and well-being of patients with chronic diseases. In this study, we used geographic information system (GIS) tools to map Veterans Health Administration (VHA) patients with multiple sclerosis (MS) and their access to MS specialty care. We created six travel-time bands around VHA facilities with MS specialty care and calculated the number of VHA patients with MS who resided in each time band and the number of patients who lived more than 2 hours from the nearest specialty clinic in fiscal year 2007. We demonstrate the utility of using GIS tools in decision-making by providing three examples of how patients' access to care is affected when additional specialty clinics are added. The mapping technique used in this study provides a powerful and valuable tool for policy and planning personnel who are evaluating how to address underserved populations and areas within the VHA healthcare system.

  14. Enhancement of Th1-biased protective immunity against avian influenza H9N2 virus via oral co-administration of attenuated Salmonella enterica serovar Typhimurium expressing chicken interferon-α and interleukin-18 along with an inactivated vaccine

    Rahman Md


    Full Text Available Abstract Background Control of currently circulating re-assorted low-pathogenicity avian influenza (LPAI H9N2 is a major concern for both animal and human health. Thus, an improved LPAI H9N2 vaccination strategy is needed to induce complete immunity in chickens against LPAI H9N2 virus strains. Cytokines play a crucial role in mounting both the type and extent of an immune response generated following infection with a pathogen or after vaccination. To improve the efficacy of inactivated LPAI H9N2 vaccine, attenuated Salmonella enterica serovar Typhimurium was used for oral co-administration of chicken interferon-α (chIFN-α and chicken interleukin-18 (chIL-18 as natural immunomodulators. Results Oral co-administration of S. enterica serovar Typhimurium expressing chIFN-α and chIL-18, prior to vaccination with inactivated AI H9N2 vaccine, modulated the immune response of chickens against the vaccine antigen through enhanced humoral and Th1-biased cell-mediated immunity, compared to chickens that received single administration of S. enterica serovar Typhimurium expressing either chIFN-α or chIL-18. To further test the protective efficacy of this improved vaccination regimen, immunized chickens were intra-tracheally challenged with a high dose of LPAI H9N2 virus. Combined administration of S. enterica serovar Typhimurium expressing chIFN-α and chIL-18 showed markedly enhanced protection compared to single administration of the construct, as determined by mortality, clinical severity, and feed and water intake. This enhancement of protective immunity was further confirmed by reduced rectal shedding and replication of AIV H9N2 in different tissues of challenged chickens. Conclusions Our results indicate the value of combined administration of chIFN-α and chIL-18 using a Salmonella vaccine strain to generate an effective immunization strategy in chickens against LPAI H9N2.

  15. Identifying Protective Factors to Promote Health in American Indian and Alaska Native Adolescents: A Literature Review.

    Henson, Michele; Sabo, Samantha; Trujillo, Aurora; Teufel-Shone, Nicolette


    Exposure to protective factors, conditions that protect against the occurrence of an undesirable outcome or promote the occurrence of a desirable outcome within an adolescent's environment, can foster healthy adolescent behaviors and reduce adult morbidity and mortality. Yet, little is known about the nature and effect of protective factors on the positive social and health outcomes among American Indian and Alaska Native (AIAN) adolescents. We conducted a review of the literature to identify the protective factors associated with positive health outcomes among AIAN adolescents. We consulted Elsevier Science Direct, ERIC EBSCOhost, PubMed, and the Web of Science databases. A total of 3421 articles were encountered. Excluded publications were those that did not focus on AIAN adolescents (n = 3341), did not identify protective factors (n = 56), were not original research studies (n = 8), or were not written in the English language. We identified nine categories of protective factors positively associated with health and social outcomes, including: current and/or future aspirations, personal wellness, positive self-image, self-efficacy, non-familial connectedness, family connectedness, positive opportunities, positive social norms, and cultural connectedness. Such factors positively influenced adolescent alcohol, tobacco, and substance use; delinquent and violent behavior; emotional health including depression, suicide attempt; resilience; and academic success. Protective factors spanned multiple domains of the socio-ecological model. Strengths-based health promotion efforts that leverage local, innate protective factors and work with AIANs to create environments rich in protective factors are key to improving the health and wellbeing of AIAN adolescents.

  16. China's laws, rights, and administrative structures in occupational safety and health: a comparison with the United States.

    Sun, Yinling; Xu, Lingzhong; Shao, Hua; Wang, He


    China has achieved rapid economic development, but faces tremendous challenges in occupational safety and health (OSH). We describe China's laws, rights, and administrative structures in OSH and in workers' compensation. The article compares these with comparable laws, rights, and administrative structures in the United States. We hope this comparison may provide useful lessons for continued OSH development and improvement in China.

  17. The Fitbit Fault Line: Two Proposals to Protect Health and Fitness Data at Work.

    Brown, Elizabeth A


    Employers are collecting and using their employees' health data, mined from wearable fitness devices and health apps, in new, profitable, and barely regulated ways. The importance of protecting employee health and fitness data will grow exponentially in the future. This is the moment for a robust discussion of how law can better protect employees from the potential misuse of their health data. While scholars have just begun to examine the problem of health data privacy, this Article contributes to the academic literature in three important ways. First, it analyzes the convergence of three trends resulting in an unprecedented growth of health-related data: the Internet of Things, the Quantified Self movement, and the Rise of Health Platforms. Second, it describes the insufficiencies of specific data privacy laws and federal agency actions in the context of protecting employee health data from employer misuse. Finally, it provides two detailed and workable solutions for remedying the current lack of protection of employee health data that will realign employer use with reasonable expectations of health and fitness privacy. The Article proceeds in four Parts. Part I describes the growth of self-monitoring apps, devices, and other sensor-enabled technology that can monitor a wide range of data related to an employee's health and fitness and the relationship of this growth to both the Quantified Self movement and the Internet of Things. Part II explains the increasing use of employee monitoring through a wide range of sensors, including wearable devices, and the potential uses of that health and fitness data. Part III explores the various regulations and agency actions that might protect employees from the potential misuse of their health and fitness data and the shortcomings of each. Part IV proposes two specific measures that would help ameliorate the ineffective legal protections that currently exist in this context. In order to improve employee notice of and control

  18. Building research administration applications for the academic health center: a case study.

    Guard, J Roger; Brueggemann, Ralph F; Highsmith, Robert F; Marine, Stephen A; Riep, Josette R; Schick, Leslie C


    The academic health center information environment is saturated with information of varying quality and overwhelming quantity. The most significant challenge is transforming data and information into knowledge. The University of Cincinnati Medical Center's (UCMC) focus is to develop an information architecture comprising data structures, Web services, and user interfaces that enable individuals to manage the information overload so that they can create new knowledge. UCMC has accomplished much of what is reported in this article with the help of a four-year Integrated Advanced Information Management Systems (IAIMS) operation grant awarded by the National Library of Medicine in 2003. In the UCMC vision for knowledge management, individuals have reliable, secure access to information that is filtered, organized, and highly relevant for specific tasks and personal needs. Current applications and tool sets will evolve to become the next generation knowledge management applications or smart digital services. When smart digital services are implemented, silo applications will disappear. A major focus of UCMC's IAIMS grant is research administration. Testing and building out existing and new research administration applications and digital services is underway. The authors review UCMC's progress and results in developing a software architecture, tools, and services for research administration. Included are sections on the evolution to full integration, the impact of the work at UCMC to date, lessons learned during this research and development process, and future plans and needs.

  19. Beyond UHC: monitoring health and social protection coverage in the context of tuberculosis care and prevention.

    Lönnroth, Knut; Glaziou, Philippe; Weil, Diana; Floyd, Katherine; Uplekar, Mukund; Raviglione, Mario


    Tuberculosis (TB) remains a major global public health problem. In all societies, the disease affects the poorest individuals the worst. A new post-2015 global TB strategy has been developed by WHO, which explicitly highlights the key role of universal health coverage (UHC) and social protection. One of the proposed targets is that "No TB affected families experience catastrophic costs due to TB." High direct and indirect costs of care hamper access, increase the risk of poor TB treatment outcomes, exacerbate poverty, and contribute to sustaining TB transmission. UHC, conventionally defined as access to health care without risk of financial hardship due to out-of-pocket health care expenditures, is essential but not sufficient for effective and equitable TB care and prevention. Social protection interventions that prevent or mitigate other financial risks associated with TB, including income losses and non-medical expenditures such as on transport and food, are also important. We propose a framework for monitoring both health and social protection coverage, and their impact on TB epidemiology. We describe key indicators and review methodological considerations. We show that while monitoring of general health care access will be important to track the health system environment within which TB services are delivered, specific indicators on TB access, quality, and financial risk protection can also serve as equity-sensitive tracers for progress towards and achievement of overall access and social protection.

  20. Beyond UHC: monitoring health and social protection coverage in the context of tuberculosis care and prevention.

    Knut Lönnroth


    Full Text Available Tuberculosis (TB remains a major global public health problem. In all societies, the disease affects the poorest individuals the worst. A new post-2015 global TB strategy has been developed by WHO, which explicitly highlights the key role of universal health coverage (UHC and social protection. One of the proposed targets is that "No TB affected families experience catastrophic costs due to TB." High direct and indirect costs of care hamper access, increase the risk of poor TB treatment outcomes, exacerbate poverty, and contribute to sustaining TB transmission. UHC, conventionally defined as access to health care without risk of financial hardship due to out-of-pocket health care expenditures, is essential but not sufficient for effective and equitable TB care and prevention. Social protection interventions that prevent or mitigate other financial risks associated with TB, including income losses and non-medical expenditures such as on transport and food, are also important. We propose a framework for monitoring both health and social protection coverage, and their impact on TB epidemiology. We describe key indicators and review methodological considerations. We show that while monitoring of general health care access will be important to track the health system environment within which TB services are delivered, specific indicators on TB access, quality, and financial risk protection can also serve as equity-sensitive tracers for progress towards and achievement of overall access and social protection.

  1. Intra-hospital transfers and adverse patient outcomes: An analysis of administrative health data.

    Blay, Nicole; Roche, Michael; Duffield, Christine; Xu, Xiaoyue


    To determine whether there was an association between intra-hospital transfers and adverse outcomes. Transfers between clinical units and between beds on the same unit are routine aspects of an episode of care in acute hospitals. The rate of these transfers per episode has increased in response to high occupancy levels, a decline in bed numbers, and increased demand for hospital services. The impact of the number of transfers between both wards and beds on patient outcomes is not widely explored. retrospective cross sectional design using hospital administrative data. Data were extracted from existing hospital administrative datasets for one large metropolitan hospital for the financial year 2008-09 in Australia (n=14,133). Descriptive analyses and logistic regression models were developed for each of 3 selected patient outcomes. Nearly one-tenth of patients (9.2%) experienced a fall with injury, 3.8% of surgical patients a wound infection and 0.1% a complication from medication errors. For each bed or ward transfer, the odds of falls and wound infections increased. Medication errors were not associated with either bed or ward moves. Hospitals should minimise the number of bed and ward transfers per episode of care in order to reduce the likelihood of adverse patient outcomes. Current bed management policies and practices should be evaluated and further refined to address this need. Additional strategies include improving coordination and communication during and after transfer. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  2. Confidentiality Protection of Digital Health Records in Cloud Computing.

    Chen, Shyh-Wei; Chiang, Dai Lun; Liu, Chia-Hui; Chen, Tzer-Shyong; Lai, Feipei; Wang, Huihui; Wei, Wei


    Electronic medical records containing confidential information were uploaded to the cloud. The cloud allows medical crews to access and manage the data and integration of medical records easily. This data system provides relevant information to medical personnel and facilitates and improve electronic medical record management and data transmission. A structure of cloud-based and patient-centered personal health record (PHR) is proposed in this study. This technique helps patients to manage their health information, such as appointment date with doctor, health reports, and a completed understanding of their own health conditions. It will create patients a positive attitudes to maintain the health. The patients make decision on their own for those whom has access to their records over a specific span of time specified by the patients. Storing data in the cloud environment can reduce costs and enhance the share of information, but the potential threat of information security should be taken into consideration. This study is proposing the cloud-based secure transmission mechanism is suitable for multiple users (like nurse aides, patients, and family members).

  3. Intranasal administration of aTf protects and repairs the neonatal white matter after a cerebral hypoxic-ischemic event.

    Guardia Clausi, Mariano; Paez, Pablo M; Campagnoni, Anthony T; Pasquini, Laura A; Pasquini, Juana M


    Our previous studies showed that the intracerebral injection of apotransferrin (aTf) attenuates white matter damage and accelerates the remyelination process in a neonatal rat model of cerebral hypoxia-ischemia (HI) injury. However, the intracerebral injection of aTf might not be practical for clinical treatments. Therefore, the development of less invasive techniques capable of delivering aTf to the central nervous system would clearly aid in its effective clinical use. In this work, we have determined whether intranasal (iN) administration of human aTf provides neuroprotection to the neonatal mouse brain following a cerebral hypoxic-ischemic event. Apotransferrin was infused into the naris of neonatal mice and the HI insult was induced by right common carotid artery ligation followed by exposure to low oxygen concentration. Our results showed that aTf was successfully delivered into the neonatal HI brain and detected in the olfactory bulb, forebrain and posterior brain 30 min after inhalation. This treatment successfully reduced white matter damage, neuronal loss and astrogliosis in different brain regions and enhanced the proliferation and survival of oligodendroglial progenitor cells (OPCs) in the subventricular zone and corpus callosum (CC). Additionally, using an in vitro hypoxic model, we demonstrated that aTf prevents oligodendrocyte progenitor cell death by promoting their differentiation. In summary, these data suggest that iN administration of aTf has the potential to be used for clinical treatment to protect myelin and to induce remyelination in demyelinating hypoxic-ischemic events in the neonatal brain. Copyright © 2012 Wiley Periodicals, Inc.

  4. Distribution and cost of wheelchairs and scooters provided by Veterans Health Administration.

    Hubbard, Sandra L; Fitzgerald, Shirley G; Vogel, Bruce; Reker, Dean M; Cooper, Rory A; Boninger, Michael L


    During fiscal years 2000 and 2001, the Veterans Health Administration provided veterans with more than 131,000 wheelchairs and scooters at a cost of $109 million. This national study is the first to investigate Veterans Health Administration costs in providing wheelchairs and scooters and to compare regional prescription patterns. With a retrospective design, we used descriptive methods to analyze fiscal years 2000 and 2001 National Prosthetics Patient Database data (cleaned data set of 113,724 records). Wheelchairs were categorized by function, weight, and adjustability options for meeting individual needs (e.g., axle position, camber, position of wheels, tilt, and recline options). Results displayed a cost distribution that was negatively skewed by low-cost accessories coded as wheelchairs. Of the standard manual wheelchairs, 3.5% could be considered beyond the customary cost. Regionally, 71% to 86% of all wheelchairs provided were manual wheelchairs, 5% to 11% were power wheelchairs, and 5% to 20% were scooters. The considerable variation found in the types of wheelchairs and scooters provided across Veterans Integrated Service Networks may indicate a need for evidence-based prescription guidelines and clinician training in wheeled-mobility technologies.

  5. Nursing leadership succession planning in Veterans Health Administration: creating a useful database.

    Weiss, Lizabeth M; Drake, Audrey


    An electronic database was developed for succession planning and placement of nursing leaders interested and ready, willing, and able to accept an assignment in a nursing leadership position. The tool is a 1-page form used to identify candidates for nursing leadership assignments. This tool has been deployed nationally, with access to the database restricted to nurse executives at every Veterans Health Administration facility for the purpose of entering the names of developed nurse leaders ready for a leadership assignment. The tool is easily accessed through the Veterans Health Administration Office of Nursing Service, and by limiting access to the nurse executive group, ensures candidates identified are qualified. Demographic information included on the survey tool includes the candidate's demographic information and other certifications/credentials. This completed information form is entered into a database from which a report can be generated, resulting in a listing of potential candidates to contact to supplement a local or Veterans Integrated Service Network wide position announcement. The data forms can be sorted by positions, areas of clinical or functional experience, training programs completed, and geographic preference. The forms can be edited or updated and/or added or deleted in the system as the need is identified. This tool allows facilities with limited internal candidates to have a resource with Department of Veterans Affairs prepared staff in which to seek additional candidates. It also provides a way for interested candidates to be considered for positions outside of their local geographic area.

  6. Effect of acute peppermint oil administration on gastric sensorimotor function and nutrient tolerance in health.

    Papathanasopoulos, A; Rotondo, A; Janssen, P; Boesmans, W; Farré, R; Vanden Berghe, P; Tack, J


    Menthol reduces intestinal motility in animal studies, an effect that is probably mediated by transient receptor potential channels. Peppermint oil (PO), with menthol as a major constituent, is widely used as a spasmolytic agent in irritable bowel syndrome. In the current study, we investigated the effect of acute PO administration on intragastric pressure (IGP) profiles and gastric sensorimotor functions in health. Healthy volunteers underwent IGP measurement before and during continuous intragastric infusion of a nutrient drink (n = 13), and gastric barostat studies (n = 13). A single capsule of PO (182 mg) or placebo was administered during the studies in a randomized controlled crossover design. Throughout the studies, healthy volunteers scored 11 epigastric symptoms on a visual analogue scale (VAS); satiation was scored on a 6-point Likert scale during intragastric infusion. During fasting, IGP and motility index (MI) of the proximal stomach decreased significantly after PO administration compared with placebo (P IGP profiles, MI, satiation scores, and epigastric symptoms. The maximum infused volume, gastric compliance or sensitivity to balloon distention did not differ between both treatment arms. However, reduced appetite scores were seen during fasting after PO treatment, as compared with placebo (P = 0.01). Postprandial VAS scores were similar between PO and placebo. Peppermint oil reduces IGP, proximal phasic contractility, and appetite, with negligible effects on gastric sensitivity, tone, accommodation, and nutrient tolerance in health. © 2013 Blackwell Publishing Ltd.

  7. Gender disparities in Veterans Health Administration care: importance of accounting for veteran status.

    Frayne, Susan M; Yano, Elizabeth M; Nguyen, Vu Q; Yu, Wei; Ananth, Lakshmi; Chiu, Victor Y; Phibbs, Ciaran S


    In an effort to assess and reduce gender-related quality gaps, the Veterans Health Administration (VHA) has promoted gender-based research. Historically, such appraisals have often relied on secondary databases, with little attention to methodological implications of the fact that VHA provides care to some nonveteran patients. To determine whether conclusions about gender differences in utilization and cost of VHA care change after accounting for veteran status. Cross-sectional. All users of VHA in 2002 (N = 4,429,414). Veteran status, outpatient/inpatient utilization and cost, from centralized 2002 administrative files. Nonveterans accounted for 50.7% of women (the majority employees) but only 3.0% of men. Among all users, outpatient and inpatient utilization and cost were far lower in women than in men, but in the veteran subgroup these differences decreased substantially or, in the case of use and cost of outpatient care, reversed. Utilization and cost were very low among women employees; women spouses of fully disabled veterans had utilization and costs similar to those of women veterans. By gender, nonveterans represent a higher proportion of women than of men in VHA, and some large nonveteran groups have low utilization and costs; therefore, conclusions about gender disparities change substantially when veteran status is taken into account. Researchers seeking to characterize gender disparities in VHA care should address this methodological issue, to minimize risk of underestimating health care needs of women veterans and other women eligible for primary care services.

  8. Protecting health from metal exposures in drinking water.

    Armour, Margaret-Ann


    Drinking water is essential to us as human beings. According to the World Health Organization "The quality of drinking-water is a powerful environmental determinant of health" (, but clean drinking water is a precious commodity not always readily available. Surface and ground water are the major sources of drinking water. Both can be contaminated, surface water with bacteria while ground water frequently contains salts of metals that occur naturally or are introduced by human activity. This paper will briefly review the metallic salts found in drinking water in areas around the world, as well as list some of the methods used to reduce or remove them. It will then discuss our research on reducing the risk of pollution of drinking water by removal of metal ions from wastewater.

  9. Mental health in France, policies and actors: developing administrative knowledge in a segmented world.

    Mossé, Philippe; Maury, Caroline; Daumerie, Nicolas; Roelandt, Jean-Luc


    The new mental health care policy, which has been set up in France, involves a change of paradigm, which has been going on since the 2000s: the emphasis is shifting from psychiatry to mental health care. This shift mainly concerns the knowledge about mental health is produced and circulates among an increasingly large number of bodies. Mainly grounded on actor interview analysis, official reports and blueprints, this study shows that the results of this process are numerous. They include the development of ambulatory care and strong moves towards decentralization. More data and knowledge are therefore to be shared in this more complex system. However, the French State, in the form of the central administration, is taking advantage of this move and is still contributing significantly to the definition and implementation of the new policy. On the other hand, the new governance dynamic is not leading to standardization of medical practices, as the mental health field remains highly heterogeneous. Copyright © 2012 John Wiley & Sons, Ltd.

  10. Derivation and Validation of the Surgical Site Infections Risk Model Using Health Administrative Data.

    van Walraven, Carl; Jackson, Timothy D; Daneman, Nick


    OBJECTIVE Surgical site infections (SSIs) are common hospital-acquired infections. Tracking SSIs is important to monitor their incidence, and this process requires primary data collection. In this study, we derived and validated a method using health administrative data to predict the probability that a person who had surgery would develop an SSI within 30 days. METHODS All patients enrolled in the National Surgical Quality Improvement Program (NSQIP) from 2 sites were linked to population-based administrative datasets in Ontario, Canada. We derived a multivariate model, stratified by surgical specialty, to determine the independent association of SSI status with patient and hospitalization covariates as well as physician claim codes. This SSI risk model was validated in 2 cohorts. RESULTS The derivation cohort included 5,359 patients with a 30-day SSI incidence of 6.0% (n=118). The SSI risk model predicted the probability that a person had an SSI based on 7 covariates: index hospitalization diagnostic score; physician claims score; emergency visit diagnostic score; operation duration; surgical service; and potential SSI codes. More than 90% of patients had predicted SSI risks lower than 10%. In the derivation group, model discrimination and calibration was excellent (C statistic, 0.912; Hosmer-Lemeshow [H-L] statistic, P=.47). In the 2 validation groups, performance decreased slightly (C statistics, 0.853 and 0.812; H-L statistics, 26.4 [P=.0009] and 8.0 [P=.42]), but low-risk patients were accurately identified. CONCLUSION Health administrative data can effectively identify postoperative patients with a very low risk of surgical site infection within 30 days of their procedure. Records of higher-risk patients can be reviewed to confirm SSI status.

  11. Cooperation between national administrative courts- the Court of the European Union and the European Court for the Protection of Fundamental Rights and Freedoms in implementing administrative court decisions after the Lisabon Treaty

    Bosiljka Britvić Vetma


    Full Text Available Over the last few decades, national administrative courts have been faced with several Copernican twists. Among them has been the ratification of the European Convention for the protection of human rights and fundamental freedoms as well as accession to the EU legal order. The authors of this paper believe it is necessary to mark the most recent changes, which have occurred as a result of Croatia gaining full membership to the EU. This includes in the cooperation among the national administrative courts, the Court of the European Union and the European Court for the Protection of Human Rights and Fundamental Freedoms in the implementation of the decisions by administrative courts. The aim of this cooperation is to avoid the conflicting court practice for the same case or the same legal problem. The authors here concisely examine the period “after” the Lisbon Treaty, noting certain difficulties and sources of conflict in implementation.

  12. Protecting Bone Health in Pediatric Rheumatic Diseases: Pharmacological Considerations.

    Zhang, Yujuan; Milojevic, Diana


    Bone health in children with rheumatic conditions may be compromised due to several factors related to the inflammatory disease state, delayed puberty, altered life style, including decreased physical activities, sun avoidance, suboptimal calcium and vitamin D intake, and medical treatments, mainly glucocorticoids and possibly some disease-modifying anti-rheumatic drugs. Low bone density or even fragility fractures could be asymptomatic; therefore, children with diseases of high inflammatory load, such as systemic onset juvenile idiopathic arthritis, juvenile dermatomyositis, systemic lupus erythematosus, and those requiring chronic glucocorticoids may benefit from routine screening of bone health. Most commonly used assessment tools are laboratory testing including serum 25-OH-vitamin D measurement and bone mineral density measurement by a variety of methods, dual-energy X-ray absorptiometry as the most widely used. Early disease control, use of steroid-sparing medications such as disease-modifying anti-rheumatic drugs and biologics, supplemental vitamin D and calcium, and promotion of weight-bearing physical activities can help optimize bone health. Additional treatment options for osteoporosis such as bisphosphonates are still controversial in children with chronic rheumatic diseases, especially those with decreased bone density without fragility fractures. This article reviews common risk factors leading to compromised bone health in children with chronic rheumatic diseases and discusses the general approach to prevention and treatment of bone fragility.

  13. Salt Matters: Preserving Choice, Protecting Health (Long Version)


    This video presents information about salt as a major contributor to high blood pressure, heart disease, and stroke.  Created: 2/1/2011 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division for Heart Disease and Stroke Prevention (DHDSP).   Date Released: 4/20/2011.

  14. Salt Matters: Preserving Choice, Protecting Health (Short Version)


    This video presents information about salt as a major contributor to high blood pressure, heart disease, and stroke.  Created: 2/1/2011 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division for Heart Disease and Stroke Prevention (DHDSP).   Date Released: 2/1/2011.

  15. Protective effects of intraperitoneal vitamin C, aprotinin and melatonin administration on retinal edema during experimental uveitis in the guinea pig.

    Kükner, A Sahap; Kükner, Aysel; Naziroğlu, Mustafa; Colakoğlu, Neriman; Celebi, Serdal; Yilmaz, Turgut; Aydemir, Orhan


    A considerable amount of clinical and experimental evidence exists suggesting the involvement of reactive oxygen substances (ROS) in the aetiology of uveitis. The activated phagocytic system of polymorphonuclear leucocytes in uveitis is involved in the generation of ROS. In addition to their direct free radical scavenging action, aprotinin, melatonin and vitamin C are known to protect against oedema formation and can preserve plasma membrane fluidity and free radical production. Histological changes in the retina that occur during uveitis are not well explained. The purpose of this study was to determine whether vitamin C, aprotinin and melatonin can protect the retina from damage accompanying experimental uveitis (EU). Thirty adult male guinea pigs were divided into five groups of six animals each. The first group was used as control. The right eyes of groups 2, 3, 4 and 5 received an intravitreal injection of bovine serum albumin for induction of experimental uveitis. At the same time and also on the consecutive third day, groups 3, 4 and 5 received intraperitoneal injections of vitamin C (ascorbic acid, 100 mg kg(-1) body wt), aprotinin (20,000 kIU kg(-1) body wt) and melatonin (10 mg kg(-1) body wt), respectively. The animals were killed on the sixth day. The average thickness of the retina and inner plexiform layer for each eye was measured in sagittal section near the optic nerve and expressed in microns. The thickness of the retina and inner plexiform layer in the control group was significantly (p vitamin C, group EU plus aprotinin, group EU plus melatonin (p vitamin C, group EU plus aprotinin and group EU plus melatonin were significantly (p 0.05). In conclusion, this study demonstrated that oedematous effects of EU on the retina were reduced by the administration of intraperitoneal vitamin C, aprotinin and melatonin, i.e. these antioxidants had significant protective effects on the retina of guinea pigs against oedematous damage in EU. However, the

  16. The quest for universal health coverage: achieving social protection for all in Mexico.

    Knaul, Felicia Marie; González-Pier, Eduardo; Gómez-Dantés, Octavio; García-Junco, David; Arreola-Ornelas, Héctor; Barraza-Lloréns, Mariana; Sandoval, Rosa; Caballero, Francisco; Hernández-Avila, Mauricio; Juan, Mercedes; Kershenobich, David; Nigenda, Gustavo; Ruelas, Enrique; Sepúlveda, Jaime; Tapia, Roberto; Soberón, Guillermo; Chertorivski, Salomón; Frenk, Julio


    Mexico is reaching universal health coverage in 2012. A national health insurance programme called Seguro Popular, introduced in 2003, is providing access to a package of comprehensive health services with financial protection for more than 50 million Mexicans previously excluded from insurance. Universal coverage in Mexico is synonymous with social protection of health. This report analyses the road to universal coverage along three dimensions of protection: against health risks, for patients through quality assurance of health care, and against the financial consequences of disease and injury. We present a conceptual discussion of the transition from labour-based social security to social protection of health, which implies access to effective health care as a universal right based on citizenship, the ethical basis of the Mexican reform. We discuss the conditions that prompted the reform, as well as its design and inception, and we describe the 9-year, evidence-driven implementation process, including updates and improvements to the original programme. The core of the report concentrates on the effects and impacts of the reform, based on analysis of all published and publically available scientific literature and new data. Evidence indicates that Seguro Popular is improving access to health services and reducing the prevalence of catastrophic and impoverishing health expenditures, especially for the poor. Recent studies also show improvement in effective coverage. This research then addresses persistent challenges, including the need to translate financial resources into more effective, equitable and responsive health services. A next generation of reforms will be required and these include systemic measures to complete the reorganisation of the health system by functions. The paper concludes with a discussion of the implications of the Mexican quest to achieve universal health coverage and its relevance for other low-income and middle-income countries.

  17. Administration of aqueous extract of Desmodium gangeticum (L) root protects rat heart against ischemic reperfusion injury induced oxidative stress.

    Kurian, Gino A; Paddikkala, Jose


    Myocardial reperfusion is believed to be associated with free radical injury. The present study evaluates the effect of aqueous extract of D. gangeticum (DG) on lipid peroxides and antioxidants in ischemic reperfused (IR) Wistar albino male rats. Significant elevation in lipid peroxide products (thiobarbituric acid reactive substances) and decreased activity of antioxidant enzymes (superoxide dismutase, catalase, glutathione peroxidase and glutathione reductase) were observed in the rat hearts during ischemia reperfusion phase. Pre treatment of rats with aqueous extract of DG orally for 30 days showed significantly improved preservation of antioxidant enzymes and subsequent reduction in lipid peroxidation. But 2,3,5 triphenyl tetrazolium chloride (TTC) stained rat heart did not show much significant antioxidant enzyme activities and lipid peroxidation. On the other hand, TTC unstained rat heart showed significant improvement in the antioxidant activities indicating cardio protective effect of aqueous extract of DG in myocardium affected by ischemia reperfusion insult. The administration of DG to normal rats did not have any significant effect on any of the parameter studied. These results indicate that DG improves the antioxidant capacity of heart and attenuate the degree of lipid peroxidation after IR.

  18. Workplace incivility and new graduate nurses' mental health: the protective role of resiliency.

    Laschinger, Heather K; Wong, Carol; Regan, Sandra; Young-Ritchie, Carol; Bushell, Pamela


    The aim of this study was to examine the relationships between coworker, physician, and supervisor workplace incivility and new graduate nurses' mental health and the protective role of personal resiliency. Positive interpersonal relationships in healthcare work environments are important for new graduate nurses' career transition and commitment. Workplace incivility threatens new graduate nurses' health and well-being. Personal resiliency helps employees to recover from negative stressors and may protect new nurses from the negative effects of workplace incivility. We surveyed 272 new graduate nurses in Ontario to explore the influence of 3 forms of workplace incivility and personal resiliency on new nurses' mental health. All sources of incivility were related to poor mental health. Results suggest that personal resiliency may protect nurses from the negative effects of incivility. New nurses are experiencing workplace incivility from a variety of sources in their work environments, which have detrimental effects on their workplace well-being.

  19. Characteristics of teacher's health protecting activities in the modern secondary school environment

    Yefimova V.M.


    Full Text Available The paper considers general approaches to the definition of the notion of anomia. It analyzes different aspects of the term's modern interpretation and discusses the main problems connected with the formation of the social context of the future teacher professional training for health protecting activities. The features of health protecting activity are exposed in the conditions of anomia. Certainly its influences on the social, psychical and physical health of young people. It is well-proven that introduction to maintenance of professional preparation of future teachers of presentations about anomia and its intercommunications with the different aspects of vital functions are necessity in connection with actualization of health protecting activity of teachers.

  20. Health protection and risks for rescuers in cases of floods.

    Janev Holcer, Nataša; Jeličić, Pavle; Grba Bujević, Maja; Važanić, Damir


    Floods can pose a number of safety and health hazards for flood-affected populations and rescuers and bring risk of injuries, infections, and diseases due to exposure to pathogenic microorganisms and different biological and chemical contaminants. The risk factors and possible health consequences for the rescuers involved in evacuation and rescuing operations during the May 2014 flood crisis in Croatia are shown, as well as measures for the prevention of injuries and illnesses. In cases of extreme floods, divers play a particularly important role in rescuing and first-response activities. Rescuing in contaminated floodwaters means that the used equipment such as diving suits should be disinfected afterwards. The need for securing the implementation of minimal health and safety measures for involved rescuers is paramount. Data regarding injuries and disease occurrences among rescuers are relatively scarce, indicating the need for medical surveillance systems that would monitor and record all injuries and disease occurrences among rescuers in order to ensure sound epidemiological data. The harmful effects of flooding can be reduced by legislation, improvement of flood forecasting, establishing early warning systems, and appropriate planning and education.

  1. Ensuring Appropriate Care for LGBT Veterans in the Veterans Health Administration.

    Sharpe, Virginia Ashby; Uchendu, Uchenna S


    Within health care systems, negative perceptions of lesbian, gay, bisexual, and transgender persons have often translated into denial of services, denial of visitation rights to same-sex partners, reluctance on the part of LGBT patients to share personal information, and failure of workers to assess and recognize the unique health care needs of these patients. Other bureaucratic forms of exclusion have included documents, forms, and policies that fail to acknowledge a patient's valued relationships because of, for example, a narrow definition of "spouse," "parent," or "family." Bureaucratic exclusion has taken a particularly prominent form in the U.S. military. Until its repeal and termination in 2011, the "Don't Ask, Don't Tell" policy had for eighteen years barred openly gay men and lesbians from serving in the military. Among the effects of DADT is a dearth of information about the number and needs of LGBT service members who transition to the Veterans Health Administration for health care at the end of their military service. The long-standing social stigma against LGBT persons, the silence mandated by DADT, and the often unrecognized bias built into the fabric of bureaucratic systems make the task of creating a welcoming culture in the VHA urgent and challenging. The VHA has accepted a commitment to that task. Its Strategic Plan for fiscal years 2013 through 2018 stipulates that "[v]eterans will receive timely, high quality, personalized, safe, effective and equitable health care irrespective of geography, gender, race, age, culture or sexual orientation." To achieve this goal, the VHA undertook a number of coordinated initiatives to create an environment and culture that is informed, welcoming, positive, and empowering for the LGBT veterans and families whom the agency serves.

  2. Protection of Health Rights from Chinese Health Care Law%略论我国卫生法律制度对健康权的保护



    The paper discusses how Chinese health care law protects health rights ,through analysis of its overall structure and review of its evolution , evaluates the current health care law and recommend to future health care laws . The framework of Chinese health care law has initially come into being .The administrative health care law ,medical torts in the civil law ,criminal medical law and related social laws are protecting the health rights . Nevertheless , there are still challenges ,such as the lack of a fundamental health law ,weak coordination between health care laws ,insufficient fineness of clauses and legislation lagged behind .Take the opportunity of carrying forward the new round of health system reform , the improvement of the health care law system should speed up ,to make the fundamental health law ,to make changes to related department laws and to strengthen the coordination of the laws .%通过分析和回顾我国卫生法律制度的整体架构和历史沿革,对当前制度进行评价并展望未来,系统阐述了我国卫生法律制度如何保障国民健康权。目前我国卫生法律制度框架已初步形成,卫生行政法、民法中的医疗侵权、医疗刑法、有关社会法等均对健康权进行保护,但制度仍面临母法缺失、协调性不佳、精细度不足和立法滞后等挑战。以新医改为契机,卫生法律制度的完善应加快进程,应尽快制定母法,并对相关部门法做出调整,加强有关法律法规之间的协调性。

  3. Analysis of U.S. Food and Drug Administration food allergen recalls after implementation of the food allergen labeling and consumer protection act.

    Gendel, Steven M; Zhu, Jianmei


    To avoid potentially life-threatening reactions, food allergic consumers rely on information on food labels to help them avoid exposure to a food or ingredient that could trigger a reaction. To help consumers in the United States obtain the information that they need, the Food Allergen Labeling and Consumer Protection Act of 2004 defined a major food allergen as being one of eight foods or food groups and any ingredient that contains protein from one of these foods or food groups. A food that contains an undeclared major food allergen is misbranded under the U.S. Food, Drug, and Cosmetic Act and is subject to recall. Food allergen labeling problems are the most common cause of recalls for U.S. Food and Drug Administration (FDA)-regulated food products. To help understand why food allergen recalls continue to occur at a high rate, information on each food allergen recall that occurred in fiscal years 2007 through 2012 was obtained from the FDA recall database. This information was analyzed to identify the food, allergen, root cause, and mode of discovery for each food allergen recall. Bakery products were the most frequently recalled food type, and milk was the most frequently undeclared major food allergen. Use of the wrong package or label was the most frequent problem leading to food allergen recalls. These data are the first reported that indicate the importance of label and package controls as public health measures.

  4. Integration of structural health monitoring solutions onto commercial aircraft via the Federal Aviation Administration structural health monitoring research program

    Swindell, Paul; Doyle, Jon; Roach, Dennis


    The Federal Aviation Administration (FAA) started a research program in structural health monitoring (SHM) in 2011. The program's goal was to understand the technical gaps of implementing SHM on commercial aircraft and the potential effects on FAA regulations and guidance. The program evolved into a demonstration program consisting of a team from Sandia National Labs Airworthiness Assurance NDI Center (AANC), the Boeing Corporation, Delta Air Lines, Structural Monitoring Systems (SMS), Anodyne Electronics Manufacturing Corp (AEM) and the FAA. This paper will discuss the program from the selection of the inspection problem, the SHM system (Comparative Vacuum Monitoring-CVM) that was selected as the inspection solution and the testing completed to provide sufficient data to gain the first approved use of an SHM system for routine maintenance on commercial US aircraft.

  5. Fibromyalgia syndrome care of Iraq- and Afghanistan-deployed Veterans in Veterans Health Administration.

    Mohanty, April F; Helmer, Drew A; Muthukutty, Anusha; McAndrew, Lisa M; Carter, Marjorie E; Judd, Joshua; Garvin, Jennifer H; Samore, Matthew H; Gundlapalli, Adi V


    Little is known regarding fibromyalgia syndrome (FMS) care among Operation Iraqi Freedom/Operation Enduring Freedom/Operation New Dawn (OIF/OEF/OND) Veterans. Current recommendations include interdisciplinary, team-based combined care approaches and limited opioid use. In this study of OIF/OEF/OND Veterans who accessed Veterans Health Administration services between 2002 and 2012, we hypothesized that combined care (defined as at least 4 primary care visits/yr with visits to mental health and/or rheumatology) versus Hispanic, and never/currently married. Combined primary, mental health, and rheumatology care was associated with at least 2 opioid prescriptions (RR [95% CI] for males 2.2 [1.1-4.4] and females 2.8 [0.4-18.6]). Also, combined care was associated with at least 2 nonopioid pain-related prescriptions, a practice supported by evidence-based clinical practice guidelines. In tandem, these results provide mixed evidence of benefit of combined care for FMS. Future studies of healthcare encounter characteristics, care coordination, and benefits for Veterans with FMS are needed.

  6. The contribution of mass drug administration to global health: past, present and future.

    Webster, Joanne P; Molyneux, David H; Hotez, Peter J; Fenwick, Alan


    Mass drug administration (MDA) is a means of delivering safe and inexpensive essential medicines based on the principles of preventive chemotherapy, where populations or sub-populations are offered treatment without individual diagnosis. High-coverage MDA in endemic areas aims to prevent and alleviate symptoms and morbidity on the one hand and can reduce transmission on the other, together improving global health. MDA is the recommended strategy of the World Health Organisation to control or eliminate several neglected tropical diseases (NTDs). More than 700 million people now receive these essential NTD medicines annually. The combined cost of integrated NTD MDA has been calculated to be in the order of $0.50 per person per year. Activities have recently been expanded due, in part, to the proposed attempt to eliminate certain NTDs in the coming two decades. More than 1.9 billion people need to receive MDA annually across several years if these targets are to be met. Such extensive coverage will require additional avenues of financial support, expanded monitoring and evaluation focusing on impact and drug efficacy, as well as new diagnostic tools and social science strategies to encourage adherence. MDA is a means to help reduce the burden of disease, and hence poverty, among the poorest sector of populations. It has already made significant improvements to global health and productivity and has the potential for further successes, particularly where incorporated into sanitation and education programmes. However logistical, financial and biological challenges remain.

  7. Measuring sustainability within the Veterans Administration Mental Health System Redesign initiative.

    Ford, James H; Krahn, Dean; Wise, Meg; Oliver, Karen Anderson


    To examine how attributes affecting sustainability differ across Veterans Health Administration organizational components and by staff characteristics. Surveys of 870 change team members and 50 staff interviews within the Veterans Affairs' Mental Health System Redesign initiative. A 1-way ANOVA with a Tukey post hoc test examined differences in sustainability by Veteran Integrated Service Networks, job classification, and tenure from staff survey data of the Sustainability Index. Qualitative interviews used an iterative process to identify "a priori" and "in vivo" themes. A simple stepwise linear regression explored predictors of sustainability. Sustainability differed across Veteran Integrated Service Networks and staff tenure. Job classification differences existed for the following: (1) benefits and credibility of the change and (2) staff involvement and attitudes toward change. Sustainability barriers were staff and institutional resistance and nonsupportive leadership. Facilitators were commitment to veterans, strong leadership, and use of quality improvement tools. Sustainability predictors were outcomes tracking, regular reporting, and use of Plan, Do, Study, Adjust cycles. Creating homogeneous implementation and sustainability processes across a national health system is difficult. Despite the Veterans Affairs' best evidence-based implementation efforts, there was significant variance. Locally tailored interventions might better support sustainability than "one-size-fits-all" approaches. Further research is needed to understand how participation in a quality improvement collaborative affects sustainability.

  8. Health care worker protection in mass casualty respiratory failure: infection control, decontamination, and personal protective equipment.

    Daugherty, Elizabeth L


    Maintenance of a safe and stable health care infrastructure is critical to an effective mass casualty disaster response. Both secondary contamination during chemical disasters and hospital-associated infections during epidemic illness can pose substantial threats to achieving this goal. Understanding basic principles of decontamination and infection control during responses to chemical and biologic disasters can help minimize the risks to patients and health care workers. Effective decontamination following toxic chemical exposure should include both removal of contaminated clothing and decontamination of the victim's skin. Wet decontamination is the most feasible strategy in a mass casualty situation and should be performed promptly by trained personnel. In the event of an epidemic, infection prevention and control measures are based on essential principles of hand hygiene and standard precautions. Expanded precautions should be instituted as needed to target contact, droplet, and airborne routes of infectious disease transmission. Specific equipment and measures for critical care delivery may serve to decrease risk to health care workers in the event of an epidemic. Their use should be considered in developing comprehensive disaster response plans.

  9. Farmers sun exposure, skin protection and public health campaigns: An Australian perspective

    Christel Smit-Kroner


    Full Text Available Non-melanoma skin cancer is a common and costly cancer in agricultural populations. Prevention and early detection are an effective way to decrease the burden of disease and associated costs. To examine sun exposure and skin protection practices in agricultural workers and farmers a thematic review of the literature between 1983 and 2014 was undertaken. Comparison between studies was complicated by differences in study design, definitions of skin protection, and analytic methods used. Farmers are the most exposed to harmful ultraviolet (UV radiation of all outdoor workers and the level of reported skin protection by farmers is suboptimal. Years of public health campaigns have failed to adequately address farmers' specific needs. Increased rates of skin cancer and subsequent higher costs are expected. Estimates of sun exposure and skin protection practice indicate that protective clothing is the most promising avenue to improve on farmers' skin protection. Early detection needs to be part of public health campaigns. This review explores the quantitative data about Australian farmers and their skin protective behaviours. We investigate what the documented measurable effect of the public health campaign Slip!Slop!Slap! has had on agricultural workers and farmers and make recommendations for future focus.

  10. 75 FR 63844 - Health Resources and Services Administration CDC/HRSA Advisory Committee on HIV and STD...


    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Health Resources and Services Administration CDC/HRSA Advisory Committee on HIV and STD Prevention and Treatment (CHACHSPT) In accordance with section 10(a)(2) of the Federal Advisory...

  11. 75 FR 22145 - Health Resources and Services Administration (HRSA); CDC/HRSA Advisory Committee on HIV and STD...


    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Health Resources and Services Administration (HRSA); CDC/HRSA Advisory Committee on HIV and STD Prevention and Treatment (CHACHSPT) In accordance with section l0(a)(2) of the Federal...

  12. Using Organization Development Concept to Conduct Administrative Assessment of Health Promoting Schools in Taiwan--A Preliminary Study

    Huang, Jen-Jen; Yeh, Gwo-Liang; Tseng, Chie-Chien; Chen, Wei William; Hwu, Yin-Jinn; Jiang, Donald Dah-Shyong


    The Health Promoting School (HPS) programs in Taiwan were initiated and implemented with funding from Department of Health and Ministry of Education during the initial phase. The purpose of this article was to describe the application of organization development (OD) concept in the administrative assessment of HPS programs and to present results…

  13. [Health promotion and computer science in radiation protection].

    Pennarola, R; Porzio, G; Cavaliere, L


    An automatic system of clinical-diagnostic information has been applied to workers exposed to ionising radiation at the University of Naples Federico II with reference to the last 5 years. For every person exposed a computerized case sheet was elaborated recording clinical, biological, dosimetric and other preventive data. In the localized risk, capillaroscopic monitoring was used. This research has highlighted the role of medical surveillance in developing health promotion criteria and the planning of the interventions with the complete control of all data in real time.


    S. Saccares


    Full Text Available Health is defined by WHO, as a “state of complete physical, mental and social well-being, not just absence of disease.” So it needs not simply treat but also prevent, inform, and promote healthy behaviors. From here the importance of putting into practice all possible strategies for prevention from age lowest. The purpose of this work is just to describe the project “Food and Culture”, between the IZSLT and and the Municipality of Ariccia in order to promote nutrition education in the family from the boys.

  15. Health protection and food preservation by gamma irradiation


    Results of several major studies on food systems for space missions beginning with Apollo 12 through Apollo-Soyuz and investigations of the application of irradiation to food for manned space flight are reported. The study of flight food systems involved the application of radurization (pasteurizing levels) doses of gamma irradiation to flour and bread supplied by Pepperidge Farms in advance of the missions. All flights from Apollo 12 through 17 carried irradiated fresh bread. On Apollo 17, cooperation with Natick Laboratories permitted the introduction of a ham sandwich using irradiated bread and irradiated sterile ham. Investigations centered on irradiated bread were conducted during the course of these missions. Studies were applied to the concept of improving fresh bread from the point of view of mold inhibition. The studies considered how irradiation could best be applied at what levels and on a variety of bread types. Throughout the studies of the application of gamma irradiation the emphasis was placed upon using low levels of irradiation in the pasteurizing or radurizing doses--under a Megarad. The primary goal was to determine if a public health benefit could be demonstrated using radurization along with food preservation and food quality improvements. The public health benefit would be parallel to that of pasteurization of milk as a concept. Publications are included providing the details of these observations, one dealing with the flour characteristics and the other dealing with the influence on fresh bread types. These demonstrate the major findings noted during the period of the studies examining bread.

  16. Organization Complexity and Primary Care Providers' Perceptions of Quality Improvement Culture Within the Veterans Health Administration.

    Korom-Djakovic, Danijela; Canamucio, Anne; Lempa, Michele; Yano, Elizabeth M; Long, Judith A


    This study examined how aspects of quality improvement (QI) culture changed during the introduction of the Veterans Health Administration (VHA) patient-centered medical home initiative and how they were influenced by existing organizational factors, including VHA facility complexity and practice location. A voluntary survey, measuring primary care providers' (PCPs') perspectives on QI culture at their primary care clinics, was administered in 2010 and 2012. Participants were 320 PCPs from hospital- and community-based primary care practices in Pennsylvania, West Virginia, Delaware, New Jersey, New York, and Ohio. PCPs in community-based outpatient clinics reported an improvement in established processes for QI, and communication and cooperation from 2010 to 2012. However, their peers in hospital-based clinics did not report any significant improvements in QI culture. In both years, compared with high-complexity facilities, medium- and low-complexity facilities had better scores on the scales assessing established processes for QI, and communication and cooperation.

  17. Relationship of hospital organizational culture to patient safety climate in the Veterans Health Administration.

    Hartmann, Christine W; Meterko, Mark; Rosen, Amy K; Shibei Zhao; Shokeen, Priti; Singer, Sara; Gaba, David M


    Improving safety climate could enhance patient safety, yet little evidence exists regarding the relationship between hospital characteristics and safety climate. This study assessed the relationship between hospitals' organizational culture and safety climate in Veterans Health Administration (VA) hospitals nationally. Data were collected from a sample of employees in a stratified random sample of 30 VA hospitals over a 6-month period (response rate = 50%; n = 4,625). The Patient Safety Climate in Healthcare Organizations (PSCHO) and the Zammuto and Krakower surveys were used to measure safety climate and organizational culture, respectively. Higher levels of safety climate were significantly associated with higher levels of group and entrepreneurial cultures, while lower levels of safety climate were associated with higher levels of hierarchical culture. Hospitals could use these results to design specific interventions aimed at improving safety climate.

  18. Strengthening institutional and organizational capacity for social health protection of the informal sector in lesser-developed countries: a study of policy barriers and opportunities in Cambodia.

    Annear, Peter Leslie; Ahmed, Shakil; Ros, Chhun Eang; Ir, Por


    Reaching out to the poor and the informal sector is a major challenge for achieving universal coverage in lesser-developed countries. In Cambodia, extensive coverage by health equity funds for the poor has created the opportunity to consolidate various non-government health financing schemes under the government's proposed social health protection structure. This paper identifies the main policy and operational challenges to strengthening existing arrangements for the poor and the informal sector, and considers policy options to address these barriers. Conducted in conjunction with the Cambodian Ministry of Health in 2011-12, the study reviewed policy documents and collected qualitative data through 18 semi-structured key informant interviews with government, non-government and donor officials. Data were analysed using the Organizational Assessment for Improving and Strengthening Health Financing conceptual framework. We found that a significant shortfall related to institutional, organisational and health financing issues resulted in fragmentation and constrained the implementation of social health protection schemes, including health equity funds, community-based health insurance, vouchers and others. Key documents proposed the establishment of a national structure for the unification of the informal-sector schemes but left unresolved issues related to structure, institutional capacity and the third-party status of the national agency. This study adds to the evidence base on appropriate and effective institutional and organizational arrangements for social health protection in the informal sector in developing countries. Among the key lessons are: the need to expand the fiscal space for health care; a commitment to equity; specific measures to protect the poor; building national capacity for administration of universal coverage; and working within the specific national context.

  19. Measuring quality of diabetes care by linking health care system administrative databases with laboratory data

    Klomp Helena


    Full Text Available Abstract Background Chronic complications of diabetes can be reduced through optimal glycemic and lipid control as evaluated through measurement of glycosylated hemoglobin (A1C and low-density lipoprotein cholesterol (LDL-C. We aimed to produce measures of quality of diabetes care in Saskatchewan and to identify sub-groups at particular risk of developing complications. Findings Prevalent adult cases of diabetes in 2005/06 were identified from administrative databases and linked with A1C and LDL-C tests measured in centralized laboratories. A1C results were performed in 33,927 of 50,713 (66.9% diabetes cases identified in Saskatchewan, and LDL-C results were performed in 12,031 of 24,207 (49.7% cases identified within the province's two largest health regions. The target A1C of Conclusions Linkage of laboratory with administrative data is an effective method of assessing quality of diabetes care on a population basis and to identify sub-groups requiring particular attention. We found that less than 50% of Saskatchewan people with diabetes achieved optimal glycemic and lipid control. Disparities were most evident among First Nations people and young women. The indicators described can be used to provide standardized information that would support quality improvement initiatives.

  20. Receipt of employment services among Veterans Health Administration users with psychiatric diagnoses.

    Abraham, Kristen M; Ganoczy, Dara; Yosef, Matheos; Resnick, Sandra G; Zivin, Kara


    This study examined the population-based reach of Veterans Health Administration (VHA) employment services to VHA patients with psychiatric diagnoses. Reach of services includes the percentage and characteristics of people who accessed services compared with those who did not. Using clinical administrative data, we identified patients with a psychiatric diagnosis among a random sample of all patients who received VHA services in 1 yr. Among VHA patients with psychiatric diagnoses, we examined their likelihood of receiving any VHA employment services and specific types of employment services, including supported employment, transitional work, incentive therapy, and vocational assistance. We identified clinical and demographic characteristics associated with receiving employment services. Results indicated that 4.2% of VHA patients with a psychiatric diagnosis received employment services. After adjusting for clinical and demographic characteristics, VHA patients with schizophrenia and bipolar disorder were more likely to receive any employment services and to receive supported employment than were patients with depression, PTSD, or other anxiety disorders. VHA patients with depression and PTSD were more likely to receive transitional work and vocational assistance than patients with schizophrenia. Future studies should examine system-level barriers to receiving employment services and identify types of employment services most appropriate for Veterans with different psychiatric diagnoses.

  1. Effects of long-term acetyl-L-carnitine administration in rats: I. increased dopamine output in mesocorticolimbic areas and protection toward acute stress exposure.

    Tolu, Pierluigi; Masi, Flavio; Leggio, Benedetta; Scheggi, Simona; Tagliamonte, Alessandro; De Montis, M Graziella; Gambarana, Carla


    Acetyl-L-carnitine (ALCAR) is the acetyl ester of carnitine that has been reported to be beneficial in depressive disorders and Alzheimer's disease. A 7-day administration of ALCAR in rats increased dopamine and serotonin output in the nucleus accumbens shell and it prevented the development of escape deficit produced by acute exposure to unavoidable stress. No tolerance developed to this protective effect, which appeared to be mediated by (1) the activation of 5-HT(1A) receptors, as it was antagonized by the administration of WAY100635 30 min before stress exposure; and (2) a process of neuronal plasticity dependent on NMDA receptor activity, as subcutaneous dizocilpine infusion during ALCAR treatment prevented the development of the protective effect on stress. Chronic stress exposure maintains an escape deficit condition that is reverted by a long-term treatment with antidepressants, but the same condition was not modified by long-term ALCAR administration. Thus, ALCAR cannot be defined as an antidepressant.

  2. Investigating m-Health Acceptance from a Protection Motivation Theory Perspective: Gender and Age Differences.

    Guo, Xitong; Han, Xiaocui; Zhang, Xiaofei; Dang, Yuanyuan; Chen, Chun


    Mobile health (m-health) services are becoming increasingly important and widely accepted. However, empirical studies on potential users' m-health acceptance behavior remain underexplored. Indeed, m-health adoption is not only a technology acceptance behavior, but also a health-related behavior. Based on the Protection Motivation Theory, this article explores users' m-health adoption behavior from the perspectives of threat appraisal and coping appraisal, and also examines the moderating role of gender and age through a survey of potential users. The survey was conducted among 500 potential m-health service participants. Our results show that threat appraisal and coping appraisal factors influence adoption intention through attitude. It is also found that gender and age play different moderating roles with threat appraisal and coping appraisal factors. Gender and age play different roles between threat appraisal and coping appraisal factors in the acceptance of m-health. Implications for research and practice are discussed.

  3. The eradication of smallpox: organizational learning and innovation in international health administration.

    Hopkins, J W


    The WHO smallpox eradication campaign represents perhaps the best example of a successful international health administration. In the 1st year of the campaign (1967), the guiding strategy was to vaccinate people en masse over a 2-3 year period in countries where smallpox was epidemic thereby conquering the disease. In Western Nigeria where 90% of the population had been vaccinated, a smallpox outbreak occurred in a religious sect resisting vaccinations and a delay in delivery of supplies forced a change in strategy. Campaign staff learned to rapidly isolate infected persons and swiftly vaccinate the uninfected in an outbreak area in order to break the transmission of smallpox, even where 1/2 the population had been vaccinated. Technological advancements also contributed to the campaign's success. For example, the jet injector vaccinated 1000 people/hour with efficient, reliable, mass produced potent, stable freeze dried vaccines (often produced in target countries) or the less costly and virtually maintenance free bifurcated needle was used. The most significant contribution to the success of the campaign, however, was the flexible mode of management adopted by the campaign staff at WHO which provided an appropriate environment for organizational learning and innovation. Although management was open and flexible, the campaign did depend on careful planning and setting of goals, continual assessment, and rapid response to field requests for assistance or advice. Trends in the incidence of smallpox was chosen as the indicator of success as opposed to the number of vaccinations. The campaign demonstrated the need for cultural adaptations as it operated in each country and region. This evaluation of the success of the smallpox campaign presents conclusions that serve as guidelines to the organization and administration of international programs designed to solve other health problems.

  4. Experience of health-system pharmacy administration residents in a longitudinal human resource management program.

    Amerine, Lindsey B Poppe; Granko, Robert P; Savage, Scott W; Daniels, Rowell; Eckel, Stephen F


    The experience of health-system pharmacy administration (HSPA) residents in a longitudinal human resource (HR) management program is described. The subsequent benefits to the residents, department, and profession are also discussed. Postgraduate year 2 HSPA residents at an academic medical center desired more responsibility for managing an operational area. To this end, a program was created in which these residents directly manage a small group of pharmacy technicians and report to a clinical manager or assistant director with oversight responsibility. These "resident managers" are responsible, under the direction of the area's clinical manager, for the personnel, schedule, time and attendance, and HR activities of the area. Resident managers have led and sustained operational improvement projects in their areas. In addition to providing learning experiences to residents, the HSPA residency program has also improved the operations of the areas in which these residents work. Benefits to the residents include conducting annual performance evaluations for employees with whom they have a relationship as it is a task every administrator completes. Resident managers at UNC have consistently stated that this longitudinal HR experience is one of the most rewarding and most challenging experiences offered in the two-year HSPA residency. The involvement of HSPA residents in longitudinal management responsibilities furthers residents' leadership success by providing trained managers who are ready to immerse themselves into practice postresidency, having employee engagement and HR skills as well as experiences with leading operational improvements. A longitudinal HR management experience was successfully incorporated into an HSPA residency combined Master of Science degree program. Copyright © 2014 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  5. Cost of readmission: can the Veterans Health Administration (VHA) experience inform national payment policy?

    Hockenberry, Jason M; Burgess, James F; Glasgow, Justin; Vaughan-Sarrazin, Mary; Kaboli, Peter J


    Scrutiny of hospital readmissions has led to the development and implementation of policies targeted at reducing readmission rates. To assess whether historic hospital readmission rates predict risk-adjusted patient readmission and to measure the costs of readmission, thus informing reimbursement policies under consideration by non-Veterans Health Administration payers. Multivariable hospital-fixed effects regression analyses of patients admitted to 129 Veterans Health Administration hospitals between 2005 and 2009 for 3 common conditions, acute myocardial infarction (AMI), community-acquired pneumonia (CAP), and congestive heart failure (CHF). We examined whether previous hospital readmission rates predicted risk-adjusted readmission or 30-day episode cost of care for subsequent patients. We then examined the 30-day inpatient hospitalization episode cost differences between those who had a readmission in the episode and those who did not. Hospital readmission rates in the previous quarter are not predictive of individual patient risk-adjusted readmission or of patients' inpatient hospitalization episode cost in the subsequent quarter. Relative to those who were not readmitted within 30 days of index visit discharge, readmitted patients had 30-day episode costs that were 53.3% (P<0.001), 82.8% (P<0.001), and 79.8% (P<0.001) higher for AMI, CAP, and CHF hospitalization episodes, respectively. Previous hospital readmission rates are poor predictors of readmission for future individual patients, therefore, policies using these measures to guide subsequent reimbursement are problematic for hospitals that are financially constrained. Our findings indicate current diagnosis related group payments would need to be raised by 10.0% for AMI, 11.5% for CAP, and 16.6% for CHF if these are to become 30-day bundled payments.

  6. [Protection of the environment, protection of the health. Note 1 - fluvial monitoring: cultural evolution and methodological evolution].

    Cocchioni, M; Scuri, S; Morichetti, L; Petrelli, F; Grappasonni, I


    The article underlines the fundamental importance of the protection and promotion of environmental quality for the human health. The evolution of fluvial monitoring techniques is contemplated from chemical and bacteriological analysis until the Index Functional Index (I.F.F). This evolution it's very important because shows a new methodological and cultural maturation that has carried from a anthropocentric vision until an ecocentric vision. The target of this ecological vision is the re-establishment of ecological functionality of the rivers, eliminating the consumer's vision of the water considered only as a usable resource. The importance of an correct monitoring of a river is confirmed, even though the preventive approach priority remains.

  7. Enabling Technology to Advance Health-Protecting Individual Rights-Are We Walking the Talk?

    Sharp, Crystal; Gwadry-Sridhar, Femida

    The evolving structure and business of health care services and delivery need the functionality and capability offered by electronic health record (EHR) systems. By electronically diffusing the traditional patient record, however, this new model blurs the long-established medical data home, raising concerns about data ownership, confidentiality, access and individual rights. In 2008 the Lawson Health Research Institute began the process of instituting a robust health informatics and collaborative research infrastructure, now known as I-THINK Research. As data are migrated to the platform and policies are developed, we are forced to confront the complexity of issues around protection of individual rights. The paper presents, in a broader context, the main issues surrounding the privacy debate and the need for education, accountability and new legislation to help define and protect individual rights as new e-health business models emerge.

  8. The protection of the environment: Protection of health and food safety - EU and Serbia

    Sič Magdolna


    Full Text Available From the last century the process of harmonization and unification of the law on food safety for the protection of consumers in the European Union (EU is ongoing. According to these rules, participants in the production and distribution of food have to respect the rules in all phases of production: 'From Farm to Fork'. Honoring of the rules is based on self-control and the responsibility of producers and distributors, and is subject to public control with appropriate sanctions by competent authorities of a Member State as well as the EU. In the Republic of Serbia, after singing the Stabilization and Association Agreement, the statutory law has been approximated with the laws of the EU. That however, is not sufficient. It is necessary to develop the self-control of producers as well as to organize an efficient public control, not only because this is a necessary condition for export of food products to the single market of the EU, or for the membership in the EU, but also for ensuring safe food in the internal market of Serbia.

  9. Co-administration of the polysaccharide of Lycium barbarum with DNA vaccine of Chlamydophila abortus augments protection.

    Ling, Yong; Li, Shaowen; Yang, Junjing; Yuan, Jilei; He, Cheng


    Lycium barbarum polysaccharides (LBP) can stimulate moderate immune responses therefore could potentially be used as a substitute for oil adjuvants in veterinary vaccines. In the present study, it was shown that the isolated active component of LBP3a, combined with a DNA vaccine encoding the major outer membrane protein (MOMP) of Chlamydophila abortus, induced protection in mice against challenge. Sixty BALB/c mice were randomly assigned to 5 groups. Sub-fractions of polysaccharide LBP3a, at 12.5, 25 and 50 mg/kg concentrations, respectively, were mixed with a pCI-neo::MOMP (pMOMP) vaccine. Mice administrated with pCI-neo + LBP3a were served as a control. All mice were inoculated at day 0, 14, and 28, and challenged on day 44. The effects of LBp3a on serum antibody levels, in vitro lymphocyte proliferation, the activity of interleaukin-2 (IL-2), interferon-γ (IFN-γ), tumor necrosis factor α(TNF-α)and chlamydia clearance were determined. A combination of DNA vaccine and LBP3a induced significantly higher antibody levels in mice, higher T cell proliferation and higher levels of IFN-γ and IL-2. Mice immunized with DNA and LBP3a also showed significantly higher levels of chlamydia clearance in mice spleens and a greater Th1 immune response. The immunoenhancement induced by 25 mg/kg LBP3a is more effective than that induced by a 12.5 and 50 mg/kg. This implies that LBP3a at 25 mg/kg has a high potential to be used as an effective adjuvant with a DNA vaccine against swine Chlamydophila abortus.

  10. Heterosubtypic cross-protection induced by whole inactivated influenza virus vaccine in mice : Influence of the route of vaccine administration

    Budimir, Natalija; de Haan, Aalzen; Meijerhof, Tjarko; Gostick, Emma; Price, David A.; Huckriede, Anke; Wilschut, Jan


    Background Development of influenza vaccines capable of inducing broad protection against different virus subtypes is necessary given the ever-changing viral genetic landscape. Previously, we showed that vaccination with whole inactivated virus (WIV) induces heterosubtypic protection against lethal

  11. Financial protection from health spending in the Philippines: policies and progress.

    Bredenkamp, Caryn; Buisman, Leander R


    The objective of this article is to assess the progress of the Philippines health sector in providing financial protection to the population, as measured by estimates of health insurance coverage, out-of-pocket spending, catastrophic payments and impoverishing health expenditures. Data are drawn from eight household surveys between 2000 and 2013, including two Demographic and Health Surveys, one Family Health Survey and five Family Income and Expenditure Surveys. We find that out-of-pocket spending increased by 150% (real) from 2000 to 2012, with the sharpest increases occurring in recent years. The main driver of health spending is medicines, accounting for almost two-thirds of total health spending, and as much as three-quarters among the poor. The incidence of catastrophic payments has tripled since 2000, from 2.5% to 7.7%. The percentage of people impoverished by health spending has also increased and, in 2012, out-of-pocket spending on health added 1.5 percentage points to the poverty rate, pushing more than 1.5 million people into poverty. In light of these findings, recent policies to enhance financial risk protection-such as the expansion of government-subsidized health insurance from the poor to the near-poor, a policy of zero copayments for the poor, a deepening of the benefit package and provider payment reform aimed at cost-containment-are to be commended. Indeed, between 2008 and 2013, self-reported health insurance coverage increased across all quintiles and its distribution became more pro-poor. To speed progress toward financial protection goals, quick wins could include issuing health insurance cards to the poor to increase awareness of coverage and limiting out-of-pocket spending by clearly defining a clear copayment structure for non-poor members. An in-depth analysis of the pharmaceutical sector would help to shed light on why medicines impose such a large financial burden on households.

  12. Cancer registration, public health and the reform of the European data protection framework: Abandoning or improving European public health research?

    Andersen, Mette Rye; Storm, Hans H


    The importance of cancer- and other disease registries for planning, management and evaluation of healthcare systems has been shown repeatedly during the last 50 years. Complete and unbiased population-level analyses on routinely collected, individual data concerning health and personal characteristics can address significant concerns about risk factors for cancer and provide sound evidence about public health and the effectiveness of healthcare systems. The existence of quality controlled and comprehensive data in registries, allowed to be used for quality control, research and public health purposes are taken as granted by most health professionals and researchers. However, the current revision of the European Union (EU) data protection framework suggests a harmonisation of requirements for confidentiality and individual consent to data processing, likely at the expense of proper use of registry data in the health sector. Consequences of excessive confidentiality rules that may lead to missed data linkages have been simulated. The simulations provide one possible explanation for observed heterogeneity among some cancer incidence data. Further, public health, quality control and epidemiological research on large populations can no longer provide evidence for health interventions, if requirements for consent renders research impossible or where attempts to obtain consent from each data subject generates biased results. Health professionals should engage in the on-going debate on the Commission's proposal for a General Data Protection Regulation. The nature and use of registry data in public health research must be explained and known to policy-makers and the public. Use of cancer registry data and other epidemiological activity will terminate abruptly if an unnecessarily strict EU data protection regulation is adopted. Research based interventions, as well as the international recognised standing of cancer registries and register-based research institutions in

  13. The importance of traceability for public health and consumer protection.

    McKean, J D


    Since the 1980s, concerns about the safety and quality of food have increased at both governmental and consumer levels. The importance of traceability of animals and animal products has grown as food production and marketing have been removed from direct consumer control. Product traceability, which requires a transparent chain of custody to maintain credibility and to complete information transfer functions, has two components, namely: a unique identification system, and a credible and verifiable mechanism for identity preservation. Traceability systems can be subdivided into the following four categories: country of origin; retail; processor; and farm-to-retail identity. Although the availability of computers and electronic data devices can enhance the speed and accuracy of data acquisition and manipulation, a common set of developmental criteria exists, irrespective of data-handling processes. As data management technologies become more powerful and less costly, product traceability requirements will multiply. Public and private sectors should seize these opportunities to improve public health and quality parameters, or risk a narrowing of their markets.

  14. The effects of periparturient administration of flunixin meglumine on the health and production of dairy cattle.

    Newby, N C; Leslie, K E; Dingwell, H D Putnam; Kelton, D F; Weary, D M; Neuder, L; Millman, S T; Duffield, T F


    Research on the assessment and management of pain in cows following difficult or assisted calving is still limited, especially on the effects of analgesics intended to mitigate this pain. The purpose of this study was to assess the effects of flunixin meglumine on the health and production of Holstein cows after calving. In total, 34 flunixin-treated and 38 placebo-treated animals were enrolled in a precalving treatment trial. A total of 633 animals given flunixin and 632 animals administered a placebo were enrolled in a postcalving treatment trial. In both cases, animals were randomly assigned to treatment, and researchers were blind to treatment condition until after analysis. A total of 1,265 animal records were analyzed for milk production for the first 14d in milk and health outcomes for the first 30d in milk. Animals treated with flunixin meglumine before calving had a significantly increased risk of stillbirth. Animals treated immediately after calving had increased odds of having a retained placenta and, in turn, increased risk of a high temperature, decreased milk production, and an increased risk of developing metritis. The administration of flunixin meglumine within 24h of parturition is not recommended in dairy cattle.

  15. Estimating the Prevalence of Treated Epilepsy Using Administrative Health Data and Its Validity: ESSENCE Study

    Lee, Seo-Young; Chung, Soo-Eun; Kim, Dong Wook; Eun, So-Hee; Kang, Hoon Chul; Cho, Yong Won; Yi, Sang Do; Kim, Heung Dong


    Background and Purpose Few of the epidemiologic studies of epilepsy have utilized well-validated nationwide databases. We estimated the nationwide prevalence of treated epilepsy based on a comprehensive medical payment database along with diagnostic validation. Methods We collected data on patients prescribed of antiepileptic drugs (AEDs) from the Health Insurance Review and Assessment service, which covers the entire population of Korea. To assess the diagnostic validity, a medical records survey was conducted involving 6,774 patients prescribed AEDs from 43 institutions based on regional clusters and referral levels across the country. The prevalence of treated epilepsy was estimated by projecting the diagnostic validity on the number of patients prescribed AEDs. Results The mean positive predictive value (PPV) for epilepsy was 0.810 for those prescribed AEDs with diagnostic codes that indicate epilepsy or seizure (Diagnosis-E), while it was 0.066 for those without Diagnosis-E. The PPV tended to decrease with age in both groups, with lower values seen in females. The prevalence was 3.84 per 1,000, and it was higher among males, children, and the elderly. Conclusions The prevalence of epilepsy in Korea was comparable to that in other East Asian countries. The diagnostic validity of administrative health data varies depending on the method of case ascertainment, age, and sex. The prescriptions of AEDs even without relevant diagnostic codes should be considered as a tracer for epilepsy.

  16. Barriers and Facilitators to Adoption of Genomic Services for Colorectal Care within the Veterans Health Administration

    Nina R. Sperber


    Full Text Available We examined facilitators and barriers to adoption of genomic services for colorectal care, one of the first genomic medicine applications, within the Veterans Health Administration to shed light on areas for practice change. We conducted semi-structured interviews with 58 clinicians to understand use of the following genomic services for colorectal care: family health history documentation, molecular and genetic testing, and genetic counseling. Data collection and analysis were informed by two conceptual frameworks, the Greenhalgh Diffusion of Innovation and Andersen Behavioral Model, to allow for concurrent examination of both access and innovation factors. Specialists were more likely than primary care clinicians to obtain family history to investigate hereditary colorectal cancer (CRC, but with limited detail; clinicians suggested templates to facilitate retrieval and documentation of family history according to guidelines. Clinicians identified advantage of molecular tumor analysis prior to genetic testing, but tumor testing was infrequently used due to perceived low disease burden. Support from genetic counselors was regarded as facilitative for considering hereditary basis of CRC diagnosis, but there was variability in awareness of and access to this expertise. Our data suggest the need for tools and policies to establish and disseminate well-defined processes for accessing services and adhering to guidelines.

  17. Barriers and Facilitators to Adoption of Genomic Services for Colorectal Care within the Veterans Health Administration.

    Sperber, Nina R; Andrews, Sara M; Voils, Corrine I; Green, Gregory L; Provenzale, Dawn; Knight, Sara


    We examined facilitators and barriers to adoption of genomic services for colorectal care, one of the first genomic medicine applications, within the Veterans Health Administration to shed light on areas for practice change. We conducted semi-structured interviews with 58 clinicians to understand use of the following genomic services for colorectal care: family health history documentation, molecular and genetic testing, and genetic counseling. Data collection and analysis were informed by two conceptual frameworks, the Greenhalgh Diffusion of Innovation and Andersen Behavioral Model, to allow for concurrent examination of both access and innovation factors. Specialists were more likely than primary care clinicians to obtain family history to investigate hereditary colorectal cancer (CRC), but with limited detail; clinicians suggested templates to facilitate retrieval and documentation of family history according to guidelines. Clinicians identified advantage of molecular tumor analysis prior to genetic testing, but tumor testing was infrequently used due to perceived low disease burden. Support from genetic counselors was regarded as facilitative for considering hereditary basis of CRC diagnosis, but there was variability in awareness of and access to this expertise. Our data suggest the need for tools and policies to establish and disseminate well-defined processes for accessing services and adhering to guidelines.

  18. Reflections on health staff working with elderly people in the public administration. Case studies /

    Concepción Nieto-Morales


    Full Text Available The speech of female health professionals who work in public residences is analyzed in this writing, a work which most of them choose as their vocation, from a perspective in public employment and personal cares. The crisis has destroyed positions, social rights, made precarious the employment done in all the environments and especially in the Administration, the outsourcing of work is started, the increasing of flexibility of the labor conditions, the instability… Everything worsens particularly the conditions of the public health professionals. The question arisen is: where are the labor stability, the vocation and working in a position each one has been trained for? The labor conditions worsen, making employment and positions more precarious. The statistics reflect there is less unemployment when there is more training; but there are many university people who work in a position different to the one they have been trained for. A group of discussion composed by six people with a university degree in Nursing and Auxiliary Nursing Care, who work in public residences for elderly people, has been created to focus on this work, out of the labor place.

  19. The Role of More Sensitive Helminth Diagnostics in Mass Drug Administration Campaigns: Elimination and Health Impacts.

    Medley, G F; Turner, H C; Baggaley, R F; Holland, C; Hollingsworth, T D


    Diagnostics play a crucial role in determining treatment protocols and evaluating success of mass drug administration (MDA) programmes used to control soil-transmitted helminths (STHs). The current diagnostic, Kato-Katz, relies on inexpensive, reusable materials and can be used in the field, but only trained microscopists can read slides. This diagnostic always underestimates the true prevalence of infection, and the accuracy worsens as the true prevalence falls. We investigate how more sensitive diagnostics would impact on the management and life cycle of MDA programmes, including number of mass treatment rounds, health impact, number of unnecessary treatments and probability of elimination. We use an individual-based model of STH transmission within the current World Health Organization (WHO) treatment guidelines which records individual disability-adjusted life years (DALY) lost. We focus on Ascaris lumbricoides due to the availability of high-quality data on existing diagnostics. We show that the effect of improving the sensitivity of diagnostics is principally determined by the precontrol prevalence in the community. Communities at low true prevalence (70%) do not benefit greatly from improved diagnostics. Communities with intermediate prevalence benefit greatly from increased chemotherapy application, both in terms of reduced DALY loss and increased probability of elimination. Our results suggest that programmes should be extended beyond school-age children, especially in high prevalence communities. Finally, we argue against using apparent or measured prevalence as an uncorrected proxy for true prevalence.

  20. Knowledge of Radiation Hazards, Radiation Protection Practices and Clinical Profile of Health Workers in a Teaching Hospital in Northern Nigeria.

    Awosan, K J; Ibrahim, Mto; Saidu, S A; Ma'aji, S M; Danfulani, M; Yunusa, E U; Ikhuenbor, D B; Ige, T A


    Use of ionizing radiation in medical imaging for diagnostic and interventional purposes has risen dramatically in recent years with a concomitant increase in exposure of patients and health workers to radiation hazards. To assess the knowledge of radiation hazards, radiation protection practices and clinical profile of health workers in UDUTH, Sokoto, Nigeria. A cross-sectional study was conducted among 110 Radiology, Radiotherapy and Dentistry staff selected by universal sampling technique. The study comprised of administration of standardized semi-structured pre-tested questionnaire (to obtain information on socio-demographic characteristics, knowledge of radiation hazards, and radiation protection practices of participants), clinical assessment (comprising of chest X-ray, abdominal ultrasound and laboratory investigation on hematological parameters), and evaluation of radiation exposure of participants (extracted from existing hospital records on their radiation exposure status). The participants were aged 20 to 65 years (mean = 34.04 ± 8.83), most of them were males (67.3%) and married (65.7%). Sixty five (59.1%) had good knowledge of radiation hazards, 58 (52.7%) had good knowledge of Personal Protective Devices (PPDs), less than a third, 30 (27.3%) consistently wore dosimeter, and very few (10.9% and below) consistently wore the various PPDs at work. The average annual radiation exposure over a 4 year period ranged from 0.0475mSv to 1.8725mSv. Only 1 (1.2%) of 86 participants had abnormal chest X-ray findings, 8 (9.4%) of 85 participants had abnormal abdominal ultrasound findings; while 17 (15.5%) and 11 (10.0%) of 110 participants had anemia and leucopenia respectively. This study demonstrated poor radiation protection practices despite good knowledge of radiation hazards among the participants, but radiation exposure and prevalence of abnormal clinical conditions were found to be low. Periodic in-service training and monitoring on radiation safety was

  1. EPA Administrative Enforcement Dockets

    U.S. Environmental Protection Agency — The EPA Administrative Enforcement Dockets database contains the electronic dockets for administrative penalty cases filed by EPA Regions and Headquarters. Visitors...

  2. A team approach to improving colorectal cancer services using administrative health data

    Porter Geoffrey


    Full Text Available Abstract Background Colorectal cancer (CRC is the third most commonly diagnosed cancer in Canada and accounts for 11.9% of all cancer-related mortality. Fortunately, previous studies have provided evidence of improved outcomes from access to timely and appropriate health services along the disease trajectory in CRC. As a result, the CIHR/CCNS Team in Access to Colorectal Cancer Services in Nova Scotia (Team ACCESS was created to build colorectal cancer (CRC research capacity in Nova Scotia (NS and to study access to and quality of CRC services along the entire continuum of cancer care. Objectives The objectives of this paper are to: 1 provide a detailed description of the methodologies employed across the various studies being conducted by Team ACCESS; 2 demonstrate how administrative health data can be used to evaluate access and quality in CRC services; and 3 provide an example of an interdisciplinary team approach to addressing health service delivery issues. Methods All patients diagnosed with CRC in NS between 2001 and 2005 were identified through the Nova Scotia Cancer Registry (NSCR and staged using the Collaborative Stage Data Collection System. Using administrative databases that were linked at the patient level, Team ACCESS created a retrospective longitudinal cohort with comprehensive demographic, clinical, and healthcare utilization data. These data were used to examine access to and quality of CRC services in NS, as well as factors affecting access to and quality of care, at various transition points along the continuum of care. Team ACCESS has also implemented integrated knowledge translation strategies targeting policy- and decision- makers. Discussion The development of Team ACCESS represents a unique approach to CRC research. We anticipate that the skills, tools, and knowledge generated from our work will also advance the study of other cancer disease sites in NS. Given the increasing prevalence of cancer, and with national and

  3. Health Equity and Financial Protection Streamlined Analysis with ADePT Software

    Bank, World


    Two key policy goals in the health sector are equity and financial protection. New methods, data and powerful computers have led to a surge of interest in quantitative analysis that permits monitoring progress toward these objectives, and comparisons across countries. ADePT is a new computer program that streamlines and automates such work, ensuring that results are genuinely comparable and allowing them to be produced with a minimum of programming skills. This book provides a step-by-step guide to the use of ADePT for quantitative analysis of equity and financial protection in the health sect

  4. Curbing transboundary air pollution : protecting health through legal action

    McKeown, D.; Campbell, M.; Clark, K.; Ursitti, F.


    Concerns regarding coal-fired power plants in North America were addressed in this report with particular reference to facilities in the United States that negatively impact the air quality and the health of residents in the City of Toronto. Aging coal-fired plants in the United States generate more pollutant emissions per unit of electricity produced than coal-fired plants in Ontario and as such, contribute to smog, acid rain and global warming. They also contribute to the contamination of fish through deposition and biotransformation of mercury in the aquatic ecosystem. Toronto's concerns also stem from actions to extend the life of several plants in the United States without investing in modern pollution control technology, an action that contradicts the requirements of the United States Clean Air Act, and which is contrary to Ontario's commitment to phase out coal-fired electricity production. Lawsuits have been filed against power plants that failed to install pollution control technology. The City of Toronto was granted Friend of the Court status in the United States court deliberating on the case involving the American Electric Power (AEP) Corporation and its contravention of the Clean Air Act. The next phase of legal proceedings will be to determine the remedy should the court find AEP in violation of the Act. The outcome of this court case could result in improvements in Toronto's air quality. The proposed United States Clear Skies legislation, however, may also delay reductions of pollutant emissions from coal-fired power plants until 2018. 12 refs., 1 tab., 4 figs., 3 appendices.

  5. Protecting human and ecological health under viral threats in Asia.

    Matsui, S


    Severe acute respiratory syndrome (SARS) outbroke in 2003, and the avian influenza A (H5N1) also outbroke in 2003 and continued to 2004. These pandemic viral diseases originated in South East Asia. Many human and animal lives were lost. Economic damages due to the pandemics were also very large. The question arises of why did the pandemics originate from South East Asian areas. Human influenza A consists of many sub-types of coronaviruses including the SARS virus and the avian influenza (H5N1) that are all variants of RNA of avian coronavirus. Variants are formed during infection of a coronavirus through not only birds but also mammals, including human beings. There are hot spots where viral infection rates are accelerated among birds, mammals and human beings. Suspicious areas are in South East Asia, where living conditions of birds, mammals and human beings are so close that there are always risks of viral infection. When we see the living conditions of farmers in southern China, northern Vietnam, Laos and northern Myanmar, they commonly raise ducks/chickens with pigs sharing ponds into which they discharge household wastewater, including human excreta, and pig excreta that are significant carriers of viruses. Bird faeces are also key carriers of the viruses. In the ponds, they raise ducks and conduct fish culture. Other important players are migrating birds from North Asia, which are principal vectors of avian influenza viruses. There is an urgent necessity of improving human and ecological health in South East Asia to control viral infection among birds, mammals and human beings. We can hinder the vicious cycle of virus infection through water contamination in ponds by providing good human, pig and chicken sanitation. It is easy to provide good sanitation practices for human, pigs and chickens, introducing collection and treatment of excreta. Our modern water technology can find good solutions for the problem.

  6. Improving Health Care Coverage, Equity, And Financial Protection Through A Hybrid System: Malaysia's Experience.

    Rannan-Eliya, Ravindra P; Anuranga, Chamara; Manual, Adilius; Sararaks, Sondi; Jailani, Anis S; Hamid, Abdul J; Razif, Izzanie M; Tan, Ee H; Darzi, Ara


    Malaysia has made substantial progress in providing access to health care for its citizens and has been more successful than many other countries that are better known as models of universal health coverage. Malaysia's health care coverage and outcomes are now approaching levels achieved by member nations of the Organization for Economic Cooperation and Development. Malaysia's results are achieved through a mix of public services (funded by general revenues) and parallel private services (predominantly financed by out-of-pocket spending). We examined the distributional aspects of health financing and delivery and assessed financial protection in Malaysia's hybrid system. We found that this system has been effective for many decades in equalizing health care use and providing protection from financial risk, despite modest government spending. Our results also indicate that a high out-of-pocket share of total financing is not a consistent proxy for financial protection; greater attention is needed to the absolute level of out-of-pocket spending. Malaysia's hybrid health system presents continuing unresolved policy challenges, but the country's experience nonetheless provides lessons for other emerging economies that want to expand access to health care despite limited fiscal resources.

  7. Ways to implement a health protective educational environment in higher education

    Mykytyuk O.M.


    Full Text Available The features of organization and creation of health protective educational environment are exposed in higher institute. They foresee creation of the special terms for realization structurally of functional model of organization of students' healthy way of life. A model plugs in itself pedagogical, organizational, material and technical, sanitary-hygenic, informatively-methodical, skilled and financial economic terms. A questionnaire is conducted 95 students of 1-3 courses. It is set that the level of factors of risk for the health of students is high enough: prevalence of smoking is 47%, swizzles use more than 20%. It is discovered that the number of students with active physical activity makes not more than 45%. Most students consider that for the health they are responsible, ready and want to get information on forming of healthy way of life. Principles of organization of health protective behave to the features of organization of health protective of educational environment, nature protective, valeological, sequence, integration, pedagogical support, flexibility.

  8. [Management System of Personal Data Protection in the Health Care Field].

    Yamamoto, Ryuichi


    In Japan, the law on personal data protection was enacted in 2005. Privacy is a human right, including the 1981 right to be let alone. The need for confidentiality in the health care field has been accepted since the ancient Greek era, and privacy in the 19th century was developed in this field. However, the concept of privacy has gradually altered, especially due to the development of information technology. The author suggests that the guideline for the security of heath information systems of the Ministry of Health, Labour, and Welfare is very important and information security management with PDCA cycles is essential for personal data protection in the health care field. In recent years, gathering a large amount of life logging or health-related data and analyzing such data for academic and/or industrial applications has become common. Revising privacy protection legislation has become an urgent political issue in many countries. The Japanese Government published their policy to personal data protection act in Dec. 2013. Balancing public benefit and privacy is a major task of future legislation. The author recommends that health care professionals pay attention to, participate in the discussion of, and make suggestions regarding this act.

  9. Integrating community health workers within Patient Protection and Affordable Care Act implementation.

    Islam, Nadia; Nadkarni, Smiti Kapadia; Zahn, Deborah; Skillman, Megan; Kwon, Simona C; Trinh-Shevrin, Chau


    The Patient Protection and Affordable Care Act's (PPACA) emphasis on community-based initiatives affords a unique opportunity to disseminate and scale up evidence-based community health worker (CHW) models that integrate CHWs within health care delivery teams and programs. Community health workers have unique access and local knowledge that can inform program development and evaluation, improve service delivery and care coordination, and expand health care access. As a member of the PPACA-defined health care workforce, CHWs have the potential to positively impact numerous programs and reduce costs. This article discusses different strategies for integrating CHW models within PPACA implementation through facilitated enrollment strategies, patient-centered medical homes, coordination and expansion of health information technology (HIT) efforts, and also discusses payment options for such integration. Title V of the PPACA outlines a plan to improve access to and delivery of health care services for all individuals, particularly low-income, underserved, uninsured, minority, health disparity, and rural populations. Community health workers' role as trusted community leaders can facilitate accurate data collection, program enrollment, and provision of culturally and linguistically appropriate, patient- and family-centered care. Because CHWs already support disease management and care coordination services, they will be critical to delivering and expanding patient-centered medical homes and Health Home services, especially for communities that suffer disproportionately from multiple chronic diseases. Community health workers' unique expertise in conducting outreach make them well positioned to help enroll people in Medicaid or insurance offered by Health Benefit Exchanges. New payment models provide opportunities to fund and sustain CHWs. Community health workers can support the effective implementation of PPACA if the capacity and potential of CHWs to serve as cultural

  10. How can hospitals better protect the privacy of electronic medical records? Perspectives from staff members of health information management departments.

    Sher, Ming-Ling; Talley, Paul C; Cheng, Tain-Junn; Kuo, Kuang-Ming


    The adoption of electronic medical records (EMR) is expected to better improve overall healthcare quality and to offset the financial pressure of excessive administrative burden. However, safeguarding EMR against potentially hostile security breaches from both inside and outside healthcare facilities has created increased patients' privacy concerns from all sides. The aim of our study was to examine the influencing factors of privacy protection for EMR by healthcare professionals. We used survey methodology to collect questionnaire responses from staff members in health information management departments among nine Taiwanese hospitals active in EMR utilisation. A total of 209 valid responses were collected in 2014. We used partial least squares for analysing the collected data. Perceived benefits, perceived barriers, self-efficacy and cues to action were found to have a significant association with intention to protect EMR privacy, while perceived susceptibility and perceived severity were not. Based on the findings obtained, we suggest that hospitals should provide continuous ethics awareness training to relevant staff and design more effective strategies for improving the protection of EMR privacy in their charge. Further practical and research implications are also discussed.

  11. Mental Health of Transgender Veterans in US States With and Without Discrimination and Hate Crime Legal Protection.

    Blosnich, John R; Marsiglio, Mary C; Gao, Shasha; Gordon, Adam J; Shipherd, Jillian C; Kauth, Michael; Brown, George R; Fine, Michael J


    To examine whether indicators of community- and state-level lesbian, gay, bisexual, and transgender equality are associated with transgender veterans' mental health. We extracted Veterans Administration data for patients who were diagnosed with gender identity disorder, had at least 1 visit in 2013, and lived in a zip code with a Municipality Equality Index score (n = 1640). We examined the associations of whether a state included transgender status in employment nondiscrimination laws and in hate crimes laws with mood disorders; alcohol, illicit drug, and tobacco use disorders; posttraumatic stress disorder; and suicidal ideation or attempt. Nearly half (47.3%) of the sample lived in states with employment discrimination protection, and 44.8% lived in states with hate crimes protection. Employment nondiscrimination protection was associated with 26% decreased odds of mood disorders (adjusted odds ratio [AOR] = 0.74; 95% confidence interval [CI] = 0.59, 0.93) and 43% decreased odds of self-directed violence (AOR = 0.57; 95% CI = 0.34, 0.95). Understanding lesbian, gay, bisexual, and transgender social stressors can inform treatment and care coordination for transgender populations.

  12. The impact of bullying on health care administration staff: reduced commitment beyond the influences of negative affectivity.

    Rodwell, John; Demir, Defne; Parris, Melissa; Steane, Peter; Noblet, Andrew


    Investigations of workplace bullying in health care settings have tended to focus on nurses or other clinical staff. However, the organizational and power structures enabling bullying in health care are present for all employees, including administrative staff. : The purpose of this study was to specifically focus on health care administration staff and examine the prevalence and consequences of workplace bullying in this occupational group. A cross-sectional study was conducted based on questionnaire data from health care administration staff who work across facilities within a medium to large health care organization in Australia. The questionnaire included measures of bullying, negative affectivity (NA), job satisfaction, organizational commitment, well-being, and psychological distress. The three hypotheses of the study were that (a) workplace bullying will be linked to negative employee outcomes, (b) individual differences on demographic factors will have an impact on these outcomes, and (c) individual differences in NA will be a significant covariate in the analyses. The hypotheses were tested using t tests and analyses of covariances. A total of 150 health care administration staff completed the questionnaire (76% response rate). Significant main effects were found for workplace bullying, with lower organizational commitment and well-being with the effect on commitment remaining over and above NA. Main effects were found for age on job satisfaction and for employment type on psychological distress. A significant interaction between bullying and employment type for psychological distress was also observed. Negative affectivity was a significant covariate for all analyses of covariance. The applications of these results include the need to consider the occupations receiving attention in health care to include administration employees, that bullying is present across health care occupations, and that some employees, particularly part-time staff, may need to be

  13. Education for the protection of young people’s reproductive health

    Rašević Mirjana


    Full Text Available Education for the protection of reproductive health is of special importance for young people in Serbia for several reasons. The first reason is an extremely low birth rate. The second is the fact that a large part of the population suffers from serious and long-standing problems in reproductive health. The third, common to all countries passing through transition, is an increase in risk behavior among young people which threatens their reproductive health either directly or indirectly. Education for reproductive health is a long-lasting process which should be initiated at an early age and should involve all social institutions, primarily health institutions, media and schools. The school is the most important link in the chain of knowledge acquisition. Therefore during elementary education, time must be found for topics such as puberty, emotional life of young people, physiology of reproduction, adolescent pregnancy, communication skills, risk behavior, contraception, sexually transmitted diseases and the importance of family and children. Over the last few years more than thirty counseling centers for young people’s reproductive health have been set up in Serbia within health clinics. Unlike health institutions, media and schools have not yet been mobilized. Therefore it is necessary to promote the role of media and schools in the process of the protection of young people’s reproductive health. .

  14. Supporting breastfeeding in emergencies: protecting women's reproductive rights and maternal and infant health.

    Gribble, Karleen D; McGrath, Marie; MacLaine, Ali; Lhotska, Lida


    Women have the right to support that enables them to breastfeed. Supporting breastfeeding in emergencies is important because artificial feeding places mothers and children at risk. In emergencies, artificial feeding is dangerous to the infant, difficult and requires substantial resources. In contrast, breastfeeding guards infant health. It is also protective against postpartum haemorrhage, maternal depletion, maternal anaemia and closely spaced births and should therefore concern not only nutritionists, but also those involved in reproductive health. However, it is common for women's ability to breastfeed to be undermined in emergencies by the indiscriminate distribution of breast-milk substitutes and the absence of breastfeeding support. Controlling the distribution of breast-milk substitutes, providing supportive environments, and appropriate medical and practical assistance to breastfeeding women safeguards the health and well-being of mothers and babies. Greater collaboration between the nutrition and reproductive health sectors is required to promote best practice in protecting breastfeeding women and their children in emergencies.

  15. On the administrative protection of consumers' right to know%论消费者知情权的行政保护



    以经济法为视角,认为消费者知情权是消费者依法享有要求经营者告知其购买、使用商品或者接受服务的真实情况,要求国家机关、公共组织提供相关消费信息的权利。考察国外消费者知情权行政保护的做法,从中得出有益启示。针对我国消费者知情权行政保护存在的问题,建议改革我国消费者行政保护体制,建立消费者行政保护协调机制,建立企业信用档案,畅通行政投诉举报渠道。%In view of the economic law,consumers are entitled to require the operator to inform them of the true situation of the purchase or use of a commodity or receiving a service,and to request state organs and public organizations to provide relevant information rights.This paper studies the overseas administrative protection of the practice of the consumers' right to know and draws beneficial enlightenment.In accordance with the problems of the administrative protection of china's consumer's right to know,this paper puts forward the following suggestions of reforming administrative protection system of our consumers,establishing administrative mechanism of consumer protection coordination and enterprise credit files so as to make administrative complaint and reporting channels unimpeded.

  16. 45 CFR 164.524 - Access of individuals to protected health information.


    ... health information is maintained in the designated record set, except for: (i) Psychotherapy notes; (ii) Information compiled in reasonable anticipation of, or for use in, a civil, criminal, or administrative action... Improvements Amendments of 1988, pursuant to 42 CFR 493.3(a)(2). (2) Unreviewable grounds for denial. A...

  17. Stress on health-related quality of life in older adults: the protective nature of mindfulness

    de Frias, Cindy M.; Whyne, Erum


    Objectives: The current study examined whether the link between stress and health-related quality of life was buffered by protective factors, namely mindfulness, in a sample of middle-aged and older adults. Methods: In this cross-sectional study, 134 healthy, community-dwelling adults (ages 50–85 years) were recruited from Dallas, TX. The participants were screened for depressive symptoms and severity (using the Patient Health Questionnaire [PHQ-9]). All participants completed measures of sel...

  18. The Veterans Health Administration: quality, value, accountability, and information as transforming strategies for patient-centered care.

    Perlin, Johnathan B; Kolodner, Robert M; Roswell, Robert H


    The Veterans Health Administration is the United States' largest integrated health system. Once disparaged as a bureaucracy providing mediocre care, the Department of Veterans Affairs (VA) reinvented itself during the past decade through a policy shift mandating structural and organizational change, rationalization of resource allocation, explicit measurement and accountability for quality and value, and development of an information infrastructure supporting the needs of patients, clinicians, and administrators. Today, the VA is recognized for leadership in clinical informatics and performance improvement, cares for more patients with proportionally fewer resources, and sets national benchmarks in patient satisfaction and for 18 indicators of quality in disease prevention and treatment.

  19. Efficacy of polysaccharide from Alcaligenes xylosoxidans MSA3 administration as protection against γ-radiation in female rats.

    Hassan, Amal I; Ghoneim, Mona A M; Mahmoud, Manal G; Asker, Mohsen M S; Mohamed, Saher S


    Damage to normal tissues is a consequence of both therapeutic and accidental exposures to ionizing radiation. A water-soluble heteropolysaccharide called AXEPS, composed of glucose, galactose, rhamnose and glucouronic acid in a molar ratio of nearly 1.0:1.6:0.4:2.3, respectively, was isolated from culture medium of strain Alcaligenes xylosoxidans MSA3 by ethanol precipitation followed by freeze-drying. Chemical analysis, Fourier-transform infrared (FTIR) and chromatographic studies revealed that the molecular weight was 1.6 × 10(4) g mol(-1). This study was designed to investigate the radioprotective and biological effects of AXEPS in alleviating the toxicity of ionizing radiation in female albino rats. A total of 32 female albino rats were divided into four groups. In the control group, rats were administered vehicle by tube for four weeks. The second group was administered AXEPS (100 mg/kg) orally by gavage for four weeks. Animals in the third group were exposed to whole-body γ-rays (5 Gy) and remained for 2 weeks without treatment. The fourth group received AXEPS (100 mg/kg) orally by gavage for two weeks before being exposed to whole-body γ-rays (5 Gy), then 24 h post γ-rays, they received AXEPS (100 mg/kg) in a treatment continuing till the end of the experiment (15 days after the whole-body γ-irradiation). Oral administration of AXEPS (100 mg/kg) significantly reversed the oxidative stress effects of radiation, as evidenced by the decrease in DNA damage in the bone marrow. Assessment of apoptosis and cell proliferation markers revealed that caspase-3 significantly increased in the irradiated group. Moreover, a significant decrease in the hematological constituents of peripheral blood, the chemotactic index and CD8+ T cells were observed in animals in the irradiation-only group, whereas an increase in the lymphocyte index was observed in animals in that group. In contrast, AXEPS treatment prevented these alterations. From our results, we conclude that

  20. Good agreement between questionnaire and administrative databases for health care use and costs in patients with osteoarthritis

    Robertson M Clare


    Full Text Available Abstract Background Estimating costs is essential to the economic analysis of health care programs. Health care costs are often captured from administrative databases or by patient report. Administrative records only provide a partial representation of health care costs and have additional limitations. Patient-completed questionnaires may allow a broader representation of health care costs; however the validity and feasibility of such methods have not been firmly established. This study was conducted to assess the validity and feasibility of using a patient-completed questionnaire to capture health care use and costs for patients with osteoarthritis, and to compare the research costs of the data-capture methods. Methods We designed a patient questionnaire and applied it in a clinical trial. We captured equivalent data from four administrative databases. We evaluated aspects of the questionnaire's validity using sensitivity and specificity, Lin's concordance correlation coefficient (ρc, and Bland-Altman comparisons. Results The questionnaire's response rate was 89%. Acceptable sensitivity and specificity levels were found for all types of health care use. The numbers of visits and the majority of medications reported by patients were in agreement with the database-derived estimates (ρc > 0.40. Total cost estimates from the questionnaire agreed with those from the databases. Patient-reported co-payments agreed with administrative records with respect to GP office transactions, but not pharmaceutical co-payments. Research costs for the questionnaire-based method were less than one-third of the costs for the databases method. Conclusion A patient-completed questionnaire is feasible for capturing health care use and costs for patients with osteoarthritis, and data collected using it mostly agree with administrative databases. Caution should be exercised when applying unit costs and collecting co-payment data.

  1. Nutrition and Other Protective Behaviors Motivated by Environmental Health Risk Awareness.

    Jones, Elizabeth W; Feng, Limin; Dixon, Jane K; Dixon, John P; Hofe, Carolyn R; Gaetke, Lisa M


    Research findings have suggested that exposure to environmental pollutants contributes to increased health risks, which may be modulated by certain nutrition and other protective health behaviors. Nutrition professionals play an important role in effectively disseminating this information and in devising specific community-based nutrition education programs for audiences located in areas with environmental health issues. To assess awareness of environmental health problems and motivation to adopt protective health behaviors for use in planning nutrition education programs for communities exposed to environmental pollutants. Data were collected from a modified, validated Environmental Health Engagement Profile (EHEP) survey instrument administered to adults (n=774) participating in community events in Kentucky based on location relative to hazardous waste sites. The modified EHEP survey instrument showed good internal consistency reliability, and demographic characteristics were evaluated. Correlation analyses revealed significant positive correlations in all groups, separately and combined, between awareness of environmental pollution in an individual's surroundings and the extent of concern that pollutants cause adverse health effects (P environmental insults (P awareness posed by pollution are those residing near federally designated hazardous waste sites. These results suggest that determining and expanding an audience's knowledge and perceptions of environmental health risks will enhance effective nutrition education program planning.

  2. 76 FR 60788 - Patient Protection and Affordable Care Act; Establishment of Exchanges and Qualified Health Plans...


    ... HUMAN SERVICES 45 CFR Parts 153, 155 and 156 Patient Protection and Affordable Care Act; Establishment... and Affordable Care Act of 2010 as amended by the Health Care and Education Reconciliation Act of 2010, referred to collectively as the Affordable Care Act. The other proposed rule would implement standards...

  3. 38 CFR 17.91 - Protection of health-care eligibility.


    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Protection of health-care eligibility. 17.91 Section 17.91 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS... veteran but only if the veteran's annual income from sources other than such earnings would, taken...

  4. Risk and Protective Factors for Depression and Health Outcomes in American Indian and Alaska Native Adolescents.

    Barney, David D.


    A study examined whether protective factors reduce the effects of depression in American Indian and Alaska Native adolescents. Surveys of 2,034 Native high school students from 33 states indicated that depression moderately influenced self-perceived health status and that caring and connectedness counteracted the risk factors from depression that…

  5. 45 CFR 164.528 - Accounting of disclosures of protected health information.


    ... individual was disclosed for such research protocol or activity, the covered entity shall, at the request of... receive an accounting of disclosures of protected health information made by a covered entity in the six...) That occurred prior to the compliance date for the covered entity. (2)(i) The covered entity must...

  6. BEIR-III report and its implications for radiation protection and public health policy

    Fabrikant, J.I.


    A general background is given of the implications the BEIR-III Report may have on societal decision-making in the regulation of activities concerned with the health effects of low-level radiation. The scientific basis for establishing appropriate radiation protection guides are discussed. (ACR)

  7. Biologically Hazardous Agents at Work and Efforts to Protect Workers' Health: A Review of Recent Reports

    Kyung-Taek Rim


    Full Text Available Because information on biological agents in the workplace is lacking, biological hazard analyses at the workplace to securely recognize the harmful factors with biological basis are desperately needed. This review concentrates on literatures published after 2010 that attempted to detect biological hazards to humans, especially workers, and the efforts to protect them against these factors. It is important to improve the current understanding of the health hazards caused by biological factors at the workplace. In addition, this review briefly describes these factors and provides some examples of their adverse health effects. It also reviews risk assessments, protection with personal protective equipment, prevention with training of workers, regulations, as well as vaccinations.

  8. Factors affecting the use of patient survey data for quality improvement in the Veterans Health Administration

    Davies Elizabeth A


    Full Text Available Abstract Background Little is known about how to use patient feedback to improve experiences of health care. The Veterans Health Administration (VA conducts regular patient surveys that have indicated improved care experiences over the past decade. The goal of this study was to assess factors that were barriers to, or promoters of, efforts to improve care experiences in VA facilities. Methods We conducted case studies at two VA facilities, one with stable high scores on inpatient reports of emotional support between 2002 and 2006, and one with stable low scores over the same period. A semi-structured interview was used to gather information from staff who worked with patient survey data at the study facilities. Data were analyzed using a previously developed qualitative framework describing organizational, professional and data-related barriers and promoters to data use. Results Respondents reported more promoters than barriers to using survey data, and particularly support for improvement efforts. Themes included developing patient-centered cultures, quality improvement structures such as regular data review, and training staff in patient-centered behaviors. The influence of incentives, the role of nursing leadership, and triangulating survey data with other data on patients' views also emerged as important. It was easier to collect data on current organization and practice than those in the past and this made it difficult to deduce which factors might influence differing facility performance. Conclusions Interviews with VA staff provided promising examples of how systematic processes for using survey data can be implemented as part of wider quality improvement efforts. However, prospective studies are needed to identify the most effective strategies for using patient feedback to improve specific aspects of patient-centered care.

  9. State-of-the-science review of the occupational health hazards of crystalline silica in abrasive blasting operations and related requirements for respiratory protection.

    Madl, Amy K; Donovan, Ellen P; Gaffney, Shannon H; McKinley, Meg A; Moody, Emily C; Henshaw, John L; Paustenbach, Dennis J


    Excessive exposures to airborne crystalline silica have been known for over 100 years to pose a serious health hazard. Work practices and regulatory standards advanced as the knowledge of the hazards of crystalline silica evolved. This article presents a comprehensive historical examination of the literature on exposure, health effects, and personal protective equipment related to silica and abrasive blasting operations over the last century. In the early 1900s, increased death rates and prevalence of pulmonary disease were observed in industries that involved dusty operations. Studies of these occupational cohorts served as the basis for the first occupational exposure limits in the 1930s. Early exposure studies in foundries revealed that abrasive blasting operations were particularly hazardous and provided the basis for many of the engineering control and respiratory protection requirements that are still in place today. Studies involving abrasive blasters over the years revealed that engineering controls were often not completely effective at reducing airborne silica concentrations to a safe level; consequently, respiratory protection has always been an important component of protecting workers. During the last 15-20 yr, quantitative exposure-response modeling, experimental animal studies, and in vitro methods were used to better understand the relationship between exposure to silica and disease in the workplace. In light of Occupational Safety and Health Administration efforts to reexamine the protectiveness of the current permissible exposure limit (PEL) for crystalline silica and its focus on protecting workers who are known to still be exposed to silica in the workplace (including abrasive blasters), this state-of-the-science review of one of the most hazardous operations involving crystalline silica should provide useful background to employers, researchers, and regulators interested in the historical evolution of the recognized occupational health hazards

  10. Administrative circular No.14 (Rev. 3) – Protection of members of the personnel against the financial consequences of illness, accident and incapacity for work


    Administrative Circular No. 14 (Rev. 3) entitled “Protection of members the personnel against the financial consequences of illness, accident and incapacity for work”, approved by the Director-General following discussion at the Standing Concertation Committee meeting of 19 April 2012 and entering into force on 1 January 2013, is available on the intranet site of the Human Resources Department.   This circular is applicable to all members of the personnel. It cancels and replaces Administrative Circular No. 14 (Rev. 2) entitled “Protection of members of the personnel against the financial consequences of illness, accident and disability” from July 2006. The circular was revised in order to improve the procedure before the Joint Advisory Rehabilitation and Disability Board (JARDB) and the management of long-term sick leave through a multidisciplinary approach launched upstream. The aim of this approach is to allow staff/fellows c...

  11. Vaccination with liposomal leishmanial antigens adjuvanted with monophosphoryl lipid-trehalose dicorynomycolate (MPL-TDM) confers long-term protection against visceral leishmaniasis through a human administrable route.

    Ravindran, Rajesh; Maji, Mithun; Ali, Nahid


    The development of a long-term protective subunit vaccine against visceral leishmaniasis depends on antigens and adjuvants that can induce an appropriate immune response. The immunization of leishmanial antigens alone shows limited efficacy in the absence of an appropriate adjuvant. Earlier we demonstrated sustained protection against Leishmania donovani with leishmanial antigens entrapped in cationic liposomes through an intraperitoneal route. However, this route is not applicable for human administration. Herein, we therefore evaluated the immune response and protection induced by liposomal soluble leishmanial antigen (SLA) formulated with monophosphoryl lipid-trehalose dicorynomycolate (MPL-TDM) through a subcutaneous route. Subcutaneous immunization of BALB/c mice with SLA entrapped in liposomes or with MPL-TDM elicited partial protection against experimental visceral leishmaniasis. In contrast, liposomal SLA adjuvanted with MPL-TDM induced significantly higher levels of protection in liver and spleen in BALB/c mice challenged 10 days post-vaccination. Protection conferred by this formulation was sustained up to 12 weeks of immunization, and infection was controlled for at least 4 months of the challenge, similar to liposomal SLA immunization administered intraperitoneally. An analysis of cellular immune responses of liposomal SLA + MPL-TDM immunized mice demonstrated the induction of IFN-γ and IgG2a antibody production not only 10 days or 12 weeks post-vaccination but also 4 months after the challenge infection and a down regulation of IL-4 production after infection. Moreover, long-term immunity elicited by this formulation was associated with IFN-γ production also by CD8⁺ T cells. Taken together, our results suggest that liposomal SLA + MPL-TDM represent a good vaccine formulation for the induction of durable protection against L. donovani through a human administrable route.

  12. Use of "excess" human embryos for stem cell research: protecting women's rights and health.

    Cohen, C B


    Proposed National Institutes of Health guidelines for stem cell research are too narrowly drawn and do not adequately protect the freedom of choice and health of women who donate embryos. They need to be expanded to cover not only the point of embryo donation, but also that of embryo creation. Guidelines are provided to ensure that donors undergoing hyperstimulation and egg retrieval gave voluntary informed consent to the production of embryos that might later prove in excess. A standard for determining when embryos have been overproduced is presented to address the possibility that additional embryos will be created for stem cell research in violation of the guidelines and at risk to women's health.

  13. Women's Health in the Age of Patient Protection and the Affordable Care Act.

    Armstrong, Joanne


    The Patient Protection and Affordable Care Act of 2010 is the most sweeping health care legislation in a generation. The goal of the legislation is to increase access to both public and private insurance, and to improve the affordability and quality of care. Many provisions of the bill have a direct impact on the women's health care services. This paper provides an overview of the bill's provisions that have the largest impact on women's health care and provides data on the impact of the bill to date.

  14. The New Zealand Health and Disability Commissioner: a comparative assessment of the commissioner's contribution to protecting the rights of mental health consumers.

    Kazmierow, Maria


    The Health and Disabliity Commissioner's contribution to the protection of mental health consumers' rights is examined. This assessment covers a number of aspects. It includes the scope of consumer rights jurisdiction, the breadth of legal entitlements, protective mechanisms used, and the effectiveness of that protection. The Commissioner's role is also assessed comparatively. It is contrasted domestically with District Inspectors of Mental Health and internationally with Scottish and United Kingdom reform proposals. While analysis reveals considerable similarities, the New Zealand Health and Disability Commissioner is favourably highlighted in contrast with Scotland and the United Kingdom, particularly in the area of enforceability of mental health consumer rights.

  15. Towards the Development of Governance Principles for the Administration of Social Protection Benefits: Comparative Lessons from Dutch and American Experiences

    Pennings, F.J.L.; Secunda, Paul


    The purpose of this article is to introduce a new approach to social protection benefit provision through an analysis and comparison of two of the advanced benefit systems in the world. Both the Dutch and American examples teach us that meaningful social benefit protection is possible, consistent, a

  16. Action planning as predictor of health protective and health risk behavior: an investigation of fruit and snack consumption

    Candel Math


    Full Text Available Abstract Background Large discrepancies between people's intention to eat a healthy diet and actual dietary behavior indicate that motivation is not a sufficient instigator for healthy behavior. Research efforts to decrease this 'intention - behavior gap' have centered on aspects of self-regulation, most importantly self-regulatory planning. Most studies on the impact of self-regulatory planning in health and dietary behavior focus on the promotion of health protective behaviors. This study investigates and compares the predictive value of action planning in health protective behavior and the restriction of health risk behavior. Methods Two longitudinal observational studies were performed simultaneously, one focusing on fruit consumption (N = 572 and one on high-caloric snack consumption (N = 585 in Dutch adults. Structural equation modeling was used to investigate and compare the predictive value of action planning in both behaviors, correcting for demographics and the influence of motivational factors and past behavior. The nature of the influence of action planning was investigated by testing mediating and moderating effects. Results Action planning was a significant predictor of fruit consumption and restricted snack consumption beyond the influence of motivational factors and past behavior. The strength of the predictive value of action planning did not differ between the two behaviors. Evidence for mediation of the intention - behavior relationship was found for both behaviors. Positive moderating effects of action planning were demonstrated for fruit consumption, indicating that individuals who report high levels of action planning are significantly more likely to translate their intentions into actual behavior. Conclusion The results indicate that the planning of specific preparatory actions predicts the performance of healthy dietary behavior and support the application of self-regulatory planning in both health protective and health

  17. Why nafta failed and what's needed to protect workers' health and safety in international trade treaties.

    Brown, Garrett


    Labor standards, including occupational health and safety regulations and enforcement, are being subjected to intense downward pressures as a result of fundamental shifts in the global economy. The 1994 North American Free Trade Agreement (NAFTA) was the first trade treaty that attempted to promote and protect workplace health and safety through a "labor side agreement." NAFTA failed to protect workers' health and safety due to the weaknesses of the side agreement's text; the political and diplomatic considerations limiting its implementation; and the failure to recognize and address the economic context, and political consequences of this context, in which the agreement was implemented. Subsequent trade treaties, both bilateral and regional, have not overcome the weaknesses of NAFTA. The treaty components needed to protect workers' health in future trade agreements are: 1) a minimum floor of occupational health and safety regulations; 2) an "upward harmonization" of regulatory standards and actual practice; 3) inclusion of employers so that they have formal responsibility and liability for violations of the standards; 4) effective enforcement of national regulations and international standards; 5) transparency and public participation; and 6) recognition of disparate economic conditions among trading partners and provision of financial and technical assistance to overcome economic disincentives and lack of resources. Also required are continued actions by non-governmental actors, including the workers themselves and civil society organizations.

  18. [ELGA--the electronic health record in the light of data protection and data security].

    Ströher, Alexander; Honekamp, Wilfried


    The introduction of an electronic health record (ELGA) is a subject discussed for a long time in Austria. Another big step toward ELGA is made at the end of 2010 on the pilot project e-medication in three model regions; other projects should follow. In addition, projects of the ELGA structure are sped up on the part of the ELGA GmbH to install the base of a functioning electronic health record. Unfortunately, many of these initiatives take place, so to speak, secretly, so that in the consciousness of the general public - and that includes not only patients but also physicians and other healthcare providers - always concerns about protection and security of such a storage of health data arouse. In this article the bases of the planned act are discussed taking into account the data protection and data security.

  19. Congress, courts, and commerce: upholding the individual mandate to protect the public's health.

    Hodge, James G; Brown, Erin C Fuse; Orenstein, Daniel G; O'Keefe, Sarah


    Among multiple legal challenges to the Patient Protection and Affordable Care Act (PPACA) is the premise that PPACA's "individual mandate" (requiring all individuals to obtain health insurance by 2014 or face civil penalties) is inviolate of Congress' interstate commerce powers because Congress lacks the power to regulate commercial "inactivity." Several courts initially considering this argument have rejected it, but federal district courts in Virginia and Florida have concurred, leading to numerous appeals and prospective review of the United States Supreme Court. Despite creative arguments, the dispositive constitutional question is not whether Congress' interstate commerce power extends to commercial inactivity. Rather, it is whether Congress may regulate individual decisions with significant economic ramifications in the interests of protecting and promoting the public's health. This article offers a counter-interpretation of the scope of Congress' interstate commerce power to regulate in furtherance of the public's health.

  20. Migration selection, protection, and acculturation in health: a binational perspective on older adults.

    Riosmena, Fernando; Wong, Rebeca; Palloni, Alberto


    In this article, we test for four potential explanations of the Hispanic Health Paradox (HHP): the "salmon bias," emigration selection, and sociocultural protection originating in either destination or sending country. To reduce biases related to attrition by return migration typical of most U.S.-based surveys, we combine data from the Mexican Health and Aging Study in Mexico and the U.S. National Health Interview Survey to compare self-reported diabetes, hypertension, current smoking, obesity, and self-rated health among Mexican-born men ages 50 and older according to their previous U.S. migration experience, and U.S.-born Mexican Americans and non-Hispanic whites. We also use height, a measure of health during childhood, to bolster some of our tests. We find an immigrant advantage relative to non-Hispanic whites in hypertension and, to a lesser extent, obesity. We find evidence consistent with emigration selection and the salmon bias in height, hypertension, and self-rated health among immigrants with less than 15 years of experience in the United States; we do not find conclusive evidence consistent with sociocultural protection mechanisms. Finally, we illustrate that although ignoring return migrants when testing for the HHP and its mechanisms, as well as for the association between U.S. experience and health, exaggerates these associations, they are not fully driven by return migration-related attrition.

  1. Patient Protection and Affordable Care Act; health insurance market rules. Final rule.


    This final rule implements provisions related to fair health insurance premiums, guaranteed availability, guaranteed renewability, single risk pools, and catastrophic plans, consistent with title I of the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010, referred to collectively as the Affordable Care Act. The final rule clarifies the approach used to enforce the applicable requirements of the Affordable Care Act with respect to health insurance issuers and group health plans that are non-federal governmental plans. This final rule also amends the standards for health insurance issuers and states regarding reporting, utilization, and collection of data under the federal rate review program, and revises the timeline for states to propose state-specific thresholds for review and approval by the Centers for Medicare & Medicaid Services (CMS).

  2. The Patient Protection and Affordable Care Act and reproductive health: harnessing data to improve care.

    Stulberg, Debra


    The Patient Protection and Affordable Care Act (PPACA) has great potential to improve reproductive health through several components: expanded coverage of people of reproductive age; required coverage of many reproductive health services; and insurance exchange structures that encourage individuals and states to hold plans and providers accountable. These components can work together to improve reproductive health. But in order for this to work, consumers and states need information with which to assess plans. This review article summarizes state contracting theory and argues that states should use this structure to require health plans to collect and report meaningful data that patients, providers, plans, payers, and third-party researchers can access. Now that the Supreme Court has upheld the PPACA and states must set up health insurance exchanges, populations can benefit from improved care and outcomes through data transparency.

  3. [Survey on individual occupational health protection behaviors of welding workers using theory of reasoned action].

    Xing, Ming-luan; Zhou, Xu-dong; Yuan, Wei-ming; Chen, Qing; Zhang, Mei-bian; Zou, Hua; Zhao, Hai-ying


    To apply theory of reasoned action at survey on welding workers occupational health protection behaviors and explore related influencing factors. nine companies were randomly selected from areas with many welding works in Zhejiang Province. All welding workers were surveyed using a questionnaire based on theory of reasoned action. 10.06%, 26.80% and 37.50% of the respondents never or seldom used eyeshade, mask and earplug, respectively. After controlling the socio-demographic factors, welding workers' behavioral belief was correlated with the behaviors of eyeshade-mask and earplug use (χ(2) = 31.88, 18.77 and 37.77, P Theory of reasoned action is suitable for welding worker occupational health related behaviors. It is useful to improve occupational health education, to effectively select health education objective and to tailor health education contents.

  4. Identifying paediatric nursing-sensitive outcomes in linked administrative health data

    Wilson Sally


    Full Text Available Abstract Background There is increasing interest in the contribution of the quality of nursing care to patient outcomes. Due to different casemix and risk profiles, algorithms for administrative health data that identify nursing-sensitive outcomes in adult hospitalised patients may not be applicable to paediatric patients. The study purpose was to test adult algorithms in a paediatric hospital population and make amendments to increase the accuracy of identification of hospital acquired events. The study also aimed to determine whether the use of linked hospital records improved the likelihood of correctly identifying patient outcomes as nursing sensitive rather than being related to their pre-morbid conditions. Methods Using algorithms developed by Needleman et al. (2001, proportions and rates of records that identified nursing-sensitive outcomes for pressure ulcers, pneumonia and surgical wound infections were determined from administrative hospitalisation data for all paediatric patients discharged from a tertiary paediatric hospital in Western Australia between July 1999 and June 2009. The effects of changes to inclusion and exclusion criteria for each algorithm on the calculated proportion or rate in the paediatric population were explored. Linked records were used to identify comorbid conditions that increased nursing-sensitive outcome risk. Rates were calculated using algorithms revised for paediatric patients. Results Linked records of 129,719 hospital separations for 79,016 children were analysed. Identification of comorbid conditions was enhanced through access to prior and/or subsequent hospitalisation records (43% of children with pressure ulcers had a form of paralysis recorded only on a previous admission. Readmissions with a surgical wound infection were identified for 103 (4.8/1,000 surgical separations using linked data. After amendment of each algorithm for paediatric patients, rates of pressure ulcers and pneumonia reduced by

  5. Oral Administration of Electron-Beam Inactivated Rhodococcus equi Failed to Protect Foals against Intrabronchial Infection with Live, Virulent R. equi.

    Joana N Rocha

    Full Text Available There is currently no licensed vaccine that protects foals against Rhodococcus equi-induced pneumonia. Oral administration of live, virulent R. equi to neonatal foals has been demonstrated to protect against subsequent intrabronchial challenge with virulent R. equi. Electron beam (eBeam-inactivated R. equi are structurally intact and have been demonstrated to be immunogenic when administered orally to neonatal foals. Thus, we investigated whether eBeam inactivated R. equi could protect foals against developing pneumonia after experimental infection with live, virulent R. equi. Foals (n = 8 were vaccinated by gavaging with eBeam-inactivated R. equi at ages 2, 7, and 14 days, or gavaged with equal volume of saline solution (n = 4, and subsequently infected intrabronchially with live, virulent R. equi at age 21 days. The proportion of vaccinated foals that developed pneumonia following challenge was similar among the vaccinated (7/8; 88% and unvaccinated foals (3/4; 75%. This vaccination regimen did not appear to be strongly immunogenic in foals. Alternative dosing regimens or routes of administration need further investigation and may prove to be immunogenic and protective.

  6. Oral Administration of Electron-Beam Inactivated Rhodococcus equi Failed to Protect Foals against Intrabronchial Infection with Live, Virulent R. equi.

    Rocha, Joana N; Cohen, Noah D; Bordin, Angela I; Brake, Courtney N; Giguère, Steeve; Coleman, Michelle C; Alaniz, Robert C; Lawhon, Sara D; Mwangi, Waithaka; Pillai, Suresh D


    There is currently no licensed vaccine that protects foals against Rhodococcus equi-induced pneumonia. Oral administration of live, virulent R. equi to neonatal foals has been demonstrated to protect against subsequent intrabronchial challenge with virulent R. equi. Electron beam (eBeam)-inactivated R. equi are structurally intact and have been demonstrated to be immunogenic when administered orally to neonatal foals. Thus, we investigated whether eBeam inactivated R. equi could protect foals against developing pneumonia after experimental infection with live, virulent R. equi. Foals (n = 8) were vaccinated by gavaging with eBeam-inactivated R. equi at ages 2, 7, and 14 days, or gavaged with equal volume of saline solution (n = 4), and subsequently infected intrabronchially with live, virulent R. equi at age 21 days. The proportion of vaccinated foals that developed pneumonia following challenge was similar among the vaccinated (7/8; 88%) and unvaccinated foals (3/4; 75%). This vaccination regimen did not appear to be strongly immunogenic in foals. Alternative dosing regimens or routes of administration need further investigation and may prove to be immunogenic and protective.

  7. Using administrative health data to describe colorectal and lung cancer care in New South Wales, Australia: a validation study

    Goldsbury David E


    Full Text Available Abstract Background Monitoring treatment patterns is crucial to improving cancer patient care. Our aim was to determine the accuracy of linked routinely collected administrative health data for monitoring colorectal and lung cancer care in New South Wales (NSW, Australia. Methods Colorectal and lung cancer cases diagnosed in NSW between 2000 and 2002 were identified from the NSW Central Cancer Registry (CCR and linked to their hospital discharge records in the NSW Admitted Patient Data Collection (APDC. These records were then linked to data from two relevant population-based patterns of care surveys. The main outcome measures were the sensitivity and specificity of data from the CCR and APDC for disease staging, investigative procedures, curative surgery, chemotherapy, radiotherapy, and selected comorbidities. Results Data for 2917 colorectal and 1580 lung cancer cases were analysed. Unknown disease stage was more common for lung cancer in the administrative data (18% than in the survey (2%. Colonoscopies were captured reasonably accurately in the administrative data compared with the surveys (82% and 79% respectively; 91% sensitivity, 53% specificity but all other colorectal or lung cancer diagnostic procedures were under-enumerated. Ninety-one percent of colorectal cancer cases had potentially curative surgery recorded in the administrative data compared to 95% in the survey (96% sensitivity, 92% specificity, with similar accuracy for lung cancer (16% and 17%; 92% sensitivity, 99% specificity. Chemotherapy (~40% sensitivity and radiotherapy (sensitivity≤30% were vastly under-enumerated in the administrative data. The only comorbidity that was recorded reasonably accurately in the administrative data was diabetes. Conclusions Linked routinely collected administrative health data provided reasonably accurate information on potentially curative surgical treatment, colonoscopies and comorbidities such as diabetes. Other diagnostic procedures

  8. The sentinel role of poisons centers in the protection of children's environmental health.

    Pronczuk de Garbino, Jenny


    Growing concern exists about the threats posed by environmental pollutants and physical agents on children's health. A number offactors, including globalization, increased industrialization, and trade of chemicals and poverty have an impact on the quality of the environment and on children's health. Acute toxic exposures lead to poisoning, and chronic low-level exposures may cause functional and organ damage during periods of special vulnerability. The need to protect children's environmental health is urgent, in view of the magnitude of the problem and the fact that "children are not little adults." The effects suffered during special developmental periods-"windows of vulnerability"-can be permanent and irreversible. The main global environmental problems affecting children's health are lack of access to safe drinking water and sanitation and exposure to indoor air pollution. Furthermore, environmentally related accidents, injuries, and poisonings have a major impact on children and adolescent's morbidity and mortality. A number of examples that illustrate the complexity of assessing and dealing with children's environmental health issues are presented. A Task Force on the Protection of Children's Environmental Health that aims to prevent disease and disability in children associated with chemical and physical threats was set up in 1999 by the World Health Organization. The priorities for action include the consideration of accidents, injuries, and poisonings (accidental, intentional, and occupational), and children in the workplace (e.g., scavenging children, children in cottage industries). Poisons Centers and related toxicology centers are in a strategic position to play a "sentinel" role in the protection of children's environmental health. They record acute and chronic toxic exposures in children in a harmonized manner, using controlled vocabularies and definitions. This will allow collecting a large, highly valuable database on the main toxicological

  9. Enrolment of older people in social health protection programs in West Africa--does social exclusion play a part?

    Parmar, Divya; Williams, Gemma; Dkhimi, Fahdi; Ndiaye, Alfred; Asante, Felix Ankomah; Arhinful, Daniel Kojo; Mladovsky, Philipa


    Although the population of older people in Africa is increasing, and older people are becoming increasingly vulnerable due to urbanisation, breakdown of family structures and rising healthcare costs, most African countries have no social health protection for older people. Two exceptions include Senegal's Plan Sesame, a user fees exemption for older people and Ghana's National Health Insurance Scheme (NHIS) where older people are exempt from paying premiums. Evidence on whether older people are aware of and enrolling in these schemes is however lacking. We aim to fill this gap. Besides exploring economic indicators, we also investigate whether social exclusion determines enrolment of older people. This is the first study that tries to explore the social, political, economic and cultural (SPEC) dimensions of social exclusion in the context of social health protection programs for older people. Data were collected by two cross-sectional household surveys conducted in Ghana and Senegal in 2012. We develop SPEC indices and conduct logistic regressions to study the determinants of enrolment. Our results indicate that older people vulnerable to social exclusion in all SPEC dimensions are less likely to enrol in Plan Sesame and those that are vulnerable in the political dimension are less likely to enrol in NHIS. Efforts should be taken to specifically enrol older people in rural areas, ethnic minorities, women and those isolated due to a lack of social support. Consideration should also be paid to modify scheme features such as eliminating the registration fee for older people in NHIS and creating administration offices for ID cards in remote communities in Senegal.

  10. 30 CFR 250.107 - What must I do to protect health, safety, property, and the environment?


    ..., property, and the environment? 250.107 Section 250.107 Mineral Resources MINERALS MANAGEMENT SERVICE... Performance Standards § 250.107 What must I do to protect health, safety, property, and the environment? (a) You must protect health, safety, property, and the environment by: (1) Performing all operations in...

  11. Graduate programs in health administration: faculty academic reputation and faculty research reputation by program location and program reputation.

    Nowicki, M


    This study used program location and program reputation to describe two important faculty characteristics: academic reputation and research reputation. The study involved 44 graduate programs in health administration representing four program locations: schools of public health, business, medicine/allied health, and graduate/independent. Fourteen programs were identified as ranked programs and the remaining 30 programs were identified as unranked programs. While the study identifies many differences, few are significant, thus adding credence to the argument for diversity in program location and diminishing credence in the argument for program reputation.

  12. 76 FR 40457 - Administrative Simplification: Adoption of Operating Rules for Eligibility for a Health Plan and...


    ... the regulatory history, see the proposed rule entitled ``Health Insurance Reform; Modifications to the Health Insurance Portability and Accountability Act (HIPAA) Electronic Transaction Standards,'' published... Insurance Portability and Accountability Act of 1996 (HIPAA) transactions: eligibility for a health plan and...

  13. Health protection in times of economic crisis: challenges and opportunities for Europe.

    McDaid, David; Quaglio, Gianluca; Correia de Campos, António; Dario, Claudio; Van Woensel, Lieve; Karapiperis, Theodoros; Reeves, Aaron


    STOA, the European Parliament's technology assessment body, and the European Observatory on Health Systems and Policies recently organised a workshop on the impacts of the economic crisis on European health systems. Evidence of the impact of the recent financial crisis on health outcomes is only just beginning to emerge. Data suggests that this latest recession has led to more frequent poor health status, rising incidence of some communicable diseases, and higher suicide rates. Further, available data are likely to underestimate the broader mental health crisis linked to increased rates of stress, anxiety, and depression among the economically vulnerable. Not only does recession affect factors that determine health, but it also affects the financial capacity to respond. Many European governments have reduced public expenditure on health services during the financial crisis, while introducing or increasing user charges. The recession has driven structural reforms, and has affected the priority given to public policies that could be used to help protect population health. The current economic climate, while challenging, presents an opportunity for reforming and restructuring health promotion actions and taking a long-term perspective.

  14. Teamwork and delegation in medical homes: primary care staff perspectives in the Veterans Health Administration.

    True, Gala; Stewart, Greg L; Lampman, Michelle; Pelak, Mary; Solimeo, Samantha L


    The patient-centered medical home (PCMH) relies on a team approach to patient care. For organizations engaged in transitioning to a PCMH model, identifying and providing the resources needed to promote team functioning is essential. To describe team-level resources required to support PCMH team functioning within the Veterans Health Administration (VHA), and provide insight into how the presence or absence of these resources facilitates or impedes within-team delegation. Semi-structured interviews with members of pilot teams engaged in PCMH implementation in 77 primary care clinics serving over 300,000 patients across two VHA regions covering the Mid-Atlantic and Midwest United States. A purposive sample of 101 core members of pilot teams, including 32 primary care providers, 42 registered nurse care managers, 15 clinical associates, and 12 clerical associates. Investigators from two evaluation sites interviewed frontline primary care staff separately, and then collaborated on joint analysis of parallel data to develop a broad, comprehensive understanding of global themes impacting team functioning and within-team delegation. We describe four themes key to understanding how resources at the team level supported ability of primary care staff to work as effective, engaged teams. Team-based task delegation was facilitated by demarcated boundaries and collective identity; shared goals and sense of purpose; mature and open communication characterized by psychological safety; and ongoing, intentional role negotiation. Our findings provide a framework for organizations to identify assets already in place to support team functioning, as well as areas in need of improvement. For teams struggling to make practice changes, our results indicate key areas where they may benefit from future support. In addition, this research sheds light on how variation in medical home implementation and outcomes may be associated with variation in team-based task delegation.

  15. Chikungunya Fever Cases Identified in the Veterans Health Administration System, 2014.

    Perti, Tara; Lucero-Obusan, Cynthia A; Schirmer, Patricia L; Winters, Mark A; Holodniy, Mark


    During December 2013, the first locally transmitted chikungunya virus (CHIKV) infections in the Americas were reported in the Caribbean. Although CHIKV infection is rarely fatal, risk for severe disease increases with age and medical comorbidities. Herein we describe characteristics of Veterans Health Administration (VHA) patients with CHIKV infection and, among those with infections diagnosed in Puerto Rico, investigated risk factors for hospitalization. We queried VHA's national electronic medical records to identify patients with CHIKV testing during 2014. Demographics, clinical history, laboratory results, and outcomes were abstracted. We investigated risk factors for hospitalization among patients with laboratory-confirmed CHIKV infection in Puerto Rico. We identified 180 laboratory-confirmed CHIKV infections; 148 (82.2%) were diagnosed in Puerto Rico, and 32 (17.8%) were diagnosed among returning travelers elsewhere in the United States. In Puerto Rico, where more patients were hospitalized (55.4% versus 20.0%) and died (4.1% versus 0%), risk for hospitalization increased with age (relative risk [RR]/each 10-year increase, 1.19; 95% confidence interval [CI], 1.06-1.32) and, adjusted for age, increased among patients with congestive heart failure (RR, 1.58; 95% CI, 1.25-1.99), chronic kidney disease (RR, 1.52; 95% CI, 1.19-1.94), diabetes mellitus (RR, 1.39; 95% CI, 1.06-1.84), or chronic lung disease (RR, 1.37; 95% CI, 1.03-1.82). CHIKV infection is an emerging problem among Veterans residing in or visiting areas with CHIKV transmission. Although overall mortality rates are low, clinicians in affected areas should be aware that older patients and patients with comorbidities may be at increased risk for severe disease.

  16. Geriatric Patient Safety Indicators Based on Linked Administrative Health Data to Assess Anticoagulant-Related Thromboembolic and Hemorrhagic Adverse Events in Older Inpatients: A Study Proposal.

    Le Pogam, Marie-Annick; Quantin, Catherine; Reich, Oliver; Tuppin, Philippe; Fagot-Campagna, Anne; Paccaud, Fred; Peytremann-Bridevaux, Isabelle; Burnand, Bernard


    -based algorithms, (3) empirical measurement of indicators using linked administrative health data, (4) validation of indicators, (5) analyses of geographic and temporal variations for reliable and valid indicators, and (6) data visualization. Study populations will consist of 166,670 Swiss and 5,902,037 French residents aged 65 years and older admitted to an acute care hospital at least once during the 2012-2014 period and insured for at least 1 year before admission and 1 year after discharge. We will extract Swiss data from the Helsana Group data warehouse and French data from the national health insurance information system (SNIIR-AM). The study has been approved by Swiss and French ethics committees and regulatory organizations for data protection. Validated GPSIs and GQIs should help support and drive quality and safety improvement in older inpatients, inform health care stakeholders, and enable international comparisons. We discuss several limitations relating to the representativeness of study populations, accuracy of administrative health data, methods used for GPSI criterion validity assessment, and potential confounding bias in comparisons based on GQIs, and we address these limitations to strengthen study feasibility and validity.

  17. [Railway medical hygiene and health protection system in Croatia between 1945 and 1953].

    Lajnert, Sinisa


    This paper describes the system of medical hygiene and health care adopted by the Croatian section of Yugoslav Railways in the aftermath of World War Two until 1953, based on archival information. In 1945, the human resources section of the Railway Administration in Zagreb included the Department of Social Welfare with offices that managed health insurance in cases of illness and accidents, workers' pension fund, and sanitary care‥ On 19 June 1947, the regional railway executive board established a medical section within the so called Secretariat and appointed Dr Marijan Derkos as its head. On 3 July 1948, central and regional healthcare offices for traffic staff were established to manage and oversee the activities of health institutions providing services for railway workers. The seat of the regional office in Zagreb was in Grgurova street. After the dismantlement of the central healthcare office in charge of railway health institutions in 1953, regional boards established new institutions, that were now self-financed.

  18. Multiple sclerosis in Germany: data analysis of administrative prevalence and healthcare delivery in the statutory health system.

    Höer, Ariane; Schiffhorst, Guido; Zimmermann, Anne; Fischaleck, Johann; Gehrmann, Luise; Ahrens, Henrik; Carl, Gunther; Sigel, Karl-Otto; Osowski, Ulrike; Klein, Maria; Bleß, Hans-Holger


    Healthcare-utilization data for multiple sclerosis (MS) are scarce in Germany. The Purpose of the study was to analyse administrative prevalence of MS, medication use and type of specialists involved in MS treatment in the outpatient setting in Bavaria. Pseudonymized claims data from Bavarian Statutory Health Insurance (SHI)-accredited physicians were used. Administrative prevalence of MS was defined as having ≥1 MS diagnosis (International Classification of Diseases, 10th edition, code G35) documented by a neurologist or psychiatrist, or ≥1 prescription for disease-modifying drugs (DMDs)). The administrative prevalence calculated for Bavaria was projected to Germany. DMD prescription and involvement of different specialities in health care service for MS patients was analysed. Administrative prevalence of MS in Bavaria increased from 0.123% to 0.175% of insured persons between 2005 and 2009; when projected, this yielded ~102,000-143,000 patients with MS in the German population. The percentage of patients receiving ≥1 DMD prescription increased from 45.5% to 50.5%. Patients with MS were mainly treated by neurologists in the ambulatory care setting. These results provide important information on the administrative prevalence of MS in Bavaria and on healthcare provision for patients, which is relevant for resource planning in the healthcare sector.

  19. Measuring financial protection for health in families with chronic conditions in Rural China

    Jiang Chunhong


    Full Text Available Abstract Background As the world’s largest developing country, China has entered into the epidemiological phase characterized by high life expectancy and high morbidity and mortality from chronic diseases. Cardiovascular diseases, chronic obstructive pulmonary diseases, and malignant tumors have become the leading causes of death since the 1990s. Constant payments for maintaining the health status of a family member who has chronic diseases could exhaust household resources, undermining fiscal support for other necessities and eventually resulting in poverty. The purpose of this study is to probe to what degree health expenditure for chronic diseases can impoverish rural families and whether the New Cooperative Medical Scheme can effectively protect families with chronic patients against catastrophic health expenditures. Methods We used data from the 4th National Health Services Survey conducted in July 2008 in China. The rural sample we included in the analysis comprised 39,054 households. We used both households suffering from medical impoverishment and households with catastrophic health expenditures to compare the financial protection for families having a chronic patient with different insurance coverage statuses. We used a logistic regression model to estimate the impact of different benefit packages on health financial protection for families having a chronic patient. Results An additional 10.53% of the families with a chronic patient were impoverished because of healthcare expenditure, which is more than twice the proportion in families without a chronic patient. There is a higher catastrophic health expenditure incidence in the families with a chronic patient. The results of logistic regression show that simply adding extra benefits did not reduce the financial risks. Conclusions There is a lack of effective financial protection for healthcare expenditures for families with a chronic patient in rural China, even though there is a high

  20. Protective Effects of Garlic Oil against Liver Damage Induced by Combined Administration of Ethanol and Carbon Tetrachloride in Rats

    Ashraf B. Abdel-Naim a, Amani E. Khalifaa, Sherif H. Ahmed b


    Full Text Available Herbs are known to play a vital role in the management of various liver diseases. Garlic oil (GO contains numerous organosulfur compounds with potential hepatoprotective effects. The present work was planned to evaluate the possible preventive role of GO on biochemical and histopathological alterations induced by combined administration of ethanol (EOH and carbon tetrachloride (CCl4 in rat liver. Two dose levels of GO (5 or 10 mg/kg/day were administered orally to rats for 7 consecutive days with EOH + CCl4-induced liver damage. Activity of GO against liver damage was compared with that of silymarin (25 mg/kg/day, p.o. for 7 consecutive days. Biochemical parameters including serum aspartate aminotransferase (AST, alanine aminotransferase (ALT, gamma glutamyl transpeptidase (­GT, alkaline phophatase (ALP and bilirubin were estimated to assess the liver function. In addition, the level of total proteins, triglycerides, total cholesterol, glutathione (GSH, and thiobarbituric acid reactive substances (TBARS, in liver tissues were estimated. Liver damage was evidenced by an increase in the activity/level of AST, ALT, -GT, ALP and bilirubin in sera of rats after the combined administration of EOH and CCl4 compared to normal animals. Pretreatment of rats with GO reduced the EOH + CCl4-induced elevated levels of the above indices. Similarly, GO significantly prevented the decline in total proteins and the increase in triglycerides and total cholesterol resulted after EOH + CCl4 administration in rat liver homogenates. In addition, GO pretreatment restored liver GSH levels decreased due to EOH + CCl4 administration. The elevation in liver TBARS level due to EOH + CCl4 administration was also prevented by pretreatment with both low and high doses of GO. Histopathological examination indicated that GO exhibited an obvious preventive effect against the centrilobular necrosis and nodule formation induced by EOH + CCl4 administration. In conclusion, GO

  1. Developments in Genetic and Epigenetic Data Protection in Behavioral and Mental Health Spaces.

    Terry, Nicolas


    The legal system has been preparing for an explosion of epigenetic issues in public health, environmental regulation and litigation. So far, this explosion has been muted, and for now epigenetic data protection merely seems to be "enjoying" the same technological and legal challenges experienced by other clinical and research data. However, three areas of development suggest where epigenetic data protection may prove problematic. This article examines these three issues, noting the rapid expansion of research based on EMR-sourced clinical data, the large number of data protection models that can apply to genetic data (including point-of-use prohibitions on discrimination and confidentiality), and the increasing and controversial dangers of deidentified information being reidentified.

  2. Protecting children's rights in the collection of health and welfare data.

    Schenk, Katie; Murove, Tapfuma; Williamson, Jan


    Program managers and researchers promoting children's rights to health, education, and an adequate standard of living often gather data directly from children to assess their needs and develop responsive services. Gathering information within a participatory framework recognizing children's views contributes to protection of their rights. Extra precautions, however, are needed to protect children because of the vulnerabilities associated with their developmental needs. Using case studies of ethical challenges faced by program implementers and sociobehavioral researchers, this article explores ways in which data collection activities among children may affect their rights. We suggest ways in which rights-based principles may be used to derive safeguards to protect against unintentional harm and abuses, based on a multidisciplinary consultation with researchers and service providers.

  3. Masculinity constructs as protective buffers and risk factors for men's health.

    Levant, Ronald F; Wimer, David J


    This study was designed to replicate the study of Levant, Wimer, and Williams (2011), which reported complex relationships between masculinity and health behaviors using a more diverse sample and updated measures. A sample of 589 college and community-dwelling men responded to an online survey consisting of five scales. Levant et al.'s (2011) study was partially replicated-some masculinity constructs were identified as protective buffers for some health behaviors and others as risk factors. The vast majority of the findings that were replicated were risk factors, suggesting that traditional masculinity is more of risk than a buffer, and occurred in the analyses involving Avoiding Anger and Stress and Avoiding Substance Use subscales, suggesting that these health behaviors are most closely associated with masculinity. The results are discussed in terms of limitations, suggestions for future research, and implications for health care practice.

  4. Industrial radiography in the State of Bahia, Brazil The health protection of workers

    Andrade, A E O D


    This study aimed to identify the Regulatory and Inspection Authority for actions developed by industrial radiography enterprises in the State of Bahia, Brazil, concerning health protection of workers exposed to ionizing radiation in industry. Institutions which legislate about this matter at international, national and State level were identified. These legislations were analysed according to recommendations by the Basic Safety Standards from the Atomic Energy International Agency. Medical Supervision is proposed as a factor to warrant protection to worker's health. This is a service evaluation study, encompassing results, processes and structural components. Emphasis is given to the process component which investigated the adequacy of which is performed by employees and workers. Five enterprises which provide industrial radiography services in the State of Bahia were identified, employing forty workers on a temporary basis. This study also observed: intense workforce, a complete process of contracting out in...

  5. Protecting children from myopia: a PMT perspective for improving health marketing communications.

    Lwin, May O; Saw, Seang-Mei


    This research examined the predictive utility of the protection motivation theory (PMT) model for myopia prevention amongst children. An integrative model for myopia prevention behavior of parents was first developed in the context of theory and survey instruments then refined using information gathered from two focus groups. Empirical data then was collected from parents of primary school children in Singapore, a country with one of the highest rates of myopia in the world, and analyzed using structural equation modeling (SEM). Our findings revealed that coping appraisal variables were more significantly associated with protection motivation, relative to threat appraisal variables. In particular, perceived self-efficacy was the strongest predictor of parental intention to enforce good visual health behaviors, while perceived severity was relatively weak. Health marketing communications and public policy implications are discussed.

  6. Wireless Subsurface Microsensors for Health Monitoring of Thermal Protection Systems on Hypersonic Vehicles

    Milos, Frank S.; Watters, David G.; Pallix, Joan B.; Bahr, Alfred J.; Huestis, David L.; Arnold, Jim (Technical Monitor)


    Health diagnostics is an area where major improvements have been identified for potential implementation into the design of new reusable launch vehicles in order to reduce life cycle costs, to increase safety margins, and to improve mission reliability. NASA Ames is leading the effort to develop inspection and health management technologies for thermal protection systems. This paper summarizes a joint project between NASA Ames and SRI International to develop 'SensorTags,' radio frequency identification devices coupled with event-recording sensors, that can be embedded in the thermal protection system to monitor temperature or other quantities of interest. Two prototype SensorTag designs containing thermal fuses to indicate a temperature overlimit are presented and discussed.

  7. Climate change and natural disasters – integrating science and practice to protect health

    Rainer Sauerborn


    Full Text Available Background: Hydro-meteorological disasters are the focus of this paper. The authors examine, to which extent climate change increases their frequency and intensity. Methods: Review of IPCC-projections of climate-change related extreme weather events and related literature on health effects. Results: Projections show that climate change is likely to increase the frequency, intensity, duration, and spatial distribution of a range of extreme weather events over coming decades. Conclusions: There is a need for strengthened collaboration between climate scientists, the health researchers and policy-makers as well as the disaster community to jointly develop adaptation strategies to protect human.

  8. Selenium in bone health: roles in antioxidant protection and cell proliferation.

    Zeng, Huawei; Cao, Jay J; Combs, Gerald F


    Selenium (Se) is an essential trace element for humans and animals, and several findings suggest that dietary Se intake may be necessary for bone health. Such findings may relate to roles of Se in antioxidant protection, enhanced immune surveillance and modulation of cell proliferation. Elucidation of the mechanisms by which Se supports these cellular processes can lead to a better understanding of the role of this nutrient in normal bone metabolism. This article reviews the current knowledge concerning the molecular functions of Se relevant to bone health.

  9. Protecting policy space for public health nutrition in an era of international investment agreements.

    Thow, Anne Marie; McGrady, Benn


    Philip Morris has recently brought claims against Australia (2011) and Uruguay (2010) under international investment agreements (IIAs). The claims allege that Philip Morris is entitled to compensation following the introduction of innovative tobacco packaging regulations to reduce smoking and prevent noncommunicable diseases (NCDs). Since tobacco control measures are often viewed as a model for public health nutrition measures, the claims raise the question of how investment law governs the latter. This paper begins to answer this question and to explain how governments can proactively protect policy space for public health nutrition in an era of expanding IIAs. The authors first consider the main interventions proposed to reduce diet-related NCDs and their intersection with investment in the food supply chain. They then review the nature of investment regimes and relevant case law and examine ways to maximize policy space for public health nutrition intervention within this legal context. As foreign investment increases across the food-chain and more global recommendations discouraging the consumption of unhealthful products are issued, investment law will increase in importance as part of the legal architecture governing the food supply. The implications of investment law for public health nutrition measures depend on various factors: the measures themselves, the terms of the applicable agreements, the conditions surrounding the foreign investment and the policies governing agricultural support. This analysis suggests that governments should adopt proactive measures--e.g. the clarification of terms and reliance on exceptions--to manage investment and protect their regulatory autonomy with respect to public health nutrition.

  10. The impact of retirement on health: quasi-experimental methods using administrative data

    Horner, Elizabeth Mokyr; Cullen, Mark R


    Background Is retirement good or bad for health? Disentangling causality is difficult. Much of the previous quasi-experimental research on the effect of health on retirement used self-reported health and relied upon discontinuities in public retirement incentives across Europe. The current study investigated the effect of retirement on health by exploiting discontinuities in private retirement incentives to test the effect of retirement on health using a quasi-experimental study design. Metho...

  11. Social capital and health-protective behavior intentions in an influenza pandemic.

    Ying-Chih Chuang

    Full Text Available Health-protective behaviors, such as receiving a vaccine, wearing a face mask, and washing hands frequently, can reduce the risk of contracting influenza. However, little is known about how social capital may influence health-protective behavior in the general population. This study examined whether each of the social capital dimensions (bonding, bridging, and linking contributed to the intention to adopt any of the health-protective behaviors in an influenza pandemic. The data of this study were from the 2014 Taiwan Social Change Survey. A stratified, three-stage probability proportional-to-size sampling from across the nation, was conducted to select adults aged 20 years and older (N = 1,745. Bonding social capital was measured by the frequency of neighborly contact and support. Bridging social capital was measured based on association membership. Linking social capital was measured according to general government trust and trust in the government's capacity to counter an influenza pandemic. Binary logistic regressions were used to assess the multivariate associations between social capital and behavioral intention. The study results indicate that social capital may influence the response to influenza pandemic. Specifically, the intention to receive a vaccine and to wash hands more frequently were associated with the linking dimension and the bonding dimension of social capital, while the intention to wear a face mask was associated with all forms of social capital. The findings of this study suggest that government credibility and interpersonal networks may play a crucial role in health-protective behavior. This study provides new insights into how to improve the effectiveness of influenza prevention campaigns.

  12. Predictor variables of happiness and its connection with risk and protective factors for health

    Maite eGaraigordobil


    Great thinkers, philosophers, scientists, and artists from History have often been concerned about one of the most important elements of life: happiness. The study had four goals: 1) To analyze possible differences in feelings of happiness as a function of sex and age; 2) To explore the relations of happiness with risk factors (psychopathological symptoms, behavior problems) and protective factors (self-concept-self-esteem, cooperative behavior, social skills) for health; 3) To identify predi...

  13. Predictor variables of happiness and its connection with risk and protective factors for health

    Garaigordobil, Maite


    Great thinkers, philosophers, scientists, and artists from History have often been concerned about one of the most important elements of life: happiness. The study had four goals: (1) To analyze possible differences in feelings of happiness as a function of sex and age; (2) To explore the relations of happiness with risk factors (psychopathological symptoms, behavior problems) and protective factors (self-concept-self-esteem, cooperative behavior, social skills) for health; (3) To identify pr...

  14. Binary choice health state valuation and mode of administration: head-to-head comparison of online and CAPI.

    Mulhern, Brendan; Longworth, Louise; Brazier, John; Rowen, Donna; Bansback, Nick; Devlin, Nancy; Tsuchiya, Aki


    Health state valuation exercises can be conducted online, but the quality of data generated is unclear. To investigate whether responses to binary choice health state valuation questions differ by administration mode: online versus face to face. Identical surveys including demographic, self-reported health status, and seven types of binary choice valuation questions were administered in online and computer-assisted personal interview (CAPI) settings. Samples were recruited following procedures employed in typical online or CAPI studies. Analysis included descriptive comparisons of the distribution of responses across the binary options and probit regression to explain the propensity to choose one option across modes of administration, controlling for background characteristics. Overall, 422 (221 online; 201 CAPI) respondents completed a survey. There were no overall age or sex differences. Online respondents were educated to a higher level than were the CAPI sample and general population, and employment status differed. CAPI respondents reported significantly better general health and health/life satisfaction. CAPI took significantly longer to complete. There was no effect of the mode of administration on responses to the valuation questions, and this was replicated when demographic differences were controlled. The findings suggest that both modes may be equally valid for health state valuation studies using binary choice methods (e.g., discrete choice experiments). There are some differences between the observable characteristics of the samples, and the groups may differ further in terms of unobservable characteristics. When designing health state valuation studies, the advantages and disadvantages of both approaches must be considered. Copyright © 2013 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  15. Co-administration of a plasmid DNA encoding IL-15 improves long-term protection of a genetic vaccine against Trypanosoma cruzi.

    Christopher S Eickhoff

    Full Text Available BACKGROUND: Immunization of mice with the Trypanosoma cruzi trans-sialidase (TS gene using plasmid DNA, adenoviral vector, and CpG-adjuvanted protein delivery has proven highly immunogenic and provides protection against acute lethal challenge. However, long-term protection induced by TS DNA vaccines has not been reported. The goal of the present work was to test whether the co-administration of a plasmid encoding IL-15 (pIL-15 could improve the duration of protection achieved through genetic vaccination with plasmid encoding TS (pTS alone. METHODOLOGY: We immunized BALB/c mice with pTS in the presence or absence of pIL-15 and studied immune responses [with TS-specific IFN-γ ELISPOT, serum IgG ELISAs, intracellular cytokine staining (IFN-γ, TNF-α, and IL-2, tetramer staining, and CFSE dilution assays] and protection against lethal systemic challenge at 1 to 6 months post vaccination. Mice receiving pTS alone developed robust TS-specific IFN-γ responses and survived a lethal challenge given within the first 3 months following immunization. The addition of pIL-15 to pTS vaccination did not significantly alter T cell responses or protection during this early post-vaccination period. However, mice vaccinated with both pTS and pIL-15 challenged 6 months post-vaccination were significantly more protected against lethal T. cruzi challenges than mice vaccinated with pTS alone (P6 months post immunization. Also, these TS-specific T cells were better able to expand after in vitro re-stimulation. CONCLUSION: Addition of pIL-15 during genetic vaccination greatly improved long-term T cell survival, memory T cell expansion, and long-term protection against the important human parasite, T. cruzi.

  16. Health Monitoring System for Nursing Homes with Lightweight Security and Privacy Protection

    Yu’e Jiang


    Full Text Available With the rapid growth of aged population in China, it is urgent to design a safe and effective monitoring system for the nursing homes. An optimized scheme and high performance security and privacy protection for monitoring system have already become the focus studied especially. So this paper proposed a health monitoring system with lightweight security and privacy protection for nursing homes. Dual-band RFID, virtual routing location algorithm, and diet and exercise data collection based on RFID were adopted to obtain the location and health information. And that fused a mobile authentication protocol based on Hash function to realize security access and privacy protection, which can improve security and reduce the complexity of calculation and the implementation cost compared with the typical authentication protocols. The experiment results show that the ratio of relative network delay is below 35%. The system has strong real-time, high security, more comprehensive data, and lower cost of computation and communication. It can satisfy the requirements of health monitoring for nursing homes.

  17. Passive administration of purified secretory IgA from human colostrum induces protection against Mycobacterium tuberculosis in a murine model of progressive pulmonary infection

    Alvarez Nadine


    Full Text Available Abstract Background Immunoglobulin A is the most abundant isotype in secretions from mucosal surfaces of the gastrointestinal, respiratory and genitourinary tracts and in external secretions such as colostrum, breast milk, tears and saliva. The high concentration of human secretory IgA (hsIgA in human colostrum strongly suggests that it should play an important role in the passive immune protection against gastrointestinal and respiratory infections. Materials and methods Human secretory IgA was purified from colostrum. The reactivity of hsIgA against mycobacterial antigens and its protective capacity against mycobacterial infection was evaluated. Results The passive administration of hsIgA reduces the pneumonic area before challenge with M. tuberculosis. The intratracheal administration of M. tuberculosis preincubated with hsIgA to mice greatly reduced the bacterial load in the lungs and diminished lung tissue injury. Conclusions HsIgA purified from colostrum protects against M. tuberculosis infection in an experimental mouse model.

  18. Induction of protective immune responses against the challenge of Actinobacillus pleuropneumoniae by the oral administration of transgenic tobacco plant expressing ApxIIA toxin from the bacteria.

    Lee, Kyung-Yeol; Kim, Dong-Heon; Kang, Tae-Jin; Kim, Ju; Chung, Gook-Hyun; Yoo, Han-Sang; Arntzen, Charles J; Yang, Moon-Sik; Jang, Yong-Suk


    Actinobacillus pleuropneumoniae is the causative agent of porcine pleuropneumonia. Among the virulence factors, ApxIIA, a bacterial exotoxin, is reportedly expressed in many serotypes and is considered as a candidate for the development of a vaccine against the bacterial infection. Previously, we isolated a field strain of A. pleuropneumoniae serotype 2 in Korea and characterized its exotoxins to develop an oral vaccine. In this study, we initially confirmed the immunogenicity of ApxIIA expressed in Escherichia coli. We then developed transgenic tobacco expressing ApxIIA and tested its efficacy to induce a protective immune response against A. pleuropneumoniae infection after oral administration of the plant powder. We observed that protective immune responses were induced in mice after oral administration of the plant powder once a week for 4 weeks. Immunoassays revealed that the levels of antigen-specific immunoglobulin G against ApxIIA increased in mice that were fed a powder made from the transgenic plant, but not in mice fed a powder made from wild-type tobacco. Additionally, mice fed the transgenic plant powder were protected from an injection of a lethal dose of A. pleuropneumoniae. These results support that the transgenic plant may be a suitable candidate for an oral vaccine that could be used effectively against A. pleuropneumoniae infection.

  19. 45 CFR 170.210 - Standards for health information technology to protect electronic health information created...


    ... information—(1) General. Any encryption algorithm identified by the National Institute of Standards and Technology (NIST) as an approved security function in Annex A of the Federal Information Processing Standards... 45 Public Welfare 1 2010-10-01 2010-10-01 false Standards for health information technology...

  20. Protective

    Wessam M. Abdel-Wahab


    Full Text Available Many active ingredients extracted from herbal and medicinal plants are extensively studied for their beneficial effects. Antioxidant activity and free radical scavenging properties of thymoquinone (TQ have been reported. The present study evaluated the possible protective effects of TQ against the toxicity and oxidative stress of sodium fluoride (NaF in the liver of rats. Rats were divided into four groups, the first group served as the control group and was administered distilled water whereas the NaF group received NaF orally at a dose of 10 mg/kg for 4 weeks, TQ group was administered TQ orally at a dose of 10 mg/kg for 5 weeks, and the NaF-TQ group was first given TQ for 1 week and was secondly administered 10 mg/kg/day NaF in association with 10 mg/kg TQ for 4 weeks. Rats intoxicated with NaF showed a significant increase in lipid peroxidation whereas the level of reduced glutathione (GSH and the activity of superoxide dismutase (SOD, catalase (CAT, glutathione S-transferase (GST and glutathione peroxidase (GPx were reduced in hepatic tissues. The proper functioning of the liver was also disrupted as indicated by alterations in the measured liver function indices and biochemical parameters. TQ supplementation counteracted the NaF-induced hepatotoxicity probably due to its strong antioxidant activity. In conclusion, the results obtained clearly indicated the role of oxidative stress in the induction of NaF toxicity and suggested hepatoprotective effects of TQ against the toxicity of fluoride compounds.

  1. Skin protective behavior amongst girl students; based on health belief model.

    Ali Davati


    Full Text Available Skin cancer is the most prevalent type of cancer in most of the countries and more than 90% of cancer cases are related to ultra violet rays of the sun. Therefore protective behaviors against sunlight are considered the most essential measures for skin cancer prevention. This study has been conducted to determine the frequency of protective behavior against sunlight among female students of Tehran city high schools. The Health Belief Model has been used for this cross-sectional study to analyze the factors related to protective behaviors. A multi-phase sampling method was used. 941 female student of Tehran city high schools were studied using a probed question form. The data were then analyzed using SPSS software. During the study of protective behaviors against the sunlight, 24.7% of participants mentioned that they always use sunscreen. The behavior of using sunscreen is related to perceived sensitivity, severity and benefit amongst the students (P<0.05. Also 3.8% of the students who participated in our study were always using gloves in summer to protect against sunlight. The behavior of using gloves in summer was also related to perceived sensitivity, severity and benefit (P<0.05. Physicians were the most effective influencing people with 84.9% influence on the appropriate decision making by these students. There is a low frequency of protective behavior against sunlight among the female students of Tehran city high schools. These findings show the necessity of training the students in this regard and promote the protective behaviors amongst them.

  2. The financial crisis, health and health inequities in Europe: the need for regulations, redistribution and social protection.

    De Vogli, Roberto


    In 2009, Europe was hit by one of the worst debt crises in history. Although the Eurozone crisis is often depicted as an effect of government mismanagement and corruption, it was a consequence of the 2008 U.S. banking crisis which was caused by more than three decades of neoliberal policies, financial deregulation and widening economic inequities.Evidence indicates that the Eurozone crisis disproportionately affected vulnerable populations in society and caused sharp increases of suicides and deaths due to mental and behavioral disorders especially among those who lost their jobs, houses and economic activities because of the crisis. Although little research has, so far, studied the effects of the crisis on health inequities, evidence showed that the 2009 economic downturn increased the number of people living in poverty and widened income inequality especially in European countries severely hit by the debt crisis. Data, however, also suggest favorable health trends and a reduction of traffic deaths fatalities in the general population during the economic recession. Moreover, egalitarian policies protecting the most disadvantaged populations with strong social protections proved to be effective in decoupling the link between job losses and suicides.Unfortunately, policy responses after the crisis in most European countries have mainly consisted in bank bailouts and austerity programs. These reforms have not only exacerbated the debt crisis and widened inequities in wealth but also failed to address the root causes of the crisis. In order to prevent a future financial downturn and promote a more equitable and sustainable society, European governments and international institutions need to adopt new regulations of banking and finance as well as policies of economic redistribution and investment in social protection. These policy changes, however, require the abandonment of the neoliberal ideology to craft a new global political economy where markets and gross

  3. [Vocational Health Schools (ETSUS) in Brazil: regulation of the integration of teaching-service-administrative sustainability of ETSUS].

    Borges, Fabiano Tonaco; Garbin, Cléa Adas Saliba; Siqueira, Carlos Eduardo; Garbin, Artênio José Ísper; Rocha, Najara Barbosa da; Lolli, Luíz Fernando; Moimaz, Suzely Adas Saliba


    The scope of this study was to discuss the administrative sustainability of Brazil's Vocational Health Schools (ETSUS) based on the principle of teaching and service integration, which brings a new dimension to healthcare work as yet unregulated by Brazilian public administration. It was a qualitative study using case study methodology. The research involved a semi-structured questionnaire given to ETSUS managers addressing institutional, administrative, and work management aspects. The sample was composed of 6 ETSUS that belong to the Network of Vocational Health Schools (RET-SUS). The ETSUS showed centralized planning and management, and decentralized implementation of their core activities. The majority did not have administrative autonomy and relied heavily on funding from the federal government. According to ETSUS managers, the lack of regulation of teaching activities by civil servants weakens the management of ETSUS. The ETSUS have managerial problems related to teaching-service integration, which has to be regulated in order to guarantee the sustainability of these schools and avoid conflicts with Brazilian legislation.

  4. The Food and Drug Administration Office of Women's Health: Impact of Science on Regulatory Policy: An Update.

    Elahi, Merina; Eshera, Noha; Bambata, Nkosazana; Barr, Helen; Lyn-Cook, Beverly; Beitz, Julie; Rios, Maria; Taylor, Deborah R; Lightfoote, Marilyn; Hanafi, Nada; DeJager, Lowri; Wiesenfeld, Paddy; Scott, Pamela E; Fadiran, Emmanuel O; Henderson, Marsha B


    The U.S. Food and Drug Administration Office of Women's Health (FDA OWH) has supported women's health research for ∼20 years, funding more than 300 studies on women's health issues, including research on diseases/conditions that disproportionately affect women in addition to the evaluation of sex differences in the performance of and response to medical products. These important women's health issues are studied from a regulatory perspective, with a focus on improving and optimizing medical product development and the evaluation of product safety and efficacy in women. These findings have influenced industry direction, labeling, product discontinuation, safety notices, and clinical practice. In addition, OWH-funded research has addressed gaps in the knowledge about diseases and medical conditions that impact women across the life span such as cardiovascular disease, pregnancy, menopause, osteoporosis, and the safe use of numerous medical products.

  5. Using Administrative Health Data to Identify Individuals with Intellectual and Developmental Disabilities: A Comparison of Algorithms

    Lin, E.; Balogh, R.; Cobigo, V.; Ouellette-Kuntz, H.; Wilton, A. S.; Lunsky, Y.


    Background: Individuals with intellectual and developmental disabilities (IDD) experience high rates of physical and mental health problems; yet their health care is often inadequate. Information about their characteristics and health services needs is critical for planning efficient and equitable services. A logical source of such information is…

  6. Using Administrative Health Data to Identify Individuals with Intellectual and Developmental Disabilities: A Comparison of Algorithms

    Lin, E.; Balogh, R.; Cobigo, V.; Ouellette-Kuntz, H.; Wilton, A. S.; Lunsky, Y.


    Background: Individuals with intellectual and developmental disabilities (IDD) experience high rates of physical and mental health problems; yet their health care is often inadequate. Information about their characteristics and health services needs is critical for planning efficient and equitable services. A logical source of such information is…

  7. 78 FR 48543 - Veterans Health Administration Fund Availability Under the VA's Homeless Providers Grant and Per...


    ... protected throughout by an approved automatic sprinkler system, unless a facility is specifically exempted... meet the requirements of the current edition of the Life Safety Code of the National Fire...

  8. 77 FR 47652 - Second Annual Food and Drug Administration Health Professional Organizations Conference


    ..., protecting patients from counterfeit and other substandard drugs/supply chain threats, and others. The goal.... 112-144) and an overview of FDA's Network of Experts (public/private partnerships). The afternoon...


    S. A. Gorbanev


    Full Text Available The article gives the main interaction trends of the Administration of Rospotrebnadzor in the Leningrad Region and the Government of Leningrad Region regarding issues of regional radiation protection. It reports on comprehensive measures devoted to the limitation of the population exposure from natural irradiation sources, monitoring of territories which suffered from Chernobyl NPP accident and monitoring of the environmental impact of unauthorized dumps and solid municipal waste sites in the Leningrad Region. It presents the basic issues of medical exposure limitation in the Leningrad Region and measures for their solving.

  10. Protective immunity against rock bream iridovirus (RBIV) infection and TLR3-mediated type I interferon signaling pathway in rock bream (Oplegnathus fasciatus) following poly (I:C) administration.

    Jung, Myung-Hwa; Jung, Sung-Ju


    In this study, we evaluated the potential of poly (I:C) to induce antiviral status for protecting rock bream from RBIV infection. Rock bream injected with poly (I:C) at 2 days before infection (1.1 × 10(4)) at 20 °C had significantly higher protection with RPS 13.4% and 33.4% at 100 and 200 μg/fish, respectively, through 100 days post infection (dpi). The addition of boost immunization with poly (I:C) at before/post infection at 20 °C clearly enhanced the level of protection showing 33.4% and 60.0% at 100 and 200 μg/fish, respectively. To investigate the development of a protective immune response, rock bream were re-infected with RBIV (1.1 × 10(7)) at 200 dpi. While 100% of the previously unexposed fish died, 100% of the previously infected fish survived. Poly (I:C) induced TLR3 and Mx responses were observed at several sampling time points in the spleen, kidney and blood. Moreover, significantly high expression levels of IRF3 (2.9- and 3.1-fold at 1 d and 2 days post administration (dpa), respectively), ISG15 and PKR expression (5.4- and 10.2-fold at 2 dpa, respectively) were observed in the blood, but the expression levels were low in the spleen and kidney after poly (I:C) administration. Our results showed the induction of antiviral immune responses and indicate the possibility of developing long term preventive measures against RBIV using poly (I:C). Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Astronautical Hygiene - A New Discipline to Protect the Health of Astronauts Working in Space

    Cain, J. R.

    This paper outlines the rationale for a new scientific discipline namely astronautical hygiene. Astronautical hygiene is an applied science that utilises a knowledge of space toxicology, space medicine, astronautics, occupational hygiene etc. to identify the hazards, assess the exposure risks to health, and thereby determine the measures to mitigate exposure to protect the health of astronauts during living and working in space. This paper describes the nature of the hazards (i.e. physical, chemical, microbial and psychological) encountered during space flight. It discusses exposure risk assessment and the use of sampling techniques to assess astronaut health risks. This paper then discusses the measures used to mitigate exposure to the exposure hazards during space exploration. A case study of the application of the principles of astronautical hygiene to control lunar dust exposure is then described.

  12. Organizational change and employees' mental health: the protective role of sense of coherence.

    Pahkin, Krista; Väänänen, Ari; Koskinen, Aki; Bergbom, Barbara; Kouvonen, Anne


    To examine the impact of sense of coherence (SOC) on psychiatric events in the context of organizational merger. Data were derived from a prospective "Still Working" study using questionnaire and health register data. The study population (n = 4279) consisted of employees with no psychiatric events prior to the 5-year mental health follow-up. Employees with a weaker premerger SOC were at a higher risk of perceiving the organizational change negatively (odds ratio = 1.83, 95% CI: 1.57 to 2.14) and had an elevated risk of postmerger psychiatric events (hazard ratio = 1.42, 95% CI: 1.04 to 1.94). A stronger SOC decreased the adverse effect of negative appraisal of change on psychiatric events. A strong premerger SOC seems to be a protective factor for mental health when the employee experiences negative changes during an organizational merger.

  13. Xanthohumol, a prenylated flavonoid from hops (Humulus lupulus L., protects rat tissues against oxidative damage after acute ethanol administration

    Carmen Pinto


    Full Text Available Ethanol-mediated free radical generation is directly involved in alcoholic liver disease. In addition, chronic alcohol bingeing also induces pathological changes and dysfunction in multi-organs. In the present study, the protective effect of xanthohumol (XN on ethanol-induced damage was evaluated by determining antioxidative parameters and stress oxidative markers in liver, kidney, lung, heart and brain of rats. An acute treatment (4 g/kg b.w. of ethanol resulted in the depletion of superoxide dismutase, catalase and glutathione S-transferase activities and reduced glutathione content. This effect was accompanied by the increased activity of tissue damage marker enzymes (glutamate oxaloacetate transaminase, glutamate pyruvate transaminase and lactate dehydrogenase and a significant increase in lipid peroxidation and hydrogen peroxide concentrations. Pre-treatment with XN protected rat tissues from ethanol-induced oxidative imbalance and partially mitigated the levels to nearly normal levels in all tissues checked. This effect was dose dependent, suggesting that XN reduces stress oxidative and protects rat tissues from alcohol-induced injury.

  14. Ethics and data protection in human biomarker studies in environmental health.

    Casteleyn, Ludwine; Dumez, Birgit; Van Damme, Karel; Anwar, Wagida A


    Human biomarker studies in environmental health are essential tools to study the relationship between health and environment. They should ultimately contribute to a better understanding of environmentally induced adverse health effects and to appropriate preventive actions. To ensure the protection of the rights and dignity of study participants a complex legal and ethical framework is applied, consisting of several international directives, conventions, and guidelines, whether or not translated in domestic laws. Main characteristics of ethics and data protection in studies using biomarkers in the field of environmental health are summarized and current discussions on related questions and bottlenecks highlighted. In the current regulatory context, dominated by the protection of the individual study participant, difficulties are reported due to the different interpretation and implementation of the regulations of concern within and across borders. Advancement of consistency and compatibility is recommended and efforts are ongoing. An increasing demand for secondary use of data and samples poses additional challenges in finding a right balance between the individual rights of the study participants on the one hand and the common interest of, and potential benefit for the public or community at large on the other. Ethics committees could play a key role in assessing problems originating from the sometimes competing needs at individual and societal level. Building trust in science amongst (potential) study participants and within the community allows the inclusion of arguments from the societal perspective. This requires increased attention for respectful communication efforts. Striving for public participation in decision making processes may promote policy relevant research and the related translation of study results into action.


    Cenker Zeki Koyuncuoğlu


    Full Text Available Purpose: The aim of this study is to evaluate oral health status and oral hygiene practices of female adolescents under state protection. Subjects and Methods: Fifty-five female participants between the age of 12 and 18 who are under the care of The Child Protection Institution were included in this study. Self-administered questionnaires were used to obtain information regarding knowledge of oral health and habits. Dental caries status was scored according to the criteria of the World Health Organization (WHO, using the indices of Decayed (D, Missing (M, Filled (F, Surfaces (S (DMFS. In addition, Gingival Index (GI and Plaque Index (PI were recorded during periodontal assessment. Data were statistically analyzed by using Oneway analysis of variance, Tukey’s HSD and Student’s t tests. Results: Fourteen children had dental fear and 52.7% of them were not satisfied with their esthetic appearance. Although 78.2% of the children knew that brushing prevents dental caries, only 18 of them were brushing regularly twice per day. Mean DMFS, GI and PI scores were 13.18±5.68, 1.35±0.37 and 1.33±0.45, respectively. Only 20% of the children were using dental floss. There was statistically no significant difference between the DMFS scores of the children in terms of flossing. However, the difference between the mean GI and PI of the same group was found to be statistically significant (p<0.05. Conclusion: Children under state protection were found to have a reasonable knowledge of the causes of dental caries and gingival bleeding. Therefore, adequate management of this positive attitude can significantly improve the oral health of this population.

  16. Immigrants’ health protection: political, institutional and social perspectives at international and Italian level

    Maurizio Marceca


    Full Text Available

    The issue of “immigrants’ health” has been the subject of increasing interest in recent years, both in scientific literature and in the declarations of international health institutions. Specifically, the Resolution of the 61st World Health Assembly (2008, and the Report of the European Parliament on the reduction of the inequalities in health within EU (2010 are worth highlighting.

    There is a clear convergence in the orientations recommended to local Governments regarding the health policies and interventions to be adopted in this sector. It may be stated that the health policies adopted in Italy in the 1980s have been pioneering in both European and international contexts. Enhanced by the unconditional recognition of the right to health, which is stated in the Italian Constitution, these orientations have been strongly suggested to the policymakers through effective lobbying efforts. Alongside ethical-legal recognition of the right to healthcare, the technical-scientific debate has also developed, especially following the publication of the WHO Report “Closing the gap in a generation” (2008. This has enabled the acknowledgement of the relevant role played by the socio-economic conditions which distinguish the different groups of immigrants.

    Moreover, the proposal of inter-sectorial policies and of an approach aimed at the empowerment of the community has become increasingly significant. In future, health protection for immigrants will be not only a priority as imposed by the recognition of health as a human right, but will also be more closely connected to capacities for the planning and support, at local level, of health promotion initiatives.

  17. The Patient Protection and Affordable Care Act and Utilization of Preventive Health Care Services

    Victor Eno


    Full Text Available We examined how (a health insurance coverage, and (b familiarity with the Patient Protection and Affordable Care Act (ACA’s or ObamaCare mandate of cost-free access to preventive health services, affect the use of preventive services by residents of a minority community. It was based on primary data collected from a survey conducted during March to April 2012 among a sample of self-identified African American adults in Tallahassee-Leon County area of northwest Florida. The Statistical Package for the Social Sciences (SPSS Version 22 was used for running frequency analysis on the data set and multivariable regression modeling. The results showed that of 524 respondents, 382 (73% had health insurance while 142 (27% lacked insurance. Majority of insured respondents, 332 (87%, used preventive health services. However, the remaining 13% of respondents did not use preventive services because they were unfamiliar with the ACA provision of free access to preventive services for insured people. Regression analysis showed a high (91.04% probability that, among the insured, the use of preventive health services depended on the person’s age, income, and education. For uninsured residents, the lack of health insurance was the key reason for non-use of preventive health services, while among the insured, lack of knowledge about the ACA benefit of free access contributed to non-use of preventive services. Expansion of Medicaid eligibility can increase insurance coverage rates among African Americans and other minority populations. Health promotion and awareness campaigns about the law’s benefits by local and state health departments can enhance the use of preventive services.

  18. Health insurance, patient protection and Affordable Care Act, and young adults.

    Dodich, Colleen; Patel, Dilip


    In summary, the ACA aims to correct some of the shortcomings of our current health insurance systems. It aims to make health insurance more affordable and more accessible and the health insurance systems easier to navigate. For the young adult population, it aims to protect more individuals by allowing them to stay on their parent's insurance longer and by making it easier to choose an insurance plan that is right for them. Those with preexisting medical conditions do not have to worry about being excluded from a health plan because of their medical history. The law is also making health insurance mandatory, which may help prevent young adults who fall ill from incurring large medical bills. Initial outcomes from the implementation of the ACA have shown both positive and negative responses. All in all, it is giving young adults more options when it comes to obtaining health insurance. As part of discussion with adolescents and young adults, physicians may take into consideration key points summarized in Table 4.

  19. Wireless Subsurface Sensors for Health Monitoring of Thermal Protection Systems on Hypersonic Vehicles

    Milos, Frank S.; Arnold, Jim (Technical Monitor)


    Health diagnostics is an area where major improvements have been identified for potential implementation into the design of new reusable launch vehicles (RLVs) in order to reduce life cycle costs, to increase safety margins, and to improve mission reliability. NASA Ames is leading the effort to develop inspection and health management technologies for thermal protection systems. This paper summarizes a joint project between NASA Ames and industry partners to develop "wireless" devices that can be embedded in the thermal protection system to monitor temperature or other quantities of interest. These devices are sensors integrated with radio-frequency identification (RFID) microchips to enable non-contact communication of sensor data to an external reader that may be a hand-held scanner or a large portal. Both passive and active prototype devices have been developed. The passive device uses a thermal fuse to indicate the occurrence of excessive temperature. This device has a diameter under 0.13 cm. (suitable for placement in gaps between ceramic TPS tiles on an RLV) and can withstand 370 C for 15 minutes. The active device contains a small battery to provide power to a thermocouple for recording a temperature history during flight. The bulk of the device must be placed beneath the TPS for protection from high temperature, but the thermocouple can be placed in a hot location such as near the external surface.

  20. Today's ``safe" radiofrequency (RF) exposure limits DON'T protect human health near transmitters!

    Lundquist, Marjorie


    Maxwell's theory implies that electromagnetic (EM) radiation carries both energy and momentum. ``The momentum may have both linear and angular contributions; angular momentum [AM] has a spin part associated with polarization and an orbital part associated with spatial distribution. Any interaction between radiation and matter is inevitably accompanied by an exchange of momentum. This often has mechanical consequences ..."^2 Voluntary consensus standards [ANSI C95; NCRP; INCIRP] protect human health from most thermal [energy transfer] effects, but no standards yet exist to protect health against athermal [momentum transfer] effects, though laboratory transfer of spin AM was reported by 1935^3 and of orbital AM by 1992^2 for an optical vortex [tip of Poynting vector (PV) traces a helix about the beam axis]. In the far field of a dipole RF transmitter, radiation is linearly polarized (minimal spin AM) and locally approximated by a plane wave (zero orbital AM), but in the near field the orbital AM is non-zero [tip of PV traces an ellipse^4 in air] implying an athermal hazard [e.g., brain tumors in cellular phone users] against which no standard now in use anywhere in the world protects! ^2 L. Allen et al. Phys. Rev. A 45:8185-9(1992). ^3 R.A. Beth, Phys. Rev. 48:471(1935); 50:115-25 (1936). ^4 F. Landstorfer, Archiv für Elektronik und übertragungstechnik 26:189-96(1972) [in German].

  1. Marketers don't wear plaid: marketing and health care administration in the Canadian context.

    Rigby, J M; Backman, A M


    Marketing has a bad reputation among Canadian health managers, even though marketing solutions may address many of their problems. This article provides an overview of current understandings of marketing and how they may be applied to health care situations. Marketing should be considered an ongoing process. This is particularly helpful if we understand the root task of health managers as creating and promoting exchanges--with governments, physicians, nurses, other health workers and client groups. Exchanges that are desirable to the health care community will more likely occur if the true costs and benefits of health services are analyzed, understood and imaginatively communicated. The public constantly evaluates the health system. Constant evaluation implies a need for marketing directed internally at staff and those within the health system, and externally at constituents outside the system. Properly understood and practiced, marketing can be part of the innovative solutions health care managers develop and apply as they deal with the difficult challenges facing them in Canada's current health care environment.

  2. Investigating public health impacts of deer in a protected drinking water supply watershed.

    Cinque, K; Stevens, M A; Haydon, S R; Jex, A R; Gasser, R B; Campbell, B E


    The World Health Organisation's (WHO) Water Safety Plans highlight the need for preventative risk management when managing water contamination risks. As part of this approach, a management framework incorporating multiple barriers is necessary and there is a need to validate those barriers through scientific evidence. This paper reports on a study undertaken to validate the effectiveness, in terms of pathogen numbers, of having protected watersheds. The study aimed to determine if the deer population in a protected watershed carried Cryptosporidium and whether or not it was human infectious. Deer faecal samples were collected from the protected watersheds over a 12 month period and analysed using a new method, developed as part of this project, for genotyping Cryptosporidium. Early results showed the presence of Cryptosporidium, but following a refinement in the method no human infectious Cryptosporidium was detected. The results give some confidence that having protected watersheds is an effective barrier against pathogen contamination. They do not, however, imply that continued monitoring and management of the deer should cease. To maintain compliance with the Water Safety Plans, continual validation of barrier effectiveness is required.

  3. Legal aspects of workers' health protection against asbestos in Poland in the light of the EU legal framework

    Beata Świątkowska


    Full Text Available Legal protection of human life and health against asbestos dust-related hazards is carried out in various dimensions of the European Union law mainly focused on health protection of employees and responsibilities of employers, as well as on environmental protection. The aim of this paper is to present the Community legal issues emphasizing the protection of workers against asbestos and discuss the current state of Polish law in this regard. An analysis of recent legal solutions provides a comprehensive look at the extensive steps currently taken to reduce the risk of exposure to asbestos dust. The legislation in the European Union, including Poland indicates sound foundations for assuring health and safety of workers still exposed to asbestos and those formerly employed in asbestos processing plants. It is only postulated to unify high standards of healthcare to provide all workers employed in asbestos exposure with equal and particular legal protection. Med Pr 2013;64(5:689–697

  4. Monogamy, the Protective Fallacy: Sexual versus Emotional Exclusivity and the Implication for Sexual Health Risk.

    Swan, D Joye; Thompson, Suzanne C


    The authors examined the hypothesis that many individuals define monogamy based on emotional rather than sexual fidelity. Participants, 373 heterosexual college students and 282 gay men, read three vignettes of decreasing mitigation in which they imagined committing an act of infidelity against a hypothetical partner and where half the participants were cued to their emotional attachment toward the partner. Despite the infidelity, relationships in the emotional attachment-cued vignettes were rated as monogamous to a greater degree than relationships in the vignettes where emotional attachment was not cued. In addition, over one-third of the participants in our study reported infidelity in their current self-defined monogamous relationships yet also reported feeling more protected from sexual health risks and reported less condom use than individuals who defined their relationship as nonmonogamous. The implications for monogamy as a protective fallacy are discussed.

  5. Democratic transitions, health institutions, and financial protection in the emerging economies: insights from Asia.

    Gómez, Eduardo J


    In recent years, several emerging economies have introduced national health insurance programs ensuring access to health care while offering financial protection from out-of-pocket and catastrophic expenses. Nevertheless, in several nations these expenses continue to increase. While recent research has emphasized the lack of funding, poor policy design and corruption as the main culprits, little is known about the politics of establishing federal regulatory agencies ensuring that state governments adhere to national insurance reimbursement and coverage procedures. This article fills in this lacuna by providing an alternative perspective, one that accounts for differences between nations in the creation of regulatory institutions, with an emphasis instead on governing elite strategies to campaign on access to health care during transitions to democracy, civil societal mobilization, constitutional constraints and the national electoral incentives to overcome ineffective decentralization processes. The cases of Indonesia and China are introduced as examples of how and why their differences in this political process accounted for Indonesia's success and China's failure to ensure financial protection.

  6. Sublingual administration of bacteria-expressed influenza virus hemagglutinin 1 (HA1) induces protection against infection with 2009 pandemic H1N1 influenza virus.

    Shim, Byoung-Shik; Choi, Jung-Ah; Song, Ho-Hyun; Park, Sung-Moo; Cheon, In Su; Jang, Ji-Eun; Woo, Sun Je; Cho, Chung Hwan; Song, Min-Suk; Kim, Hyemi; Song, Kyung Joo; Lee, Jae Myun; Kim, Suhng Wook; Song, Dae Sub; Choi, Young Ki; Kim, Jae-Ouk; Nguyen, Huan Huu; Kim, Dong Wook; Bahk, Young Yil; Yun, Cheol-Heui; Song, Man Ki


    Influenza viruses are respiratory pathogens that continue to pose a significantly high risk of morbidity and mortality of humans worldwide. Vaccination is one of the most effective strategies for minimizing damages by influenza outbreaks. In addition, rapid development and production of efficient vaccine with convenient administration is required in case of influenza pandemic. In this study, we generated recombinant influenza virus hemagglutinin protein 1 (sHA1) of 2009 pandemic influenza virus as a vaccine candidate using a well-established bacterial expression system and administered it into mice via sublingual (s.l.) route. We found that s.l. immunization with the recombinant sHA1 plus cholera toxin (CT) induced mucosal antibodies as well as systemic antibodies including neutralizing Abs and provided complete protection against infection with pandemic influenza virus A/CA/04/09 (H1N1) in mice. Indeed, the protection efficacy was comparable with that induced by intramuscular (i.m.) immunization route utilized as general administration route of influenza vaccine. These results suggest that s.l. vaccination with the recombinant non-glycosylated HA1 protein offers an alternative strategy to control influenza outbreaks including pandemics.

  7. Sizing up the individual market for health insurance: a comparison of survey and administrative data sources.

    Abraham, Jean M; Karaca-Mandic, Pinar; Boudreaux, Michel


    Provisions within the Affordable Care Act, including the introduction of subsidized, Exchange-based coverage for lower income Americans lacking access to employer coverage, are expected to greatly expand the size and importance of the individual market. Using multiple federal surveys and administrative data from the National Association of Insurance Commissioners, we generate national-, regional-, and state-level estimates of the individual market. In 2009, the number of nonelderly persons with individual coverage ranged from 9.55 million in the Medical Expenditure Panel Survey to 25.3 million in the American Community Survey. Notable differences also exist between survey estimates and National Association of Insurance Commissioners administrative counts, an outcome likely driven by variation in the type and measurement of individual coverage considered by surveys relative to administrative data. Future research evaluating the impact of the Affordable Care Act coverage provisions must be mindful of differences across surveys and administrative sources as it relates to the measurement of individual market coverage.

  8. Who strategies and action to protect and promote the health of workers

    Ivan Dimov Ivanov


    Full Text Available WHO's action on protecting and promoting the health of workers is mandated by the Constitution of the Organization and a number of resolutions of the World Health Assembly. Recognizing that occupational health is closely linked to public health and health systems development, WHO is addressing all determinants of workers' health, including risks for disease and injury in the occupational environment, social and individual factors, and access to health services. Furthermore, the workplace is being used as a setting for protecting and promoting the health of workers and their families. Concerned that despite the existence of effective interventions to prevent occupational diseases and injuries there are still major gaps in the health status of workers between and within countries, the 60th World Health Assembly in 2007 endorsed the Global Plan of Action on Workers' Health. This Plan provides a political framework for development of policies, infrastructure, technologies and partnerships for achieving a basic level of health protection in all workplaces throughout the world. The Health Assembly also urged the 193 Member States of WHO to develop national plans and strategies for implementing the Global Plan of Action and to work towards full coverage of all workers with essential interventions and basic services for prevention of occupational diseases and injuries. A large network of 65 collaborating centres provides support to WHO's action on workers' health. The priorities for global action in the coming ten years include policy instruments on workers' health, workplace health protection and promotion, occupational health services, evidence for action and practice, and workers' health in other policies. Thus, WHO action on workers' health contributes to the global health agenda with regards to health security, climate change and Millenium Development Goals.Las acciones de protección y promoción de la salud de los trabajadores se corresponde con

  9. A comparison of academic curricula in the MPH and MHA-type degrees in health administration at the accredited schools of public health.

    Singh, D A; Stoskope, C H; Ciesla, J R


    Based on a survey of the departments of health services administration in accredited schools of public health, this study presents (1) a profile of the M.P.H. and M.H.A. (and similar) programs concentrating in health administration, and (2) a comparison of the M.P.H. and M.H.A. degrees. All 27 schools currently accredited by the Council on Education for Public Health (CEPH) are represented in this research. The curriculum from each school was broken down and classified into eight components: (1) epidemiology, (2) statistics, (3) accounting/finance, (4) management theory, (5) management application, (6) public health policy, (7) electives, and (8) other. That the M.H.A. programs compared to the M.P.H. programs, have higher course requirements to furnish skills in business management and quantitative/analytical areas is the main hypothesis tested. Statistically significant differences were found in seven of the eight curriculum components for M.P.H. and M.H.A. degrees. Overall, the M.H.A. degree was found to be more rigorous in applied management and analytical courses. Implications and recommendations are discussed.

  10. Environmental Assessment for the Health Protection Instrument Calibration Facility at the Savannah River Site


    The purpose of this Environmental Assessment (EA) is to review the possible environmental consequences associated with the construction and operation of a Health Protection Instrument Calibration Facility on the Savannah River Site (SRS). The proposed replacement calibration facility would be located in B Area of SRS and would replace an inadequate existing facility currently located within A Area of SRS (Building 736-A). The new facility would provide laboratories, offices, test equipment and the support space necessary for the SRS Radiation Monitoring Instrument Calibration Program to comply with DOE Orders 5480.4 (Environmental Protection, Safety and Health Protection Standards) and 5480.11 (Radiation Protection for Occupational Workers). The proposed facility would serve as the central site source for the evaluation, selection, inspection, testing, calibration, and maintenance of all SRS radiation monitoring instrumentation. The proposed facility would be constructed on a currently undeveloped portion in B Area of SRS. The exact plot associated with the proposed action is a 1.2 hectare (3 acre) tract of land located on the west side of SRS Road No. 2. The proposed facility would lie approximately 4.4 km (2.75 mi) from the nearest SRS site boundary. The proposed facility would also lie within the confines of the existing B Area, and SRS safeguards and security systems. Archaeological, ecological, and land use reviews have been conducted in connection with the use of this proposed plot of land, and a detailed discussion of these reviews is contained herein. Socioeconomic, operational, and accident analyses were also examined in relation to the proposed project and the findings from these reviews are also contained in this EA.

  11. Report: Opportunities to Improve Data Quality and Children’s Health through the Food Quality Protection Act

    Report #2006-P-00009, January 10, 2006. To meet the requirements of FQPA, EPA instituted numerous data requirements designed to provide infants and children with better protection against the health risks of pesticides.

  12. Reading About the Flu Online: How Health-Protective Behavioral Intentions Are Influenced by Media Multitasking, Polychronicity, and Strength of Health-Related Arguments.

    Kononova, Anastasia; Yuan, Shupei; Joo, Eunsin


    As health organizations increasingly use the Internet to communicate medical information and advice (Shortliffe et al., 2000; World Health Organization, 2013), studying factors that affect health information processing and health-protective behaviors becomes extremely important. The present research applied the elaboration likelihood model of persuasion to explore the effects of media multitasking, polychronicity (preference for multitasking), and strength of health-related arguments on health-protective behavioral intentions. Participants read an online article about influenza that included strong and weak suggestions to engage in flu-preventive behaviors. In one condition, participants read the article and checked Facebook; in another condition, they were exposed only to the article. Participants expressed greater health-protective behavioral intentions in the media multitasking condition than in the control condition. Strong arguments were found to elicit more positive behavioral intentions than weak arguments. Moderate and high polychronics showed greater behavioral intentions than low polychronics when they read the article in the multitasking condition. The difference in intentions to follow strong and weak arguments decreased for moderate and high polychronics. The results of the present study suggest that health communication practitioners should account for not only media use situations in which individuals typically read about health online but also individual differences in information processing, which puts more emphasis on the strength of health-protective suggestions when targeting light multitaskers.

  13. 77 FR 22949 - Administrative Simplification: Adoption of a Standard for a Unique Health Plan Identifier...


    ...-- Institutional. NCPDP D.0 and Version 1.2 Health care claims--Retail pharmacy drug. ASC X12 837 P and NCPDP D.0... Version 1.2 Coordination of Benefits-- Retail pharmacy drug. ASC X12 837 D Coordination of Benefits... institutional. NCPDP D.0 Eligibility for a health plan (request and response)--Retail pharmacy drugs. ASC X12...

  14. Filling the Position of Lead Administrator in Schools of Allied Health: The Experience of Search Committees.

    Layman, Elizabeth J.; Bamberg, Richard; Jones, Harold P.


    Responses from 20 chairs of allied health dean/director search committees indicated that 55% found filling the position very or moderately easy. Mean time was 6.9 months. Most (65%) new deans/directors had health professions backgrounds; 30% had been assistant deans/directors. With a mean number of 11.7 viable candidates, the applicant pool was…

  15. Patient protection and Affordable Care Act; data collection to support standards related to essential health benefits; recognition of entities for the accreditation of qualified health plans. Final rule.


    This final rule establishes data collection standards necessary to implement aspects of section 1302 of the Patient Protection and Affordable Care Act (Affordable Care Act), which directs the Secretary of Health and Human Services to define essential health benefits. This final rule outlines the data on applicable plans to be collected from certain issuers to support the definition of essential health benefits. This final rule also establishes a process for the recognition of accrediting entities for purposes of certification of qualified health plans.

  16. Why are chemotherapy administration errors not reported? Perceptions of oncology nurses in a Nigerian tertiary health institution

    Chinomso Ugochukwu Nwozichi


    Full Text Available Objective: The administration of chemotherapy forms a major part of the clinical role of oncology nurses. When a mistake is made during chemotherapy administration, admitting and reporting the error timely could save the lives of cancer patients. The main objective of this study was to assess the perceptions of oncology nurses about why chemotherapy administration errors are not reported. Methods: This is a descriptive study that surveyed a convenient sample of 128 oncology nurses currently practicing in the Ogun State University Teaching Hospital, Nigeria. The tool for data collection was a structured questionnaire that consisted of two sections. The first section was for the demographic data of participants and the second section consisted of questions constructed based on the Medication Administration Error (MAE reporting survey developed by Wakefield and his team. Results: Findings showed that majority of the nurses (89.8% have made at least one MAE in the course of their professional practice. Fear (mean = 3.63 and managerial response (mean = 2.87 were the two major barriers to MAE reporting perceived among oncology nurses. Conclusion: Critically analyzing why medication errors are not reported among oncology nurses is crucial to identifying strategic interventions that would promote reporting of all errors, especially those related to chemotherapy administration. It is therefore recommended that nurse managers and health care administrators should create a favorable atmosphere that does not only prevent medication errors but also supports nurses′ voluntary reporting of MAEs. Education, information and communication strategies should also be put in place to train nurses on the need to report, if possible prevent, all medication errors.

  17. Health Education Specialists' Knowledge, Attitudes, and Perceptions of the Patient Protection and Affordable Care Act.

    Strong, Jessica; Hanson, Carl L; Magnusson, Brianna; Neiger, Brad


    The changing landscape of health care as a result of the Patient Protection and Affordable Care Act (ACA) may provide new opportunities for health education specialists (HES). The purpose of this study was to survey HES in the United States on their knowledge and attitudes of the ACA and assess their perceptions of job growth under the law. A random sample of 220 (36% response rate) certified HES completed a 53-item cross sectional survey administered online through Qualtrics. Findings were compared to public opinion on health care reform. HES are highly favorable of the law (70%) compared to the general public (23%). A total of 85% of respondents were able to list a provision of the ACA, and most (81%) thought the ACA would be successful at increasing insured Americans. Over half (64.6%) believe job opportunities will increase. Those who viewed the law favorably were significantly more likely to score better on a knowledge scale related to the ACA. HES understand publicized provisions but are uncertain about common myths and specific provisions related to Title IV, "Prevention of Chronic Disease and Improving Public Health." Directed and continuing education to HES regarding the ACA is warranted. © 2015 Society for Public Health Education.

  18. Generation of Hospital Waste: An Awareness Impact on Health and Environmental Protection

    Deepak Sharma


    Full Text Available World is generating more and more waste as the population of people in the world & Hospitals are increasing day by day. Health care activities are a means of protecting health, curing patients and saving lives. Waste generating from hospitals, health centers and medicals are no exceptions. Medical waste contains toxic chemicals, can be infectious and pose contamination risks both to public health and environment. But they also generate waste, out of which 25 percent entail risks, either of infection, of trauma or radiation exposure. In addition the inappropriate treatment or disposal of the waste can lead to environmental contamination or pollution. Seventy five percent of the hospital waste is similar to household waste and do not entail any particular hazard. In general, PVC plastic waste represents the large amount in hospital waste. In this paper we are addressing the issue of incineration of medical waste and to control the surface water mercurial pollution, their impacts on health, environment and their remediation.

  19. Protective effect of nitric oxide synthase inhibition or antioxidants on brain oxidative damage caused by intracerebroventricular arginine administration.

    Delwing, Débora; Delwing, Daniela; Bavaresco, Caren S; Wyse, Angela T S


    We have previously demonstrated that acute arginine administration induces oxidative stress and compromises energy metabolism in rat hippocampus. In the present study, we initially investigated the effect of intracerebroventricular infusion of arginine (0.1, 0.5 and 1.5 mM solution) on Na(+),K(+)-ATPase activity and on some parameters of oxidative stress, namely thiobarbituric acid-reactive substances (TBA-RS) and total radical-trapping antioxidant parameter (TRAP) in the hippocampus of rats. Results showed that 1.5 mM arginine solution significantly increases TBA-RS and reduces Na(+),K(+)-ATPase activity and TRAP in the rat hippocampus. We also evaluated the influence of the nitric oxide synthase inhibitor, N(omega)-nitro-L-arginine methyl ester (L-NAME), and antioxidants, namely alpha-tocopherol plus ascorbic acid, on the effects elicited by arginine on Na(+),K(+)-ATPase activity, TBA-RS and TRAP. Results showed that treatment with alpha-tocopherol plus ascorbic acid per se did not alter these parameters but prevented these effects. Furthermore, intracerebroventricular infusion of L-NAME prevented the inhibition caused by arginine on Na(+),K(+)-ATPase activity, as well as the increased of TBA-RS. Our findings indicate that intracerebroventricular infusion of arginine induces oxidative stress in rat hippocampus and that the inhibition of Na(+),K(+)-ATPase activity caused by this amino acid was probably mediated by NO and/or its derivatives ONOO(-) and/or other free radicals. Finally, we suggest that the administration of antioxidants should be considered as an adjuvant therapy to specific diets in hyperargininemia.

  20. Acute Coronary Syndromes, Gastrointestinal Protection, and Recommendations Regarding Concomitant Administration of Proton-Pump Inhibitors (Omeprazol/Esomeprazole) and Clopidogrel.

    Lozano, Iñigo; Sanchez-Insa, Esther; de Leiras, Sergio Rodríguez; Carrillo, Pilar; Ruiz-Quevedo, Valeriano; Pinar, Eduardo; Gopar-Gopar, Silvia; Bayon, Jeremías; Mañas, Pilar; Lasa, Garikoitz; CruzGonzalez, Ignacio; Hernandez, Felipe; Fernandez-Portales, Javier; Fernandez-Fernandez, Javier; Pérez-Serradilla, Ana; de la Torre Hernandez, José M; Gomez-Jaume, Alfredo


    The Food and Drug Administration and the European Medicines Agency sent a warning in 2010 discouraging the concomitant use of clopidogrel with omeprazole or esomeprazole. The purpose is to know the gastroprotective approach in patients with acute coronary syndrome (ACS) and the level of follow-up of the alert. In 17 hospitals with catheterization laboratory in Spain, 1 per region, we studied 25 consecutive patients per hospital whose diagnosis of discharge since October 1, 2013, had been any type of ACS. We analyzed their baseline clinical profile, the gatroprotective agents at admission and discharge and the antiplatelet therapy at discharge. The number of patients included was 425: age 67.2 ± 12.5 years, women 29.8%, diabetes 36.5%. The patients presented unstable angina in 21.6%, non-ST-elevation myocardial infarction in 35.3% and ST-elevation myocardial infarction in 43.1%. Conservative approach was chosen in 17.9%, bare-metal stents 32.2%, ≥ 1 drug-eluting stent 48.5%, and surgery 1.4%. Aspirin was indicated in 1.9%, aspirin + clopidogrel 73.6%, aspirin + prasugrel 17.6%, and aspririn + ticagrelor 6.8%. Gastroprotective agents were present in 40.2% patients at admission and this percentage increased to 93.7% at discharge. Of the 313 (73.6%) on clopidogrel in 96 (30.6%) was combined with omeprazole and 3 (0.95%) with esomeprazole, whereas the most commonly used was pantoprazole with 190 patients (44.7%). In conclusion, almost the totality of the patients with an ACS receive gastroprotective agents at the moment of discharge, most of them with proton-pump inhibitors. In one every 3 cases of the patients who are on clopidogrel, the recommendation of the Food and Drug Administration and the European Medicines Agency is not followed.

  1. Health Risk Perceptions and Exercise in Older Adulthood: An Application of Protection Motivation Theory.

    Ruthig, Joelle C


    Protection Motivation Theory (PMT) was applied to explore the relationship between perceived risk of acute health crises and intent to exercise. Interviews of 351 community-living older adults assessed prior physical activity (PPA), all PMT components, and exercise intent. A multi-group structural equation model revealed gender differences in PMT predictors of exercise intent. PPA, age, self-efficacy, and response efficacy directly predicted men's intent. Women's PPA and age predicted PMT components of self-efficacy and response costs, which predicted intent. Findings have implications for devising interventions to enhance physical activity in later life by targeting different PMT components for older men and women.

  2. Concomitant administration of Mycobacterium bovis BCG with the meningococcal C conjugate vaccine to neonatal mice enhances antibody response and protective efficacy.

    Brynjolfsson, Siggeir F; Bjarnarson, Stefania P; Mori, Elena; Del Giudice, Giuseppe; Jonsdottir, Ingileif


    Mycobacterium bovis BCG is administered to human neonates in many countries worldwide. The objective of the study was to assess if BCG could act as an adjuvant for polysaccharide-protein conjugate vaccines in newborns and thereby induce protective immunity against encapsulated bacteria in early infancy when susceptibility is high. We assessed whether BCG could enhance immune responses to a meningococcal C (MenC) conjugate vaccine, MenC-CRM(197), in mice primed as neonates, broaden the antibody response from a dominant IgG1 toward a mixed IgG1 and IgG2a/IgG2b response, and increase protective efficacy, as measured by serum bactericidal activity (SBA). Two-week-old mice were primed subcutaneously (s.c.) with MenC-CRM(197). BCG was administered concomitantly, a day or a week before MenC-CRM(197). An adjuvant effect of BCG was observed only when it was given concomitantly with MenC-CRM(197), with increased IgG response (P = 0.002) and SBA (8-fold) after a second immunization with MenC-CRM(197) without BCG, indicating increased T-cell help. In neonatal mice (1 week old) primed s.c. with MenC-CRM(197) together with BCG, MenC-polysaccharide (PS)-specific IgG was enhanced compared to MenC-CRM(197) alone (P = 0.0015). Sixteen days after the second immunization with MenC-CRM(197), increased IgG (P CRM(197) plus BCG showed affinity maturation and detectable SBA (SBA > 128). Thus, vaccination with a meningococcal conjugate vaccine (and possibly with other conjugates) may benefit from concomitant administration of BCG in the neonatal period to accelerate and enhance production of protective antibodies, compared to the current infant administration of conjugate which follows BCG vaccination at birth.

  3. Protective effect of maternal prenatal melatonin administration on rat pups born to mothers submitted to constant light during gestation

    C.D. Cisternas


    Full Text Available We studied the effects of adverse conditions such as constant light (LL on the circadian rhythm of malate (MDH, EC and lactate (LDH, EC dehydrogenase activities of the testes of male Wistar rats on postnatal day 28 (PN28, anxiety-like behavior (elevated plus-maze test at PN60 and sexual behavior at PN120. The rats were assigned to mother groups on day 10 of pregnancy: control (12-h light/dark, LL (light from day 10 to 21 of pregnancy, and LL+Mel (LL and sc injection to the mothers of a daily dose of melatonin, 1 mg/kg body weight at circadian time 12, from day 17 to 21 of pregnancy. LL offspring did not show circadian rhythms of MDH (N = 62 and LDH (N = 63 activities (cosinor and ANOVA-LSD Fisher. They presented a 44.7% decrease in open-arm entries and a 67.9% decrease in time (plus-maze test, N = 15, P < 0.001, Mann-Whitney U-test and Kruskal-Wallis test, an increase in mounting (94.4%, intromission (94.5% and ejaculation (56.6% latencies (N = 12, P < 0.01, Mann-Whitney U-test and Kruskal-Wallis test and lower numbers of these events (61, 59 and 73%, respectively; P < 0.01, N = 12 compared to controls. The offspring of the LL+Mel group presented MDH and LDH circadian rhythms (P < 0.05, N = 50, cosinor and ANOVA-LSD Fisher, anxiety-like and sexual behaviors similar to control. These findings supported the importance of the melatonin signal and provide evidence for the protective effects of hormones on maternal programming during gestation. This protective action of melatonin is probably related to its entrainment capacity, favoring internal coupling of the fetal multioscillatory system.

  4. Protective Effects of Long Term Administration of Zinc on Bone Metabolism Parameters in Male Wistar Rats Treated with Cadmium

    Shiva Najafi


    Full Text Available Background Violent poisoning by cadmium in human is created through drinks or meals which have packed in the metallic tins with cadmium plating. The symptoms of variation in the mineral metabolism of bones are observed and different conditions maybe appeared. The toxic (poisonous effect due to cadmium can be neutralized by intervening zinc. This study has been designed to investigate the protective effects of zinc for reducing the poisonous effects due to cadmium on the metabolism in the parameters related to the bone in rat. Methods In this experimental study, 48 male rats of wistar species were distributed in eight experimental groups and tested in the investigative lab of Falavarjan university. These groups were received 0.5 cc physiological serum, 0.5 mg/kg Zinc, 0.5, 1, 2 mg/kg Cadmium respectively and some groups were included in those were taken all there cadmium and zinc concentrations synchronously. Blood samples were taken in a 60 days period and those factors related to the bone metabolism were measured. The data were analyzed by 2-ANOVA Ways, complementary tests through software SPSS 16. Results The results showed that 0.5, 1, 2 mg/kg doses cadmium chloride caused to increase alkaline Phosphatase, calcium, phosphorus, magnesium and decrease albumin as compared with control group. Also, synchronous usage of all three cadmium chloride concentrations with zinc cause to decrease alkaline phosphatase, calcium, phosphorus, magnesium and increase albumin concentration. In a word, the other bone parameters have been significant in different cadmium and zinc doses (P < 0.05. Conclusions Findings showed that zinc can play a protective role on the metabolism parameters related to bone against to poisoning caused by cadmium.

  5. Dietary supplements and their future in health care: commentary on draft guidelines proposed by the Food and Drug Administration.

    Umhau, John C; Garg, Keva; Woodward, Albert M


    The Dietary Supplement and Health and Education Act of 1994 gives the U.S. Food and Drug Administration (FDA) responsibility for oversight of the dietary supplement industry. Recent draft guidelines proposed by the FDA to insure the safety of new dietary ingredients would significantly alter the ability of manufacturers to bring new dietary ingredients to market, and may cause many products introduced since 1994 to be discontinued. These changes will have an impact on health care, but with limited research on dietary supplements and how their use affects the health care system, there is no way to predict what their overall effect on health will be. Since the natural raw materials for dietary supplements are often inexpensive and generally cannot be patented, manufactures have little incentive to conduct the research which might otherwise be warranted. Appropriate clinical trials that evaluate the use and efficacy of various supplements may be critical for our health care system. If inexpensive dietary supplements are found to be safe and effective, such research could yield significant cost savings as well as health benefits.

  6. Measures of the General Administration of Customs of the People's Republic of China for Implementing the Regulations of the People's Republic of China on Customs Protection of Intellectual Property Rights (Part Ⅱ)


    @@ The Measures of the General Administration of Customs of the People's Republic of China for Implementing the Regulations of the People's Republic of China on Customs Protection of Intellectual Property Rights discussed and passed at the executive meeting of the General Administration of Customs (GAC) on Feb.17,2009 is hereby promulgated,which take effects on July 1,2009.

  7. Electronic Communication of Protected Health Information: Privacy, Security, and HIPAA Compliance.

    Drolet, Brian C; Marwaha, Jayson S; Hyatt, Brad; Blazar, Phillip E; Lifchez, Scott D


    Technology has enhanced modern health care delivery, particularly through accessibility to health information and ease of communication with tools like mobile device messaging (texting). However, text messaging has created new risks for breach of protected health information (PHI). In the current study, we sought to evaluate hand surgeons' knowledge and compliance with privacy and security standards for electronic communication by text message. A cross-sectional survey of the American Society for Surgery of the Hand membership was conducted in March and April 2016. Descriptive and inferential statistical analyses were performed of composite results as well as relevant subgroup analyses. A total of 409 responses were obtained (11% response rate). Although 63% of surgeons reported that they believe that text messaging does not meet Health Insurance Portability and Accountability Act of 1996 security standards, only 37% reported they do not use text messages to communicate PHI. Younger surgeons and respondents who believed that their texting was compliant were statistically significantly more like to report messaging of PHI (odds ratio, 1.59 and 1.22, respectively). A majority of hand surgeons in this study reported the use of text messaging to communicate PHI. Of note, neither the Health Insurance Portability and Accountability Act of 1996 statute nor US Department of Health and Human Services specifically prohibits this form of electronic communication. To be compliant, surgeons, practices, and institutions need to take reasonable security precautions to prevent breach of privacy with electronic communication. Communication of clinical information by text message is not prohibited under Health Insurance Portability and Accountability Act of 1996, but surgeons should use appropriate safeguards to prevent breach when using this form of communication. Copyright © 2017 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  8. 45 CFR 164.308 - Administrative safeguards.


    ... business processes for protection of the security of electronic protected health information while... REQUIREMENTS SECURITY AND PRIVACY Security Standards for the Protection of Electronic Protected Health... confidentiality, integrity, and availability of electronic protected health information held by the covered...

  9. Information security governance: a risk assessment approach to health information systems protection.

    Williams, Patricia A H


    It is no small task to manage the protection of healthcare data and healthcare information systems. In an environment that is demanding adaptation to change for all information collection, storage and retrieval systems, including those for of e-health and information systems, it is imperative that good information security governance is in place. This includes understanding and meeting legislative and regulatory requirements. This chapter provides three models to educate and guide organisations in this complex area, and to simplify the process of information security governance and ensure appropriate and effective measures are put in place. The approach is risk based, adapted and contextualized for healthcare. In addition, specific considerations of the impact of cloud services, secondary use of data, big data and mobile health are discussed.

  10. Rationing health protection: a proposal to exempt nuisance dust from US Clean Air Act regulations.

    Centner, Terence J; Colson, Gregory


    The US House of Representative has passed a bill called the "Farm Dust Regulation Prevention Act" (Dust Act) that would exempt most types of particulate matter (PM) in rural areas from the air quality controls of the US Clean Air Act. The Dust Act would markedly change the country's air quality standards. An examination of the proposed provisions shows that they would exempt non-combustion PM pollutants from mining, smelting, petroleum production, and power generation from existing air quality standards. Persons downwind from pollutants generated in rural areas could be exposed to concentrations of carcinogenic heavy metals, asbestos, and benzene known to adversely affect their health and ecological resources. Existing federal air quality standards based on science would be replaced by a flexible standard that rations health protection.

  11. Bending the curve: force health protection during the insertion phase of the Ebola outbreak response.

    Bailey, Mark S; Beaton, K; Bowley, D; Eardley, W; Hunt, P; Johnson, S; Round, J; Tarmey, N T; Williams, A


    After >10 years of enduring operations in Iraq and Afghanistan, Defence Strategic Direction is returning to a contingency posture. As the first post-Afghanistan operation, in September 2014, a UK Joint Inter-Agency Task Force deployed to Sierra Leone in response to the Ebola virus disease (EVD) epidemic in West Africa. The aims were expanding treatment capacity, assisting with training and supporting host nation resilience. The insertion phase of this deployment created a unique set of challenges for force health protection. In addition to the considerable risk of tropical disease and trauma, deployed personnel faced the risks of working in an EVD epidemic. This report explores how deployed medical assets overcame the difficulties of mounting a short-notice contingent operation in a region of the world with inherent major climatic and health challenges.

  12. A novel dentifrice technology for advanced oral health protection: A review of technical and clinical data.

    Baig, Arif; He, Tao


    Throughout the world, dentifrices have played a key role in the practice of good oral hygiene and promotion of better oral health. In addition to providing general dental cleaning, toothpastes also have served as an excellent vehicle for the introduction of new agents that deliver therapeutic and cosmetic benefits. Key examples of using dentifrices to provide added benefits include the introduction in 1955 of the first fluoridated toothpaste clinically proven to fight caries (Crest Cavity Protection) and the launch of the first tartar-control dentifrice (Crest Tartar Control) in the mid-1980s. To continue expanding the health and esthetic benefits offered by a single dentifrice, a multitude of agents have been investigated over the past 3 decades. The focus of these investigations has been in the multibenefit segment, the most widely used among US consumers.

  13. Integrating biodiversity management and indigenous biopiracy protection to promote environmental justice and global health.

    Mackey, Tim K; Liang, Bryan A


    Many potentially useful medicines arise from developing countries' biodiverse environments and indigenous knowledge. However, global intellectual property rules have resulted in biopiracy, raising serious ethical concerns of environmental justice, exploitation, and health disparities in these populations. Furthermore, state-based approaches have not led to adequate biodiversity protection, management, or resource sharing, which affect access to lifesaving drugs. In response, country delegates adopted the Nagoya Protocol, which aims at promoting biodiversity management, combating biopiracy, and encouraging equitable benefits sharing with indigenous communities. However, the effectiveness of this framework in meeting these objectives remains in question. To address these challenges, we propose a policy building on the Nagoya Protocol that employs a World Health Organization-World Trade Organization Joint Committee on Bioprospecting and Biopiracy.

  14. A health protection model for Hispanic adults with Type 2 diabetes.

    Latham, Christine L; Calvillo, Evelyn


    The Hispanic Health Protection Model (HHPM) was designed to assist practitioners' systematic assessment of Hispanic people to establish baselines and evaluate the success of early diabetes treatment. This article provides the research basis of the HHPM and related assessment tools. The treatment of diabetes incorporates lifestyle change, and this adjustment is particularly important to follow with vulnerable groups. One such group is the Hispanic population, since the impact of diabetes is greatest on economically disadvantaged segments of this population, who suffer disproportionately higher Type 2 diabetes prevalence and higher levels of morbidity and mortality as compared with other populations. Traditional Hispanic health beliefs are often in conflict with Western medicine, so the adjustments to the lifestyle demands of this disease need to be evaluated. To understand this discrepancy fully in patient outcomes, a culturally sensitive assessment framework was developed based on health protection theories and research with Hispanic people with diabetes and, based on this framework, assessment tools were translated for use during interviews with low literacy, Spanish-speaking patients. The HHPM translated measures of premorbid lifestyle, health beliefs, support, self-efficacy, quality of life, knowledge of diabetes, and physiological parameters can be used during consecutive clinic visits during the first six months of therapy to map the success of patients' understanding of and psychological adjustment to diabetes. The HHPM is a culturally-relevant, systematic, and holistic approach to assessing adjustment of Hispanic people to a new diagnosis of diabetes, including their psychological, cognitive, and physiological outcomes. Using this type of systematic approach will allow practitioners to target barriers to therapy, such as a lack of self-efficacy or incomplete knowledge of the disease and its treatment in a strategic manner to improve patient success in

  15. Short-term administration of (-)-epigallocatechin gallate reduces hepatic steatosis and protects against warm hepatic ischemia/reperfusion injury in steatotic mice.

    Fiorini, Ryan N; Donovan, Jennifer L; Rodwell, David; Evans, Zachary; Cheng, Gang; May, Harold D; Milliken, Charles E; Markowitz, John S; Campbell, Crystal; Haines, Julia K; Schmidt, Michael G; Chavin, Kenneth D


    Hepatic steatosis increases the extent of cellular injury incurred during ischemia/reperfusion (I/R) injury. (-)-Epigallocatechin gallate (EGCG), the major flavonoid component of green tea (camellia sinensis) is a potent antioxidant that inhibits fatty acid synthase (FAS) in vitro. We investigated the effects of EGCG on hepatic steatosis and markers of cellular damage at baseline and after I/R injury in ob/ob mice. Animals were pretreated with 85 mg/kg EGCG via intraperitoneal (ip) injection for 2 days or oral consumption in the drinking water for 5 days before 15 minutes of warm ischemia and 24 hours of reperfusion. After EGCG administration, total baseline hepatic fat content decreased from baseline. Palmitic acid and linoleic acid levels also were reduced substantially in all ECGC-treated animals before I/R. Alanine aminotransferase (ALT) levels decreased in all EGCG-treated animals compared with control animals after I/R. Histologic analysis demonstrated an average decrease of 65% necrosis after EGCG administration. EGCG administration also increased resting hepatic energy stores as determined by an increase in cellular adenosine triphosphate (ATP) with a concomitant decrease in uncoupling protein 2 (UCP2) before I/R. Finally, there was an increased level of glutathione (GSH) in the EGCG-treated mice compared with the vehicle-treated mice both at baseline and after I/R. In conclusion, taken together, this study demonstrates that treatment with ECGC by either oral or ip administration, significantly protects the liver after I/R, possibly by reducing hepatic fat content, increasing hepatic energy status, and functioning as an antioxidant.

  16. Is the Road to Mental Health Paved With Good Incentives? Estimating the Population Impact of Physician Incentives on Mental Health Care Using Linked Administrative Data.

    Puyat, Joseph H; Kazanjian, Arminee; Wong, Hubert; Goldner, Elliot M


    The use of physician incentives to improve health care, in general, has been extensively studied but its value in mental health care has rarely been demonstrated. In this study the population-level impact of physician incentives on mental health care was estimated using indicators for receipt of counseling/psychotherapy (CP); antidepressant therapy (AT); minimally adequate counseling/psychotherapy; and minimally adequate antidepressant therapy. The incentives' impacts on overall continuity of care and of mental health care were also examined. Monthly cohorts of individuals diagnosed with major depression were identified between January 2005 and December 2012 and their use of mental health services tracked for 12 months following initial diagnosis. Linked health administrative data were used to ascertain cases and measure health service use. Pre-post changes associated with the introduction of physician incentives were estimated using segmented regression analyses, after adjusting for seasonal variation. Physician incentives reversed the downward and upward trends in CP and AT. Five years postintervention, the estimated impacts in percentage points for CP, AT, minimally adequate counseling/psychotherapy, and minimally adequate antidepressant therapy were +3.28 [95% confidence interval (CI), 2.05-4.52], -4.47 (95% CI, -6.06 to -2.87), +1.77 (95% CI, 0.94-2.59), and -2.24 (95% CI, -4.04 to -0.45). Postintervention, the downward trends in continuity of care failed to reverse, but were disrupted, netting estimated impacts of +7.53 (95% CI, 4.54-10.53) and +4.37 (95% CI, 2.64-6.09) for continuity of care and of mental health care. The impact of physician incentives on mental health care was modest at best. Other policy interventions are needed to close existing gaps in mental health care.

  17. Oral administration of a cholera toxin B subunit-insulin fusion protein produced in silkworm protects against autoimmune diabetes.

    Gong, Zhaohui; Jin, Yongfeng; Zhang, Yaozhou


    The oral administration of disease-specific autoantigens can induce oral immune tolerance and prevent or delay the onset of autoimmune disease symptoms. Here, we describe the construction of an edible vaccine consisting of a fusion protein composed of cholera toxin B subunit (CTB) and insulin that is produced in silkworm larvae at levels of up to 0.3 mg/ml of hemolymph. The silkworm bioreactor produced this fusion protein vaccine as the pentameric CTB-insulin form, which retained the GM1-ganglioside binding affinity and the native antigenicity of CTB and insulin. Non-obese diabetic mice fed hemolymph containing microgram quantities of the CTB-insulin fusion protein showed a prominent reduction in pancreatic islet inflammation and a delay in the development of symptoms of clinical diabetes. These results demonstrate that the silkworm bioreactor is a feasible production and delivery system for an oral protein vaccine designed to develop immunological tolerance against T-cell-mediated autoimmune diabetes by regulatory T-cell induction.

  18. Goals: A Significant Tool for Protection of Mental and Physical Health

    Ali Eryilmaz


    Full Text Available Human beings want to have mental and physical health, attach to life, and also have a happy life. In this process, they need several tools. The goals are the most important tool for a happy and healthy life. Goals help individuals become aware of problems in a timely fashion, which in turn leads to healthy solutions. Goals give direction for life of an individual, and also help avoid chaos. Goals can help motivate individual by clarifying and communicating what the individual is striving to achieve. In addition to these, goals are important determinants for physical and mental health. In this article, the history of goals in psychology, definition of goals, types of goals, transferring of goals for real life, relationships between goals and cultures, implementation programs which are goal oriented, goals in national literature, and also relationships between goals, physical and mental health have been briefly reviewed. As a result, many scientific disciplines could use goals as protective and preventive tools for mental and physical health of individuals.

  19. Health Monitoring Technology for Thermal Protection Systems on Reusable Hypersonic Vehicles

    Milos, Frank S.; Watters, D. G.; Heinemann, J. M.; Karunaratne, K. S.; Arnold, Jim (Technical Monitor)


    Integrated subsystem health diagnostics is an area where major improvements have been identified for potential implementation into the design of new reusable launch vehicles (RLVs) in order to reduce life cycle costs, to increase safety margins, and to improve mission reliability. This talk summarizes a joint effort between NASA Ames and industry partners to develop rapid non-contact diagnostic tools for health and performance monitoring of thermal protection systems (TPS) on future RLVs. The specific goals for TPS health monitoring are to increase the speed and reliability of TPS inspections for improved operability at lower cost. The technology being developed includes a 3-D laser scanner for examining the exterior surface of the TPS, and a subsurface microsensor suite for monitoring the health and performance of the TPS. The sensor suite consists of passive overlimit sensors and sensors for continuous parameter monitoring in flight. The sensors are integrated with radio-frequency identification (RFID) microchips to enable wireless communication of-the sensor data to an external reader that may be a hand-held scanner or a large portal. Prototypes of the laser system and both types of subsurface sensors have been developed. The laser scanner was tested on Shuttle Orbiter Columbia and was able to dimension surface chips and holes on a variety of TPS materials. The temperature-overlimit microsensor has a diameter under 0.05 inch (suitable for placement in gaps between ceramic TPS tiles) and can withstand 700 F for 15 minutes.

  20. Can economic deprivation protect health? Paradoxical multilevel effects of poverty on Hispanic children's wheezing.

    Collins, Timothy W; Kim, Young-an; Grineski, Sara E; Clark-Reyna, Stephanie


    Prior research suggests that economic deprivation has a generally negative influence on residents' health. We employ hierarchical logistic regression modeling to test if economic deprivation presents respiratory health risks or benefits to Hispanic children living in the City of El Paso (Texas, USA) at neighborhood- and individual-levels, and whether individual-level health effects of economic deprivation vary based on neighborhood-level economic deprivation. Data come from the US Census Bureau and a population-based survey of El Paso schoolchildren. The dependent variable is children's current wheezing, an established respiratory morbidity measure, which is appropriate for use with economically-deprived children with an increased likelihood of not receiving a doctor's asthma diagnosis. Results reveal that economic deprivation (measured based on poverty status) at both neighborhood- and individual-levels is associated with reduced odds of wheezing for Hispanic children. A sensitivity analysis revealed similar significant effects of individual- and neighborhood-level poverty on the odds of doctor-diagnosed asthma. Neighborhood-level poverty did not significantly modify the observed association between individual-level poverty and Hispanic children's wheezing; however, greater neighborhood poverty tends to be more protective for poor (as opposed to non-poor) Hispanic children. These findings support a novel, multilevel understanding of seemingly paradoxical effects of economic deprivation on Hispanic health.

  1. Benzoxazinoids: Cereal phytochemicals with putative therapeutic and health-protecting properties.

    Adhikari, Khem B; Tanwir, Fariha; Gregersen, Per L; Steffensen, Stine K; Jensen, Bettina M; Poulsen, Lars K; Nielsen, Claus H; Høyer, Søren; Borre, Michael; Fomsgaard, Inge S


    Benzoxazinoids (BXs) are a group of natural chemical compounds with putative pharmacological and health-protecting properties. BXs were formerly identified in and isolated from selected dicot medicinal plants and young cereal plants. Recently, BXs were found to be present in mature cereal grains and bakery products, such that knowledge about the pharmacological properties of BXs, which until now have unknowingly been consumed through the daily bread and breakfast cereals, has come into new focus. This review discusses published results from in vitro studies and a few human and animal model studies on the health effects and pharmacological responses of various BX compounds. Many of these studies have reported antimicrobial, anticancer, reproductive system stimulatory, central nervous system stimulatory, immunoregulatory, and appetite- and weight-reducing effects of BXs and/or BX derivatives. The health benefits of wholegrain intake may be associated with the solitary and/or overlapping biological effects of fibers, lignans, phenolic acids, alkylresorcinols, BXs, and other bioactive compounds. In the context of BXs as dietary ingredients, further comprehensive investigations are required to understand their biological functions, to elucidate the underlying mechanisms, to explore their potential contribution on the health effects associated with wholegrain consumption, and to examine their potential as functional food ingredients.

  2. Electrosmog. Health hazards, limit values, consumer protection; 4. rev. ed.; Elektrosmog. Gesundheitsrisiken, Grenzwerte, Verbraucherschutz

    Karus, M.; Ebert, L.; Wilke, I.; Schneider, W.; Koehnecke, W.; Loefflad, H.; Plotzke, O.; Niessen, P.


    The book deals with ``electrosmog``, the electromagnetic fields in our environment that are generated by electrical equipment and installations and which are being studied more closely recently as a suspected source of a variety of health hazards or diseases. The initial chapter explains the physical fundamentals and terminology, the process and the sources generating the electrical and magnetic fields found in our environment, as well as the measuring techniques applied for detection and assessment. The following chapters present information on the state of the art in research into the health effects of electrosmog in the low and high-frequency ranges, on currently applicable limit values and the underlying concepts of calculation, as well as the policy pursued in this context. The concluding chapters of the book discuss the sources of electrosmog in a variety of living environments as well as mitigating or protective measures defined from the angle of consumer protection. (FK) [Deutsch] Dieses Buch befasst sich mit der unter dem Namen `Elektrosmog` bekannt gewordenen elektromagnetischen Umweltbelastung, die in juengster Zeit fuer eine Vielzahl von Krankheiten verantwortlich gemacht wird. Eingangs werden grundlegende physikalische Begriffe, das Auftreten von elektrischen und magnetischen Feldern im Alltag sowie die Messung von Elektrosmog behandelt. Das folgende Kapitel stellt den aktuellen Forschungsstand ueber die gesundheitlichen Auswirkungen von Elektrosmog im Nieder- und Hochfrequenzbereich dar. Anschliessend werden die derzeit gueltigen Grenzwerte und ihre konzeptionelle und politische Basis diskutiert. Der letzte Teil geht auf die vielfaeltigen Quellen von Elektrosmog in den unterschiedlichen Lebensbereichen ein und diskutiert Massnahmen fuer den Verbraucherschutz. (FK)

  3. Protection of Penaeus monodon against white spot syndrome by continuous oral administration of a low concentration of Bacillus subtilis spores expressing the VP28 antigen.

    Pham, K-C; Tran, H T T; Van Doan, C; Le, P H; Van Nguyen, A T; Nguyen, H A; Hong, H A; Cutting, S M; Phan, T-N


    In this study, Bacillus subtilis spores expressing a chimeric protein, CotB-VP28, were used as a probiotic vaccine to protect black tiger shrimps (Penaeus monodon) against white spot syndrome virus (WSSV) infection. Oral administration of pellets coated with CotB-VP28 spores (at ≥1 × 10(9 ) CFU per g pellet) to shrimps induced immune-relating phenoloxydase activity (PO) in shrimps after 14 days of feeding (prior challenge) and at day 3 post challenge (1·26 and 1·70 fold increase respectively). A 75% protection rate was obtained by continuous feeding of the spore-coated pellets at ≥1 × 10(9 ) CFU per g for 14 days prior to WSSV challenge and during all the postchallenge period. Even when the amount of CotB-VP28 spores in feed pellets was reduced down to ≥5 × 10(7)  CFU per g and ≥1 × 10(6)  CFU per g, relatively high protection rates of 70 and 67·5%, respectively, were still obtained. By contrast, feeding pellets without spores (untreated group) and with naked spores (PY79 group) at ≥1 × 10(9)  CFU per g could not protect shrimps against WSSV. These data suggest that supplementation of CotB-VP28 spores at low dose of ≥1 × 10(6)  CFU per g could be effective as a prophylactic treatment of WSS for black tiger shrimps.

  4. Measures of the General Administration of Customs of the People's Republic of China for Implementing the Regulations of the People's Republic of China on Customs Protection of Intellectual Property Rights


    @@ The Measures of the General Administration of Customs of the People's Republic of China for Implementing the Regulations of the People's Republic of China on Customs Protection of Intellectual Property Rights discussed and passed at the executive meeting of the General Administration of Customs (GAC) on Feb.17,2009 is hereby promulgated,which take effects on July 1,2009.The Measures of the General Administration of Customs of the People's Republic of China for Implementing the Regulations of the People's Republic of China on Customs Protection of Intellectual Property Rights promulgated by No.114 Decree of the GAC on May 25,2004 shall be repealed simultaneously.

  5. [Glass ceiling and slippery stairs? Gender inequalities and strategies for change in the Spanish Society of Public Health and Health Services Administration].

    Colomer Revuelta, C; Peiró Pérez, R


    In scientific societies, as in other social fields, women's participation in decision making is lower than that of men. We describe the situation in SESPAS (Spanish Society of Public Health and Health Services Administration) where, despite representing a 40% of its members, very few women have been in positions in which decisions are taken or in those of professional recognition. The process of change implemented during recent years and some of the effects of the actions taken are presented. Making the existing inequalities known has generated debate and interest in the intervention. A gender and public health working group was set up. In the last two years more women have been promoted to more senior positions in SESPAS.

  6. Intravenous administration of glutathione protects parenchymal and non-parenchymal liver cells against reperfusion injury following rat liver transplantation

    Rolf J. Schauer; Sinan Kalmuk; Alexander L. Gerbes; Rosemarie Leiderer; Herbert Meissner; Friedrich W. Schildberg; Konrad Messmer; Manfred Bilzer


    AIM: To investigate the effects of intravenous administration of the antioxidant glutathione (GSH) on reperfusion injury following liver transplantation.METHODS: Livers of male Lewis rats were transplantedafter 24 h of hypothermic preservation in University of Wisconsin solution in a syngeneic setting. During a 2-h reperfusion period either saline (controls, n=8) or GSH administered via the jugular vein.RESULTS: Two hours after starting reperfusion plasma ALT increased to 1 457±281 U/L (mean±SE) in controls but to only 908±187 U/L (P<0.05) in animals treated with morphological findings on electron microscopy: GSH treatment prevented detachment of sinusoidal endothelial cells (SECs) as well as loss of microvilli and mitochondrial swelling of hepatooytes. Accordingly, postischemic bile flow increased 2-fold. Intravital fluorescence microscopy revealed a nearly complete restoration of sinusoidal blood flow and a significant reduction of leukocyte adherence to sinusoids and postsinusoidal venules. Following infusion of 50 μmol and and 97±18 mol/L, but to only 20±3 mol/L in untreated recipients. Furthermore, plasma glutathione disulfide (GSSG) increased untreated controls (1.8±0.5 mol/L vs 2.2±0.2 mol/L).CONCLUSION: Plasma GSH levels above a critical level may act as a "sink" for ROS produced in the hepatic vasculature during reperfusion of liver grafts. Therefore, GSH can be considered a candidate antioxidant for the prevention of reperfusion injury after liver transplantation, in particular since it has a low toxicity in humans.

  7. Sun protective behaviour in renal transplant recipients. A qualitative study based on individual interviews and the Health Belief Model

    Skiveren, Jette; Mortensen, Erik Lykke; Haedersdal, Merete


    BACKGROUND: Renal transplant recipients (RTRs) are at high-risk of developing aggressive and potentially lethal non-melanoma skin cancer, which emphasizes the need for consistent sun protective behaviour. OBJECTIVE: To identify factors that exert an influence on the sun protective behaviour of RTRs...... towards the use of sunscreens and wearing hats were barriers against efficient sun protective behaviour. CONCLUSIONS: This study shows that the Health Belief Model can be used to identify and describe factors that influence decisions and behaviour among RTRs regarding sun protective behaviour. We......: The major result was the finding that patients did not perceive the threat of skin cancer as an important health problem and, therefore, did not give a high priority to sun protection, even though patients were aware of their increased risk of developing skin cancer. Moreover, negative individual attitudes...

  8. Administration of over-the-counter medication to children at home--a survey of parents from community health centers.

    Anderson, Colleen; Rolfe, Paula; Brennan-Hunter, Andrea


    Parents (n = 135) were surveyed in relation to administering antipyretic/analgesic medications to their children (2 months-6 years) at home. Parents usually chose acetaminophen, calculated dosages based on weight but did not always know the child's weight, administered medications with a dropper, and reported having a sick child was moderately stressful. Many children were medicated for pain and/or fever during the week prior to immunization and many weighed more than the age/weight recommended dosages on the label. Community health nurses can facilitate safe administration of medications by integrating knowledge of parents' pain and fever management practices into discussions and anticipatory planning during clinic visits.

  9. Protection against bovine tuberculosis induced by oral vaccination of cattle with Mycobacterium bovis BCG is not enhanced by co-administration of mycobacterial protein vaccines.

    Wedlock, D Neil; Aldwell, Frank E; Vordermeier, H Martin; Hewinson, R Glyn; Buddle, Bryce M


    Mycobacterium bovis bacille Calmette-Guérin (BCG) delivered to calves by the oral route in a formulated lipid matrix has been previously shown to induce protection against bovine tuberculosis. A study was conducted in cattle to determine if a combination of a low dose of oral BCG and a protein vaccine could induce protective immunity to tuberculosis while not sensitising animals to tuberculin. Groups of calves (10 per group) were vaccinated by administering 2 × 10(7)colony forming units (CFU) of BCG orally or a combination of 2 × 10(7)CFU oral BCG and a protein vaccine comprised of M. bovis culture filtrate proteins (CFP) formulated with the adjuvants Chitin and Gel 01 and delivered by the intranasal route, or CFP formulated with Emulsigen and the TLR2 agonist Pam(3)CSK(4) and administered by the subcutaneous (s.c.) route. Two further groups were vaccinated with the CFP/Chitin/Gel 01 or CFP/Emulsigen/Pam(3)CSK(4) vaccines alone. Positive control groups were given 10(8)CFU oral BCG or 10(6)CFU s.c. BCG while a negative control group was non-vaccinated. All animals were challenged with M. bovis 15 weeks after vaccination and euthanized and necropsied at 16 weeks following challenge. Groups of cattle vaccinated with s.c. BCG, 10(8)CFU or 2 × 10(7)CFU oral BCG showed significant reductions in seven, three and four pathological or microbiological disease parameters, respectively, compared to the results for the non-vaccinated group. There was no evidence of protection in calves vaccinated with the combination of oral BCG and CFP/Emulsigen/Pam(3)CSK(4) or oral BCG and CFP/Chitin/Gel 01 or vaccinated with the protein vaccines alone. Positive responses in the comparative cervical skin test at 12 weeks after vaccination were only observed in animals vaccinated with s.c. BCG, 10(8)CFU oral BCG or a combination of 2 × 10(7)CFU oral BCG and CFP/Chitin/Gel 01. In conclusion, co-administration of a protein vaccine, administered by either systemic or mucosal routes with oral

  10. Implementing evidence-based patient self-management programs in the Veterans Health Administration: perspectives on delivery system design considerations.

    Damush, T M; Jackson, G L; Powers, B J; Bosworth, H B; Cheng, E; Anderson, J; Guihan, M; LaVela, S; Rajan, S; Plue, L


    While many patient self-management (PSM) programs have been developed and evaluated for effectiveness, less effort has been devoted to translating and systematically delivering PSM in primary and specialty care. Therefore, the purpose of this paper is to review delivery system design considerations for implementing self-management programs in practice. As lessons are learned about implementing PSM programs in Veterans Health Administration (VHA), resource allocation by healthcare organization for formatting PSM programs, providing patient access, facilitating PSM, and incorporating support tools to foster PSM among its consumers can be refined and tailored. Redesigning the system to deliver and support PSM will be important as implementation researchers translate evidence based PSM practices into routine care and evaluate its impact on the health-related quality of life of veterans living with chronic disease.

  11. National utilization of antihypertensive medications from 2000 to 2006 in the Veterans Health Administration: focus on thiazide diuretics.

    Furmaga, Elaine M; Cunningham, Francesca E; Cushman, William C; Dong, Diane; Jiang, Rong; Basile, Jan; Katz, Lois A; Rutan, Gale H; Berlowitz, Dan R; Papademetriou, Vasilios; Glassman, Peter A


    The authors sought to determine the prescribing practices of clinicians treating veterans with hypertension. A descriptive analysis was performed using a national pharmacy database of patients with a diagnosis of hypertension receiving antihypertensive medication in the fiscal years 2000 to 2006. Angiotensin-converting enzyme inhibitors were the most frequently prescribed antihypertensive class, with utilization increasing from 56.0% in fiscal year 2000 to 63.2% of patients in 2006. Utilization of thiazide-type diuretics increased from 31.9% of patients in fiscal year 2000 to 42.0% in 2006. When patient comorbidities were taken into consideration, 48.1% of patients defined as having uncomplicated hypertension had at least one prescription for a thiazide diuretic in fiscal year 2006. Utilization by monotherapy and combination therapy were also evaluated. The trends in utilization allowed for identification of areas in which a change in prescribing practices may improve blood pressure control and health outcomes in the Veterans Health Administration.

  12. The Healthcare Administrator’s Desk Reference: A Managed Care and Health Care Contracting Dictionary for the Military Health System


    Desk Reference 1 Running head : DICTIONARY The healthcare administrator’s desk reference: A managed care and healthcare contracting dictionary for...Berkowitz, E. N. (1996). Essentials of health care marketing . (4th ed.). Gaithersburg, MD: Aspen Publications. Borsos, D. (1998, October). Bid price...Mediation & Conciliation Service FMG Foreign Medical Graduate FMP 1. Family Member Prefix 2. Fair Market Price 3. Federal Personnel Manual FMS Foreign

  13. 77 FR 1555 - Administrative Simplification: Adoption of Standards for Health Care Electronic Funds Transfers...


    ...) transfers, Fedwire transfers, transfers made at automatic teller machines (ATMs), and point-of-sale..., Attention: CMS-0024-IFC, Mail Stop C4-26-05, 7500 Security Boulevard, Baltimore, MD 21244-1850. 4. By hand... & Medicaid Services, Department of Health and Human Services, 7500 Security Boulevard, Baltimore, MD 21244...

  14. Health informatics and analytics - building a program to integrate business analytics across clinical and administrative disciplines.

    Tremblay, Monica Chiarini; Deckard, Gloria J; Klein, Richard


    Health care organizations must develop integrated health information systems to respond to the numerous government mandates driving the movement toward reimbursement models emphasizing value-based and accountable care. Success in this transition requires integrated data analytics, supported by the combination of health informatics, interoperability, business process design, and advanced decision support tools. This case study presents the development of a master's level cross- and multidisciplinary informatics program offered through a business school. The program provides students from diverse backgrounds with the knowledge, leadership, and practical application skills of health informatics, information systems, and data analytics that bridge the interests of clinical and nonclinical professionals. This case presents the actions taken and challenges encountered in navigating intra-university politics, specifying curriculum, recruiting the requisite interdisciplinary faculty, innovating the educational format, managing students with diverse educational and professional backgrounds, and balancing multiple accreditation agencies. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email:

  15. The Impact of Word Processing on Office Administration in the Medical and Allied Health Professions.

    Platt, Naomi Dornfeld

    The effect of word processing equipment on the future medical secretarial science curriculum was studied. A literature search focused on word processing and the medical and allied health professions, word processing and business education, and futuring of and changes in the secretarial science curriculum. Questionnaires to identify various aspects…

  16. Guidelines for health surveillance in the NASA (National Aeronautics and Space Administration) workplace


    The adequacy of biomedical data sheets used by the NASA medical staff for NASA employees and contractors was assessed. Procedures for developing medical histories, conducting medical examinations, and collecting toxicity data were reviewed. Recommendations for employee health maintenance and early detection of work-related abnormalities are given.

  17. [Public relations in institutions and establishments of the health administration system].

    Martynenko, A V


    The article is dedicated to development of directions and specific functions of the health system bodies/institutions public relations (PR) activities. Priorities are set forth depending on the form of property thereof. A complex use of approaches toward carrying out of PR activities permits optimizing work both within the system itself and relations with the society as a whole.

  18. 77 FR 54663 - Administrative Simplification: Adoption of a Standard for a Unique Health Plan Identifier...


    ... with the organization, disclose them to any entity that needs the NPIs to identify the prescribers in... serve as an other entity identifier (OEID), or an identifier for entities that are not health plans... disclose a National Provider Identifier (NPI). Lastly, this final rule changes the compliance date for the...

  19. The quality of Indigenous identification in administrative health data in Australia: insights from studies using data linkage

    Thompson Sandra C


    Full Text Available Abstract Background Missing or incorrect Indigenous status in health records hinders monitoring of Indigenous health indicators. Linkage of administrative data has been used to improve the ascertainment of Indigenous status. Data linkage was pioneered in Western Australia (WA and is now being used in other Australian states. This systematic review appraises peer-reviewed Australian studies that used data linkage to elucidate the impact of under-ascertainment of Indigenous status on health indicators. Methods A PubMed search identified eligible studies that used Australian linked data to interrogate Indigenous identification using more than one identifier and interrogated the impact of the different identifiers on estimation of Indigenous health indicators. Results Eight papers were included, five from WA and three from New South Wales (NSW. The WA papers included a self-identified Indigenous community cohort and showed improved identification in hospital separation data after 2000. In CVD hospitalised patients (2000–05, under-identification was greater in urban residents, older people and socially more advantaged Indigenous people, with varying algorithms giving different estimates of under-count. Age-standardised myocardial infarction incidence rates (2000–2004 increased by about 10%-15% with improved identification. Under-ascertainment of Indigenous identification overestimated secular improvements in life expectancy and mortality whereas correcting infectious disease notifications resulted in lower Indigenous/ non-Indigenous rate ratios. NSW has a history of poor Indigenous identification in administrative data systems, but the NSW papers confirmed the usefulness of data linkage for improving Indigenous identification and the potential for very different estimates of Indigenous disease indicators depending upon the algorithm used for identification. Conclusions Under-identification of Indigenous status must be addressed in health analyses

  20. [Rethinking social protection in health in Latin America and the Caribbean].

    Rosenberg, H; Andersson, B


    Despite what is written in the constitutions and other basic document mandates of the countries of the Region, exclusion from social protection in health (SPH) affects an important proportion of the population (at least 20%, which represents, in absolute figures, between 80 and 200 million people). These estimates are obtained through a series of theoretical (social security coverage) and practical indicators that encompass structural indicators (poverty, ethnicity, and geographical barriers) as well as process indicators (non-institutional births, compliance with vaccination schedules, and access to basic sanitation). Exclusion levels in a society are affected by the degree of segmentation of the health system. Traditionally, most countries of the Region have had a public, a social security and a private subsystem in health. Lack of attention to the problem has resulted in the formation of a community-based subsystem. The coexistence of many subsystems, along with poor regulation on the part of health authorities, has resulted in high levels of exclusion and inefficient resource allocation within the sector. The organization of social dialogue processes focusing on SPH within the context of health sector reform initiatives in each country is recommended. The process, which should be participatory, should include a full diagnosis of the situation (how many are excluded, who are they, and why, and what mechanisms are the most appropriate for tackling the issue in each country). It should also provide a political and technical feasibility analysis of the most suitable options for each society, and a determination of whether or not conventional subsystems have exhausted their potential. The process should culminate in a program for implementing the specific proposals made in each society, in an effort to maximize SPH.