WorldWideScience

Sample records for health region emergence

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

    Science.gov (United States)

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

    2016-08-01

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

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

    Science.gov (United States)

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

    2018-05-09

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

  3. Polio eradication in the African Region on course despite public health emergencies.

    Science.gov (United States)

    Okeibunor, Joseph C; Ota, Martin C; Akanmori, Bartholomew D; Gumede, Nicksy; Shaba, Keith; Kouadio, Koffi I; Poy, Alain; Mihigo, Richard; Salla, Mbaye; Moeti, Matshidiso R

    2017-03-01

    The World Health Organization, African Region is heading toward eradication of the three types of wild polio virus, from the Region. Cases of wild poliovirus (WPV) types 2 and 3 (WPV2 and WPV3) were last reported in 1998 and 2012, respectively, and WPV1 reported in Nigeria since July 2014 has been the last in the entire Region. This scenario in Nigeria, the only endemic country, marks a remarkable progress. This significant progress is as a result of commitment of key partners in providing the much needed resources, better implementation of strategies, accountability, and innovative approaches. This is taking place in the face of public emergencies and challenges, which overburden health systems of countries and threaten sustainability of health programmes. Outbreak of Ebola and other diseases, insecurity, civil strife and political instability led to displacement of populations and severely affected health service delivery. The goal of eradication is now within reach more than ever before and countries of the region should not relent in their efforts on polio eradication. WHO and partners will redouble their efforts and introduce better approaches to sustain the current momentum and to complete the job. The carefully planned withdrawal of oral polio vaccine type II (OPV2) with an earlier introduction of one dose of inactivated poliovirus vaccine (IPV), in routine immunization, will boost immunity of populations and stop cVDPVs. Environmental surveillance for polio viruses will supplement surveillance for AFP and improve sensitivity of detection of polio viruses. Copyright © 2016 World Health Organization. Published by Elsevier Ltd. Published by Elsevier Ltd.. All rights reserved.

  4. Emergence of regional clusters

    DEFF Research Database (Denmark)

    Dahl, Michael S.; Østergaard, Christian Richter; Dalum, Bent

    2010-01-01

    The literature on regional clusters has increased considerably during the last decade. The emergence and growth patterns are usually explained by such factors as unique local culture, regional capabilities, tacit knowledge or the existence of location-specific externalities (knowledge spillovers...

  5. Empathy and burnout of emergency professionals of a health region: A cross-sectional study.

    Science.gov (United States)

    Yuguero, Oriol; Forné, Carles; Esquerda, Montserrat; Pifarré, Josep; Abadías, María José; Viñas, Joan

    2017-09-01

    The objective of this study is to assess the association between levels of empathy and burnout of emergency professionals in all the assistance levels.A cross-sectional observational study was conducted in the health region of Lleida and the Pyrenees with 100 professionals from the field of Urgency. Participation reached 40.8%. Empathy and burnout were measured using the Spanish versions of the Jefferson Scale of Physician Empathy (JSPE) and Maslach Burnout Inventory (MBI) respectively. The total MBI score and its 3 dimensions (emotional exhaustion, depersonalization, and personal accomplishment) were analyzed. The JSPE and MBI scores were categorized into tertiles that were identified as "low," "moderate," and "high" levels.The median (interquartile range) was 112 (102-123) and 37 (27-53.5) for the JSPE and MBI scores respectively. Professionals with high burnout (MBI≥47) showed the lowest levels of empathy, that is, JSPE score of 105 (98-114); those with moderate burnout (31≤MBI empathy were associated with the lowest levels of burnout, especially in depersonalization, and to a lesser extent in personal accomplishment. There were no differences in empathy and burnout for any of the other study variables.Our findings suggest that the empathy of emergency professionals is associated with burnout. Hence, reducing professional burnout could help keep emergency professionals' empathy levels high, which in turn would ensure a better quality of care. Nevertheless, it would be necessary to carry out prospective studies to describe the profiles of burnout and empathy as well as their association and evolution.

  6. Review of emergency obstetric care interventions in health facilities in the Upper East Region of Ghana: a questionnaire survey.

    Science.gov (United States)

    Kyei-Onanjiri, Minerva; Carolan-Olah, Mary; Awoonor-Williams, John Koku; McCann, Terence V

    2018-03-15

    Maternal morbidity and mortality is most prevalent in resource-poor settings such as sub-Saharan Africa and southern Asia. In sub-Saharan Africa, Ghana is one of the countries still facing particular challenges in reducing its maternal morbidity and mortality. Access to emergency obstetric care (EmOC) interventions has been identified as a means of improving maternal health outcomes. Assessing the range of interventions provided in health facilities is, therefore, important in determining capacity to treat obstetric emergencies. The aim of this study was to examine the availability of emergency obstetric care interventions in the Upper East Region of Ghana. A cross-sectional survey of 120 health facilities was undertaken. Status of emergency obstetric care was assessed through an interviewer administered questionnaire to directors/in-charge officers of maternity care units in selected facilities. Data were analysed using descriptive statistics. Eighty per cent of health facilities did not meet the criteria for provision of emergency obstetric care. Comparatively, private health facilities generally provided EmOC interventions less frequently than public health facilities. Other challenges identified include inadequate skill mix of maternity health personnel, poor referral processes, a lack of reliable communication systems and poor emergency transport systems. Multiple factors combine to limit women's access to a range of essential maternal health services. The availability of EmOC interventions was found to be low across the region; however, EmOC facilities could be increased by nearly one-third through modest investments in some existing facilities. Also, the key challenges identified in this study can be improved by enhancing pre-existing health system structures such as Community-based Health Planning and Services (CHPS), training more midwifery personnel, strengthening in-service training and implementation of referral audits as part of health service

  7. Emerging and Reemerging Diseases in the World Health Organization (WHO) Eastern Mediterranean Region-Progress, Challenges, and WHO Initiatives.

    Science.gov (United States)

    Buliva, Evans; Elhakim, Mohamed; Tran Minh, Nhu Nguyen; Elkholy, Amgad; Mala, Peter; Abubakar, Abdinasir; Malik, Sk Md Mamunur Rahman

    2017-01-01

    The Eastern Mediterranean Region (EMR) of the World Health Organization (WHO) continues to be a hotspot for emerging and reemerging infectious diseases and the need to prevent, detect, and respond to any infectious diseases that pose a threat to global health security remains a priority. Many risk factors contribute in the emergence and rapid spread of epidemic diseases in the Region including acute and protracted humanitarian emergencies, resulting in fragile health systems, increased population mobility, rapid urbanization, climate change, weak surveillance and limited laboratory diagnostic capacity, and increased human-animal interaction. In EMR, several infectious disease outbreaks were detected, investigated, and rapidly contained over the past 5 years including: yellow fever in Sudan, Middle East respiratory syndrome in Bahrain, Oman, Qatar, Saudi Arabia, United Arab Emirates, and Yemen, cholera in Iraq, avian influenza A (H5N1) infection in Egypt, and dengue fever in Yemen, Sudan, and Pakistan. Dengue fever remains an important public health concern, with at least eight countries in the region being endemic for the disease. The emergence of MERS-CoV in the region in 2012 and its continued transmission currently poses one of the greatest threats. In response to the growing frequency, duration, and scale of disease outbreaks, WHO has worked closely with member states in the areas of improving public health preparedness, surveillance systems, outbreak response, and addressing critical knowledge gaps. A Regional network for experts and technical institutions has been established to facilitate support for international outbreak response. Major challenges are faced as a result of protracted humanitarian crises in the region. Funding gaps, lack of integrated approaches, weak surveillance systems, and absence of comprehensive response plans are other areas of concern. Accelerated efforts are needed by Regional countries, with the continuous support of WHO, to

  8. Water Security, Climate Forcings and Public Health Impacts in Emerging Regions

    Science.gov (United States)

    Serman, E. A.; Akanda, A. S.; Craver, V.; Boving, T. B.

    2014-12-01

    Our world is rapidly urbanizing, with more than 80% of world's population is expected to be living in a city by the end of the century. A majority of these nations are rapidly urbanizing due to massive rural-to-urban migratory trends, with rapid development of unplanned urban settlements, or slums, with lack of adequate water or sanitation facilities and other municipal amenities. With global environmental change, natural disasters will expose millions more to drought, floods, and disease epidemics, and existing vulnerabilities will worsen. At the same time, rapid urbanization and fast changing land-use leads to widespread damage of infrastructure by stormwater, especially in lowlands and economically poor areas. The factor that consistently stands out among different cities from both the developed and the developing worlds is that the slums are typically the most vulnerable to water related natural hazards and climatic threats, such as water scarcity and quality issues in drought conditions, or water and sanitation breakdown and stormwater contamination problems. Onsite or decentralized water, wastewater and stormwater treatment as well as point-of-use water treatment options can be an economic, safe, and reliable alternative to conventional large-scale treatment especially, in urban fringes as well as rural areas. These systems can be designed to fit communities in terms of their economic, cultural, environmental, and demographic resources. As part of this study, we develop a database of urban water quality and quantity indices such as with urban land-use, water usage, climate, and socio-economic characteristics in various emerging regions in the world. We analyze past and current data to identify and quantify long-term trends and the impacts of large-scale climatic and anthropogenic changes on urban hydrology and health impacts. We specifically focus on five major cities from distinct groups of countries and geographies: Providence, RI, USA from the developed

  9. [Importance of a regional observatory of malarial chemoresistance, an emerging public health problem in the Guyanas region].

    Science.gov (United States)

    Esterre, P; Volney, B; Meynard, J-B; Legrand, E

    2009-08-01

    A regular implementation of prophylactic and therapeutic decision trees was organized on a consensus basis in Cayenne, French Guiana in 1990, 1995 and 2002. The updated recommendations were based on the knowledge of the in vitro chemosensitivity profiles of the local isolates, mainly coming from big rivers (Maroni and Oyapock, frontiers with Suriname and Brazil, respectively; and more recently Approuague). Most of the patients infected by Plasmodium falciparum were followed by the medical staff of the main hospitals (Cayenne and Saint-Laurent) and of the peripheral health centers in remote areas. Consequently the epidemiological situation and evolution of chemoresistance have been widely observed on a long-term (since 1994) basis in the Maroni region. Yet, we have only partial information coming from the Oyapock valley, even though an important (most of the time) illegal immigration has been developing since the 90s' leading to a notable modification of the epidemiological status of malaria in this eastern region, including a regular increase of P. vivax infections. Presently very little P. vivax chloroquine (and mefloquine) resistance has been identified but this result could lead to a real public health problem in a near future. As such, the National Reference Center on Plasmodium Chemoresistance in the French West Indies and Guiana (CNRCP-AG in French) is a unique observatory of malaria chemoresistance in the Guyanese shield which works with research laboratories of the Institut Pasteur, Paris. This network strategy offers a very attractive perspective for applications of modern tools, including the validation of chemoresistance molecular markers, for malaria control at both medical and public health levels. Some examples related to chloroquine and artemether resistance are given.

  10. Regional cooperation for emergency plan

    International Nuclear Information System (INIS)

    Chu, D.S.L.; Liu, P.C.

    1981-01-01

    It has become increasingly evident since the Three Mile Island (TMI) accident that a sound emergency plan is indispensable to the overall nuclear power generation program. In some developing countries in Eastern Aisa, the availability of manpower resources and facilities to handle a nuclear power plant accident are rather limited. Therefore, the establishment of a regional mutual emergency plan is deemed necessary. A preliminary idea concerning this establishment is presented for deliberation by this Conference

  11. Emergency Health Services Selected Bibliography.

    Science.gov (United States)

    Health Services and Mental Health Administration (DHEW), Bethesda, MD.

    This annotated bibliography contains books, journal articles, visual aids, and other documents pertaining to emergency health care, which are organized according to: (1) publications dealing with day-to-day health emergencies that occur at home, work, and play, (2) documents that will help communities prepare for emergencies, including natural…

  12. Emerging Gastrointestinal and Liver Diseases in Asia Pacific: Implications to Health Care in the Region (World Gastroenterology Organization: Asian Pacific Association of Gastroenterology Distinguished Global Lecture 2015).

    Science.gov (United States)

    Goh, Khean-Lee

    2017-07-01

    Colorectal cancer (CRC), gastroesophageal reflux disease (GERD), inflammatory bowel disease (IBD), and nonalcoholic fatty liver disease are considered important emerging diseases in the Asia Pacific (AP) region. The incidence rate of CRC is the highest among gastrointestinal cancers in the region surpassing that of gastric cancer. However, population CRC screening is limited by availability of adequate health resources and financing. GERD is a highly prevalent disease in AP with the prevalence of GERD symptoms and reflux esophagitis reported to be increasing. The usage of proton pump inhibitors has also been reported to be high. The incidence and prevalence of IBD is not as high as in the west but is now an increasingly recognizable disease in the AP region. Being a complicated disease, IBD will pose a huge financial burden with the increasing use of expensive biological drugs. In tandem with the exponential increase in obesity and diabetes mellitus in AP, nonalcoholic fatty liver disease will become the most important liver disease in the region in the coming years. These emerging diseases reflect the continued fast-paced socioeconomic development in the region with marked lifestyle changes and increasing affluence.

  13. Building a foundation for 'One Health': an education strategy for enhancing and sustaining national and regional capacity in endemic and emerging zoonotic disease management.

    Science.gov (United States)

    Vink, W D; McKenzie, Joanna S; Cogger, Naomi; Borman, Barry; Muellner, Petra

    2013-01-01

    The rapid global spread of diseases such as SARS, H5N1, and H1N1 influenza has emphasized the pressing need for trans-disciplinary collaboration and cross-border action, and has also exposed a serious deficit of capacity and coordination in dealing effectively with emerging disease threats. The need for capacity development is particularly acute in the developing world, which is the least well-equipped to respond adequately. Such capacity development can be achieved through education and the implementation of applied 'One Health' activities. This chapter describes the establishment of a 'One Health' capacity development program in South Asia, consisting of two phases. The first phase provides Masters level training for public health doctors and veterinarians, with a focus on epidemiology, and disease control. The second phase reinforces the postgraduate training by establishing a sustainable framework for the implementation of collaborative 'One Health' activities such as the development of multidisciplinary professional networks, implementation of applied zoonotic disease investigation projects, and support for continuing professional development. The objectives are to provide individual skills required to strengthen capacity; to develop an appreciation of the cross-cutting issues which affect human and animal health, set within an institutional context; and to facilitate the development of regional professional networks which will be instrumental in implementing 'One Health' activities.

  14. Regional insertion: an emergent approach

    International Nuclear Information System (INIS)

    Serra, M.T.F.; Nascimento Teixeira, P. do

    1989-01-01

    The Brazilian Electrical Sector incorporates new variables that expressing the extensive spectrum of environmental impacts in the take of decisions, referring to the viability of realizing a electrical undertaking, attends the several restrictions that are important by the sector and by the society in the environment area and promotes the adequate generation of liquid benefits, consequential of the electrical undertaking. Due to these factors, the Electrical Sector is improving the concept of regional insertion, with the sectorial expansion in long-dated and the created demand in the environmental and social area, focalizing the solution for these questions. (C.G.C.). 1 fig, 2 tabs

  15. The Regional Environmental Emergency Team (REET)

    International Nuclear Information System (INIS)

    Maddock, M.

    2001-01-01

    This paper outlined the approach taken in Ontario to set up the Regional Environmental Emergency Team (REET) teams and the progress made in developing partnerships and coordination in response to environmental emergencies in Ontario. Environment Canada has been involved with the Ontario Regional Environmental Emergency Team (REET) Program for the past decade in order to review emergency response roles and responsibilities. REET is designed to enhance communication between emergency response agencies, foster recognition of the various responsibilities involved in an environmental emergency response and to increase the basic understanding of emergency response techniques and procedures within the emergency response community. During emergency response situations REET operates as a flexible and expandable multi-disciplinary and multi-agency team that provides comprehensive and coordinated environmental advice, information and assistance. The Ontario REET program currently consists of 18 area teams throughout the province with informal partnerships with Environment Canada, the Canadian Coast Guard, the Ontario Ministry of the Environment, Emergency Measures Ontario and the Ontario Ministry of Natural Resources. The program was inspired in 1970 and continues to provide an appropriate forum for environmental emergency planning and response. 6 refs., 1 fig

  16. The use of emerging technology to build health promotion capacity in regions with diversity in language and culture.

    Science.gov (United States)

    Perry, Martha W; Mittelmark, Maurice B

    2006-01-01

    Today in the human development arena, three actors play complementary, sometimes competing, and even conflicting roles on the world stage: governments, commercial enterprises and non-governmental organisations. Given their mission and available resources, each of these interact in different ways between each other, but have the same basis and needs for communication among each other. Two of the factors that come into play in these actors' operations are technology and internationalisation. We currently live the digital era brought on by the technological revolution. This has provided international actors with speed and flexibility over traditional communication formats to disseminate their work and collaborate more closely in real time and across geographical, cultural and language barriers. In order to be efficient and effective, these actors have begun and must continue to engage in this global transformation. All this is relevant to the IUHPE as a global organisation with members in over 90 countries. The hundreds of cultures and languages of our members enrich our ability to advocate for health in every corner of the world. However, our diversity can hinder our effectiveness. Language barriers separating even neighbours can make collaborative work difficult. There are several solutions that the IUHPE is adopting to bridge this divide, among them, using Information and Communication Technology (ICT). Within this context, this paper examines the different multi-dimensional dialogue and information platforms offered by ICTs today and its future developments. This will include advantages and limitations with regard to both technological and financial nuances. The use of technology will be defined in relation to the implications for knowledge acquisition, conversation and action. The scenarios include the web as a global resource database and ICTs, including machine translation, for one-on-one and multi-party communication. In a world that is increasingly entwined

  17. Public health implications of emerging zoonoses.

    Science.gov (United States)

    Meslin, F X; Stöhr, K; Heymann, D

    2000-04-01

    Many new, emerging and re-emerging diseases of humans are caused by pathogens which originate from animals or products of animal origin. A wide variety of animal species, both domestic and wild, act as reservoirs for these pathogens, which may be viruses, bacteria or parasites. Given the extensive distribution of the animal species affected, the effective surveillance, prevention and control of zoonotic diseases pose a significant challenge. The authors describe the direct and indirect implications for public health of emerging zoonoses. Direct implications are defined as the consequences for human health in terms of morbidity and mortality. Indirect implications are defined as the effect of the influence of emerging zoonotic disease on two groups of people, namely: health professionals and the general public. Professional assessment of the importance of these diseases influences public health practices and structures, the identification of themes for research and allocation of resources at both national and international levels. The perception of the general public regarding the risks involved considerably influences policy-making in the health field. Extensive outbreaks of zoonotic disease are not uncommon, especially as the disease is often not recognised as zoonotic at the outset and may spread undetected for some time. However, in many instances, the direct impact on health of these new, emerging or re-emerging zoonoses has been small compared to that of other infectious diseases affecting humans. To illustrate the tremendous indirect impact of emerging zoonotic diseases on public health policy and structures and on public perception of health risks, the authors provide a number of examples, including that of the Ebola virus, avian influenza, monkeypox and bovine spongiform encephalopathy. Recent epidemics of these diseases have served as a reminder of the existence of infectious diseases and of the capacity of these diseases to occur unexpectedly in new

  18. Health Concerns in the Amazon Region

    Centers for Disease Control (CDC) Podcasts

    2009-04-09

    Residents of the Amazon region of South America contend with a number of health threats - from mosquito-borne diseases to difficulty accessing doctors and healthcare facilities in such a vast area. This podcast helps explore some of the health issues in the region and what's being done to address them.  Created: 4/9/2009 by Emerging Infectious Diseases.   Date Released: 4/9/2009.

  19. Emerging health issues: the widening challenge for population health promotion.

    Science.gov (United States)

    McMichael, Anthony J; Butler, Colin D

    2006-12-01

    The spectrum of tasks for health promotion has widened since the Ottawa Charter was signed. In 1986, infectious diseases still seemed in retreat, the potential extent of HIV/AIDS was unrecognized, the Green Revolution was at its height and global poverty appeared less intractable. Global climate change had not yet emerged as a major threat to development and health. Most economists forecast continuous improvement, and chronic diseases were broadly anticipated as the next major health issue. Today, although many broadly averaged measures of population health have improved, many of the determinants of global health have faltered. Many infectious diseases have emerged; others have unexpectedly reappeared. Reasons include urban crowding, environmental changes, altered sexual relations, intensified food production and increased mobility and trade. Foremost, however, is the persistence of poverty and the exacerbation of regional and global inequality. Life expectancy has unexpectedly declined in several countries. Rather than being a faint echo from an earlier time of hardship, these declines could signify the future. Relatedly, the demographic and epidemiological transitions have faltered. In some regions, declining fertility has overshot that needed for optimal age structure, whereas elsewhere mortality increases have reduced population growth rates, despite continuing high fertility. Few, if any, Millennium Development Goals (MDG), including those for health and sustainability, seem achievable. Policy-makers generally misunderstand the link between environmental sustainability (MDG #7) and health. Many health workers also fail to realize that social cohesion and sustainability--maintenance of the Earth's ecological and geophysical systems--is a necessary basis for health. In sum, these issues present an enormous challenge to health. Health promotion must address population health influences that transcend national boundaries and generations and engage with the

  20. Diferenças regionais de conhecimento, opinião e uso de contraceptivo de emergência entre universitários brasileiros de cursos da área de saúde Regional differences in knowledge, attitudes, and practice in emergency contraceptive use among health sciences university students in Brazil

    Directory of Open Access Journals (Sweden)

    Flávia Calanca da Silva

    2010-09-01

    Full Text Available O objetivo deste estudo foi avaliar as diferenças regionais de conhecimento, opinião e uso de anticoncepção de emergência entre universitários brasileiros. Questionário semi-estruturado abordando conhecimento, opinião, experiência com anticoncepção de emergência e comportamento sexual foi aplicado a adolescentes de universidades brasileiras. Para análise estatística utilizou-se o teste exato de Fisher e ANOVA. Diferenças foram significantes quando o valor de p The aim of this study was to evaluate regional differences in knowledge, attitudes, and practice in emergency contraception use among Brazilian university students. A sample of university students answered a semi-structured questionnaire on knowledge, attitudes, and practice related to emergency contraception and sexual behavior. Fisher's exact test and ANOVA were used for statistical analysis. Statistical significance was set at p < 0.05. Ninety-six percent (n = 588 of the students had heard of emergency contraception, and 19% (n = 111 knew all the situations in which emergency contraception is indicated, with statistical differences between regions of the country. Forty-two percent of sexually active women in the sample had already used emergency contraception; 35% (n = 207 of students equated emergency contraception with abortion; and 81% (n = 473 thought emergency contraception involves health risks. No significant difference was observed between regions of the country regarding use and attitudes towards emergency contraception. Inter-regional differences in knowledge had no impact on students' attitudes and practice in emergency contraception. National awareness-raising campaigns are needed to improve knowledge on emergency contraception.

  1. When chronic conditions become emergencies - a report from regional Queensland.

    Science.gov (United States)

    Harriss, Linton R; Thompson, Fintan; Dey, Arindam; Mills, Jane; Watt, Kerrianne; McDermott, Robyn

    2016-12-01

    To describe chronic conditions and injuries as a proportion of total emergency presentations to a large public hospital in regional Queensland, and to investigate differences in presentation rates associated with Indigenous status. Cross-sectional analysis using Emergency Department Information System data between 1 July 2012 and 30 June 2014. Regional Queensland, Australia. A total of 95 238 emergency presentations were generated by 50 083 local residents living in the 10 statistical local areas (SLAs) immediately around the hospital. Emergency presentations for chronic conditions and injuries identified from discharge ICD-10-AM principal diagnosis. Age-standardised presentation rates were calculated using the Australian 2001 reference population. Approximately half of all presentations were for chronic conditions (20.2%) and injuries (28.8%). Two-thirds of all chronic condition presentations were for mental and behavioural disorders (34.6%) and circulatory diseases (33.2%). Head injuries accounted for the highest proportion of injuries (18.9%). Age-standardised rates for major diagnostic groups were consistently higher for Indigenous residents, whose presentations were lower in mean age (95% CI) by 7.7 (7.3-8.1) years, 23% less likely to be potentially avoidable GP-type presentations [RR (95% CI) = 0.77 (0.75-0.80)], 30% more likely to arrive by ambulance [1.31 (1.28-1.33)] and 11% more likely to require hospital admission [1.11 (1.08-1.13)]. Opportunities exist to enhance current coordinated hospital avoidance and primary health services in regional Queensland targeting common mental and circulatory disorders, especially for Indigenous Australians. © 2016 The Authors. Australian Journal of Rural Health published by John Wiley & Sons Australia, Ltd on behalf of National Rural Health Alliance Inc.

  2. Public health emergencies in urban India

    Directory of Open Access Journals (Sweden)

    Bhabani Prasad Acharya

    2018-03-01

    Full Text Available Public health emergencies in urban India can be caused by natural or man-made disasters. Occurrence of a public health emergency adds to the already stretched health system. This paper looks into the public health emergency conditions in urban India, and our preparedness to tackle them. To address this composite threat to nation’s health and development, a concerted public health response is needed, that can ensure efficient delivery in emergency situations Public health emergency is an occurrence or eminent threat of an illness or health condition caused by bio-terrorism, epidemic or pandemic disease, or novel and highly fatal infectious agent or biological toxin, that possess a substantial risk of a significant number of human facilities or incidents or permanent or long–term disability (1. It is a condition that requires the government to declare a state of public health emergency. The declaration of a state of public health emergency permits the government to suspend state regulations,and change the functions of state agencies (2. Term “Urban” refers to perplexing variety of environments.  Health circumstances of small cities and town differ in many ways from larger cities and metros. Within cities, change in lifestyle of residents is observed. The urban system is often present with full array of health providers ranging from traditional healer, street drug seller to highly –trained surgeons (3.

  3. Conceptions of mobile emergency service health professionals concerning psychiatric emergency

    Directory of Open Access Journals (Sweden)

    Diego Bonfada

    2012-06-01

    Full Text Available Under the Brazilian Psychiatric Reformation, assistance to psychological seizures represents a challenge for the emergency services. Therefore, the objective of this paper is the analysis of the conceptions of health professionals who work at the Mobile Emergency Service in Natal on psychiatric emergency care. This paper is, then, a qualitative study that used interviews as tools for collecting information. By using thematic analysis, the speeches were grouped into three categories: the stigma on patients and the professionals' fear of services interventions in psychiatric emergencies; having psychiatric emergencies regarded as harmful to patients and others' security; psychiatric emergencies being taken as patients' aggressiveness or severe depression. The data collected indicate that the interviewed professionals' ideas are supported by elements associated with the ideology that insanity implies social segregation and dangerousness. Thus, the survey prompted reflection on relevant issues to the process of psychiatric reformation implementation.

  4. Towards integrated crisis support of regional emergency networks.

    Science.gov (United States)

    Caro, D H

    1999-01-01

    Emergency and crisis management pose multidimensional information systems challenges for communities across North America. In the quest to reduce mortality and morbidity risks and to increase the level of crisis preparedness, regional emergency management networks have evolved. Integrated Crisis Support Systems (ICSS) are enabling information technologies that assist emergency managers by enhancing the ability to strategically manage and control these regional emergency networks efficiently and effectively. This article underscores the ICCS development, control and leadership issues and their promising implications for regional emergency management networks.

  5. Manual on public health action in radiation emergencies

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1994-12-31

    Over the years, the World Health Organization (WHO) has issued a series of reports and publications providing guidance on the public health aspects of nuclear power production, in line with target 11 of the European policy for health for all, which calls for the reduction of injury, disability and death from accidents. Immediately after the nuclear accident at Chernobyl in April 1986, the WHO Regional Office for Europe established an emergency operation to provide technical cooperation and communication links with Member States. A special project on the public health dimensions of radiation emergencies was subsequently established, which included a series of activities related both directly to the Chernobyl accident and to emergency planning for future accidents. This manual brings together the experience gained in the special project to improve the planning for and response to emergencies. It has been prepared to meet public health needs arising from all types of major radiation emergency in the European Region. The manual describes the guiding principles and advises on the practical application of measures to protect and inform the public in a radiation emergency. It is hoped that the manual will promote close interaction between the WHO Member States in this field. The advice given in earlier WHO publications on radiation emergencies has been examined and revised in the light of recent experience 12 refs, 4 figs, 4 tabs

  6. Manual on public health action in radiation emergencies

    International Nuclear Information System (INIS)

    1994-01-01

    Over the years, the World Health Organization (WHO) has issued a series of reports and publications providing guidance on the public health aspects of nuclear power production, in line with target 11 of the European policy for health for all, which calls for the reduction of injury, disability and death from accidents. Immediately after the nuclear accident at Chernobyl in April 1986, the WHO Regional Office for Europe established an emergency operation to provide technical cooperation and communication links with Member States. A special project on the public health dimensions of radiation emergencies was subsequently established, which included a series of activities related both directly to the Chernobyl accident and to emergency planning for future accidents. This manual brings together the experience gained in the special project to improve the planning for and response to emergencies. It has been prepared to meet public health needs arising from all types of major radiation emergency in the European Region. The manual describes the guiding principles and advises on the practical application of measures to protect and inform the public in a radiation emergency. It is hoped that the manual will promote close interaction between the WHO Member States in this field. The advice given in earlier WHO publications on radiation emergencies has been examined and revised in the light of recent experience

  7. Mobile health systems and emergence

    NARCIS (Netherlands)

    Jones, Valerie M.; Graziosi, Barbara

    2015-01-01

    Changes in the age distribution of the population and increased prevalence of chronic illnesses, together with a shortage of health professionals and other resources, will increasingly challenge the ability of national healthcare systems to meet rising demand for services. Large-scale use of eHealth

  8. Mental health triage in emergency medicine.

    Science.gov (United States)

    Smart, D; Pollard, C; Walpole, B

    1999-02-01

    The aim of this study was to: (i) develop a triage scale consistent with the National Triage Scale (NTS) for patients with mental health problems attending emergency departments; and (ii) to reduce emergency waiting times, transit times and improve skills assessing mental health problems. We developed a Mental Health Triage Scale (MHTS) consistent with the NTS. The MHTS was then implemented using a structured education package, and evaluated from March to August 1994. Further evaluation occurred after 2 years. A four-tiered MHTS was produced: category 2, violent, aggressive or suicidal, danger to self or others or with police escort; category 3, very distressed or psychotic, likely to deteriorate, situational crisis, danger to self or others; category 4, long-standing semi-urgent mental health disorder, supporting agency present; and category 5, long-standing non-acute mental health disorder, no support agency present. Patients with illness, injury or self-harm were triaged using combined mental health and medical information. Mean emergency waiting times and transit times were reduced. More consistent triaging for mental health patients occurred, and more consistent admission rates by urgency. Reduced mental health 'did not waits' showed improved customer satisfaction. Mental Health Triage Scale was considered appropriate by liaison psychiatry and its use has continued at 2 years follow-up. A systematic approach to mental health triaging produced a workable scale, reduced waiting times, transit times, and provided effective and consistent integration of mental health patients into a general emergency department.

  9. Illuminating collaboration in emergency health care situations

    DEFF Research Database (Denmark)

    Sonnenwald, Diane H.; Söderholm, Hanna Maurin; Welch, Gregory F.

    2014-01-01

    reported the technology would require additional training, changes to existing financial models used in emergency health care, and increased access to physicians. Conclusions. Teaching collaboration skills and strategies to physicians and paramedics could benefit their collaboration today, and increase...

  10. Federal Emergency Management Agency (FEMA) Regions

    Data.gov (United States)

    Department of Homeland Security — Regional Offices manage, operate and maintain all delegated programs, functions and activities not managed, operated or maintained by headquarters organizational...

  11. One Health Perspectives on Emerging Public Health Threats

    Directory of Open Access Journals (Sweden)

    Sukhyun Ryu

    2017-11-01

    Full Text Available Antimicrobial resistance and emerging infectious diseases, including avian influenza, Ebola virus disease, and Zika virus disease have significantly affected humankind in recent years. In the premodern era, no distinction was made between animal and human medicine. However, as medical science developed, the gap between human and animal science grew deeper. Cooperation among human, animal, and environmental sciences to combat emerging public health threats has become an important issue under the One Health Initiative. Herein, we presented the history of One Health, reviewed current public health threats, and suggested opportunities for the field of public health through better understanding of the One Health paradigm.

  12. Emerging trends in regional coal production

    International Nuclear Information System (INIS)

    Watson, W.D.

    1994-01-01

    At an average annual growth rate of 1.9%, the total national demand for coal will increase from 850 million short tons in 1985 to 2 billion short tons annually by the year 2030. A market simulation model (described in this paper) determines the regional pattern of coal production needed to meet these demands. Because compliance or low-sulfur coal resources are a low-cost option for meeting environmental regulations, they could be mined out substantially in the medium term. In the next 15 to 25 years, most of the Eastern compliance coal up to a mining cost of $40 per ton could be mined out and 4 billion short tons of Western compliance coal could be produced. By the year 2030, almost all Eastern low-sulfur coal could be mined out. Most Western compliance coal costing less than $20/ton could be mined out by 2030

  13. Globalisation, complex humanitarian emergencies and health.

    Science.gov (United States)

    O'Dempsey, T J D; Munslow, B

    2006-01-01

    A new political economy of conflict has emerged in the aftermath of colonialism and the Cold War. Complex political emergencies have been simmering in the post-colonial world for more than three decades. Intra-country armed conflict, often combined with natural disasters, at present contributes to the displacement of over 20 million people world-wide. The international community remains profoundly uncomfortable with the complex political emergencies of the new era, torn between the respect for national sovereignty upon which the international political system of the United Nations and other agencies is built, and the growth of concern with human rights and a burgeoning International Humanitarian Law. Globalisation may have brought many benefits to some but there are also many losers. The Word Bank and the International Monetary Fund imposed structural adjustment policies to ensure debt repayment and economic restructuring that have resulted in a net reduction in expenditure on health, education and development. A downward spiral has been created of debt, disease, malnutrition, missed education, economic entrapment, poverty, powerlessness, marginalization, migration and instability. Africa's complex political emergencies are particularly virulent and tenacious. Three examples that are among the most serious humanitarian emergencies to have faced the world in recent times--those in Angola, the Democratic Republic of Congo and Sudan--are reviewed here in detail. The political evolution of these emergencies and their impact on the health of the affected populations are also explored.

  14. Emergency response and radiation monitoring systems in Russian regions

    International Nuclear Information System (INIS)

    Arutyunyan, R.; Osipiyants, I.; Kiselev, V.; Ogar, K; Gavrilov, S.

    2008-01-01

    Full text: Preparedness of the emergency response system to elimination of radiation incidents and accidents is one of the most important elements of ensuring safe operation of nuclear power facilities. Routine activities on prevention of emergency situations along with adequate, efficient and opportune response actions are the key factors reducing the risks of adverse effects on population and environment. Both high engineering level and multiformity of the nuclear branch facilities make special demands on establishment of response system activities to eventual emergency situations. First and foremost, while resolving sophisticated engineering and scientific problems emerging during the emergency response process, one needs a powerful scientific and technical support system.The emergency response system established in the past decade in Russian nuclear branch provides a high efficiency of response activities due to the use of scientific and engineering potential and experience of the involved institutions. In Russia the responsibility for population protection is imposed on regional authority. So regional emergence response system should include up-to-date tools of radiation monitoring and infrastructure. That's why new activities on development of radiation monitoring and emergency response system were started in the regions of Russia. The main directions of these activities are: 1) Modernization of the existing and setting-up new facility and territorial automatic radiation monitoring systems, including mobile radiation surveillance kits; 2) Establishment of the Regional Crisis Centres and Crisis Centres of nuclear and radiation hazardous facilities; 3) Setting up communication systems for transfer, acquisition, processing, storage and presentation of data for participants of emergency response at the facility, regional and federal levels; 4) Development of software and hardware systems for expert support of decision-making on protection of personnel, population

  15. Regional insertion: an emergent approach; Insercao regional: uma abordagem emergente

    Energy Technology Data Exchange (ETDEWEB)

    Serra, M T.F.; Nascimento Teixeira, P do [ELETROBRAS, Rio de Janeiro, RJ (Brazil). Dept. de Meio Ambiente

    1990-12-31

    The Brazilian Electrical Sector incorporates new variables that expressing the extensive spectrum of environmental impacts in the take of decisions, referring to the viability of realizing a electrical undertaking, attends the several restrictions that are important by the sector and by the society in the environment area and promotes the adequate generation of liquid benefits, consequential of the electrical undertaking. Due to these factors, the Electrical Sector is improving the concept of regional insertion, with the sectorial expansion in long-dated and the created demand in the environmental and social area, focalizing the solution for these questions. (C.G.C.). 1 fig, 2 tabs.

  16. Radiological Emergency Response Health and Safety Manual

    Energy Technology Data Exchange (ETDEWEB)

    D. R. Bowman

    2001-05-01

    This manual was created to provide health and safety (H&S) guidance for emergency response operations. The manual is organized in sections that define each aspect of H and S Management for emergency responses. The sections are as follows: Responsibilities; Health Physics; Industrial Hygiene; Safety; Environmental Compliance; Medical; and Record Maintenance. Each section gives guidance on the types of training expected for managers and responders, safety processes and procedures to be followed when performing work, and what is expected of managers and participants. Also included are generic forms that will be used to facilitate or document activities during an emergency response. These ensure consistency in creating useful real-time and archival records and help to prevent the loss or omission of information.

  17. Effects of a dedicated regional psychiatric emergency service on boarding of psychiatric patients in area emergency departments.

    Science.gov (United States)

    Zeller, Scott; Calma, Nicole; Stone, Ashley

    2014-02-01

    Mental health patients boarding for long hours, even days, in United States emergency departments (EDs) awaiting transfer for psychiatric services has become a considerable and widespread problem. Past studies have shown average boarding times ranging from 6.8 hours to 34 hours. Most proposed solutions to this issue have focused solely on increasing available inpatient psychiatric hospital beds, rather than considering alternative emergency care designs that could provide prompt access to treatment and might reduce the need for many hospitalizations. One suggested option has been the "regional dedicated emergency psychiatric facility," which serves to evaluate and treat all mental health patients for a given area, and can accept direct transfers from other EDs. This study sought to assess the effects of a regional dedicated emergency psychiatric facility design known at the "Alameda Model" on boarding times and hospitalization rates for psychiatric patients in area EDs. Over a 30-day period beginning in January 2013, 5 community hospitals in Alameda County, California, tracked all ED patients on involuntary mental health holds to determine boarding time, defined as the difference between when they were deemed stable for psychiatric disposition and the time they were discharged from the ED for transfer to the regional psychiatric emergency service. Patients were also followed to determine the percentage admitted to inpatient psychiatric units after evaluation and treatment in the psychiatric emergency service. In a total sample of 144 patients, the average boarding time was approximately 1 hour and 48 minutes. Only 24.8% were admitted for inpatient psychiatric hospitalization from the psychiatric emergency service. The results of this study indicate that the Alameda Model of transferring patients from general hospital EDs to a regional psychiatric emergency service reduced the length of boarding times for patients awaiting psychiatric care by over 80% versus

  18. Local Helioseismology of Emerging Active Regions: A Case Study

    Science.gov (United States)

    Kosovichev, Alexander G.; Zhao, Junwei; Ilonidis, Stathis

    2018-04-01

    Local helioseismology provides a unique opportunity to investigate the subsurface structure and dynamics of active regions and their effect on the large-scale flows and global circulation of the Sun. We use measurements of plasma flows in the upper convection zone, provided by the Time-Distance Helioseismology Pipeline developed for analysis of solar oscillation data obtained by Helioseismic and Magnetic Imager (HMI) on Solar Dynamics Observatory (SDO), to investigate the subsurface dynamics of emerging active region NOAA 11726. The active region emergence was detected in deep layers of the convection zone about 12 hours before the first bipolar magnetic structure appeared on the surface, and 2 days before the emergence of most of the magnetic flux. The speed of emergence determined by tracking the flow divergence with depth is about 1.4 km/s, very close to the emergence speed in the deep layers. As the emerging magnetic flux becomes concentrated in sunspots local converging flows are observed beneath the forming sunspots. These flows are most prominent in the depth range 1-3 Mm, and remain converging after the formation process is completed. On the larger scale converging flows around active region appear as a diversion of the zonal shearing flows towards the active region, accompanied by formation of a large-scale vortex structure. This process occurs when a substantial amount of the magnetic flux emerged on the surface, and the converging flow pattern remains stable during the following evolution of the active region. The Carrington synoptic flow maps show that the large-scale subsurface inflows are typical for active regions. In the deeper layers (10-13 Mm) the flows become diverging, and surprisingly strong beneath some active regions. In addition, the synoptic maps reveal a complex evolving pattern of large-scale flows on the scale much larger than supergranulation

  19. Emerging health isues in Asia and the Pacific: implications for public health policy

    OpenAIRE

    Amarakoon Bandara

    2005-01-01

    The Asia-Pacific region is confronted with several emerging healthrelated issues. The prevalence of diseases causing high rates of mortality and morbidity, and the lack of skilled health personnel, infrastructure, financial resources and health systems that are responsive to the needs of society, are among them. A pragmatic approach with a focus on issues of major health and socio-economic concern is vital for the development of successful public health services. Striking a balance between di...

  20. The emergence and consolidation of the Urban-Rural Region

    DEFF Research Database (Denmark)

    Fertner, Christian

    2013-01-01

    of a wider metropolitan region. Most recently, however, a shift of migration towards the urban centre has occurred. Was the emergence of the urban-rural region just an ephemeral phenomenon? Migration patterns are used to analyse urban-rural relationships. Generally, in-migration was concentrated in areas...

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

    Science.gov (United States)

    Burkle, Frederick M

    2016-08-01

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

  2. Enhancing crisis leadership in public health emergencies.

    Science.gov (United States)

    Deitchman, Scott

    2013-10-01

    Reviews of public health emergency responses have identified a need for crisis leadership skills in health leaders, but these skills are not routinely taught in public health curricula. To develop criteria for crisis leadership in public health, published sources were reviewed to identify attributes of successful crisis leadership in aviation, public safety, military operations, and mining. These sources were abstracted to identify crisis leadership attributes associated with those disciplines and compare those attributes with crisis leadership challenges in public health. Based on this review, the following attributes are proposed for crisis leadership in public health: competence in public health science; decisiveness with flexibility; ability to maintain situational awareness and provide situational assessment; ability to coordinate diverse participants across very different disciplines; communication skills; and the ability to inspire trust. Of these attributes, only competence in public health science is currently a goal of public health education. Strategies to teach the other proposed attributes of crisis leadership will better prepare public health leaders to meet the challenges of public health crises.

  3. Publication ethics in public health emergencies.

    Science.gov (United States)

    Shaw, David; Elger, Bernice S

    2017-09-01

    In this article, we describe and analyse three issues in publication ethics that are raised when conducting research in emergencies and disasters. These include reluctance to share data and samples because of concerns about publications, loss of individual authorship in high high-profile multi-entity publications, and the deaths of authors during dangerous research projects. An emergency research pledge may be useful in avoiding some of these issues. © The Author 2016. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  4. Access to emergency care services: a transversal ecological study about Brazilian emergency health care network.

    Science.gov (United States)

    Rocha, T A H; da Silva, N C; Amaral, P V; Barbosa, A C Q; Rocha, J V M; Alvares, V; de Almeida, D G; Thumé, E; Thomaz, E B A F; de Sousa Queiroz, R C; de Souza, M R; Lein, A; Toomey, N; Staton, C A; Vissoci, J R N; Facchini, L A

    2017-12-01

    Studies of health geography are important in the planning and allocation of emergency health services. The geographical distribution of health facilities is an important factor in timely and quality access to emergency services; therefore, the present study analyzed the emergency health care network in Brazil, focusing the analysis at the roles of small hospitals (SHs). Cross-sectional ecological study. Data were collected from 9429 hospitals of which 3524 were SHs and 5905 were high-complexity centers (HCCs). For analytical purposes, we considered four specialties when examining the proxies of emergency care capability: adult, pediatrics, neonatal, and obstetric. We analyzed the spatial distribution of hospitals, identifying municipalities that rely exclusively on SHs and the distance of these cities from HCCs. More than 14 and 30 million people were at least 120 km away from HCCs with an adult intensive care unit (ICU) and pediatric ICU, respectively. For neonatal care distribution, 12% of the population was more than 120 km away from a health facility with a neonatal ICU. The maternities situation is different from other specialties, where 81% of the total Brazilian population was within 1 h or less from such health facilities. Our results highlighted a polarization in distribution of Brazilian health care facilities. There is a concentration of hospitals in urban areas more developed and access gaps in rural areas and the Amazon region. Our results demonstrate that the distribution of emergency services in Brazil is not facilitating access to the population due to geographical barriers associated with great distances. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  5. Regional Branching Reconsidered: Emergence of the Fuel Cell Industry in European Regions

    DEFF Research Database (Denmark)

    Tanner, Anne Nygaard

    2014-01-01

    The literature on economic geography suffers from a lack of attention to the emergence of new industries. Recent literature on “regional branching” proposes that new industries emerge in regions where preexisting economic activities are technologically related to the emerging industry. This article...... provides a more grounded basis for the emerging literature on regional branching by confronting the regional branching thesis with the realities of an emerging industry, namely, the fuel cell industry. The analysis is based on patent data and qualitative interviews conducted in a selection of European NUTS...... new technologies to their product portfolio. The importance of further investigating and disentangling different dimensions of relatedness and their impact on regional branching is stressed....

  6. Medical Emergency Workload of a Regional UK HEMS Service.

    Science.gov (United States)

    McQueen, Carl; Crombie, Nick; Cormack, Stef; Wheaton, Steve

    2015-01-01

    Regionalized trauma networks have been established in England to centralize specialist care at dedicated centers of excellence throughout the country. Helicopter emergency medical services (HEMS) in the West Midlands region have been redesigned to form an integrated component of such systems. The continued use of such valuable and scarce resources for medical emergencies requires evaluation. A retrospective review of mission data for a regional Air Ambulance Service in England over a two year period. Medical emergencies continue to contribute a large proportion of the overall workload of the service. Requirement for advanced interventions at the scene was rare, with less than 10% of patients attended by HEMS teams having care needs that fall beyond the scope of standard paramedic practice. Dynamic solutions are needed to ensure that HEMS support for cases of medical emergency are appropriately targeted to incidents in which clinical benefit is conferred to the patient. Intelligent tasking of appropriate resources has the potential to improve the HEMS response to medical emergencies while optimizing the availability of resources to respond to other incidents, most notably cases of major trauma. Copyright © 2015 Air Medical Journal Associates. Published by Elsevier Inc. All rights reserved.

  7. Assessment of emergency medical services in the Ashanti region of ...

    African Journals Online (AJOL)

    Deficient areas in need of development are governance, reliable revenue, public access, community integration, clinical care guidelines, research and quality assurance processes. Conclusions: The Ashanti Region has a growing and thriving emergency medical services system. Although many essential areas for ...

  8. The French Regions and Their Social Health

    Science.gov (United States)

    Jany-Catrice, Florence

    2009-01-01

    In this article, a new indicator designed to capture the multidimensionality of the social health of the French regions is put to the test. Drawing on regional data for 2004, this indicator of social health (ISH) sheds new light on the social performance of the French regions. The worst performers are the highly urbanised regions, whereas others,…

  9. [Health alert management and emerging risk].

    Science.gov (United States)

    Pillonel, J

    2010-12-01

    Following health crisis that have occurred in the nineties (contaminated blood, mad cow, asbestos, etc.) and more recently those generated by the heat wave in 2003 or by emerging infectious pathogens (SARS, West Nile, Chikungunya, H5N1, H1N1…), a real health vigilance system has been progressively developed in France. After a brief historical overview of the health alert system, this article will give the guiding principles of its current organization in France and will present two examples of recent health alerts (Chikungunya in the Reunion Island in 2005-2006 and hepatitis A outbreak in the Côtes-d'Armor in August 2007), that have needed the implementation of preventive measures regarding the blood donor selection. These two examples have shown that the position of the alert in the French health vigilance system needs to be very close to the event. In that case, health alert is a very useful tool for decision making especially when measures have to be taken to prevent transfusion-transmitted pathogens. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

  10. The emergent discipline of health web science.

    Science.gov (United States)

    Luciano, Joanne S; Cumming, Grant P; Wilkinson, Mark D; Kahana, Eva

    2013-08-22

    The transformative power of the Internet on all aspects of daily life, including health care, has been widely recognized both in the scientific literature and in public discourse. Viewed through the various lenses of diverse academic disciplines, these transformations reveal opportunities realized, the promise of future advances, and even potential problems created by the penetration of the World Wide Web for both individuals and for society at large. Discussions about the clinical and health research implications of the widespread adoption of information technologies, including the Internet, have been subsumed under the disciplinary label of Medicine 2.0. More recently, however, multi-disciplinary research has emerged that is focused on the achievement and promise of the Web itself, as it relates to healthcare issues. In this paper, we explore and interrogate the contributions of the burgeoning field of Web Science in relation to health maintenance, health care, and health policy. From this, we introduce Health Web Science as a subdiscipline of Web Science, distinct from but overlapping with Medicine 2.0. This paper builds on the presentations and subsequent interdisciplinary dialogue that developed among Web-oriented investigators present at the 2012 Medicine 2.0 Conference in Boston, Massachusetts.

  11. Priority setting for health in emerging markets.

    Science.gov (United States)

    Glassman, Amanda; Giedion, Ursula; McQueston, Kate

    2013-05-01

    The use of health technology assessment research in emerging economies is becoming an increasingly important tool to determine the uses of health spending. As low- and middle-income countries' gross domestic product grows, the funding available for health has increased in tandem. There is growing evidence that comparative effectiveness research and cost-effectiveness can be used to improve health outcomes within a predefined financial space. The use of these evaluation tools, combined with a systematized process of priority setting, can help inform national and global health payers. This review of country institutions for health technology assessment illustrates two points: the efforts underway to use research to inform priorities are widespread and not confined to wealthier countries; and many countries' efforts to create evidence-based policy are incomplete and more country-specific research will be needed. Further evidence shows that there is scope to reduce these gaps and opportunity to support better incorporation of data through better-defined priority-setting processes.

  12. RTSTEP regional transportation simulation tool for emergency planning - final report.

    Energy Technology Data Exchange (ETDEWEB)

    Ley, H.; Sokolov, V.; Hope, M.; Auld, J.; Zhang, K.; Park, Y.; Kang, X. (Energy Systems)

    2012-01-20

    Large-scale evacuations from major cities during no-notice events - such as chemical or radiological attacks, hazardous material spills, or earthquakes - have an obvious impact on large regions rather than on just the directly affected area. The scope of impact includes the accommodation of emergency evacuation traffic throughout a very large area; the planning of resources to respond appropriately to the needs of the affected population; the placement of medical supplies and decontamination equipment; and the assessment and determination of primary escape routes, as well as routes for incoming emergency responders. Compared to events with advance notice, such as evacuations based on hurricanes approaching an affected area, the response to no-notice events relies exclusively on pre-planning and general regional emergency preparedness. Another unique issue is the lack of a full and immediate understanding of the underlying threats to the population, making it even more essential to gain extensive knowledge of the available resources, the chain of command, and established procedures. Given the size of the area affected, an advanced understanding of the regional transportation systems is essential to help with the planning for such events. The objectives of the work described here (carried out by Argonne National Laboratory) is the development of a multi-modal regional transportation model that allows for the analysis of different evacuation scenarios and emergency response strategies to build a wealth of knowledge that can be used to develop appropriate regional emergency response plans. The focus of this work is on the effects of no-notice evacuations on the regional transportation network, as well as the response of the transportation network to the sudden and unusual demand. The effects are dynamic in nature, with scenarios changing potentially from minute to minute. The response to a radiological or chemical hazard will be based on the time-delayed dispersion of

  13. Regional governance: strategies and disputes in health region management

    Directory of Open Access Journals (Sweden)

    Adriano Maia dos Santos

    2014-08-01

    Full Text Available OBJECTIVE To analyze the regional governance of the health systemin relation to management strategies and disputes. METHODOLOGICAL PROCEDURES A qualitative study with health managers from 19 municipalities in the health region of Bahia, Northeastern Brazil. Data were drawn from 17 semi-structured interviews of state, regional, and municipal health policymakers and managers; a focus group; observations of the regional interagency committee; and documents in 2012. The political-institutional and the organizational components were analyzed in the light of dialectical hermeneutics. RESULTS The regional interagency committee is the chief regional governance strategy/component and functions as a strategic tool for strengthening governance. It brings together a diversity of members responsible for decision making in the healthcare territories, who need to negotiate the allocation of funding and the distribution of facilities for common use in the region. The high turnover of health secretaries, their lack of autonomy from the local executive decisions, inadequate technical training to exercise their function, and the influence of party politics on decision making stand as obstacles to the regional interagency committee’s permeability to social demands. Funding is insufficient to enable the fulfillment of the officially integrated agreed-upon program or to boost public supply by the system, requiring that public managers procure services from the private market at values higher than the national health service price schedule (Brazilian Unified Health System Table. The study determined that “facilitators” under contract to health departments accelerated access to specialized (diagnostic, therapeutic and/or surgical services in other municipalities by direct payment to physicians for procedure costs already covered by the Brazilian Unified Health System. CONCLUSIONS The characteristics identified a regionalized system with a conflictive pattern of

  14. Regenerative Medicine as an Emergent Cluster in Tampere Region

    Directory of Open Access Journals (Sweden)

    Tuomo Heinonen

    2015-01-01

    Full Text Available Clusters are important for regional economies and emergent clusters are in a key position, as a means of adding more diversification to the current economic activity by involving new technologies and industries. Science-based industries may be the most promising in this regard since they are encouraged to develop and enhance the economic imaginaries of territories under the umbrella of radical innovations or in the name of broadening the current economic model based on mostly traditional industries. Regenerative medicine (RM could be an example of these so-called emergent clusters. Regenerative medicine is highly dependent on academic research, which means that local territories must fund the research in this field and, hence, they expect some returns as well. As territories do not typically have existing industries specifically in RM, these industries must emerge or expand from existing ones. Regenerative medicine involves a wide spectrum of different technologies and industries that are likely to form a cluster and benefit from it if successfully developed. The first aim of this paper is to show how some obstacles eventually impede the proper development of these emergent clusters. The second aim is to shed light on how innovations emerge in the cluster and what are the main implications for the territory. In this study, existing literature is used in order to describe the technology market and commercial aspects of the RM sector. Empirically this study is based on the emergent RM cluster in the region of Tampere in Finland. Analysis of 24 conducted interviews helps to contextualize the emergence of the RM cluster in Tampere, where academia is both the booster and the driver of the emergent RM cluster. Commercialization of research in the RM field is one of the goals at the university, even though there are no commercial outcomes yet available. This study contributes to the understanding of emergent cluster development in science

  15. PLACING INDIA IN THE EMERGING REGIONAL DYNAMICS OF CENTRAL ASIA

    Directory of Open Access Journals (Sweden)

    Meena Singh Roy

    2017-10-01

    Full Text Available The present article tries to examine India’s initiatives in the region in the context of the emerging regional geo-strategic landscape. With an aim to enhance political, economic and strategic ties, India’s policy towards the region has moved from ‘Look North’ to ‘Connect North’. Notably, the full membership of SCO offers India greater synergies to play a more active role in the region. India is, thus, all set to build more meaningful partnerships with the region in the context of new geo-political changes shaping Central Asia. More importantly, the region is seeking India to play a more active role. It is argued that the beginning of a new era of cooperation initiated by PM Modi can only be sustained if New Delhi continues to implement its various agreements and commitments. While building stronger bilateral ties with the region is important, working closely in the regional groupings will also help address regional economic and security challenges

  16. Determinants of health disparities between Italian regions

    Directory of Open Access Journals (Sweden)

    Giannoni Margherita

    2010-06-01

    Full Text Available Abstract Background Among European countries, Italy is one of the countries where regional health disparities contribute substantially to socioeconomic health disparities. In this paper, we report on regional differences in self-reported poor health and explore possible determinants at the individual and regional levels in Italy. Methods We use data from the "Indagine Multiscopo sulle Famiglie", a survey of aspects of everyday life in the Italian population, to estimate multilevel logistic regressions that model poor self-reported health as a function of individual and regional socioeconomic factors. Next we use the causal step approach to test if living conditions, healthcare characteristics, social isolation, and health behaviors at the regional level mediate the relationship between regional socioeconomic factors and self-rated health. Results We find that residents living in regions with more poverty, more unemployment, and more income inequality are more likely to report poor health and that poor living conditions and private share of healthcare expenditures at the regional level mediate socioeconomic disparities in self-rated health among Italian regions. Conclusion The implications are that regional contexts matter and that regional policies in Italy have the potential to reduce health disparities by implementing interventions aimed at improving living conditions and access to quality healthcare.

  17. Emergency contraception in a public health emergency: exploring pharmacy availability in Brazil.

    Science.gov (United States)

    Tavares, Marilia P; Foster, Angel M

    2016-08-01

    Dedicated progestin-only emergency contraceptive pills (ECPs) have been available with a prescription in Brazil since 1999. However, utilization of emergency contraception has been limited. We conducted a mystery client study at retail pharmacies in three regions to assess current availability. Using a predetermined client profile, we approached a random sample of chain and independent pharmacies in urban areas in the southeastern, northeastern and central-west regions. We documented product availability, price and the client-pharmacy representative interaction at each site. We analyzed these data with descriptive statistics and for content and themes. We visited 122 pharmacies in early 2016. All but three pharmacies (97.5%) had ECPs in stock at the time of the interaction and offered our client the medication without a prescription. In general, pharmacy representatives did not ask questions or provide our client with information about emergency contraception. When prompted, over one third of the pharmacy representatives (37.7%) inaccurately reported that levonorgestrel ECPs could only be used immediately or within 12, 24 or 48h from the time of intercourse. Despite the current regulatory status, our findings suggest that progestin-only ECPs are widely available without a prescription. Additional efforts to ensure that women have up-to-date and medically accurate information about progestin-only ECPs appear warranted. Our findings suggest that more work needs to be done to align national regulatory policies with international standards and evidence-based practices. The Zika virus epidemic has shined a spotlight on the importance of providing timely access to emergency contraception in Latin America. This public health emergency offers a window of opportunity to advance national policies and practices to ensure that Brazilian women have access to a full range of reproductive health services. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Setting the agenda in emergency medicine in the southern African region: Conference assumptions and recommendations, Emergency Medicine Conference 2014: Gaborone, Botswana

    Directory of Open Access Journals (Sweden)

    Lloyd D. Christopher

    2014-09-01

    Full Text Available The first international emergency medicine (EM conference in Botswana was held on 15th and 16th May 2014 at the Gaborone International Convention Centre. The support from key stakeholders positioned the conference, from its conception, to deliver expert guidance on emergency medicine relevance, education and systems implementation. The conference theme was aptly: “Setting the Agenda in Emergency Medicine in the Southern African Region.” Over 300 local, regional and international delegates convened to participate in this landmark event. Country representation included Botswana, South Africa, Zambia, Namibia, Zimbabwe, Swaziland, Lesotho, Nigeria and the United States of America. Conference assumptions intersected emergency care, African burden of injury and illness and the role of the state; the public protection ethic of emergency care, and the developmental, economic and health interest in promoting EM. The recommendations addressed emergency care relevance; health systems research as an imperative for emergency systems development in southern Africa; community agency as a requisite for emergency care resilience; emergency care workers as pivotal to the emergency medical system, and support of EM system implementation. The conference recommendations – by way of setting an agenda, augur well for emergency care development and implementation in the southern African region and are likely to prove useful to the southern African countries seeking to address health service quality, EM advocacy support and implementation guidance. Emergency medicine is the only discipline with ‘universality’ and ‘responsivity’ at the point of need. This implies the widespread potential for facilitation of access to health care: a public health goal nuanced by the African development agenda.

  19. Regional training course on medical response on radiological emergencies. Annex

    International Nuclear Information System (INIS)

    2000-01-01

    This short information is an annex of the documentation distributed to the participants to the International Atomic Energy Agency (IAEA) Regional Training Course on Medical Response on Radiological Emergencies, organised by the IAEA in co-operation with the Government of Argentina thought the Nuclear Regulatory Authority, held in Buenos Aires, Argentina, 16-20 October 2000. The course was intended to people from IAEA Member State in the Latin American and Caribbean region, and to professionals and workers on medicine related with the radiation protection. This annex present information about: Radioactive materials transport; Internal and external contamination; Radiation accidents; Physical dosimetry

  20. Russian Pharmaceutical Companies Export Potential in Emerging Regional Clusters

    OpenAIRE

    Elena Vladimirovna Sapir; Igor Andreyevich Karachyov; Mingzhu Zhang

    2016-01-01

    This article analyzes a diverse range of the enterprise’s export potential growth factors in emerging pharmaceutical clusters of Central European Russia. Classification and comparative analysis were used to identify export potential attributes (production, finance, labor and marketing), which have allowed to reveal the strong connection of cluster and regional factor groups with the results of export performance. The purpose of the study is to provide exports-seeking pharmaceutical c...

  1. Best practices in managing child and adolescent behavioral health emergencies.

    Science.gov (United States)

    Feuer, Vera; Rocker, Joshua; Saggu, Babar M; Andrus, Jason M

    2018-01-01

    Behavioral health emergencies most commonly present as depression, suicidal behavior, aggression, and severe disorganization. Emergency clinicians should avoid relying solely on past medical history or previous psychiatric diagnoses that might prematurely rule out medical pathologies. Treatments for behavioral health emergencies consist of de-escalation interventions aimed at preventing agitation, aggression, and harm. This issue reviews medical pathologies and underlying causes that can result in psychiatric presentations and summarizes evidence-based practices to evaluate, manage, and refer patients with behavioral health emergencies.

  2. Emerging health issues of cyanobacterial blooms

    Directory of Open Access Journals (Sweden)

    Maura Manganelli

    2012-12-01

    Full Text Available This paper describes emerging issue related to cyanobacterial dynamics and toxicity and human health risks. Data show an increasing cyanobacteria expansion and dominance in many environments. However there are still few information on the toxic species fitness, or on the effects of specific drivers on toxin production. Open research fields are related to new exposure scenario (cyanotoxins in water used for haemodialysis and in food supplements; to new patterns of co-exposure between cyanotoxins and algal toxins and/or anthropogenic chemicals; to dynamics affecting toxicity and production of different cyanotoxin variants under environmental stress; to the accumulation of cyanotoxins in the food web. In addition, many data gaps exist in the characterization of the toxicological profiles, especially about long term effects.

  3. Auckland regional emergency medicine trainee mentoring uptake survey.

    Science.gov (United States)

    Nicholls, Gordon Michael Mike; Lawrey, Emma; Jones, Peter

    2017-10-01

    The primary objective of this study is to quantify how many Auckland region emergency medicine (EM) trainees would like a formal mentoring programme. The secondary objectives were to quantify how many Auckland region EM trainees would like to participate in a formal mentoring programme; to determine trainees' current understanding of mentoring; how trainees prefer mentors to be allocated; why trainees may want a mentor; what mentees perceive would be good qualities in a mentor; and trainees' prior experience with mentoring. Online survey of EM trainees in the Auckland region in June 2015. Of 61 potential respondents, 40 (65.6%) respondents replied to the survey. Of the 40, 38 (95%; 95% confidence interval (CI) 82.6-99.5) respondents indicated they would like some form of mentoring system, and of the 38, 25 (65.8%; 95% CI 49.8-78.9) preferred this to be formal. Of the 38, 19 (50%; 95% CI 34.9-65.2) currently wanted assistance obtaining a mentor. Of the 40, 30 (75%; 95% CI 59.6-86.0) are not currently in any form of mentoring relationship. Respondents believed that mentors would be most beneficial in critical incidents, career development and with work/life balance. The attributes participants considered most important in a mentor were respecting confidentiality, being honest and the ability to provide constructive feedback. Many EM trainees in Auckland want a formal mentoring system and would like a mentor. Appropriate mentor-mentee matching through a formalised voluntary system, with adequate mentor training, may enable the Auckland region to develop a suitable mentoring programme for EM trainees. © 2017 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  4. State of emergency preparedness for US health insurance plans.

    Science.gov (United States)

    Merchant, Raina M; Finne, Kristen; Lardy, Barbara; Veselovskiy, German; Korba, Caey; Margolis, Gregg S; Lurie, Nicole

    2015-01-01

    Health insurance plans serve a critical role in public health emergencies, yet little has been published about their collective emergency preparedness practices and policies. We evaluated, on a national scale, the state of health insurance plans' emergency preparedness and policies. A survey of health insurance plans. We queried members of America's Health Insurance Plans, the national trade association representing the health insurance industry, about issues related to emergency preparedness issues: infrastructure, adaptability, connectedness, and best practices. Of 137 health insurance plans queried, 63% responded, representing 190.6 million members and 81% of US plan enrollment. All respondents had emergency plans for business continuity, and most (85%) had infrastructure for emergency teams. Some health plans also have established benchmarks for preparedness (eg, response time). Regarding adaptability, 85% had protocols to extend claim filing time and 71% could temporarily suspend prior medical authorization rules. Regarding connectedness, many plans shared their contingency plans with health officials, but often cited challenges in identifying regulatory agency contacts. Some health insurance plans had specific policies for assisting individuals dependent on durable medical equipment or home healthcare. Many plans (60%) expressed interest in sharing best practices. Health insurance plans are prioritizing emergency preparedness. We identified 6 policy modifications that health insurance plans could undertake to potentially improve healthcare system preparedness: establishing metrics and benchmarks for emergency preparedness; identifying disaster-specific policy modifications, enhancing stakeholder connectedness, considering digital strategies to enhance communication, improving support and access for special-needs individuals, and developing regular forums for knowledge exchange about emergency preparedness.

  5. An emergency decision-making on a regional environmental contamination

    International Nuclear Information System (INIS)

    Yasuda, Hiroshi

    1996-01-01

    When an environmental contamination occurs in a wide area, it is necessary to estimate the future influence by emergent environmental monitoring and rapidly take measures for it. This study aimed to support an emergency decision-making by constructing practical schemes with regards to the following three items in the dose limitation system recommended by ICRP; validity of intervention actions, optimization of protection and dose limitation. A framework of decision-making process was constructed to make clear the corresponding responsibility and the principle of intervention, to introduce stochastic techniques for estimating the environmental radiation shift and to reduce the social burden for the contamination. The results obtained by using this method were variable depending on the characteristics of subjects and regions applied. Therefore, it is needed to select an appropriate evaluation model and specific parameters suitable for the respective cases. (M.N.)

  6. Complex emergencies in the Eastern Mediterranean Region: Impact on tuberculosis control.

    Science.gov (United States)

    Seita, Akihiro

    2016-12-01

    The Eastern Mediterranean Region (EMR) has witnessed the largest refugee crisis in history. Overall, 70% of the global refugee populations are from Palestine, Syria, Afghanistan, or Somalia. We reviewed the possible impact of such crisis on the tuberculosis situation in EMR. We used the available data and information from the World Health Organization and other international and national institutions. Overall, 15 out of 22 countries in the EMR are either engulfed in complex emergencies (10 countries) or suffering from their neighbors' complex emergencies (7 countries), whereas two countries suffer from both. Eighty-five percent of the total population (636 million) in the region lives in these 15 countries. For tuberculosis, these 15 countries account for a significant burden in EMR: 94% of the estimated total incidence of 740,000 cases a year and 95% of the estimated total mortality of 91,000 a year. These countries have yet to show the significant negative impact on tuberculosis epidemiology as such changes take considerable time to manifest. Still, there are reports on health systems impact: access to health facilities, destruction of health facilities, health staff casualties, and shortage of medicines. Complex emergencies pose a significant negative impact on tuberculosis in the EMR. This issue should be raised in the global health and political arena. This is a time bomb for tuberculosis. Copyright © 2016.

  7. Health Concerns in the Amazon Region

    Centers for Disease Control (CDC) Podcasts

    Residents of the Amazon region of South America contend with a number of health threats - from mosquito-borne diseases to difficulty accessing doctors and healthcare facilities in such a vast area. This podcast helps explore some of the health issues in the region and what's being done to address them.

  8. Mercosur's regional health agenda: architecture and themes

    Directory of Open Access Journals (Sweden)

    Luisa Guimaraes Queiroz

    Full Text Available This article describes the shaping of institutional health spaces in the Mercosur, with analysis of themes and results and considerations on the construction of the regional agenda and on the effects of regional economic integration processes on health policies and systems. We discuss the organization, operation, focus topics, and results achieved in specific health forums (Meeting of Ministers of Health and Sub-Working Group 11, seeking to analyze the architecture and issues addressed by the regional agenda and drawing parallels with the European experience. The aim of this reflection is to identify how the work done by Mercosur structures contributes to building a regional agenda, with the expectation that the integration can contribute to reducing inequalities in access to health care in the region.

  9. Veneto Region, Italy. Health system review.

    Science.gov (United States)

    Toniolo, Franco; Mantoan, Domenico; Maresso, Anna

    2012-01-01

    The Health Systems in Transition (HiT) profiles are country-based reports that provide a detailed description of a health system and of policy initiatives in progress or under development. This HiT is one of the first to be written on a subnational level of government and focuses on the Veneto Region of northern Italy. HiTs examine different approaches to the organization, financing and delivery of health services and the role of the main actors in health systems; describe the institutional framework, process, content and implementation of health and health care policies; and highlight challenges and areas that require more in-depth analysis. The Veneto Region is one of Italy's richest regions and the health of its resident population compares favourably with other regions in Italy. Life expectancy for both men and women, now at 79.1 and 85.2 years, respectively, is slightly higher than the national average, while mortality rates are comparable to national ones. The major causes of death are tumours and cardiovascular diseases. Under Italy's National Health Service, the organization and provision of health care is a regional responsibility and regions must provide a nationally defined (with regional input) basic health benefit package to all of their citizens; extra services may be provided if budgets allow. Health care is mainly financed by earmarked central and regional taxes, with regions receiving their allocated share of resources from the National Health Fund. Historically, health budget deficits have been a major problem in most Italian regions, but since the early 2000s the introduction of efficiency measures and tighter procedures on financial management have contributed to a significant decrease in the Veneto Regions health budget deficit.The health system is governed by the Veneto Region government (Giunta) via the Departments of Health and Social Services, which receive technical support from a single General Management Secretariat. Health care is

  10. Emerging Radiation Health-Risk Mitigation Technologies

    International Nuclear Information System (INIS)

    Wilson, J.W.; Cucinotta, F.A.; Schimmerling, W.

    2004-01-01

    Past space missions beyond the confines of the Earth's protective magnetic field have been of short duration and protection from the effects of solar particle events was of primary concern. The extension of operational infrastructure beyond low-Earth orbit to enable routine access to more interesting regions of space will require protection from the hazards of the accumulated exposures of Galactic Cosmic Rays (GCR). There are significant challenges in providing protection from the long-duration exposure to GCR: the human risks to the exposures are highly uncertain and safety requirements places unreasonable demands in supplying sufficient shielding materials in the design. A vigorous approach to future radiation health-risk mitigation requires a triage of techniques (using biological and technical factors) and reduction of the uncertainty in radiation risk models. The present paper discusses the triage of factors for risk mitigation with associated materials issues and engineering design methods

  11. Zika Virus: An Emerging Global Health Threat

    Directory of Open Access Journals (Sweden)

    Rahul Mittal

    2017-12-01

    Full Text Available Zika virus (ZIKV is an emerging healthcare threat. The presence of the mosquito Aedes species across South and Central America in combination with complementary climates have incited an epidemic of locally transmitted cases of ZIKV infection in Brazil. As one of the most significant current public health concerns in the Americas, ZIKV epidemic has been a cause of alarm due to its known and unknown complications. At this point, there has been a clear association between ZIKV infection and severe clinical manifestations in both adults and neonates, including but not limited to neurological deficits such as Guillain-Barré syndrome (GBS and microcephaly, respectively. The gravity of the fetal anomalies linked to ZIKV vertical transmission from the mother has prompted a discussion on whether to include ZIKV as a formal member of the TORCH [Toxoplasma gondii, other, rubella virus, cytomegalovirus (CMV, and herpes] family of pathogens known to breach placental barriers and cause congenital disease in the fetus. The mechanisms of these complex phenotypes have yet to be fully described. As such, diagnostic tools are limited and no effective modalities are available to treat ZIKV. This article will review the recent advancements in understanding the pathogenesis of ZIKV infection as well as diagnostic tests available to detect the infection. Due to the increase in incidence of ZIKV infections, there is an immediate need to develop new diagnostic tools and novel preventive as well as therapeutic modalities based on understanding the molecular mechanisms underlying the disease.

  12. Zika Virus: An Emerging Global Health Threat

    Science.gov (United States)

    Mittal, Rahul; Nguyen, Desiree; Debs, Luca H.; Patel, Amit P.; Liu, George; Jhaveri, Vasanti M.; S. Kay, Sae-In; Mittal, Jeenu; Bandstra, Emmalee S.; Younis, Ramzi T.; Chapagain, Prem; Jayaweera, Dushyantha T.; Liu, Xue Zhong

    2017-01-01

    Zika virus (ZIKV) is an emerging healthcare threat. The presence of the mosquito Aedes species across South and Central America in combination with complementary climates have incited an epidemic of locally transmitted cases of ZIKV infection in Brazil. As one of the most significant current public health concerns in the Americas, ZIKV epidemic has been a cause of alarm due to its known and unknown complications. At this point, there has been a clear association between ZIKV infection and severe clinical manifestations in both adults and neonates, including but not limited to neurological deficits such as Guillain-Barré syndrome (GBS) and microcephaly, respectively. The gravity of the fetal anomalies linked to ZIKV vertical transmission from the mother has prompted a discussion on whether to include ZIKV as a formal member of the TORCH [Toxoplasma gondii, other, rubella virus, cytomegalovirus (CMV), and herpes] family of pathogens known to breach placental barriers and cause congenital disease in the fetus. The mechanisms of these complex phenotypes have yet to be fully described. As such, diagnostic tools are limited and no effective modalities are available to treat ZIKV. This article will review the recent advancements in understanding the pathogenesis of ZIKV infection as well as diagnostic tests available to detect the infection. Due to the increase in incidence of ZIKV infections, there is an immediate need to develop new diagnostic tools and novel preventive as well as therapeutic modalities based on understanding the molecular mechanisms underlying the disease. PMID:29276699

  13. Policy statement--emergency information forms and emergency preparedness for children with special health care needs.

    Science.gov (United States)

    2010-04-01

    Children with chronic medical conditions rely on complex management plans for problems that cause them to be at increased risk for suboptimal outcomes in emergency situations. The emergency information form (EIF) is a medical summary that describes medical condition(s), medications, and special health care needs to inform health care providers of a child's special health conditions and needs so that optimal emergency medical care can be provided. This statement describes updates to EIFs, including computerization of the EIF, expanding the potential benefits of the EIF, quality-improvement programs using the EIF, the EIF as a central repository, and facilitating emergency preparedness in disaster management and drills by using the EIF.

  14. What is a health emergency? The difference in definition and understanding between patients and health professionals.

    Science.gov (United States)

    Morgans, Amee; Burgess, Stephen J

    2011-08-01

    Investigations into 'inappropriate' use of emergency health services are limited by the lack of definition of what constitutes a health emergency. Position papers from Australian and international sources emphasise the patient's right to access emergency healthcare, and the responsibility of emergency health care workers to provide treatment to all patients. However, discordance between the two perspectives remain, with literature labelling patient use of emergency health services as 'inappropriate'. To define a 'health emergency' and compare patient and health professionals perspectives. A sample of 600 emergency department (ED) patients were surveyed about a recent health experience and asked to rate their perceived urgency. This rating was compared to their triage score allocated at the hospital ED. No significant relationship was found between the two ratings of urgency (P=0.51). CONCLUSIONS; Differing definitions of a 'health emergency' may explain patient help-seeking behaviour when accessing emergency health resources including hospital ED and ambulance services. A new definition of health emergency that encapsulates the health professional and patient perspectives is proposed. An agreed definition of when emergency health resources should be used has the potential to improve emergency health services demand and patient flow issues, and optimise emergency health resource allocation.

  15. From basic concepts to emerging technologies in regional anesthesia.

    Science.gov (United States)

    Dillane, Derek; Tsui, Ban C H

    2010-10-01

    The present article details how our understanding of the basic concepts of regional anesthesia has recently evolved. We will appraise current technological advances and question the commensurate nature of the relationship between tradition and innovation. Ultrasound localization has enhanced our understanding of the needle-nerve relationship. Intraneural injection of local anesthetic may occur with greater frequency than previously thought without inevitably leading to neurological complications. The ratio of neural to non-neural tissue varies both between and within nerves and may be an important determinant of neural injury. Ultrasonographic evidence of intraneural injection is subject to observer expertise and the resolution of the ultrasound image. Current ultrasound resolution capability does not reliably permit differentiation between intrafascicular and extrafascicular drug injection. Perineural electrical impedance may be a determinant of current threshold and conceivably distinguish between intraneural and extraneural tissue. Technology that enhances the sonographic image of both procedure needle and target nerve is the focus of current endeavors in ultrasound innovation.There is inconclusive evidence that the use of ultrasound technology has reduced the incidence of local anesthetic toxicity. Lipid emulsion therapy is now an accepted treatment for systemic local anesthetic toxicity. There are new reports on the development of an ultra long-acting local anesthetic agent that would permit lower doses and superannuate catheter-based continuous regional anesthesia techniques. Over the past decade, our understanding of the fundamental concepts of regional anesthesia continues to be challenged by emerging experimental and clinical evidence.

  16. [Regional Study of Patient Safety Incidents (ERIDA) in the Emergency Services].

    Science.gov (United States)

    Alcaraz-Martínez, J; Aranaz-Andrés, J M; Martínez-Ros, C; Moreno-Reina, S; Escobar-Álvaro, L; Ortega-Liarte, J V

    2016-01-01

    Evaluate the patient safety incidents that occur in the emergency departments of our region. Observational study conducted in all the hospital emergency departments in the Regional Health Service of Murcia. After systematic random sampling, data were collected during care and a week later by telephone survey. Health professionals of each service were trained and collected the information, following the methodology of the National Study of Adverse Events Related to Hospitalization -ENEAS- and the Adverse Events Related to Spanish Hospital Emergency Department Care -EVADUR-. A total of 393 samples were collected, proportional to the cases treated in each hospital. In 10 cases (3.1%) the complaint was a previous safety incident. At least one incident was detected in 47 patients (11.95%; 8.7 to 15.1%). In 3 cases there were 2 incidents, bringing the number of incidents to 50. Regarding the impact, the 51% of incidents caused harm to the patients. The effects more frequent in patients were the need for repeat visits (9 cases), and mismanagement of pain (8 cases). In 24 cases (51.1%) health care was not affected, although 3 cases required an additional test, 11 cases required further consultation, and led to hospitalisation in 2 cases. The most frequent causal factors of these incidents were medication (14) and care (12). The incidents were considered preventable in 60% of cases. A rate of incidents in the emergency departments, representative of the region, has been obtained. The implications of the results for the population means that 12 out of every 100 patients treated in emergency departments have an adverse event, and 7 of these are avoidable. Copyright © 2016 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

  17. Health regionalization in Amazonas: progress and challenges.

    Science.gov (United States)

    Garnelo, Luiza; Sousa, Amandia Braga Lima; Silva, Clayton de Oliveira da

    2017-04-01

    This paper analyses the health services regionalization process in the State of Amazonas through a case study covering the health sub-region Manaus Surroundings. This is a qualitative, descriptive and analytical research, which data were collected using interviews, documents and Internet reviews, oriented by the guiding concept of health regionalization. Study findings revealed a social setting dominated by asymmetry, verticality, competitiveness and fragile multilateral relations among municipalities, associated to a bureaucratic profile of local institutions operating in the region under study. The political agents have limited acknowledgement of the sociopolitical and institutional conditions in which they operate. They usually impute healthcare networks' management and operational issues to the natural and geographical characteristics of the Amazon region, but their financing, governance and technical capacity are insufficient to overcome them.

  18. Heat Stroke: A Medical Emergency Appearing in New Regions

    Directory of Open Access Journals (Sweden)

    Sofie Søndergaard Mørch

    2017-01-01

    Full Text Available Heat stroke is an acute, life-threatening emergency characterized clinically by elevated body temperature and central nervous system dysfunction. Early recognition and treatment including aggressive cooling and management of life-threatening systemic complications are essential to reduce morbidity and mortality. This case report describes two Danish patients diagnosed with heat stroke syndrome during a heat wave in the summer of 2014. Both patients were morbidly obese and had several predisposing illnesses. However since heat stroke is a rare condition in areas with temperate climate, they were not diagnosed until several days after admittance; hence treatment with cooling was delayed. Both patients were admitted to the intensive care unit, where they were treated with an external cooling device and received treatment for complications. Both cases ended fatally. As global warming continues, more heat waves will occur in previously cooler regions. Therefore it is important to raise awareness of heat stroke since outcome depends on early recognition and rapid cooling.

  19. Managing psychiatric emergencies in persons with mental health ...

    African Journals Online (AJOL)

    Background: Psychiatric emergencies are commonly encountered by the emergency room team where non-mental health specialists are often the first care providers. Materials and Methods: The study took place at the University of Ibadan Health Service, it was a descriptive cross-sectional study and participants were ...

  20. Newborns health in the Danube Region

    DEFF Research Database (Denmark)

    Andersen, Zorana J; Sram, Radim J; Ščasný, Milan

    2016-01-01

    risks, and knowledge gaps in the Danube Region, based on publicly available databases, registers, and literature, as a rationale and incentive for a new integrated project. The review also proposes the concept for the project aiming to characterize in utero exposures to multiple environmental factors....... Estimating the burden of environmental exposures on early-life health is a growing research area in Europe which has major public health implications, but the data from the Danube Region are largely missing. AIM: This review presents an inventory of current environmental challenges, related early-life health...... and estimate their effect on early-life health, evaluate economic impact, as well as identify interventions with a potential to harness social norms to reduce emissions, exposures and health risks in the Danube Region. METHODS: Experts in environmental epidemiology, human biomonitoring and social science...

  1. Quality improvement and emerging global health priorities

    Science.gov (United States)

    Mensah Abrampah, Nana; Syed, Shamsuzzoha Babar; Hirschhorn, Lisa R; Nambiar, Bejoy; Iqbal, Usman; Garcia-Elorrio, Ezequiel; Chattu, Vijay Kumar; Devnani, Mahesh; Kelley, Edward

    2018-01-01

    Abstract Quality improvement approaches can strengthen action on a range of global health priorities. Quality improvement efforts are uniquely placed to reorient care delivery systems towards integrated people-centred health services and strengthen health systems to achieve Universal Health Coverage (UHC). This article makes the case for addressing shortfalls of previous agendas by articulating the critical role of quality improvement in the Sustainable Development Goal era. Quality improvement can stimulate convergence between health security and health systems; address global health security priorities through participatory quality improvement approaches; and improve health outcomes at all levels of the health system. Entry points for action include the linkage with antimicrobial resistance and the contentious issue of the health of migrants. The work required includes focussed attention on the continuum of national quality policy formulation, implementation and learning; alongside strengthening the measurement-improvement linkage. Quality improvement plays a key role in strengthening health systems to achieve UHC. PMID:29873793

  2. Adolescents’ Knowledge, Attitude and Utilization of Emergency Contraceptive Pills in Nigeria’s Niger Delta Region

    Science.gov (United States)

    Onasoga, Olayinka A.; Afolayan, Joel Adeleke; Asamabiriowei, Tariebi Florence; Jibril, Umar Nda; Imam, Abubakar Ayinla

    2016-01-01

    Background and Objective: Risky sexual activity among adolescents is on the increase and contraceptive prevalence rate is low which is evidenced by high rate of teenage pregnancy in Bayelsa state, Nigeria. This study assesses the adolescents’ knowledge, attitude and utilization of emergency contraceptive pills (ECP) in Amassoma Community, Bayelsa State, in the Niger Delta region of Nigeria. Methods: The study was a descriptive cross-sectional research design. A purposive sampling technique was used to select a sample of 220 respondents from the target population. Data were collected using a self-structured questionnaire. Descriptive and inferential statistics were used to analyze the data generated. Results: Majority of the respondents had high level of knowledge and positive attitude towards emergency contraceptive pills but had low level of utilization. Concerns about what others may say, parental attitude, contraceptive availability, contraceptive accessibility, and peer influences were the major factors that influenced the utilization of contraceptive pills. There was no significant relationship between knowledge and utilization of emergency contraceptive pills, as well as level of knowledge and their utilization of emergency contraceptive pills. Conclusions and Global Health Implications: Adolescents in the study were more likely to use emergency contraceptive pills, if parents and others reaction to adolescents’ contraceptive use were positive about those. Health care professionals, especially nurses, should organize enlightenment programs to educate adolescents, parents and the public on the benefits of adolescents’ contraceptives use, especially ECP. PMID:28058193

  3. Russian Pharmaceutical Companies Export Potential in Emerging Regional Clusters

    Directory of Open Access Journals (Sweden)

    Elena Vladimirovna Sapir

    2016-12-01

    Full Text Available This article analyzes a diverse range of the enterprise’s export potential growth factors in emerging pharmaceutical clusters of Central European Russia. Classification and comparative analysis were used to identify export potential attributes (production, finance, labor and marketing, which have allowed to reveal the strong connection of cluster and regional factor groups with the results of export performance. The purpose of the study is to provide exports-seeking pharmaceutical companies with a set of tools to enhance their export potential. The hypothesis that the cumulative impact of the specified attributes leads to the strengthening of pharmaceutical cluster export potential and promotes an effective integration of the region in the world economic space, is developed and tested. The methodology combines the geo-economy-based theory with the theory of clusters competitive advantages. The impacts of export potential growth factors are estimated by using an econometric model based on math statistics. Thus, five Russian regional pharmaceutical clusters (Belgorod, Kaluga, Moscow, Oryol, Yaroslavl are shown. Findings identify an objective causal link between enterprise export potential growth and competitiveness factors of cluster origin (network business chains, production functions interconnectedness and flexibility, production localization. An action plan for the purpose of the maximum use of competitive advantages of the cluster organization for export activities of the entities of the pharmaceutical industry is developed. Conclusions and recommendations of the study are intended to enterprises in pharmaceutical industry and regions’ public authorities, implementing cluster development strategies. It is thus essential to improve marketing and organizational innovations, reduction of commercial expenses under the cluster environment, development of drugs production and delivery chains from R&D to end-users in order to enjoy greater

  4. Emergency contraception - potential for women's health.

    Science.gov (United States)

    Mittal, Suneeta

    2014-11-01

    Emergency contraception (EC) is a safe and effective method which is used to prevent unwanted pregnancy after unprotected sexual intercourse. Many of the unwanted pregnancies end in unsafe abortions. The search for an ideal contraceptive, which does not interfere with spontaneity or pleasure of the sexual act, yet effectively controls the fertility, is still continuing. Numerous contraceptive techniques are available, yet contraceptive coverage continues to be poor in India. Thus, even when not planning for a pregnancy, exposure to unprotected sex takes place often, necessitating the use of emergency contraception. This need may also arise due to failure of contraceptive method being used (condom rupture, diaphragm slippage, forgotten oral pills) or following sexual assault. Emergency contraception is an intervention that can prevent a large number of unwanted pregnancies resulting from failure of regular contraception or unplanned sexual activity, which in turn helps in reducing the maternal mortality and morbidity due to unsafe abortions. However, a concern has been expressed regarding repeated and indiscriminate usage of e-pill, currently the rational use of emergency contraception is being promoted as it is expected to make a significant dent in reducing the number of unwanted pregnancies and unsafe abortions. In fact, since the introduction of emergency contraception, the contribution of unsafe abortion towards maternal mortality has declined from 13 to 8 per cent.

  5. Occupational Risks of Health Professionals in Turkey as an Emerging Economy.

    Science.gov (United States)

    Ulutasdemir, Nilgun; Cirpan, Metin; Copur, Ebru Ozturk; Tanir, Ferdi

    2015-01-01

    Health services are one of the work areas that contain important risks in terms of the occupational health and safety of the laborer. Professionals in various areas of health services encounter biological, chemical, physical, ergonomic, and psychosocial risks, particularly in hospitals. This study has been performed to evaluate the impacts of the occupational risks on health of health professionals in Turkey. In Turkey, as an emerging economy, the history of studies on health professionals is not longstanding. There have been various regulations intended for the occupational health and safety of health professionals in line with the Regulation of the Provision on Patient and Staff Safety prepared in 2012. However, applications can differ from region to region, institution to institution, and person to person. We believe that this review will lead health professionals to be aware of occupational risks and contribute to planning health services for health professionals. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  6. Behavioral Health Emergencies Managed by School Nurses Working with Adolescents

    Science.gov (United States)

    Ramos, Mary M.; Greenberg, Cynthia; Sapien, Robert; Bauer-Creegan, Judith; Hine, Beverly; Geary, Cathy

    2013-01-01

    Background: As members of interdisciplinary teams, school nurses provide behavioral health services. Studies indicate that school nurses may lack sufficient continuing education in adolescent behavioral health and in the management of behavioral health emergencies, specifically. We conducted this study to describe the adolescent behavioral health…

  7. 21 CFR 25.16 - Public health and safety emergencies.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 1 2010-04-01 2010-04-01 false Public health and safety emergencies. 25.16... ENVIRONMENTAL IMPACT CONSIDERATIONS Agency Actions Requiring Environmental Consideration § 25.16 Public health... importance to the public health or safety, may make full adherence to the procedural provisions of NEPA and...

  8. The Emergence of Personalized Health Technology.

    Science.gov (United States)

    Allen, Luke Nelson; Christie, Gillian Pepall

    2016-05-10

    Personalized health technology is a noisy new entrant to the health space, yet to make a significant impact on population health but seemingly teeming with potential. Devices including wearable fitness trackers and healthy-living apps are designed to help users quantify and improve their health behaviors. Although the ethical issues surrounding data privacy have received much attention, little is being said about the impact on socioeconomic health inequalities. Populations who stand to benefit the most from these technologies are unable to afford, access, or use them. This paper outlines the negative impact that these technologies will have on inequalities unless their user base can be radically extended to include vulnerable populations. Frugal innovation and public-private partnership are discussed as the major means for reaching this end.

  9. Mental Health and Drivers of Need in Emergent and Non-Emergent Emergency Department (ED) Use: Do Living Location and Non-Emergent Care Sources Matter?

    Science.gov (United States)

    McManus, Moira C; Cramer, Robert J; Boshier, Maureen; Akpinar-Elci, Muge; Van Lunen, Bonnie

    2018-01-13

    Emergency department (ED) utilization has increased due to factors such as admissions for mental health conditions, including suicide and self-harm. We investigate direct and moderating influences on non-emergent ED utilization through the Behavioral Model of Health Services Use. Through logistic regression, we examined correlates of ED use via 2014 New York State Department of Health Statewide Planning and Research Cooperative System outpatient data. Consistent with the primary hypothesis, mental health admissions were associated with emergent use across models, with only a slight decrease in effect size in rural living locations. Concerning moderating effects, Spanish/Hispanic origin was associated with increased likelihood for emergent ED use in the rural living location model, and non-emergent ED use for the no non-emergent source model. 'Other' ethnic origin increased the likelihood of emergent ED use for rural living location and no non-emergent source models. The findings reveal 'need', including mental health admissions, as the largest driver for ED use. This may be due to mental healthcare access, or patients with mental health emergencies being transported via first responders to the ED, as in the case of suicide, self-harm, manic episodes or psychotic episodes. Further educating ED staff on this patient population through gatekeeper training may ensure patients receive the best treatment and aid in driving access to mental healthcare delivery changes.

  10. Adolescents' Knowledge, Attitude and Utilization of Emergency Contraceptive Pills in Nigeria's Niger Delta Region.

    Science.gov (United States)

    Onasoga, Olayinka A; Afolayan, Joel Adeleke; Asamabiriowei, Tariebi Florence; Jibril, Umar Nda; Imam, Abubakar Ayinla

    2016-01-01

    Risky sexual activity among adolescents is on the increase and contraceptive prevalence rate is low which is evidenced by high rate of teenage pregnancy in Bayelsa state, Nigeria. This study assesses the adolescents' knowledge, attitude and utilization of emergency contraceptive pills (ECP) in Amassoma Community, Bayelsa State, in the Niger Delta region of Nigeria. The study was a descriptive cross-sectional research design. A purposive sampling technique was used to select a sample of 220 respondents from the target population. Data were collected using a self-structured questionnaire. Descriptive and inferential statistics were used to analyze the data generated. Majority of the respondents had high level of knowledge and positive attitude towards emergency contraceptive pills but had low level of utilization. Concerns about what others may say, parental attitude, contraceptive availability, contraceptive accessibility, and peer influences were the major factors that influenced the utilization of contraceptive pills. There was no significant relationship between knowledge and utilization of emergency contraceptive pills, as well as level of knowledge and their utilization of emergency contraceptive pills. Adolescents in the study were more likely to use emergency contraceptive pills, if parents and others reaction to adolescents' contraceptive use were positive about those. Health care professionals, especially nurses, should organize enlightenment programs to educate adolescents, parents and the public on the benefits of adolescents' contraceptives use, especially ECP.

  11. Mobile Integrated Health Care and Community Paramedicine: An Emerging Emergency Medical Services Concept.

    Science.gov (United States)

    Choi, Bryan Y; Blumberg, Charles; Williams, Kenneth

    2016-03-01

    Mobile integrated health care and community paramedicine are models of health care delivery that use emergency medical services (EMS) personnel to fill gaps in local health care infrastructure. Community paramedics may perform in an expanded role and require additional training in the management of chronic disease, communication skills, and cultural sensitivity, whereas other models use all levels of EMS personnel without additional training. Currently, there are few studies of the efficacy, safety, and cost-effectiveness of mobile integrated health care and community paramedicine programs. Observations from existing program data suggest that these systems may prevent congestive heart failure readmissions, reduce EMS frequent-user transports, and reduce emergency department visits. Additional studies are needed to support the clinical and economic benefit of mobile integrated health care and community paramedicine. Copyright © 2015 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  12. Bradford Hill’s criteria, emerging zoonoses, and One Health

    Directory of Open Access Journals (Sweden)

    G.V. Asokan

    2016-09-01

    Full Text Available Zoonoses constitute more than 60% of infectious diseases and 75% of emerging infectious diseases. Inappropriate overemphasis of specialization of disciplines has ignored public health. Identifying the causes of disease and determining how exposures are related to outcomes in “emerging zoonoses” affecting multiple species are considered to be the hallmarks of public health research and practice that compels the adoption of “One Health”. The interactions within and among populations of vertebrates in the causation and transmissions of emerging zoonotic diseases are inherently dynamic, interdependent, and systems based. Disease causality theories have moved from one or several agents causing disease in a single species, to one infectious agent causing disease in multiple species-emerging zoonoses. Identification of the causative pathogen components or structures, elucidating the mechanisms of species specificity, and understanding the natural conditions of emergence would facilitate better derivation of the causal mechanism. Good quality evidence on causation in emerging zoonoses affecting multiple species makes a strong recommendation under the One Health approach for disease prevention and control from diagnostic tests, treatment, antimicrobial resistance, preventive vaccines, and evidence informed health policies. In the tenets of One Health, alliances work best when the legitimate interests of the different partners combine to prevent and control emerging zoonoses.

  13. Emerging trends in health care finance.

    Science.gov (United States)

    Sterns, J B

    1994-01-01

    Access to capital will become more difficult. Capital access is dependent on ability to repay debt, which, in turn, is dependent on internally generated cash flows. Under any health care reform proposal, revenue inflows will be slowed. The use of corporate finance techniques to limit financial risk and lower cost will be a permanent response to fundamental changes to the health care system. These changes will result in greater balance sheet management, centralized capital allocation, and alternative sources of capital.

  14. Physicians’ circularity in health regions in Brazil

    Directory of Open Access Journals (Sweden)

    Paulo Henrique Seixas

    Full Text Available Abstract Objectives: to characterize the medical circularity in Brazil and to discuss the case in the North and South Barretos regions, São Paulo. Methods: a cross-sectional study using secondary data from the national registrations and a case study of physician’s sample in the North-Barretos and South-Barretos regions. Results: in the health regions in Brazil, on an average, 45% of the physicians in activities circulate in more than one region. The Capitals of the States have more stable physicians while more than 50% of the medical workforce work in other regions. The professionals with the greatest tendency to move from one work place to another are those who work in surgical specialties in services to uphold the diagnostic and therapy. Conclusions: there is a high circulation of physicians among the regions, with distinct characteristics between geographical and health regions. In case of Barretos area, the professionals move from one workplace to another according to their professional association and specialized practice.

  15. Bradford Hill’s criteria, emerging zoonoses, and One Health

    OpenAIRE

    G.V. Asokan; Vanitha Asokan

    2016-01-01

    Zoonoses constitute more than 60% of infectious diseases and 75% of emerging infectious diseases. Inappropriate overemphasis of specialization of disciplines has ignored public health. Identifying the causes of disease and determining how exposures are related to outcomes in “emerging zoonoses” affecting multiple species are considered to be the hallmarks of public health research and practice that compels the adoption of “One Health”. The interactions within and among populations of vertebra...

  16. Regional Climate Change and Development of Public Health Decision Aids

    Science.gov (United States)

    Hegedus, A. M.; Darmenova, K.; Grant, F.; Kiley, H.; Higgins, G. J.; Apling, D.

    2011-12-01

    According to the World Heath Organization (WHO) climate change is a significant and emerging threat to public health, and changes the way we must look at protecting vulnerable populations. Worldwide, the occurrence of some diseases and other threats to human health depend predominantly on local climate patterns. Rising average temperatures, in combination with changing rainfall patterns and humidity levels, alter the lifecycle and regional distribution of certain disease-carrying vectors, such as mosquitoes, ticks and rodents. In addition, higher surface temperatures will bring heat waves and heat stress to urban regions worldwide and will likely increase heat-related health risks. A growing body of scientific evidence also suggests an increase in extreme weather events such as floods, droughts and hurricanes that can be destructive to human health and well-being. Therefore, climate adaptation and health decision aids are urgently needed by city planners and health officials to determine high risk areas, evaluate vulnerable populations and develop public health infrastructure and surveillance systems. To address current deficiencies in local planning and decision making with respect to regional climate change and its effect on human health, our research is focused on performing a dynamical downscaling with the Weather Research and Forecasting (WRF) model to develop decision aids that translate the regional climate data into actionable information for users. WRF model is initialized with the Max Planck Institute European Center/Hamburg Model version 5 (ECHAM5) General Circulation Model simulations forced with the Special Report on Emissions (SRES) A1B emissions scenario. Our methodology involves development of climatological indices of extreme weather, quantifying the risk of occurrence of water/rodent/vector-borne diseases as well as developing various heat stress related decision aids. Our results indicate that the downscale simulations provide the necessary

  17. [Implementation of a regional system for the emergency care of acute ischemic stroke: Initial results].

    Science.gov (United States)

    Soares-Oliveira, Miguel; Araújo, Fernando

    2014-06-01

    Implementing integrated systems for emergency care of patients with acute ischemic stroke helps reduce morbidity and mortality. We describe the process of organizing and implementing a regional system to cover around 3.7 million people and its main initial results. We performed a descriptive analysis of the implementation process and a retrospective analysis of the following parameters: number of patients prenotified by the pre-hospital system; number of times thrombolysis was performed; door-to-needle time; and functional assessment three months after stroke. The implementation process started in November 2005 and ended in December 2009, and included 11 health centers. There were 3574 prenotifications from the prehospital system. Thrombolysis was performed in 1142 patients. The percentage of patients receiving thrombolysis rose during the study period, with a maximum of 16%. Median door-to-needle time was 62 min in 2009. Functional recovery three months after stroke was total or near total in 50% of patients. The regional system implemented for emergency care of patients with acute ischemic stroke has led to health gains, with progressive improvements in patients' access to thrombolysis, and to greater equity in the health care system, thus helping to reduce mortality from cerebrovascular disease in Portugal. Our results, which are comparable with those of international studies, support the strategy adopted for implementation of this system. Copyright © 2013 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

  18. E-smoking: Emerging public health problem?

    Directory of Open Access Journals (Sweden)

    Mateusz Jankowski

    2017-06-01

    Full Text Available E-cigarette use has become increasingly popular, especially among the young. Its long-term influence upon health is unknown. Aim of this review has been to present the current state of knowledge about the impact of e-cigarette use on health, with an emphasis on Central and Eastern Europe. During the preparation of this narrative review, the literature on e-cigarettes available within the network PubMed was retrieved and examined. In the final review, 64 research papers were included. We specifically assessed the construction and operation of the e-cigarette as well as the chemical composition of the e-liquid; the impact that vapor arising from the use of e-cigarette explored in experimental models in vitro; and short-term effects of use of e-cigarettes on users’ health. Among the substances inhaled by the e-smoker, there are several harmful products, such as: formaldehyde, acetaldehyde, acroleine, propanal, nicotine, acetone, o-methyl-benzaldehyde, carcinogenic nitrosamines. Results from experimental animal studies indicate the negative impact of e-cigarette exposure on test models, such as ascytotoxicity, oxidative stress, inflammation, airway hyper reactivity, airway remodeling, mucin production, apoptosis, and emphysematous changes. The short-term impact of e-cigarettes on human health has been studied mostly in experimental setting. Available evidence shows that the use of e-cigarettes may result in acute lung function responses (e.g., increase in impedance, peripheral airway flow resistance and induce oxidative stress. Based on the current available evidence, e-cigarette use is associated with harmful biologic responses, although it may be less harmful than traditional cigarettes. Int J Occup Med Environ Health 2017;30(3:329–344

  19. E-smoking: Emerging public health problem?

    Science.gov (United States)

    Jankowski, Mateusz; Brożek, Grzegorz; Lawson, Joshua; Skoczyński, Szymon; Zejda, Jan Eugeniusz

    2017-05-08

    E-cigarette use has become increasingly popular, especially among the young. Its long-term influence upon health is unknown. Aim of this review has been to present the current state of knowledge about the impact of e-cigarette use on health, with an emphasis on Central and Eastern Europe. During the preparation of this narrative review, the literature on e-cigarettes available within the network PubMed was retrieved and examined. In the final review, 64 research papers were included. We specifically assessed the construction and operation of the e-cigarette as well as the chemical composition of the e-liquid; the impact that vapor arising from the use of e-cigarette explored in experimental models in vitro; and short-term effects of use of e-cigarettes on users' health. Among the substances inhaled by the e-smoker, there are several harmful products, such as: formaldehyde, acetaldehyde, acroleine, propanal, nicotine, acetone, o-methyl-benzaldehyde, carcinogenic nitrosamines. Results from experimental animal studies indicate the negative impact of e-cigarette exposure on test models, such as ascytotoxicity, oxidative stress, inflammation, airway hyper reactivity, airway remodeling, mucin production, apoptosis, and emphysematous changes. The short-term impact of e-cigarettes on human health has been studied mostly in experimental setting. Available evidence shows that the use of e-cigarettes may result in acute lung function responses (e.g., increase in impedance, peripheral airway flow resistance) and induce oxidative stress. Based on the current available evidence, e-cigarette use is associated with harmful biologic responses, although it may be less harmful than traditional cigarettes. Int J Occup Med Environ Health 2017;30(3):329-344. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

  20. Health Services Utilization Patterns Associated with Emergency Department Closure

    DEFF Research Database (Denmark)

    Hansen, Kristian Schultz; Enemark, Ulrika; Foldspang, Anders

    2011-01-01

    , 1997-2003. Data were extracted from administrative registries including information on individual use of emergency services and other hospital care, contact with GPs and socioeconomic background. Health services' use by the Morsø population was measured before reduction in emergency room opening hours...... of substitute health services. By contrast, Morsø women compared to the rest of Viborg county reduced their use of GP services in terms of face-to-face visits (β = -0.08, P = 0.020), telephone consultations (β = -0.11, P = 0.007), home visits (β = -0.48, P = 0.009), and their inpatient hospital utilization (β...... = -0.12, P = 0.022) during the period when emergeny services were only available in the daytime. CONCLUSIONS: Emergency services at neighbouring hospitals (40 kilometres distance) were able to compensate, in part, for the decreased local emergency service provision. Concurrent changes in health care...

  1. Emerging issues in occupational safety and health.

    Science.gov (United States)

    Schulte, Paul A

    2006-01-01

    In developed countries, changes in the nature of work and the workforce may necessitate recalibrating the vision of occupational safety and health (OSH) researchers, practitioners, and policymakers to increase the focus on the most important issues. New methods of organizing the workplace, extensive labor contracting, expansion of service and knowledge sectors, increase in small business, aging and immigrant workers, and the continued existence of traditional hazards in high-risk sectors such as construction, mining, agriculture, health care, and transportation support the need to address: 1) broader consideration of the role and impact of work, 2) relationship between work and psychological dysfunction, 3) increased surveillance basis for research and intervention, 4) overcoming barriers to the conduct and use of epidemiologic research, 5) information and knowledge transfer and application, 6) economic issues in prevention, and 7) the global interconnectedness of OSH. These issues are offered to spur thinking as new national research agendas for OSH are considered for developed countries.

  2. EMERGE - ESnet/MREN Regional Science Grid Experimental NGI Testbed

    Energy Technology Data Exchange (ETDEWEB)

    Mambretti, Joe; DeFanti, Tom; Brown, Maxine

    2001-07-31

    This document is the final report on the EMERGE Science Grid testbed research project from the perspective of the International Center for Advanced Internet Research (iCAIR) at Northwestern University, which was a subcontractor to this UIC project. This report is a compilation of information gathered from a variety of materials related to this project produced by multiple EMERGE participants, especially those at Electronic Visualization Lab (EVL) at the University of Illinois at Chicago (UIC), Argonne National Lab and iCAIR. The EMERGE Science Grid project was managed by Tom DeFanti, PI from EVL at UIC.

  3. International health law : an emerging field of public international law

    NARCIS (Netherlands)

    Toebes, Brigit

    This article discusses the nature and scope of international health law as an emerging field of public international law. It is argued that the protection of health reflects a pressing social need that should now be spoken of in the vocabulary of international law. Furthermore, there is an urgent

  4. Ebola disease: an international public health emergency

    Directory of Open Access Journals (Sweden)

    Saurabh RamBihariLal Shrivastava

    2015-04-01

    Full Text Available Ebola virus disease (EVD, previously known as Ebola hemorrhagic fever, is a severe illness caused by Ebola filovirus, and is often fatal if left untreated. The first case of the current EVD was diagnosed in Guinea in March 2014, and since then it has spread to Sierra Leone, Liberia, Nigeria, and Senegal. The current review has been performed with an objective to explore the magnitude of the current Ebola virus epidemic and identify the multiple determinants that have resulted in the exponential growth of the epidemic. An extensive search of all materials related to the topic was done for almost two months (August-October in Pubmed, Medline, World Health Organization website and Google Scholar search engines. Relevant documents, reports, recommendations, guidelines and research articles focusing on the different aspects of Ebola virus and its current outbreak, published in the period 2002-2014 were included in the review. Keywords used in the search include Ebola virus, Ebola virus disease, Ebola hemorrhagic fever, Ebola vaccine, and Ebola treatment. The current EVD epidemic has turned out to be extensive, severe, and uncontrollable because of a delayed response and ineffective public health care delivery system. In fact, multiple challenges have also been identified and thus a range of interventions have been proposed to control the epidemic. In conclusion, the 2014 epidemic of EVD has shown to the world that in absence of a strong public health care delivery system even a rare disease can risk the lives of millions of people. The crux of this epidemic is that a large scale and coordinated international response is the need of the hour to support affected and at-risk nations in intensifying their response activities and strengthening of national capacities.

  5. Health Departments’ Engagement in Emergency Preparedness Activities: The Influence of Health Informatics Capacity

    OpenAIRE

    Gulzar H. Shah; Bobbie Newell; Ruth E. Whitworth

    2016-01-01

    Background: Local health departments (LHDs) operate in a complex and dynamic public health landscape, with changing demands on their emergency response capacities. Informatics capacities might play an instrumental role in aiding LHDs emergency preparedness. This study aimed to explore the extent to which LHDs’ informatics capacities are associated with their activity level in emergency preparedness and to identify which health informatics capacities are associated with improved em...

  6. The emergence of industrial relations in regional trade blocks: a comparative analysis

    NARCIS (Netherlands)

    Kaminska, M.E.; Visser, J.

    2011-01-01

    This article analyses the emergence and institutionalization of regional industrial relations arrangements in six regional integration agreements (European Union, North American Free Trade Association, Mercado Común del Sur, Economic Community of West African States, Southern African Development

  7. Emerging role of Vitamin D in health

    Directory of Open Access Journals (Sweden)

    Deepanjali Lomte

    2014-03-01

    Full Text Available Vit. D is a steroid prohormone. It is synthesized in the skin under ultra –violet light exposure. Traditionally, Vit.D3, cholecalciferol and calcitriol were known to have a role only in calcium and bone mineral metabolism. This article takes an account of the current view on the impact of Vit D deficiency on human health. Research has now shown the indisputable role of Vit D in prevention/treatment of some cancers, osteoporosis, rheumatoid arthritis, multiple sclerosis, tuberculosis, hypertension, and diabetes mellitus. In addition lower maternal Vit. D levels are associated with Pregnancy Induced Hypertension (PIH, suggesting that Vit. D deficiency may be a modifiable risk factor for PIH. Greater awareness of the problem of a high prevalence of vitamin D inadequacy is required among researchers, clinicians, and patients. Special efforts on the medical and social fronts are nec­essary to combat this preventable epidemic of vitamin D deficiency.

  8. Construction of the All-region Linkage System for Emergency Management of Agricultural Product Quality and Safety in West China

    Institute of Scientific and Technical Information of China (English)

    Hua; YU; Yanbin; QI; Yubao; YAN

    2013-01-01

    Quality and safety of agricultural products are significant for national socioeconomic development,sustainable development,and vital interests of people.To safeguard quality and safety of agricultural products in west China is to safeguard economic safety and ecological safety of the country,public health and social stability,of which an important task is to properly handle emergencies concerning quality and safety of agricultural products.Considering actual conditions of west China,suggestions are given to construct the all-region linkage system for emergency management of agricultural product quality and safety in the local area,enhance the all-region linkage,and improve the linkage efficiency.

  9. Exploring mHealth Participation for Emergency Response Communities

    Directory of Open Access Journals (Sweden)

    David G. Schwartz

    2017-03-01

    Full Text Available We explore the challenges of participation by members of emergency response communities who share a similar condition and treatment, and are called upon to participate in emergency events experienced by fellow members. Smartphones and location-based social networking technologies present an opportunity to re-engineer certain aspects of emergency medical response. Life-saving prescription medication extended in an emergency by one individual to another occurs on a micro level, anecdotally documented. We illustrate the issues and our approach through the example of an app to support patients prone to anaphylaxis and prescribed to carry epinephrine auto-injectors. We address unique participation challenges in an mHealth environment in which interventions are primarily short-term interactions which require clear and precise decision-making and constant tracking of potential participants in responding to an emergency medical event. The conflicting effects of diffused responsibility and shared identity are identified as key factors in modeling participation.

  10. UC3M Emergencies : health center search, first aid, defibrillators, emergency exits, last warnings and torch (iOS platform)

    OpenAIRE

    Martín Civiac, María

    2013-01-01

    This document contains Maria Martin’s bachelor thesis. The issues that this project wants to solve are emergencies-related: health centersand emergency exits location,emergency call, first aid instructions and information and latest emergency alerts at Carlos III University. It has been detected that members of Carlos III University currently have difficulties to find health centers, emergency exits and first aid information. Furthermore, the University itself did not have any mechanism to pu...

  11. The Effect of Firm Strategy and Corporate Performance on Software Market Growth in Emerging Regions

    Science.gov (United States)

    Mertz, Sharon A.

    2013-01-01

    The purpose of this research is to evaluate the impact of firm strategies and corporate performance on enterprise software market growth in emerging regions. The emerging regions of Asia Pacific, Eastern Europe, the Middle East and Africa, and Latin America, currently represent smaller overall markets for software vendors, but exhibit high growth…

  12. 76 FR 23708 - Safety Zone; Pierce County Department of Emergency Management Regional Water Exercise, East...

    Science.gov (United States)

    2011-04-28

    ...-AA00 Safety Zone; Pierce County Department of Emergency Management Regional Water Exercise, East... the Regional Water Rescue Exercise. Basis and Purpose The Pierce County, Washington, Department of... to read as follows: Sec. 165.T13-0251 Safety Zone; Pierce County Department of Emergency Management...

  13. Neonatal and pediatric regionalized systems in pediatric emergency mass critical care.

    Science.gov (United States)

    Barfield, Wanda D; Krug, Steven E; Kanter, Robert K; Gausche-Hill, Marianne; Brantley, Mary D; Chung, Sarita; Kissoon, Niranjan

    2011-11-01

    Improved health outcomes are associated with neonatal and pediatric critical care in well-organized, cohesive, regionalized systems that are prepared to support and rehabilitate critically ill victims of a mass casualty event. However, present systems lack adequate surge capacity for neonatal and pediatric mass critical care. In this document, we outline the present reality and suggest alternative approaches. In May 2008, the Task Force for Mass Critical Care published guidance on provision of mass critical care to adults. Acknowledging that the critical care needs of children during disasters were unaddressed by this effort, a 17-member Steering Committee, assembled by the Oak Ridge Institute for Science and Education with guidance from members of the American Academy of Pediatrics, convened in April 2009 to determine priority topic areas for pediatric emergency mass critical care recommendations.Steering Committee members established subcommittees by topic area and performed literature reviews of MEDLINE and Ovid databases. The Steering Committee produced draft outlines through consensus-based study of the literature and convened October 6-7, 2009, in New York, NY, to review and revise each outline. Eight draft documents were subsequently developed from the revised outlines as well as through searches of MEDLINE updated through March 2010.The Pediatric Emergency Mass Critical Care Task Force, composed of 36 experts from diverse public health, medical, and disaster response fields, convened in Atlanta, GA, on March 29-30, 2010. Feedback on each manuscript was compiled and the Steering Committee revised each document to reflect expert input in addition to the most current medical literature. States and regions (facilitated by federal partners) should review current emergency operations and devise appropriate plans to address the population-based needs of infants and children in large-scale disasters. Action at the state, regional, and federal levels should address

  14. Health, Health Care, and Systems Science: Emerging Paradigm.

    Science.gov (United States)

    Janecka, Ivo

    2017-02-15

    Health is a continuum of an optimized state of a biologic system, an outcome of positive relationships with the self and others. A healthy system follows the principles of systems science derived from observations of nature, highlighting the character of relationships as the key determinant. Relationships evolve from our decisions, which are consequential to the function of our own biologic system on all levels, including the genome, where epigenetics impact our morphology. In healthy systems, decisions emanate from the reciprocal collaboration of hippocampal memory and the executive prefrontal cortex. We can decide to change relationships through choices. What is selected, however, only represents the cognitive interpretation of our limited sensory perception; it strongly reflects inherent biases toward either optimizing state, making a biologic system healthy, or not. Health or its absence is then the outcome; there is no inconsequential choice. Public health effort should not focus on punitive steps (e.g. taxation of unhealthy products or behaviors) in order to achieve a higher level of public's health. It should teach people the process of making healthy decisions; otherwise, people will just migrate/shift from one unhealthy product/behavior to another, and well-intended punitive steps will not make much difference. Physical activity, accompanied by nutrition and stress management, have the greatest impact on fashioning health and simultaneously are the most cost-effective measures. Moderate-to-vigorous exercise not only improves aerobic fitness but also positively influences cognition, including memory and senses. Collective, rational societal decisions can then be anticipated. Health care is a business system principally governed by self-maximizing decisions of its components; uneven and contradictory outcomes are the consequences within such a non-optimized system. Health is not health care. We are biologic systems subject to the laws of biology in spite of

  15. Integrating Social Media Monitoring Into Public Health Emergency Response Operations.

    Science.gov (United States)

    Hadi, Tamer A; Fleshler, Keren

    2016-10-01

    Social media monitoring for public health emergency response and recovery is an essential response capability for any health department. The value of social media for emergency response lies not only in the capacity to rapidly communicate official and critical incident information, but as a rich source of incoming data that can be gathered to inform leadership decision-making. Social media monitoring is a function that can be formally integrated into the Incident Command System of any response agency. The approach to planning and required resources, such as staffing, logistics, and technology, is flexible and adaptable based on the needs of the agency and size and scope of the emergency. The New York City Department of Health and Mental Hygiene has successfully used its Social Media Monitoring Team during public health emergency responses and planned events including major Ebola and Legionnaires' disease responses. The concepts and implementations described can be applied by any agency, large or small, interested in building a social media monitoring capacity. (Disaster Med Public Health Preparedness. 2016;page 1 of 6).

  16. Privacy Attitudes among Early Adopters of Emerging Health Technologies.

    Directory of Open Access Journals (Sweden)

    Cynthia Cheung

    Full Text Available Advances in health technology such as genome sequencing and wearable sensors now allow for the collection of highly granular personal health data from individuals. It is unclear how people think about privacy in the context of these emerging health technologies. An open question is whether early adopters of these advances conceptualize privacy in different ways than non-early adopters.This study sought to understand privacy attitudes of early adopters of emerging health technologies.Transcripts from in-depth, semi-structured interviews with early adopters of genome sequencing and health devices and apps were analyzed with a focus on participant attitudes and perceptions of privacy. Themes were extracted using inductive content analysis.Although interviewees were willing to share personal data to support scientific advancements, they still expressed concerns, as well as uncertainty about who has access to their data, and for what purpose. In short, they were not dismissive of privacy risks. Key privacy-related findings are organized into four themes as follows: first, personal data privacy; second, control over personal information; third, concerns about discrimination; and fourth, contributing personal data to science.Early adopters of emerging health technologies appear to have more complex and nuanced conceptions of privacy than might be expected based on their adoption of personal health technologies and participation in open science. Early adopters also voiced uncertainty about the privacy implications of their decisions to use new technologies and share their data for research. Though not representative of the general public, studies of early adopters can provide important insights into evolving attitudes toward privacy in the context of emerging health technologies and personal health data research.

  17. Privacy Attitudes among Early Adopters of Emerging Health Technologies.

    Science.gov (United States)

    Cheung, Cynthia; Bietz, Matthew J; Patrick, Kevin; Bloss, Cinnamon S

    2016-01-01

    Advances in health technology such as genome sequencing and wearable sensors now allow for the collection of highly granular personal health data from individuals. It is unclear how people think about privacy in the context of these emerging health technologies. An open question is whether early adopters of these advances conceptualize privacy in different ways than non-early adopters. This study sought to understand privacy attitudes of early adopters of emerging health technologies. Transcripts from in-depth, semi-structured interviews with early adopters of genome sequencing and health devices and apps were analyzed with a focus on participant attitudes and perceptions of privacy. Themes were extracted using inductive content analysis. Although interviewees were willing to share personal data to support scientific advancements, they still expressed concerns, as well as uncertainty about who has access to their data, and for what purpose. In short, they were not dismissive of privacy risks. Key privacy-related findings are organized into four themes as follows: first, personal data privacy; second, control over personal information; third, concerns about discrimination; and fourth, contributing personal data to science. Early adopters of emerging health technologies appear to have more complex and nuanced conceptions of privacy than might be expected based on their adoption of personal health technologies and participation in open science. Early adopters also voiced uncertainty about the privacy implications of their decisions to use new technologies and share their data for research. Though not representative of the general public, studies of early adopters can provide important insights into evolving attitudes toward privacy in the context of emerging health technologies and personal health data research.

  18. Regional and international approaches on prevention and control of animal transboundary and emerging diseases.

    Science.gov (United States)

    Domenech, J; Lubroth, J; Eddi, C; Martin, V; Roger, F

    2006-10-01

    Transboundary animal diseases pose a serious risk to the world animal agriculture and food security and jeopardize international trade. The world has been facing devastating economic losses from major outbreaks of transboundary animal diseases (TADs) such as foot-and-mouth disease, classical swine fever, rinderpest, peste des petits ruminants (PPR), and Rift Valley fever. Lately the highly pathogenic avian influenza (HPAI) due to H5N1 virus, has become an international crisis as all regions around the world can be considered at risk. In the past decades, public health authorities within industrialized countries have been faced with an increasing number of food safety issues. The situation is equally serious in developing countries. The globalization of food (and feed) trade, facilitated by the liberalization of world trade, while offering many benefits and opportunities, also represents new risks. The GF-TADs Global Secretariat has carried out several regional consultations for the identification of priority diseases and best ways for their administration, prevention and control. In the questionnaires carried out and through the consultative process, it was noted that globally, FMD was ranked as the first and foremost priority. Rift Valley fever, and today highly pathogenic avian influenza, are defined as major animal diseases which also affect human health. PPR and CBPP, a disease which is particularly serious in Africa and finally, African swine fever (ASF) and classical swine fever (CSF) are also regionally recognised as top priorities on which the Framework is determined to work. The FAO philosophy--shared by the OIE--embraces the need to prevent and control TADs and emerging diseases at their source, which is most of the time in developing countries. Regional and international approaches have to be followed, and the FAO and OIE GF-TADs initiative provides the appropriate concepts and objectives as well as an organizational framework to link international and

  19. Mental Health of General Practitioners in Emergency Wards

    Directory of Open Access Journals (Sweden)

    Sepehrmanesh Z.1 PhD,

    2015-01-01

    Full Text Available Aims General practitioners have an essential role in patient care and are exposed to high levels of job stress. General practitioners’ mental health has effects on their functional abilities and medical managements.This study was carried out to evaluate the mental health of general practitioners in emergency wards in KashanUniversity of Medical Sciences, Iran. Materials & Methods In this cross-sectional study, all of General practitioners in emergency wards (n=87 were studied. The survey instruments includedtwo questionnaires: 1-demographic variables and 2- General Health Questionnaire (GHQ-28. Data were analyzed using SPSS 16 software and Chi square, Fisher exactand Mann-Whitney statistical tests. Findings The mean age of general practitioners was 36.11±5.67 years; 89.7% of them were married; 60.3% were male. 41% of the total general practitioners had mental health problems. The mean score of GHQ was 22.56±9.24. There were significant relationships between mental health and each age, employment situation, and number of children (p0.05. Conclusion The majority of employed general practitioners in emergency rooms do not have proper mental health statuses.

  20. Hantaviruses: an emerging public health threat in India? A review

    Indian Academy of Sciences (India)

    PRAKASH KUMAR

    is to increase awareness of these emerging pathogens and the threats they pose to the public health system. [Chandy S, Abraham P and ..... distribution of the hosts through international shipping routes. The majority of SEOV-related .... Dalrymple J M 1994 Serological relationships among viruses in the Hantavirus genus, ...

  1. Occupational health surveillance: Pulmonary function testing in emergency responders

    Directory of Open Access Journals (Sweden)

    James D McCluskey

    2014-01-01

    Full Text Available Emergency responders may be exposed to a variety of fumes, gases, and particulates during the course of their job that can affect pulmonary function (PF and require the use of respiratory protection. This investigation used occupational health monitoring examination data to characterize PF in a population currently employed as emergency responders. PF tests for workers who required health examinations to ensure fitness for continued respirator use were compared to the National Health and Nutrition Examination Survey (NHANES III Raw Spirometry database to determine if decreased PF was associated with employment as an emergency responder. The results of this research indicated that the emergency responders experienced a modest, but statistically significant, increase in forced expiratory volume in 1 second (FEV1 and forced vital capacity (FVC mean values over the NHANES III population in both total and stratified analyses, including stratification by age, gender, height, and smoking history. Results are likely due to a combination of effectively controlled exposures in the workplace, and the healthy worker effect among long-term workers. PF testing required by the Occupational and Safety Health Administration (OSHA has substantial utility for conducting occupational surveillance at the population level. In this investigation, we were able to quickly evaluate if abnormal PF existed in an industrial sector known to have exposures that, when uncontrolled, can lead to PF impairment.

  2. Regional long-term co-operation in the field of nuclear and radiation emergency preparedness

    International Nuclear Information System (INIS)

    Sladek, V.; Metke, E.; Janko, K.; Hohenberg, J. K.; Hofer, P.

    2004-01-01

    Emergency preparedness is generally covered by methodical and coordinative activities of the International Atomic Energy Agency (IAEA) in Member States of the IAEA and by the European Commission (EC) in EU Member and EU Accession Countries. However, the regional harmonisation of emergency arrangements is an important trend of emergency preparedness. The present paper gives a couple of illustrative examples for a regional co-operation in the field of emergency preparedness in Central Europe and an overview on international exercises in this region. The penultimate section contains an outlook on future activities regarding regional co-operation in Central Europe. The following topics have been suggested inter alia: the harmonisation of intervention criteria and countermeasures, co-ordination in the field of information of the public, comprehensive bi lateral and multilateral exercises, exchange of experts between the national nuclear emergency centres and inter-comparison calculations of the computer codes. (authors)

  3. Prevalence of burnout among public health nurses in charge of mental health services and emergency care systems in Japan.

    Science.gov (United States)

    Imai, Hirohisa; Nakao, Hiroyuki; Nakagi, Yoshihiko; Niwata, Satoko; Sugioka, Yoshihiko; Itoh, Toshihiro; Yoshida, Takahiko

    2006-11-01

    The Community Health Act came into effect in 1997 in Japan. This act altered the work system for public health nurses (PHNs) in public health centers (PHCs) nationwide from region-specific to service-specific work. Such major changes to working environment in the new system seem to be exposing PHNs to various types of stress. The present study examined whether prevalence of burnout is higher among PHNs in charge of mental health services (psychiatric PHNs) than among PHNs in charge of other services (non-psychiatric PHNs), and whether attributes of emergency mental health care systems in communities are associated with increased prevalence of burnout. A questionnaire including the Pines burnout scale for measuring burnout was mailed to 525 psychiatric PHNs and 525 non-psychiatric PHNs. The 785 respondents included in the final analysis comprised 396 psychiatric PHNs and 389 non-psychiatric PHNs. Prevalence of burnout was significantly higher for psychiatric PHNs (59.2%) than for non-psychiatric PHNs (51.5%). When prevalence of burnout in each group was analyzed in relation to question responses regarding emergency service and patient referral systems, prevalence of burnout for psychiatric PHNs displayed significant correlations to frequency of cases requiring overtime emergency services, difficulties referring patients, and a feeling of "restriction". Prevalence of burnout is high among psychiatric PHNs, and inadequate emergency mental health service systems contribute to burnout among these nurses. Countermeasures for preventing such burnout should be taken as soon as possible.

  4. The Emerging Architecture of a Regional Security Complex in the ...

    African Journals Online (AJOL)

    2015-03-03

    Mar 3, 2015 ... Council for the Development of Social Science Research in Africa, 2017 .... of International Security Studies by appropriating Regional Security .... collaborative network is also embedded across Saharan and Sahelian Africa, ... (previously located in the city of Baga in Nigeria's Borno State), fell into the.

  5. Air Quality and Heart Health: An Emerging Topic for Heart ...

    Science.gov (United States)

    Air Quality and Heart Health: An Emerging Topic for Heart Month: Ambient air particle pollution increases short- and long-term cardiovascular morbidity and mortality. Older-people, those with pre-existing heart disease and lung disease and diabetes are at higher risk. Mechanisms are under investigation and are likely related to oxidative stress, inflammation and effects on autonomic control. Improvements in air pollution levels reduce health impacts and increase life expectancy. Reductions of short-term exposure in those at highest risk are predicted to mitigate adverse health effects. EPA regularly evaluates the standards, health risks and issues improved standards when needed. Public health action is needed along with EPA standards to reduce the public health burden of short- and long-term adverse health effects of air pollution. Health risks remain and need to be addressed through integrated efforts of public health, health care, environmental health, individuals and communities. Presented at Webinar for the National Association of Clean Air Agencies, February 2, 2017, Chapel Hill, NC- This webinar provided an update of environmental health information related to the effects of air pollution and heart and blood vessel disease. Such information is critically important for the Clean Air Agencies to understand as it provides the justification of their actions.

  6. Theoretical reflections on governance in health regions.

    Science.gov (United States)

    Bretas, Nilo; Shimizu, Helena Eri

    2017-04-01

    This article analyzes governance in health regions, through the contributions of two studies: one on a governance model and the other on duties in the management of public policies networks. The former conducted a meta-analysis of 137 case studies in the literature on collaborative governance aimed at preparing an explanatory and analytical model. Authors identified critical variables that will influence the results: a previous history of conflict or cooperation, incentives for participation, power imbalances, leadership and institutional design. They also identified key factors: face-to-face dialogue, trust building and development of commitment and shared vision. The latter study examined networks of public policies in the analytic tradition and the perspective of governance, incorporating concepts from the field of political science, economics and interorganizational relations, in order to support the management of public policies networks. The study identified network management as equivalent to a strategic game involving functions: network activation, framework of relations, intermediation, facilitation and consensus building and mediation and arbitration. The combination of the two reflections provides a conceptual reference for better understanding of governance in health regions.

  7. The health of healthcare: Emergency department physician well-being

    Directory of Open Access Journals (Sweden)

    Martin Gagne

    2017-07-01

    Full Text Available Introduction: Physician health and well-being is an important issue that ultimately affects job performance. We compared the self-reported incidence of known medical issues, physical and mental health symptoms, and health behaviors of Emergency Physicians (EPs with the general public in the United States. Methods: Questions selected from a national survey conducted by the Center for Disease Control (CDC about public health trends were distributed to via Facebook to a private group of 12,917 EPs. Responses were compared between EPs and the general population using Chi-square tests of independence. Results: Our results demonstrated that EPs suffer less from chronic diseases, especially those related to the cardiopulmonary system; however, they suff er from a higher incidence of musculoskeletal pain and infectious disease complaints. EPs also exhibit higher rates of mental health symptoms, sleep-related complications, and alcohol consumption. Conclusions: Awareness, education, and advocacy may help improve physician health and ultimately job performance.

  8. Physician's emerging roles relating to trends in health information technology.

    Science.gov (United States)

    David Johnson, J

    2014-08-12

    Objective: To determine the new roles that physicians will adopt in the near future to adjust to accelerating trends from managed care to outcome-based practice to health care reform to health information technology to the evolving role of health consumers. Methods: Trends and related developments concerning the changing roles of physicians based on prior literature reviews. Results: Six possible roles, traditional, gatekeeper, coach, navigator, informatician and one voice among many, are discussed in terms of physician's centrality, patient autonomy, decision-making and uncertainty, information seeking, satisfaction and outcomes, particularly those related to compliance. Conclusion: A greater understanding of these emerging roles could lead to more efficacious outcomes in our ever changing, increasingly complex medical system. Patients often have little understanding of emerging trends that lead to the development of specialized roles such as hospitalist and navigators and, relatedly, the evolving roles of physicians.

  9. Small State Strategies in emerging Regional Governance Structures

    DEFF Research Database (Denmark)

    Kluth, Michael Friederich; Lynggaard, Kennet

    2017-01-01

    This article departs from the puzzling observation that of the five littoral arctic states the Danish realm has been the most consistent backer in China’s quest to gain observer status in the Arctic Council. Small states are generally assumed to adapt to changes in the international system...... such as spatial reconfigurations and alterations in the distribution of capabilities. Yet Denmark’s enabling role in relation to China seems to contravene that assumption. Why would a small state invite one of the world’s leading powers to enter its regional domain while its principle allies and regional partners...... explanation suggesting that unease with growing Canadian securitisation of Arctic issues has prompted courting China as a balancing act. 3) a foreign policy identity explanation focussing on the normative desire to enmeshment China into a liberal Arctic order....

  10. EMERGENCE OF ENTIRELY NEW POISONING IN RURAL INDIA; AN UPCOMING HEALTH HAZARD TO THE COMMUNITY HEALTH.

    Directory of Open Access Journals (Sweden)

    A Kumar

    2012-10-01

    Full Text Available Acute agrochemical poisoning is a leading cause of mortality and morbidity in India. Pendimethalin (herbicide and Pancycuron (fungicide are frequently used worldwide and considered quite a remarkably safe one for humans. Their acute toxicity is not yet widely known. Here we are reporting cases of their acute poisoning in young. To the best of our knowledge not a single such case of their poisoning has been reported so far in india. Such poisoning by entirely new compounds is an emerging problem in the tropics. In this communication we are reporting such unusual and entirely new toxicities and trying to highlight the need of their early recognition and timely management in rural regions where health facilities are already at the stake.

  11. Cloud based emergency health care information service in India.

    Science.gov (United States)

    Karthikeyan, N; Sukanesh, R

    2012-12-01

    A hospital is a health care organization providing patient treatment by expert physicians, surgeons and equipments. A report from a health care accreditation group says that miscommunication between patients and health care providers is the reason for the gap in providing emergency medical care to people in need. In developing countries, illiteracy is the major key root for deaths resulting from uncertain diseases constituting a serious public health problem. Mentally affected, differently abled and unconscious patients can't communicate about their medical history to the medical practitioners. Also, Medical practitioners can't edit or view DICOM images instantly. Our aim is to provide palm vein pattern recognition based medical record retrieval system, using cloud computing for the above mentioned people. Distributed computing technology is coming in the new forms as Grid computing and Cloud computing. These new forms are assured to bring Information Technology (IT) as a service. In this paper, we have described how these new forms of distributed computing will be helpful for modern health care industries. Cloud Computing is germinating its benefit to industrial sectors especially in medical scenarios. In Cloud Computing, IT-related capabilities and resources are provided as services, via the distributed computing on-demand. This paper is concerned with sprouting software as a service (SaaS) by means of Cloud computing with an aim to bring emergency health care sector in an umbrella with physical secured patient records. In framing the emergency healthcare treatment, the crucial thing considered necessary to decide about patients is their previous health conduct records. Thus a ubiquitous access to appropriate records is essential. Palm vein pattern recognition promises a secured patient record access. Likewise our paper reveals an efficient means to view, edit or transfer the DICOM images instantly which was a challenging task for medical practitioners in the

  12. Involvement of the Public Health Authority in emergency planning and preparedness for nuclear facilities in Hungary

    International Nuclear Information System (INIS)

    Sztanyik, L.B.

    1986-01-01

    It is required by the Hungarian Atomic Energy Act and its enacting clause of 1980 that facilities established for the application of atomic energy be designed, constructed and operated in such a manner that abnormal operational occurrences can be avoided and unplanned exposures to radiation and radioactive substances can be prevented. The primary responsibility for planning and implementing emergency actions rests with the management of the operating organization. Thus one of the prerequisites of licensing the first nuclear power plant in Hungary was the preparation and submission for approval of an emergency plan by the operating organization. In addition to this, the council of the county where the power plant is located has also been obliged to prepare a complementary emergency plan, in co-operation with other regional and national authorities, for the prevention of consequences from an emergency that may extend beyond the site boundary of the plant. In preparing the complementary plan, the emergency plan of the facility had to be taken into account. Unlike most national authorities involved in nuclear matters, the Public Health Authority is involved in the preparation of plans for every kind of emergency in a nuclear facility, including even those whose consequences can probably be confined to the plant site. The paper discusses in detail the role and responsibility of the Public Health Authority in emergency planning and preparedness for nuclear facilities. (author)

  13. Preparedness and Emergency Response Learning Centers: supporting the workforce for national health security.

    Science.gov (United States)

    Richmond, Alyson L; Sobelson, Robyn K; Cioffi, Joan P

    2014-01-01

    The importance of a competent and prepared national public health workforce, ready to respond to threats to the public's health, has been acknowledged in numerous publications since the 1980s. The Preparedness and Emergency Response Learning Centers (PERLCs) were funded by the Centers for Disease Control and Prevention in 2010 to continue to build upon a decade of focused activities in public health workforce preparedness development initiated under the Centers for Public Health Preparedness program (http://www.cdc.gov/phpr/cphp/). All 14 PERLCs were located within Council on Education for Public Health (CEPH) accredited schools of public health. These centers aimed to improve workforce readiness and competence through the development, delivery, and evaluation of targeted learning programs designed to meet specific requirements of state, local, and tribal partners. The PERLCs supported organizational and community readiness locally, regionally, or nationally through the provision of technical consultation and dissemination of specific, practical tools aligned with national preparedness competency frameworks and public health preparedness capabilities. Public health agencies strive to address growing public needs and a continuous stream of current and emerging public health threats. The PERLC network represented a flexible, scalable, and experienced national learning system linking academia with practice. This system improved national health security by enhancing individual, organizational, and community performance through the application of public health science and learning technologies to frontline practice.

  14. Regional and inter-regional economic rules and the enforcement of the right to health: The case of Colombia.

    Science.gov (United States)

    Rodríguez, Liliana Lizarazo; De Lombaerde, Philippe

    2015-12-01

    The regional policy level is often seen as a (potential) source of progressive policy-making in health (and in social policy more widely), complementing or substituting national policy levels, which are perceived as underperforming. While it can certainly be argued that there are important opportunities to adopt regional approaches to tackle border-crossing health issues, this article draws the attention to the fact that the linkage between (inter-)regional and national policy levels is not uni-directional. While in some instances the regional level may indeed take the lead in the promotion of (the right to) health, in other instances it may well be the other way round. This article focuses on the case of Colombia, where international economic rules have deeply permeated public policies in the health sector. On one hand, Colombia has been opening markets through the conclusion of regional integration arrangements (e.g. Andean Community and the Pacific Alliance) and the new generation of Free Trade Agreements. On the other hand, Colombia has been one of the most active emerging countries in promoting the right to health as a justiciable fundamental right, in line with the International Covenant on Economic, Social, and Cultural Rights of the United Nations mainly due to the judicial activism of the Colombian Constitutional Court with interesting implications for regional social governance. The article shows that national courts can play an important role in the protection of the right to health in a context of economic integration and the absence of regional balancing policies.

  15. Anthropology in public health emergencies: what is anthropology good for?

    Science.gov (United States)

    Stellmach, Darryl; Beshar, Isabel; Bedford, Juliet; du Cros, Philipp; Stringer, Beverley

    2018-01-01

    Recent outbreaks of Ebola virus disease (2013-2016) and Zika virus (2015-2016) bring renewed recognition of the need to understand social pathways of disease transmission and barriers to care. Social scientists, anthropologists in particular, have been recognised as important players in disease outbreak response because of their ability to assess social, economic and political factors in local contexts. However, in emergency public health response, as with any interdisciplinary setting, different professions may disagree over methods, ethics and the nature of evidence itself. A disease outbreak is no place to begin to negotiate disciplinary differences. Given increasing demand for anthropologists to work alongside epidemiologists, clinicians and public health professionals in health crises, this paper gives a basic introduction to anthropological methods and seeks to bridge the gap in disciplinary expectations within emergencies. It asks: 'What can anthropologists do in a public health crisis and how do they do it?' It argues for an interdisciplinary conception of emergency and the recognition that social, psychological and institutional factors influence all aspects of care.

  16. The politics of emergency health powers and the isolation of public health.

    Science.gov (United States)

    Colmers, John M; Fox, Daniel M

    2003-03-01

    The Model State Emergency Health Powers Act became a contentious document in more than 30 states in 2001 and 2002. Controversy has focused on recommendations by the authors of the Model Act that seemed to accord higher priority to collective action in emergencies than to protecting privacy and property. This situation has several causes that derive from the characteristics of public health emergencies during the past half century and the relative isolation of public health officials from both their colleagues in government and many members of the public.

  17. An insight into the emerging role of regional medical advisor in the pharmaceutical industry

    Directory of Open Access Journals (Sweden)

    Sandeep Kumar Gupta

    2013-01-01

    Full Text Available The position of regional medical advisor (RMA is relatively new in the pharmaceutical industry and its roles and responsibility are still evolving. The RMA is a field based position whose main mission is to foster collaborative relationships with the key opinion leaders (KOLs and to facilitate the exchange of unbiased scientific information between the medical community and the company. Field-based medical liaison teams are expanding world-wide as part of the pharmaceutical industry′s increased focus on global operations including emerging markets. Now, the position of the RMA has evolved into comprehensive, complex, highly interactive, targeted, highly strategic, innovative, and independent role since its inception by the Upjohn Company in 1967. The major objective of the RMA is to develop the professional relationships with the health-care community, particularly KOLs, through peer-to-peer contact. The RMA can facilitate investigator-initiated clinical research proposals from approval until completion, presentation, and publication. It is possible for a RMA to have valuable access to KOLs through his expertise in the clinical research. The RMA can assist in the development, review, and follow-up of the clinical studies initiated within the relevant therapeutic area at the regional/local level. The RMA can lead regional/local clinical projects to ensure that all clinical trials are conducted in compliance with the International Conference of Harmonisation Good Clinical Practice (ICH GCP guidelines.

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

    Science.gov (United States)

    Heifetz, Marina; Lunsky, Yona

    2018-01-01

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

  19. The Relationship between Health Locus of Control and Health Behaviors in Emergency Medicine Personnel.

    Science.gov (United States)

    Pourhoseinzadeh, Mansour; Gheibizadeh, Mahin; Moradikalboland, Mehrnaz

    2017-10-01

    Health locus of control defined as individual beliefs based on past experiences in health issues and having external or internal control over them, could affect health. Health locus of control plays a role in health behaviors. We aimed to investigate the relationship between health locus of control and health behavior in emergency medical personnel in Ahvaz during 2016. This is a cross-sectional descriptive study, which began in August 2016 for a period of six months on 215 emergency medical personnel in Ahvaz who were selected randomly. The data were collected by a demographic questionnaire, Rotter's locus of control questionnaire, and health behavior questionnaire and analyzed using SPSS software, version 22. The correlation between variables was estimated by Pearson's correlation coefficient and independent t test. The level of significance for all statistical tests was set at 0.05. We found no significant relationship between health locus of control (external and internal) and health behavior (P>0.05).Health behaviors were very good in terms of personal health (86.5%), nutrition (53%), and sleep and rest (48.4%), and poor in terms of physical activity (52.6%) and stress management (79.5%). Furthermore, 79.5% of the emergency personnel, in general, had poor heath behaviors. Leaders and officials in the field of health must necessarily design programs in relation to health locus of control and the factors developing and affecting it as well as the role of health locus of control in doing correct behaviors.

  20. Overview of Emerging Contaminants and Associated Human Health Effects

    Directory of Open Access Journals (Sweden)

    Meng Lei

    2015-01-01

    Full Text Available In recent decades, because of significant progress in the analysis and detection of trace pollutants, emerging contaminants have been discovered and quantified in living beings and diverse environmental substances; however, the adverse effects of environmental exposure on the general population are largely unknown. This review summarizes the conclusions of the comprehensive epidemic literature and representative case reports relevant to emerging contaminants and the human body to address concerns about potential harmful health effects in the general population. The most prevalent emerging contaminants include perfluorinated compounds, water disinfection byproducts, gasoline additives, manufactured nanomaterials, human and veterinary pharmaceuticals, and UV-filters. Rare but statistically meaningful connections have been reported for a number of contaminants and cancer and reproductive risks. Because of contradictions in the outcomes of some investigations and the limited number of articles, no significant conclusions regarding the relationship between adverse effects on humans and extents of exposure can be drawn at this time. Here, we report that the current evidence is not conclusive and comprehensive and suggest prospective cohort studies in the future to evaluate the associations between human health outcomes and emerging environmental contaminants.

  1. Overview of Emerging Contaminants and Associated Human Health Effects

    Science.gov (United States)

    Lei, Meng; Zhang, Lun; Lei, Jianjun; Zong, Liang; Li, Jiahui; Wu, Zheng; Wang, Zheng

    2015-01-01

    In recent decades, because of significant progress in the analysis and detection of trace pollutants, emerging contaminants have been discovered and quantified in living beings and diverse environmental substances; however, the adverse effects of environmental exposure on the general population are largely unknown. This review summarizes the conclusions of the comprehensive epidemic literature and representative case reports relevant to emerging contaminants and the human body to address concerns about potential harmful health effects in the general population. The most prevalent emerging contaminants include perfluorinated compounds, water disinfection byproducts, gasoline additives, manufactured nanomaterials, human and veterinary pharmaceuticals, and UV-filters. Rare but statistically meaningful connections have been reported for a number of contaminants and cancer and reproductive risks. Because of contradictions in the outcomes of some investigations and the limited number of articles, no significant conclusions regarding the relationship between adverse effects on humans and extents of exposure can be drawn at this time. Here, we report that the current evidence is not conclusive and comprehensive and suggest prospective cohort studies in the future to evaluate the associations between human health outcomes and emerging environmental contaminants. PMID:26713315

  2. Moving towards South-South International Health: debts and challenges in the regional health agenda.

    Science.gov (United States)

    Herrero, María Belén

    2017-07-01

    The aim of this paper is twofold. First, it aims to investigate the increased interest in health as an important dimension of the foreign policy and diplomatic concerns together with the emergence of a new framework for regional health integration and regional health diplomacy. Second, it seeks to understand the role and practices of new regional blocs in the field of health and whether they are conducting to the emergence of new strategies for addressing health regional policies in South America. The regional policy process relates to health as a right. Thus, some practices and processes in social policy are setting new standards for political and social cohesion in the construction of new regionalism. Health crosses national, regional, and global agendas in a multi-directional fashion, rather than via one-way, top-down policy transfer. A special feature of Unasur is upholding regional health sovereignty despite the unique fact that member countries retain national autonomy. Unasur has projected foreign policy that promotes social values in ways that seem innovative. Experience as Unasur shows that regional organisms can become a game changer in global diplomacy and an influential actor in the international agenda. Resumen El objetivo de este artículo es doble. En primer lugar,investigar el creciente interés en la salud como una dimensión importante de la política exterior, en sintonía con el surgimiento de un nuevo marcopara la integración regional y la diplomacia en salud. En segundo lugar, comprender el papel y las prácticas de los nuevos bloques regionales en el campo de la salud y si estasconducena la emergencia de nuevas estrategias para abordar las políticas sanitarias regionales en América del Sur. Los nuevos procesos de integración regional se refieren a la salud como un derecho. Así, algunas prácticas y procesos de la política regional están estableciendo nuevos patrones de cohesión política y social en el avancede un nuevo regionalismo

  3. Emerging arboviruses and public health challenges in Brazil

    OpenAIRE

    Lima-Camara,Tamara Nunes

    2016-01-01

    ABSTRACT Environmental modification by anthropogenic actions, disordered urban growth, globalization of international exchange and climate change are some factors that help the emergence and dissemination of human infectious diseases transmitted by vectors. This review discusses the recent entry of three arboviruses in Brazil: Chikungunya, West Nile, and Zika virus, focusing on the challenges for the Country’s public health. The Brazilian population is exposed to infections caused by th...

  4. Deciphering emerging Zika and dengue viral epidemics: Implications for global maternal–child health burden

    Directory of Open Access Journals (Sweden)

    Ernest Tambo

    2016-05-01

    Full Text Available Summary: Since its discovery in 1947 in Uganda and control and eradication efforts have aimed at its vectors (Aedes mosquitoes in Latin America in the 1950s, an absolute neglect of Zika programs and interventions has been documented in Aedes endemic and epidemic-prone countries. The current unprecedented Zika viral epidemics and rapid spread in the Western hemisphere pose a substantial global threat, with associated anxiety and consequences. The lack of safe and effective drugs and vaccines against Zika or dengue epidemics further buttresses the realization from the West Africa Ebola outbreak that most emerging disease-prone countries are still poorly prepared for an emergency response. This paper examines knowledge gaps in both emerging and neglected arthropod-borne flavivirus infectious diseases associated with poverty and their implications for fostering local, national and regional emerging disease preparedness, effective and robust surveillance–response systems, sustained control and eventual elimination. Strengthening the regional and Global Health Flavivirus Surveillance-Response Network (GHFV-SRN with other models of socio-economic, climatic, environmental and ecological mitigation and adaptation strategies will be necessary to improve evidence-based national and global maternal–child health agenda and action plans. Keywords: Zika virus, Epidemics, Health, Preparedness, Surveillance, Maternal–child

  5. Commercial products that convey personal health information in emergencies.

    Science.gov (United States)

    Potini, Vishnu C; Weerasuriya, Dilani N; Lowery-North, Douglas W; Kellermann, Arthur L

    2011-12-01

    Describe commercially available products and services designed to convey personal health information in emergencies. The search engine Google®, supplemented by print ads, was used to identify companies and organizations that offer relevant products and services to the general market. Disease-specific, health system, and health plan-specific offerings were excluded. Vendor web sites were the primary sources of information, supplemented by telephone and e-mail queries to sales representatives. Perfect inter-rater agreement was achieved. Thirty-nine unique vendors were identified. Eight sell engraved jewelry. Three offer an embossed card or pamphlet. Twelve supply USB drives with various features. Eleven support password-protected web sites. Five maintain national call centers. Available media differed markedly with respect to capacity and accessibility. Quoted prices ranged from a one-time expenditure of $3.50 to an annual fee of $200. Associated features and annual fees varied widely. A wide range of products and services exist to help patients convey personal health information. Health care providers should be familiar with their features, so they can access the information in a disaster or emergency.

  6. The public health aspects of complex emergencies and refugee situations.

    Science.gov (United States)

    Toole, M J; Waldman, R J

    1997-01-01

    Populations affected by armed conflict have experienced severe public health consequences mediated by population displacement, food scarcity, and the collapse of basic health services, giving rise to the term complex humanitarian emergencies. These public health effects have been most severe in underdeveloped countries in Africa, Asia, and Latin America. Refugees and internally displaced persons have experienced high mortality rates during the period immediately following their migration. In Africa, crude mortality rates have been as high as 80 times baseline rates. The most common causes of death have been diarrheal diseases, measles, acute respiratory infections, and malaria. High prevalences of acute malnutrition have contributed to high case fatality rates. In conflict-affected European countries, such as the former Yugoslavia, Georgia, Azerbaijan, and Chechnya, war-related injuries have been the most common cause of death among civilian populations; however, increased incidence of communicable diseases, neonatal health problems, and nutritional deficiencies (especially among the elderly) have been documented. The most effective measures to prevent mortality and morbidity in complex emergencies include protection from violence; the provision of adequate food rations, clean water and sanitation; diarrheal disease control; measles immunization; maternal and child health care, including the case management of common endemic communicable diseases; and selective feeding programs, when indicated.

  7. Complex emergencies in the Eastern Mediterranean Region: Impact on tuberculosis control

    Directory of Open Access Journals (Sweden)

    Akihiro Seita

    2016-01-01

    Conclusion: Complex emergencies pose a significant negative impact on tuberculosis in the EMR. This issue should be raised in the global health and political arena. This is a time bomb for tuberculosis.

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

    Science.gov (United States)

    McCarron, P; Yates, B

    2000-06-01

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

  9. Ebola Hemorrhagic Fever as a Public Health Emergency of International Concern; a Review Article.

    Science.gov (United States)

    Safari, Saeed; Baratloo, Alireza; Rouhipour, Alaleh; Ghelichkhani, Parisa; Yousefifard, Mahmood

    2015-01-01

    Ebola hemorrhagic fever (EHF) was first reported in 1976 with two concurrent outbreaks of acute viral hemorrhagic fever centered in Yambuku (near the Ebola river), Democratic Republic of Congo, and in Nzara, Sudan. The current outbreak of the Ebola virus was started by reporting the first case in March 2014 in the forest regions of southeastern Guinea. Due to infection rates raising over 13,000% within a 6-month period, Ebola is now considered as a global public health emergency and on August 8(th), 2014 the World Health Organization (WHO) declared the epidemic to be a Public Health Emergency of International Concern. With more than 5000 involved cases and nearly 3000 deaths, this event has turned into the largest and most dangerous Ebola virus outbreak in the world. Based on the above-mentioned, the present article aimed to review the virologic characteristics, transmission, clinical manifestation, diagnosis, treatment, and prevention of Ebola virus disease.

  10. Role of India's wildlife in the emergence and re-emergence of zoonotic pathogens, risk factors and public health implications.

    Science.gov (United States)

    Singh, B B; Gajadhar, A A

    2014-10-01

    Evolving land use practices have led to an increase in interactions at the human/wildlife interface. The presence and poor knowledge of zoonotic pathogens in India's wildlife and the occurrence of enormous human populations interfacing with, and critically linked to, forest ecosystems warrant attention. Factors such as diverse migratory bird populations, climate change, expanding human population and shrinking wildlife habitats play a significant role in the emergence and re-emergence of zoonotic pathogens from India's wildlife. The introduction of a novel Kyasanur forest disease virus (family flaviviridae) into human populations in 1957 and subsequent occurrence of seasonal outbreaks illustrate the key role that India's wild animals play in the emergence and reemergence of zoonotic pathogens. Other high priority zoonotic diseases of wildlife origin which could affect both livestock and humans include influenza, Nipah, Japanese encephalitis, rabies, plague, leptospirosis, anthrax and leishmaniasis. Continuous monitoring of India's extensively diverse and dispersed wildlife is challenging, but their use as indicators should facilitate efficient and rapid disease-outbreak response across the region and occasionally the globe. Defining and prioritizing research on zoonotic pathogens in wildlife are essential, particularly in a multidisciplinary one-world one-health approach which includes human and veterinary medical studies at the wildlife-livestock-human interfaces. This review indicates that wild animals play an important role in the emergence and re-emergence of zoonotic pathogens and provides brief summaries of the zoonotic diseases that have occurred in wild animals in India. Copyright © 2014 Elsevier B.V. All rights reserved.

  11. Public health implications of complex emergencies and natural disasters.

    Science.gov (United States)

    Culver, Amanda; Rochat, Roger; Cookson, Susan T

    2017-01-01

    During the last decade, conflict or natural disasters have displaced unprecedented numbers of persons. This leads to conditions prone to outbreaks that imperil the health of displaced persons and threaten global health security. Past literature has minimally examined the association of communicable disease outbreaks with complex emergencies (CEs) and natural disasters (NDs). To examine this association, we identified CEs and NDs using publicly available datasets from the Center for Research on the Epidemiology of Disasters and United Nations Flash and Consolidated Appeals archive for 2005-2014. We identified outbreaks from World Health Organization archives. We compared findings to identify overlap of outbreaks, including their types (whether or not of a vaccine-preventable disease), and emergency event types (CE, ND, or Both) by country and year using descriptive statistics and measure of association. There were 167 CEs, 912 NDs, 118 events linked to 'Both' types of emergencies, and 384 outbreaks. Of CEs, 43% were associated with an outbreak; 24% NDs were associated with an outbreak; and 36% of 'Both' types of emergencies were associated with an outbreak. Africa was disproportionately affected, where 67% of total CEs, 67% of 'Both' events (CE and ND), and 46% of all outbreaks occurred for the study period. The odds ratio of a vaccine-preventable outbreak occurring in a CE versus an ND was 4.14 (95% confidence limits 1.9, 9.4). CEs had greater odds of being associated with outbreaks compared with NDs. Moreover, CEs had high odds of a vaccine-preventable disease causing that outbreak. Focusing on better vaccine coverage could reduce CE-associated morbidity and mortality by preventing outbreaks from spreading.

  12. Community Assessment Tool for Public Health Emergencies Including Pandemic Influenza

    Energy Technology Data Exchange (ETDEWEB)

    HCTT-CHE

    2011-04-14

    The Community Assessment Tool (CAT) for Public Health Emergencies Including Pandemic Influenza (hereafter referred to as the CAT) was developed as a result of feedback received from several communities. These communities participated in workshops focused on influenza pandemic planning and response. The 2008 through 2011 workshops were sponsored by the Centers for Disease Control and Prevention (CDC). Feedback during those workshops indicated the need for a tool that a community can use to assess its readiness for a disaster—readiness from a total healthcare perspective, not just hospitals, but the whole healthcare system. The CAT intends to do just that—help strengthen existing preparedness plans by allowing the healthcare system and other agencies to work together during an influenza pandemic. It helps reveal each core agency partners' (sectors) capabilities and resources, and highlights cases of the same vendors being used for resource supplies (e.g., personal protective equipment [PPE] and oxygen) by the partners (e.g., public health departments, clinics, or hospitals). The CAT also addresses gaps in the community's capabilities or potential shortages in resources. While the purpose of the CAT is to further prepare the community for an influenza pandemic, its framework is an extension of the traditional all-hazards approach to planning and preparedness. As such, the information gathered by the tool is useful in preparation for most widespread public health emergencies. This tool is primarily intended for use by those involved in healthcare emergency preparedness (e.g., community planners, community disaster preparedness coordinators, 9-1-1 directors, hospital emergency preparedness coordinators). It is divided into sections based on the core agency partners, which may be involved in the community's influenza pandemic influenza response.

  13. 75 FR 32855 - Safety Zone; Pierce County, WA, Department of Emergency Management, Regional Water Exercise

    Science.gov (United States)

    2010-06-10

    ...-AA00 Safety Zone; Pierce County, WA, Department of Emergency Management, Regional Water Exercise AGENCY: Coast Guard, DHS. ACTION: Temporary final rule. SUMMARY: The Pierce County, Washington, Department of... immediate action is necessary to ensure safety of participants in the Pierce County Regional Water Rescue...

  14. The emerging architecture of a regional security complex in the Lake ...

    African Journals Online (AJOL)

    This article explores the emerging regional security architecture to fight terrorism and insurgency in the Lake Chad Basin (LCB). It diagnoses the evolution of the Lake Chad Basin Commission (LCBC) as a sub-regional organization that unites Chad, Cameroon, Niger and Nigeria. In particular, the article critically investigates ...

  15. Emergency planning and management in health care: priority research topics.

    Science.gov (United States)

    Boyd, Alan; Chambers, Naomi; French, Simon; Shaw, Duncan; King, Russell; Whitehead, Alison

    2014-06-01

    Many major incidents have significant impacts on people's health, placing additional demands on health-care organisations. The main aim of this paper is to suggest a prioritised agenda for organisational and management research on emergency planning and management relevant to U.K. health care, based on a scoping study. A secondary aim is to enhance knowledge and understanding of health-care emergency planning among the wider research community, by highlighting key issues and perspectives on the subject and presenting a conceptual model. The study findings have much in common with those of previous U.S.-focused scoping reviews, and with a recent U.K.-based review, confirming the relative paucity of U.K.-based research. No individual research topic scored highly on all of the key measures identified, with communities and organisations appearing to differ about which topics are the most important. Four broad research priorities are suggested: the affected public; inter- and intra-organisational collaboration; preparing responders and their organisations; and prioritisation and decision making.

  16. Important historical efforts at emergency department categorization in the United States and implications for regionalization.

    Science.gov (United States)

    Mehrotra, Abhishek; Sklar, David P; Tayal, Vivek S; Kocher, Keith E; Handel, Daniel A; Myles Riner, R

    2010-12-01

    This article is drawn from a report created for the American College of Emergency Physicians (ACEP) Emergency Department (ED) Categorization Task Force and also reflects the proceedings of a breakout session, "Beyond ED Categorization-Matching Networks to Patient Needs," at the 2010 Academic Emergency Medicine consensus conference, "Beyond Regionalization: Integrated Networks of Emergency Care." The authors describe a brief history of the significant national and state efforts at categorization and suggest reasons why many of these efforts failed to persevere or gain wider implementation. The history of efforts to categorize hospital (and ED) emergency services demonstrates recognition of the potential benefits of categorization, but reflects repeated failures to implement full categorization systems or limited excursions into categorization through licensing of EDs or designation of receiving and referral facilities. An understanding of the history of hospital and ED categorization could better inform current efforts to develop categorization schemes and processes. 2010 by the Society for Academic Emergency Medicine.

  17. [Characteristics of the emergency health service demand in Southern Brazil].

    Science.gov (United States)

    Carret, Maria Laura Vidal; Fassa, Anaclaudia Gastal; Paniz, Vera Maria Vieira; Soares, Patrícia Carret

    2011-01-01

    This study evaluated the demand of emergency health service. It was performed a descriptive analyses of 1647 adults that consulted at emergency public service of Pelotas, Brazil. Older subjects, non white skin color, lower schooling, without partner, and smokers presented higher prevalence of consultations at this service when compared with the general population. Individuals waited, on average, 15 minutes to have their consultations, exams were requested in more than 40% of the visits, and intravenous medication were administered in one third of the visits. Elderly waited longer before searching the service, but they had lowest awaiting time after arriving at emergency service and had higher percentage of regular doctor and social support. Elderly had more diagnosis related to circulatory system, while among the youngest, external causes were the most frequent. The low waiting average for consultation suggest this service provide an immediate care while the great number of ill-defined signs or symptoms indicate that the provided care is provisional. It is necessary to train emergency professionals to reduce the number of tests requested and to assure that either professional as the population is conscious about the importance of a continuity of care.

  18. Designing smartphone mental health applications for emergency service workers.

    Science.gov (United States)

    Deady, M; Peters, D; Lang, H; Calvo, R; Glozier, N; Christensen, H; Harvey, S B

    2017-08-01

    Emergency service workers are often exposed to trauma and have increased risk of a range of mental health (MH) conditions. Smartphone applications have the potential to provide this group with effective psychological interventions; however, little is known about the acceptability and preferences regarding such initiatives. To describe the preferences and opinions of emergency service workers regarding the use of smartphone MH applications and to examine the impact of age on these preferences. Participants were recruited from four metropolitan Fire and Rescue NSW stations and responded to questionnaire items covering three key domains: current smartphone use, potential future use and preferences for design and content as well as therapeutic techniques. Overall, approximately half the sample (n = 106) claimed they would be interested in trying a tailored emergency-worker MH smartphone application. There were few differences between age groups on preferences. The majority of respondents claimed they would use an app for mental well-being daily and preferred terms such as 'well-being' and 'mental fitness' for referring to MH. Confidentiality, along with a focus on stress, sleep, exercise and resiliency were all considered key features. Behavioural therapeutic techniques were regarded most favourably, compared with other therapies. Emergency workers were interested in utilizing smartphone applications focused on MH, but expressed clear preferences regarding language used in promotion, features required and therapeutic techniques preferred. © The Author 2017. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  19. Innovation in Graduate Education for Health Professionals in Humanitarian Emergencies.

    Science.gov (United States)

    Evans, Dabney P; Anderson, Mark; Shahpar, Cyrus; Del Rio, Carlos; Curran, James W

    2016-10-01

    The objective of this report was to show how the Center for Humanitarian Emergencies (the Center) at Emory University (Atlanta, Georgia USA) has trained graduate students to respond to complex humanitarian emergencies (CHEs) through innovative educational programs, with the goal of increasing the number of trained humanitarian workers. Natural disasters are on the rise with more than twice as many occurring from 2000-2009 as there were from 1980-1989. In 2012 alone, 144 million people were affected by a natural disaster or displaced by conflict worldwide. This has created an immense need for trained humanitarian workers to respond effectively to such disasters. The Center has developed a model for educational programming that targets learners along an educational continuum ranging from the undergraduate level through continuing professional education. These programs, based in the Rollins School of Public Health (RSPH) of Emory University, include: a competency-based graduate certificate program (the Certificate) in humanitarian emergencies; a fellowship program for mid-career professionals; and funded field practica. The competency-based Certificate program began in 2010 with a cohort of 14 students. Since then, 101 students have received the Certificate with 50 more due for completion in 2016 and 2017 combined. The fellowship program for mid-career professionals has hosted four fellows from conflict-affected or resource-poor countries, who have then gone on to assume leadership positions with humanitarian organizations. From 2009-2015, the field practicum program supported 34 students in international summer practicum experiences related to emergency response or preparedness. Students have participated in summer field experiences on every continent but Australia. Together the Certificate, funded field practicum opportunities, and the fellowship comprise current efforts in providing innovative education and training for graduate and post-graduate students of public

  20. Foundational workplace safety and health competencies for the emerging workforce☆

    Science.gov (United States)

    Okun, Andrea H.; Guerin, Rebecca J.; Schulte, Paul A.

    2016-01-01

    Introduction Young workers (aged 15–24) suffer disproportionately from workplace injuries, with a nonfatal injury rate estimated to be two times higher than among workers age 25 or over. These workers make up approximately 9% of the U.S. workforce and studies have shown that nearly 80% of high school students work at some point during high school. Although young worker injuries are a pressing public health problem, the critical knowledge and skills needed to prepare youth for safe and healthy work are missing from most frameworks used to prepare the emerging U.S. workforce. Methods A framework of foundational workplace safety and health knowledge and skills (the NIOSH 8 Core Competencies)was developed based on the Health Belief Model (HBM). Results The proposed NIOSH Core Competencies utilize the HBM to provide a framework for foundational workplace safety and health knowledge and skills. An examination of how these competencies and the HBM apply to actions that workers take to protect themselves is provided. The social and physical environments that influence these actions are also discussed. Conclusions The NIOSH 8 Core Competencies, grounded in one of the most widely used health behavior theories, fill a critical gap in preparing the emerging U.S. workforce to be cognizant of workplace risks. Practical applications Integration of the NIOSH 8 Core Competencies into school curricula is one way to ensure that every young person has the foundational workplace safety and health knowledge and skills to participate in, and benefit from, safe and healthy work. National Safety Council and Elsevier Ltd. All rights reserved. PMID:27846998

  1. Health region development from the perspective of system theory - an empirical cross-regional case study.

    Science.gov (United States)

    Volgger, Michael; Mainil, Tomas; Pechlaner, Harald; Mitas, Ondrej

    2015-01-01

    Governments are increasingly establishing health regions to deal with current challenges of public health service. These regions are seen as instruments to balance public and private stakeholders, and offer health care to regional citizens as well as to medical/health tourists. However, it is still unclear how the development of such health regions as well as their governance may be conceptualized. We apply Luhmann's system theory approach in the context of a cross-regional case study that compares health region developments in the Autonomous Province of Bolzano-South Tyrol (Italy) with particular regard to the Eastern Dolomites and in the province of Zeeland (the Netherlands). We suggest that Luhmann's system theory provides a useful set of criteria to evaluate and judge health region development. Fully developed health regions can be understood as auto-poietic systems. By emphasizing programs, personnel, and communication channels, these case studies illustrate the suitability of the system theory toolset to analyze the governance and spatial embeddedness of health regions. Additionally, the study contributes to literature by indicating that health regions are closely related to identity issues and to decision making in regions. Copyright © 2014 Elsevier Ltd. All rights reserved.

  2. Assessing the health equity impacts of regional land-use plan making: An equity focussed health impact assessment of alternative patterns of development of the Whitsunday Hinterland and Mackay Regional Plan, Australia (Short report)

    International Nuclear Information System (INIS)

    Gunning, Colleen; Harris, Patrick; Mallett, John

    2011-01-01

    Health service and partners completed an equity focussed health impact assessment to influence the consideration of health and equity within regional land-use planning in Queensland, Australia. This project demonstrated how an equity oriented assessment matrix can assist in testing regional planning scenarios. It is hoped that this HIA will contribute to the emerging interest in ensuring that potential differential health impacts continue to be considered as part of land-use planning processes.

  3. New computer simulation technology of WSPEEDI for local and regional environmental assessment during nuclear emergency

    International Nuclear Information System (INIS)

    Chino, Masamichi; Furuno, Akiko; Terada, Hiroaki; Kitabata, Hideyuki

    2002-01-01

    The increase of nuclear power plants in the Asian region necessitates the capability to predict long-range atmospheric dispersions of radionuclides and radiological impacts due to a nuclear accident. For this purpose, we have developed a computer-based emergency response system WSPEEDI. This paper aims to expanding the capability of WSPEEDI so that it can be applied to simultaneous multi-scale predictions of local and regional scales in the Asian region

  4. Attitudes of prehospital emergency care professionals toward refusal of treatment: A regional survey in Turkey.

    Science.gov (United States)

    Erbay, Hasan; Alan, Sultan; Kadioglu, Selim

    2014-08-01

    Prehospital emergency medicine is a specific field of emergency medicine. The basic approach of prehospital emergency medicine is to provide patients with medical intervention at the scene of the incident. This special environment causes health professionals to encounter various problems. One of the most important problems in this field is ethics, in particular questions involving refusal of treatment and the processes associated with it. The objective of this study is to identify emergency health professionals' views regarding refusal of treatment. This study was conducted with 356 health professionals who were on active duty in prehospital emergency health services. The data were collected through a form which included 10 statements. The participants were asked to indicate their level of agreement with the statements given by rating them between 0 and 10. Before conducting the research, permission was received from the local ethics committee. Participants were given written information about the purpose of the study. Participants were assured that their participation was voluntary. The healthcare professionals with fewer years of experience in the profession and female participants adopted an attitude of giving priority to providing care. Young participants, in general, respected patient autonomy. However, paradoxically, when it comes to emergency medical cases, they expressed an opinion closer to paternalism. This study has found that prehospital emergency health professionals generally respect the patient's right to refuse treatment; however, they do not prioritize this right when there is a life-threatening situation or when the person does not have decision-making capacity. In these cases, prehospital emergency health professionals tended to adopt a more paternalistic approach. © The Author(s) 2013.

  5. Developing an Emergency Physician Productivity Index Using Descriptive Health Analytics.

    Science.gov (United States)

    Khalifa, Mohamed

    2015-01-01

    Emergency department (ED) crowding became a major barrier to receiving timely emergency care. At King Faisal Specialist Hospital and Research Center, Saudi Arabia, we identified variables and factors affecting crowding and performance to develop indicators to help evaluation and improvement. Measuring efficiency of work and activity of throughput processes; it was important to develop an ED physician productivity index. Data on all ED patients' encounters over the last six months of 2014 were retrieved and descriptive health analytics methods were used. Three variables were identified for their influence on productivity and performance; Number of Treated Patients per Physician, Patient Acuity Level and Treatment Time. The study suggested a formula to calculate the productivity index of each physician through dividing the Number of Treated Patients by Patient Acuity Level squared and Treatment Time to identify physicians with low productivity index and investigate causes and factors.

  6. [Professional satisfaction for doctors of the Mobile Emergency Team and the Emergency Coordinator Office 061. Region of Murcia].

    Science.gov (United States)

    Carrillo-García, C; Martínez-Roche, M E; Vivo-Molina, M C; Quiñonero-Méndez, F; Gómez-Sánchez, R; Celdrán-Gil, F

    2014-01-01

    The objective was to analyze the phenomenon of work satisfaction of doctors of the Mobile Emergency Team and the Emergency Coordinator Office 061 of the Region of Murcia. A observational, analytical and cross-sectional study of development carried out with the medical staff of the Casualty and Emergency Operations Department 061 of the Region of Murcia. Data collection was carried out in December 2013 and January 2014. NTP 394 was used. Work satisfaction: general satisfaction scale. nonparametric tests for 2 samples or k samples depending on type of comparison. A participation rate of 88.2% was obtained, in relation to the general job satisfaction, the average of the participants was 69.55 (SD = 14.4). Of the 15 items that make up the questionnaire, « work colleagues » is the factor with which doctors are more satisfied with, indicating that up to an 87%, show a positive assessment on this point. Being the second aspect most respondents valued their « job stability » with a percentage of positive ratings of 76.7%. The main findings clearly demonstrate the importance of inter-professional relations and human potential as the cornerstone in the exercise of the activity of healthcare professionals. Copyright © 2014 SECA. Published by Elsevier Espana. All rights reserved.

  7. [Emergency care in the autonomous regions of Spain. Improvement in pre-hospital emergency care and welfare coordination. SESPAS Report 2012].

    Science.gov (United States)

    Miguel García, Félix; Fernández Quintana, Ana Isabel; Díaz Prats, Amadeo

    2012-03-01

    The present article describes the general organization of pre-hospital emergency care in the autonomous regions and provides data on activity corresponding to 2010, drawn from the information available in the Primary Care Information System of the Ministry of Health, Social Policy and Equality. Emergency care is provided through various organizational structures covering 24-hour periods. Family medicine attended 17.8 million emergency consultations and nursing attended 10.2 million (year 2010, 14 autonomous communities, 79.7% of the National Health System population). Emergency department utilization ranged between 0.11 and 0.83 urgent family physician consultations per inhabitant/year and between 0.05 and 0.57 nursing consultations per inhabitant/year. Any reform in the management of pre-hospital emergency care will involve organizational changes and aims to produce measurable improvements in healthcare coordination. In the new organizational designs, most of the responsibility lies with human resources in order to achieve the new goals for the future aims to be presented in an operational teamwork structure. Undoubtedly, the main challenge is to achieve optimal coordination with other welfare levels, including the police, social services, nursing homes, etc. If optimal care of the population needs to count on the efforts of all these groups, mobility, individual differences, consistent achievement of high standards, and -most of all- the use of these services by citizens will determine the final result. The results can be quantified in various ways, but evaluation should concentrate on the resources used, the degree of satisfaction among all the parties involved and optimal management of demand, which will help to disseminate the need for a rational resource use. Copyright © 2011 SESPAS. Published by Elsevier Espana. All rights reserved.

  8. Internet Gaming Disorder: An Emergent Health Issue for Men.

    Science.gov (United States)

    Chen, Kevin H; Oliffe, John L; Kelly, Mary T

    2018-03-01

    Internet gaming is a legitimate leisure activity worldwide; however, there are emerging concerns that vast numbers of gamers are becoming addicted. In 2013, the American Psychiatric Association (APA) classified Internet Gaming Disorder (IGD) as a condition warranting more clinical research ahead of formalizing it as a mental disorder. Proposed as a behavioral addiction, IGD shares many similarities in both physical and psychosocial manifestations with substance use disorder, including cerebral changes on functional magnetic resonance imaging (fMRI). Among the gaming population, compared to females, adolescent and adult males demonstrate far more addictive internet gaming use in terms of screen hours, craving, and negative impacts on health, which have, in isolated incidents, also caused death. The current article draws findings from a scoping review of literature related to IGD as a means to raising awareness about an emergent men's health issue. Included are three themes: (a) unveiling the nature, impacts and symptoms of IGD; (b) conceptualizing IGD through neuroscience; and (c) treatment approaches to IGD. Afforded by these themes is an overview and synthesis of the existing literature regarding IGD as a means of providing direction for much needed research on gaming addiction and orientating primary care providers (PCPs) to the specificities of IGD in men's health. The findings are applied to a discussion of the connections between IGD and masculinity and the importance of recognizing how behaviors such as social isolation and game immersion can be maladaptive coping strategies for males.

  9. Assessing Emergency Preparedness and Response Capacity Using Community Assessment for Public Health Emergency Response Methodology: Portsmouth, Virginia, 2013.

    Science.gov (United States)

    Kurkjian, Katie M; Winz, Michelle; Yang, Jun; Corvese, Kate; Colón, Ana; Levine, Seth J; Mullen, Jessica; Ruth, Donna; Anson-Dwamena, Rexford; Bayleyegn, Tesfaye; Chang, David S

    2016-04-01

    For the past decade, emergency preparedness campaigns have encouraged households to meet preparedness metrics, such as having a household evacuation plan and emergency supplies of food, water, and medication. To estimate current household preparedness levels and to enhance disaster response planning, the Virginia Department of Health with remote technical assistance from the Centers for Disease Control and Prevention conducted a community health assessment in 2013 in Portsmouth, Virginia. Using the Community Assessment for Public Health Emergency Response (CASPER) methodology with 2-stage cluster sampling, we randomly selected 210 households for in-person interviews. Households were questioned about emergency planning and supplies, information sources during emergencies, and chronic health conditions. Interview teams completed 180 interviews (86%). Interviews revealed that 70% of households had an emergency evacuation plan, 67% had a 3-day supply of water for each member, and 77% had a first aid kit. Most households (65%) reported that the television was the primary source of information during an emergency. Heart disease (54%) and obesity (40%) were the most frequently reported chronic conditions. The Virginia Department of Health identified important gaps in local household preparedness. Data from the assessment have been used to inform community health partners, enhance disaster response planning, set community health priorities, and influence Portsmouth's Community Health Improvement Plan.

  10. Bank vole immunoheterogeneity may limit Nephropatia Epidemica emergence in a French non-endemic region.

    Science.gov (United States)

    Dubois, A; Castel, G; Murri, S; Pulido, C; Pons, J-B; Benoit, L; Loiseau, A; Lakhdar, L; Galan, M; Marianneau, P; Charbonnel, N

    2018-03-01

    Ecoevolutionary processes affecting hosts, vectors and pathogens are important drivers of zoonotic disease emergence. In this study, we focused on nephropathia epidemica (NE), which is caused by Puumala hantavirus (PUUV) whose natural reservoir is the bank vole, Myodes glareolus. We questioned the possibility of NE emergence in a French region that is considered to be NE-free but that is adjacent to a NE-endemic region. We first confirmed the epidemiology of these two regions and we demonstrated the absence of spatial barriers that could have limited dispersal, and consequently, the spread of PUUV into the NE-free region. We next tested whether regional immunoheterogeneity could impact PUUV chances to circulate and persist in the NE-free region. We showed that bank voles from the NE-free region were sensitive to experimental PUUV infection. We observed high levels of immunoheterogeneity between individuals and also between regions. Antiviral gene expression (Tnf and Mx2) reached higher levels in bank voles from the NE-free region. During experimental infections, anti-PUUV antibody production was higher in bank voles from the NE-endemic region. These results indicated a lower susceptibility to PUUV for bank voles from this NE-free region, which might limit PUUV persistence and therefore, the risk of NE.

  11. Regionalization and political dynamics of Brazilian health federalism.

    Science.gov (United States)

    Dourado, Daniel de Araujo; Elias, Paulo Eduardo Mangeon

    2011-02-01

    The implications from the Brazilian federal structure on the regionalization of health actions and services in the National Unified Health System (SUS) were analyzed, considering that the regional health planning in Brazil takes place within the context of intergovernmental relations as an expression of cooperative federalism in health. The analysis was based on a historical approach to Brazilian health federalism, recognizing two development periods, decentralization and regionalization. Regional health planning of SUS was explored in light of the theoretical framework of federalism. It is concluded that relative centralization of the process is needed in intergovernmental committees to actualize federal coordination and that it is essential to consider formalizing opportunities for dissent, both in regional management boards and in the intergovernmental committees, so that the consensus decision-making can be accomplished in healthcare regionalization.

  12. Magnetic Energy and Helicity in Two Emerging Active Regions in the Sun

    Science.gov (United States)

    Liu, Y.; Schuck, P. W.

    2012-01-01

    The magnetic energy and relative magnetic helicity in two emerging solar active regions, AR 11072 and AR 11158,are studied. They are computed by integrating over time the energy and relative helicity fluxes across the photosphere. The fluxes consist of two components: one from photospheric tangential flows that shear and braid field lines (shear term), the other from normal flows that advect magnetic flux into the corona (emergence term). For these active regions: (1) relative magnetic helicity in the active-region corona is mainly contributed by the shear term,(2) helicity fluxes from the emergence and the shear terms have the same sign, (3) magnetic energy in the corona (including both potential energy and free energy) is mainly contributed by the emergence term, and(4) energy fluxes from the emergence term and the shear term evolved consistently in phase during the entire flux emergence course.We also examine the apparent tangential velocity derived by tracking field-line footpoints using a simple tracking method. It is found that this velocity is more consistent with tangential plasma velocity than with the flux transport velocity, which agrees with the conclusion by Schuck.

  13. Blended learning: emerging best practices in allied health workforce development.

    Science.gov (United States)

    Brandt, Barbara F; Quake-Rapp, Cindee; Shanedling, Janet; Spannaus-Martin, Donna; Martin, Peggy

    2010-01-01

    To remain dynamic and viable, academic institutions preparing the future workforce need to convert to a more accessible and convenient pathway for students. The need for responsiveness is especially true when considering strategies to prepare an allied health workforce in areas of shortages and to meet the needs of the underserved. A blended or hybrid learning model that strategically uses web-based and face-to-face teaching/learning methods is an innovative and strategic way that promotes learner-centered higher education and facilitates a higher learning experience. A model and emerging best practices for implementation are presented from our experience at the Center for Allied Health Programs at the University of Minnesota.

  14. Increased risk environment for emergency general surgery in the context of regionalization and specialization.

    Science.gov (United States)

    Beecher, S; O'Leary, D P; McLaughlin, R

    2015-09-01

    The pressures on tertiary hospitals with increased volume and complexity related to regionalization and specialization has impacted upon availability of operating theatres with consequent displacement of emergencies to high risk out of hours settings. A retrospective review of an electronic emergency theatre list prospectively maintained database was performed over a two year period. Data gathered included type of operation performed, Time to Theatre (TTT), operation start time and length of stay (LOS). Of 7041 emergency operations 25% were performed out of hours. 2949 patient had general surgical emergency procedures with 910 (30%) performed out of hours. 53% of all emergency laparotomies and 54% of appendicectomies were out of hours. 57% of cases operated on out of hours had been awaiting surgery during the day. Mean TTT was shorter for those admitted at the weekend compared to those admitted during the week (15.6 vs 24.9 h) (p emergency surgery is performed out of hours in a way unfavorable to good clinical outcomes. It is of concern that more than half of the most life threating procedures involving laparotomy, take place out of hours. Regionalization needs to be accompanied by infrastructure planning to accommodate emergency surgery. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

  15. Women's mental health research: the emergence of a biomedical field.

    Science.gov (United States)

    Blehar, Mary C

    2006-01-01

    This review surveys the field of women's mental health, with particular emphasis on its evolution into a distinct area of biomedical research. The field employs a biomedical disease model but it also emphasizes social and cultural influences on health outcomes. In recent years, its scope has expanded beyond studies of disorders occurring in women at times of reproductive transitions and it now encompasses a broader study of sex and gender differences. Historical and conceptual influences on the field are discussed. The review also surveys gender differences in the prevalence and clinical manifestations of mental disorders. Epidemiological findings have provided a rich resource for theory development, but without research tools to test theories adequately, findings of gender differences have begged the question of their biological, social, and cultural origins. Clinical depression is used to exemplify the usefulness of a sex/gender perspective in understanding mental illness; and major theories proposed to account for gender differences are critically evaluated. The National Institutes of Health (NIH) is the primary federal funding source for biomedical women's mental health research. The review surveys areas of emphasis in women's mental health research at the NIH as well as some collaborative activities that represent efforts to translate research findings into the public health and services arenas. As new analytic methods become available, it is anticipated that a more fundamental understanding of the biological and behavioral mechanisms underlying sex and gender differences in mental illness will emerge. Nonetheless, it is also likely that integration of findings predicated on different conceptual models of the nature and causes of mental illness will remain a challenge. These issues are discussed with reference to their impact on the field of women's mental health research.

  16. Improvement of Emergency Management Mechanism of Public Health Crisis in Rural China: A Review Article.

    Science.gov (United States)

    Hu, Jiaxiang; Chen, Chao; Kuai, Tingting

    2018-02-01

    With the rapid development of social economy in China, various public health emergencies frequently occur. Such emergencies cause a serious threat to human health and public safety, especially in rural China. Owing to flaws in emergency management mechanism and policy, the government is not capable to effectively deal with public health emergencies. Therefore, this study aimed to discuss the path to improve the emergency management mechanism for public health emergency in rural China. This study was conducted in 2017 to detect the emergency management mechanism of public health crisis (EMMPHC) in Rural China. Data were collected using the following keywords: Rural China, public health emergency, emergency management mechanism, organization mechanism, operation mechanism in the databases of PubMed, Scopus, Web of Science, and CNKI. EMMPHC in rural China can be enhanced from the following three aspects. First, a permanent institution for rural emergency management with public health management function is established. Second, the entire process of emergency management mechanism, including the stages of pre-disaster, disaster, and post-disaster, is improved. Finally, investment in rural public health is increased, and an adequate reserve system for emergency resources is formed. The new path of EMMPHC in rural China can effectively help the local government accomplish the dispatch capability in public health emergency, and it has important research significance for the protection of public health and social stability of residents in rural China.

  17. Assessing subject privacy and data confidentiality in an emerging region for clinical trials: United Arab Emirates.

    Science.gov (United States)

    Nair, Satish Chandrasekhar; Ibrahim, Halah

    2015-01-01

    Pharmaceutical sponsored clinical trials, formerly conducted predominantly in the United States and Europe, have expanded to emerging regions, including the Middle East. Our study explores factors influencing clinical trial privacy and confidentiality in the United Arab Emirates. Factors including concept familiarity, informed consent compliance, data access, and preservation, were analyzed to assess current practices in the Arab world. As the UAE is an emerging region for clinical trials, there is a growing need for regulations related to data confidentiality and subject privacy. Informational and decisional privacy should be viewed within the realms of Arab culture and religious background.

  18. Emerging and Reemerging Diseases in the World Health Organization (WHO Eastern Mediterranean Region—Progress, Challenges, and WHO Initiatives

    Directory of Open Access Journals (Sweden)

    Evans Buliva

    2017-10-01

    Full Text Available The Eastern Mediterranean Region (EMR of the World Health Organization (WHO continues to be a hotspot for emerging and reemerging infectious diseases and the need to prevent, detect, and respond to any infectious diseases that pose a threat to global health security remains a priority. Many risk factors contribute in the emergence and rapid spread of epidemic diseases in the Region including acute and protracted humanitarian emergencies, resulting in fragile health systems, increased population mobility, rapid urbanization, climate change, weak surveillance and limited laboratory diagnostic capacity, and increased human–animal interaction. In EMR, several infectious disease outbreaks were detected, investigated, and rapidly contained over the past 5 years including: yellow fever in Sudan, Middle East respiratory syndrome in Bahrain, Oman, Qatar, Saudi Arabia, United Arab Emirates, and Yemen, cholera in Iraq, avian influenza A (H5N1 infection in Egypt, and dengue fever in Yemen, Sudan, and Pakistan. Dengue fever remains an important public health concern, with at least eight countries in the region being endemic for the disease. The emergence of MERS-CoV in the region in 2012 and its continued transmission currently poses one of the greatest threats. In response to the growing frequency, duration, and scale of disease outbreaks, WHO has worked closely with member states in the areas of improving public health preparedness, surveillance systems, outbreak response, and addressing critical knowledge gaps. A Regional network for experts and technical institutions has been established to facilitate support for international outbreak response. Major challenges are faced as a result of protracted humanitarian crises in the region. Funding gaps, lack of integrated approaches, weak surveillance systems, and absence of comprehensive response plans are other areas of concern. Accelerated efforts are needed by Regional countries, with the continuous

  19. Primary health care in the Southern Mediterranean region.

    NARCIS (Netherlands)

    Weide, M.G.; Fakiri, F. el; Kulu Glasgow, I.; Grielen, S.J.; Zee, J. van der

    1998-01-01

    This book gives an overview of primary health care in the Southern Mediterranean region. For twelve countries detailed information is provided on the structure and financing of health care, the organisation of primary care (including mother and child health care and immunisation programmes), health

  20. Public health emergencies and the public health/managed care challenge.

    Science.gov (United States)

    Rosenbaum, Sara; Skivington, Skip; Praeger, Sandra

    2002-01-01

    The relationship between insurance and public health is an enduring topic in public health policy and practice. Insurers share certain attributes with public health. But public health agencies operate in relation to the entire community that they are empowered by public law to serve and without regard to the insurance status of community residents; on the other hand, insurers (whether managed care or otherwise) are risk-bearing entities whose obligations are contractually defined and limited to enrolled members and sponsors. Public insurers such as Medicare and Medicaid operate under similar constraints. The fundamental characteristics that distinguish managed care-style insurance and public health become particularly evident during periods of public health emergency, when a public health agency's basic obligations to act with speed and flexibility may come face to face with the constraints on available financing that are inherent in the structure of insurance. Because more than 70% of all personal health care in the United States is financed through insurance, public health agencies effectively depend on insurers to finance necessary care and provide essential patient-level data to the public health system. Critical issues of state and federal policy arise in the context of the public health/insurance relations during public health emergencies. These issues focus on coverage and the power to make coverage decisions, as well as the power to define service networks and classify certain data as exempt from public reporting. The extent to which a formal regulatory approach may become necessary is significantly affected by the extent to which private entities themselves respond to the problem with active efforts to redesign their services and operations to include capabilities and accountability in the realm of public health emergency response.

  1. Health Information Technology Adoption in the Emergency Department.

    Science.gov (United States)

    Selck, Frederic W; Decker, Sandra L

    2016-02-01

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

  2. [Social skills in emergency and critical care professionals of a regional public hospital].

    Science.gov (United States)

    Leal Costa, C; Luján Cebrián, I; Gascón García, J; Ferrer Villalonga, L; Van-der Hofstadt Román, C J

    2010-01-01

    To assess the social skills of health care professionals in the emergency and critical care units of the regional hospital Vega Baja and analyze the association between a series of sociodemographic and professionals variables and social skills. A cross-sectional, descriptive study. Two evaluation tools were used. These included a sociodemographic and professional variables questionnaire, and the Elena Gismero's Social Skills Scale (SSS). A response rate of 82.6% was obtained. Considering the standards made by the author in SSS validation, it can be seen that the sample has obtained a medium-high score in each one of the aspects. Significant differences have been found when considering the sociodemographic variable gender as an independent variable with the complete score of SSS (F=6.555; p=0.013), and with the scale dimensions, self-expression in social situations (F=4.468; p=0.039) and making a demand (F=7.982; p=0.007). In each one of the SSS dimensions, the sample has obtained a slightly higher score than the standard sample and it within the 50-69 percentile. This indicates the existence of a medium-high level of Social Skill. The doctors score higher than the nurses, although these differences are not statistically significant. Copyright © 2010 Elsevier España, S.L. y SEEIUC. All rights reserved.

  3. Regional and inter-regional economic rules and the enforcement of the right to health: The case of Colombia

    Science.gov (United States)

    Rodríguez, Liliana Lizarazo; De Lombaerde, Philippe

    2015-01-01

    The regional policy level is often seen as a (potential) source of progressive policy-making in health (and in social policy more widely), complementing or substituting national policy levels, which are perceived as underperforming. While it can certainly be argued that there are important opportunities to adopt regional approaches to tackle border-crossing health issues, this article draws the attention to the fact that the linkage between (inter-)regional and national policy levels is not uni-directional. While in some instances the regional level may indeed take the lead in the promotion of (the right to) health, in other instances it may well be the other way round. This article focuses on the case of Colombia, where international economic rules have deeply permeated public policies in the health sector. On one hand, Colombia has been opening markets through the conclusion of regional integration arrangements (e.g. Andean Community and the Pacific Alliance) and the new generation of Free Trade Agreements. On the other hand, Colombia has been one of the most active emerging countries in promoting the right to health as a justiciable fundamental right, in line with the International Covenant on Economic, Social, and Cultural Rights of the United Nations mainly due to the judicial activism of the Colombian Constitutional Court with interesting implications for regional social governance. The article shows that national courts can play an important role in the protection of the right to health in a context of economic integration and the absence of regional balancing policies. PMID:26635499

  4. Income-related health inequalities across regions in Korea

    Directory of Open Access Journals (Sweden)

    Ahn Byung

    2011-10-01

    Full Text Available Abstract Introduction In addition to economic inequalities, there has been growing concern over socioeconomic inequalities in health across income levels and/or regions. This study measures income-related health inequalities within and between regions and assesses the possibility of convergence of socioeconomic inequalities in health as regional incomes converge. Methods We considered a total of 45,233 subjects (≥ 19 years drawn from the four waves of the Korean National Health and Nutrition Examination Survey (KNHANES. We considered true health as a latent variable following a lognormal distribution. We obtained ill-health scores by matching self-rated health (SRH to its distribution and used the Gini Coefficient (GC and an income-related ill-health Concentration Index (CI to examine inequalities in income and health, respectively. Results The GC estimates were 0.3763 and 0.0657 for overall and spatial inequalities, respectively. The overall CI was -0.1309, and the spatial CI was -0.0473. The spatial GC and CI estimates were smaller than their counterparts, indicating substantial inequalities in income (from 0.3199 in Daejeon to 0.4233 Chungnam and income-related health inequalities (from -0.1596 in Jeju and -0.0844 in Ulsan within regions. The results indicate a positive relationship between the GC and the average ill-health and a negative relationship between the CI and the average ill-health. Those regions with a low level of health tended to show an unequal distribution of income and health. In addition, there was a negative relationship between the GC and the CI, that is, the larger the income inequalities, the larger the health inequalities were. The GC was negatively related to the average regional income, indicating that an increase in a region's average income reduced income inequalities in the region. On the other hand, the CI showed a positive relationship, indicating that an increase in a region's average income reduced health

  5. Use of emergency department services by women victims of violence in Lazio region, Italy.

    Science.gov (United States)

    Farchi, Sara; Polo, Arianna; Asole, Simona; Ruggieri, Maria Pia; Di Lallo, Domenico

    2013-07-19

    Violence against women is a significant health problem and a hidden phenomenon, in Italy that about 31% of the women have been victims of violence once in life. Aims of this study are to describe characteristics of women victims of violence (VV) attending the EDs in the Lazio region in 2008 and to illustrate the frequency and characteristics of previous ED visits. Using the Emergency Information System, visits of women, (15-49 years), in the 60 EDs, for a violent trauma have been analysed. For each VV identified, we considered the last episode and searched for ED attendances in a six year period (2003-08) in order to identify other visits. We performed descriptive analyses of socio-demographic and clinical factors of VV and we analyzed the impact previous ED visits. We compared ED utilization of women VV with a random sample of women with the same age distribution who gave birth in 2008. In 2008, 7,725 ED attendances of women VV were found (1.1% of the ED visits) corresponding to 6,936 women (prevalence = 52.0x10,000). The mean number of ED visits for each woman in five years was 5.0 (1-190). Prevalent diagnoses were contusions (45.8%), neurotic disorders (5.4%) complications of medical care (6.3%). The women were young, approximately 70% were residents in Rome or the surrounding areas. Foreign women were three times more likely to visit the ED for intentional injuries than were Italian women (114.1 vs 44.4 per 10.000). This study shows high prevalence of violence against women in Lazio region, Italy. Most of the women have been visited by the ED several times before the violent episode, often with traumas. ED medical and nursing staff should be prepared and trained to successfully manage victims of violence.

  6. Regional health governance: A suggested agenda for Southern African health diplomacy.

    Science.gov (United States)

    Penfold, Erica Dale; Fourie, Pieter

    2015-12-01

    Regional organisations can effectively promote regional health diplomacy and governance through engagement with regional social policy. Regional bodies make decisions about health challenges in the region, for example, the Union of South American Nations (UNASUR) and the World Health Organisation South East Asia Regional Office (WHO-SEARO). The Southern African Development Community (SADC) has a limited health presence as a regional organisation and diplomatic partner in health governance. This article identifies how SADC facilitates and coordinates health policy, arguing that SADC has the potential to promote regional health diplomacy and governance through engagement with regional social policy. The article identifies the role of global health diplomacy and niche diplomacy in health governance. The role of SADC as a regional organisation and the way it functions is then explained, focusing on how SADC engages with health issues in the region. Recommendations are made as to how SADC can play a more decisive role as a regional organisation to implement South-South management of the regional social policy, health governance and health diplomacy agenda.

  7. Regional Interrelationships: A Leadership Opportunity for Health Care.

    Science.gov (United States)

    Rotarius, Timothy; Liberman, Aaron

    Given the impact that the health care industry has on the national economy, health care executives need to move beyond simply providing health care treatments and instead focus on strategically leading their regions, including the other key industry contributors in their specific regions. Geographic and economic regions can be viewed as concentric circles of influence, with each circle recognizing the resources and contributions that are specific to a region. An acknowledgement by health care executives of the regional interrelationships that exist in a specific region is necessary for health care managers to strategically lead regional interrelationships. A template for implementation of this process is included. To understand the various factors that exist within circles of influence, several distinct yet interrelated vertical bases of knowledge will be discussed. The 5 bases of knowledge examined here include the following: Health Care, Tourism, Defense and Technology, Education, and Retail. It is important to note that the resources identified in the Tourism, Defense and Technology, Education, and Retail knowledge bases all have a direct influential relationship upon the health care resources of the region. For description purposes, the Central Florida geographic and economic region will be examined for interrelationships between the 5 knowledge bases.

  8. Incentivizing health care behaviors in emerging adults: a systematic review

    Directory of Open Access Journals (Sweden)

    Yu CH

    2016-03-01

    Full Text Available Catherine H Yu,1,2 Giuliana Guarna,1 Pamela Tsao,3 Jude R Jesuthasan,1 Adrian NC Lau,3,4 Ferhan S Siddiqi,1 Julie Anne Gilmour,3 Danyal Ladha,1 Henry Halapy,5 Andrew Advani1–3 1Li Ka Shing Knowledge Institute, St Michael’s Hospital, 2Division of Endocrinology and Metabolism, Department of Medicine, St Michael’s Hospital, University of Toronto, 3Department of Medicine, Faculty of Medicine, University of Toronto, 4Division of Endocrinology, Department of Medicine, University Health Network, 5Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada Purpose: For emerging adults with chronic medical diseases, the transition from pediatric to adult health care is often a time of great upheaval, commonly associated with unhealthy self-management choices, loss to follow-up, and adverse outcomes. We conducted a systematic review to examine the use of incentive strategies to promote positive health-related behaviors in young adults with chronic medical diseases.Methods: The Medline, CINAHL, Embase, PsycInfo, and Cochrane databases were searched through June 2014. Studies of any design where an incentive was used to achieve a target behavior or outcome in a pediatric or emerging adult population (age <30 years with chronic medical conditions including addictions, were included.Results: A total of 26 studies comprising 10,880 patients met our inclusion criteria after screening 10,305 abstracts and 301 full-text articles. Of these studies, 20 examined the effects of behavioral incentives on cigarette smoking or substance abuse, including alcohol; four studies explored behavioral incentives in the setting of HIV or sexual health; and two articles studied individuals with other chronic medical conditions. Seventeen articles reported a statistically significant benefit of the behavioral incentive on one or more outcomes, although only half reported follow-up after the incentive period was terminated.Conclusion: While the majority of

  9. [Social inequalities in health, missions of a regional healthcare agency].

    Science.gov (United States)

    Ginot, Luc

    The presence of social inequalities in health requires a multi-faceted intervention, focusing on the social determinants as well as the provision of care and prevention strategies. Regional health agencies have important levers at their disposal, as illustrated by the example of the Île-de-France region. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  10. Ethics, health policy, and Zika: From emergency to global epidemic?

    Science.gov (United States)

    Jamrozik, Euzebiusz; Selgelid, Michael J

    2018-05-01

    Zika virus was recognised in 2016 as an important vector-borne cause of congenital malformations and Guillain-Barré syndrome, during a major epidemic in Latin America, centred in Northeastern Brazil. The WHO and Pan American Health Organisation (PAHO), with partner agencies, initiated a coordinated global response including public health intervention and urgent scientific research, as well as ethical analysis as a vital element of policy design. In this paper, we summarise the major ethical issues raised during the Zika epidemic, highlighting the PAHO ethics guidance and the role of ethics in emergency responses, before turning to ethical issues that are yet to be resolved. Zika raises traditional bioethical issues related to reproduction, prenatal diagnosis of serious malformations and unjust disparities in health outcomes. But the epidemic has also highlighted important issues of growing interest in public health ethics, such as the international spread of infectious disease; the central importance of reproductive healthcare in preventing maternal and neonatal morbidity and mortality; diagnostic and reporting biases; vector control and the links between vectors, climate change, and disparities in the global burden of disease. Finally, there are controversies regarding Zika vaccine research and eventual deployment. Zika virus was a neglected disease for over 50 years before the outbreak in Brazil. As it continues to spread, public health agencies should promote gender equity and disease control efforts in Latin America, while preparing for the possibility of a global epidemic. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  11. Global health risks and cosmopolitisation: from emergence to interference.

    Science.gov (United States)

    Figuié, Muriel

    2013-02-01

    According to Beck's 'World at Risk' theory, global risks push nations towards a cosmopolitisation of their health policy and open opportunities for a democratic turn. This article provides an empirical analysis of Beck's theory, based on the experience of Vietnamese authorities from 2003 to 2007 in managing the emerging avian flu virus. It shows how Vietnam's framing of avian flu has shifted, under the pressure from international organisations and the US administration, from an epizootic and zoonotic risk (or a classic risk) to a pandemic threat (or a late modern risk). Vietnam's response was part of its overall strategy to join the World Trade Organization and it was limited by Vietnam's defence of its sovereignty. This strategy has been successful for Vietnam but has limited the possibility of cosmopolitan and democratic transformations. The case study highlights the constructed dimension of risks of late modernity and their possible instrumentalisation: it minimises the role of a community of fear relative to a community of trade. © 2013 The Author. Sociology of Health & Illness © 2013 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd.

  12. EMERGENCE OF "DRIVERS" FOR THE IMPLEMENTATION OF HEALTH TECHNOLOGY ASSESSMENT.

    Science.gov (United States)

    Castro Jaramillo, Hector Eduardo; Moreno-Mattar, Ornella; Osorio-Cuevas, Diana

    2016-01-01

    Health technology assessment (HTA) examines the consequences of the application of health technologies and is aimed at better informing decision-makers. Over the past 30 years, different countries have implemented HTA organizations. Colombia established by law its own HTA agency (IETS) in 2011 which started operations in November 2012. The aim of this study was to assess the feasibility of conducting and using HTA to inform decision-making in this context. Through a qualitative approach, ten "drivers" emerged with the ability to help or hinder HTA development in this context: availability and quality of data, implementation strategy, cultural aspects, local capacity, financial support, policy/political support, globalization, stakeholder pressure, health system context, and usefulness perception. Semi-structured interviews were conducted with key HTA researchers, after following rigorous transcription, and thematic content analysis, those aspects that may be barriers or facilitator for HTA development and use in Colombia were identified. Although HTA has become a tool to inform decision-making around the world, its use may vary according to setting. Determining those aspects which may enable or interfere with HTA development and use in Colombia may be useful for other countries when considering the establishment of HTA systems. The conceptual transferability of concepts like "drivers" with caveats may be of interest for similar settings trying to incorporate HTA processes and institutions into systematic decision-making.

  13. Embedding health literacy into health systems: a case study of a regional health service.

    Science.gov (United States)

    Vellar, Lucia; Mastroianni, Fiorina; Lambert, Kelly

    2017-12-01

    Objective The aim of the present study was to describe how one regional health service the Illawarra Shoalhaven Local Health District embedded health literacy principles into health systems over a 3-year period. Methods Using a case study approach, this article describes the development of key programs and the manner in which clinical incidents were used to create a health environment that allows consumers the right to equitably access quality health services and to participate in their own health care. Results The key outcomes demonstrating successful embedding of health literacy into health systems in this regional health service include the creation of a governance structure and web-based platform for developing and testing plain English consumer health information, a clearly defined process to engage with consumers, development of the health literacy ambassador training program and integrating health literacy into clinical quality improvement processes via a formal program with consumers to guide processes such as improvements to access and navigation around hospital sites. Conclusions The Illawarra Shoalhaven Local Health District has developed an evidence-based health literacy framework, guided by the core principles of universal precaution and organisational responsibility. Health literacy was also viewed as both an outcome and a process. The approach taken by the Illawarra Shoalhaven Local Health District to address poor health literacy in a coordinated way has been recognised by the Australian Commission on Safety and Quality in Health Care as an exemplar of a coordinated approach to embed health literacy into health systems. What is known about the topic? Poor health literacy is a significant national concern in Australia. The leadership, governance and consumer partnership culture of a health organisation can have considerable effects on an individual's ability to access, understand and apply the health-related information and services available to them

  14. Use of a Combination of Regional and General Anesthesia during Emergency Thoracic Surgery

    Directory of Open Access Journals (Sweden)

    V. Kh. Sharipova

    2015-01-01

    Full Text Available Objective: to elaborate multimodal anesthetic regimens and to evaluate their efficiency during emergency thoracic surgeries for varying injuries. Subjects and methods. A total of 116 patients emergently admitted to the Republican Research Center for Emergency Medical Care for chest traumatic injuries were examined and divided into 3 groups according to the mode of anesthesia. Results. Perioperative multimodal anesthetic regimens for emergency thoracic surgery, which involved all components of the pathogenesis of pain, were elaborated. Conclusion. The combination of regional and general anesthesia contributes to the smooth course of an intra operative period with minimal hemodynamic stress and it is cost effective in decreasing the use of narcotic anal gesics in the intraoperative period. 

  15. Emerging Persistent Organic Pollutants in Chinese Bohai Sea and Its Coastal Regions

    Directory of Open Access Journals (Sweden)

    Xiaomin Li

    2014-01-01

    Full Text Available Emerging persistent organic pollutants (POPs have widely aroused public concern in recent years. Polybrominated diphenyl ethers (PBDEs and perfluorooctane sulfonyl fluoride/perfluorooctane sulfonic acid (POSF/PFOS had been newly listed in Stockholm Convention in 2009, and short chain chlorinated paraffins (SCCPs and hexabromocyclododecanes (HBCDs were listed as candidate POPs. Bohai Sea is located in the arms of numbers of industrial cities, the semienclosed location of which makes it an ideal sink of emerging pollutants. In the present paper, latest contamination status of emerging POPs in Bohai Sea was reviewed. According to the literature data, Bohai Sea areas are not heavily contaminated by emerging POPs (PBDE: 0.01–720 ng/g; perfluorinated compounds: 0.1–304 ng/g; SCCPs: 64.9–5510 ng/g; HBCDs: nd-634 ng/g. Therefore, humans are not likely to be under serious risk of emerging POPs exposure through consuming seafood from Bohai Sea. However, the ubiquitous occurrence of emerging POPs in Bohai Sea region might indicate that more work should be done to expand the knowledge about potential risk of emerging POPs pollution.

  16. Emerging Persistent Organic Pollutants in Chinese Bohai Sea and Its Coastal Regions

    Science.gov (United States)

    Wang, Yawei; Pan, Yuanyuan

    2014-01-01

    Emerging persistent organic pollutants (POPs) have widely aroused public concern in recent years. Polybrominated diphenyl ethers (PBDEs) and perfluorooctane sulfonyl fluoride/perfluorooctane sulfonic acid (POSF/PFOS) had been newly listed in Stockholm Convention in 2009, and short chain chlorinated paraffins (SCCPs) and hexabromocyclododecanes (HBCDs) were listed as candidate POPs. Bohai Sea is located in the arms of numbers of industrial cities, the semienclosed location of which makes it an ideal sink of emerging pollutants. In the present paper, latest contamination status of emerging POPs in Bohai Sea was reviewed. According to the literature data, Bohai Sea areas are not heavily contaminated by emerging POPs (PBDE: 0.01–720 ng/g; perfluorinated compounds: 0.1–304 ng/g; SCCPs: 64.9–5510 ng/g; HBCDs: nd-634 ng/g). Therefore, humans are not likely to be under serious risk of emerging POPs exposure through consuming seafood from Bohai Sea. However, the ubiquitous occurrence of emerging POPs in Bohai Sea region might indicate that more work should be done to expand the knowledge about potential risk of emerging POPs pollution. PMID:24688410

  17. The utilization rate of the regional health information exchange: how it impacts on health care delivery outcomes.

    Science.gov (United States)

    Mäenpää, Tiina; Asikainen, Paula; Gissler, Mika; Siponen, Kimmo; Maass, Marianne; Saranto, Kaija; Suominen, Tarja

    2012-01-01

    Interest in improving quality and effectiveness is the primary driver for health information exchange efforts across a health care system to improve the provision of public health care services. The aim here was to describe and identify the impact of a regional health information exchange (HIE) using quantitative statistics for 2004-2008 in one hospital district in Finland. We conducted a comparative, longitudinal 5-year follow-up study to evaluate the utilization rates of HIE, and the impact on health care delivery outcomes. The selected outcomes were total laboratory tests, radiology examinations, appointments, emergency visits, and referrals. The HIE utilization rates increased annually in all 10 federations of municipalities, and the viewing of reference information increased steadily in each professional group over the 5-year study period. In these federations, a significant connection was found to the number of laboratory tests and radiology examinations, with a statistically significant increase in the number of viewed references and use of HIE. The higher the numbers of emergency visits and appointments, the higher the numbers of emergency referrals to specialized care, viewed references, and HIE usage among the groups of different health care professionals. There is increasing interest in HIE usage through regional health information system among health professionals to improve health care delivery regionally and bring information on the patient directly to care delivery. It will be important to study which changes in working methods in the service system are explained by RHIS. Also, the experiences of the change that has taken place should be studied among the different stakeholders, administrative representatives, and patients.

  18. Health impact assessment in China: Emergence, progress and challenges

    Energy Technology Data Exchange (ETDEWEB)

    Huang Zheng, E-mail: huangzhg@mails.tjmu.edu.cn

    2012-01-15

    The values, concepts and approaches of health impact assessment (HIA) were outlined in the Gothenburg consensus paper and some industrialized countries have implemented HIA for many years. HIA has played an important role in environmental protection in China, however, the emergence, progress and challenges of HIA in China have not been well described. In this paper, the evolution of HIA in China was analyzed and the challenges of HIA were presented based on the author's experiences. HIA contributed to decision-making for large capital construction projects, such as the Three Gorges Dam project, in its emergence stage. Increasing attention has been given to HIA in recent years due to supportive policies underpinning development of the draft HIA guidelines in 2008. However enormous challenges lie ahead in ensuring the institutionalization of HIA into project, program and policy decision-making process due to limited scope, immature tools and insufficient professionals in HIA practice. HIA should broaden its horizons by encompassing physical, chemical, biological and socio-economic aspects and constant attempts should be made to integrate HIA into the decision-making process, not only for projects and programs but also for policies as well.

  19. Health conditions and role limitation in three European Regions: a public-health perspective

    Directory of Open Access Journals (Sweden)

    Gabriela Barbaglia

    2017-01-01

    Conclusion: The contribution of health conditions to role limitation in the three European regions studied is high. Mental disorders are associated with the largest impact in most of the regions. There is a need for mainstreaming disability in the public health agenda to reduce the role limitation associated with health conditions. The cross-regional differences found require further investigation.

  20. The emergency of concept global health: perspectives for the field of public health

    Directory of Open Access Journals (Sweden)

    João Roberto Cavalcante Sampaio

    2016-12-01

    Full Text Available In recent years, we have witnessed the emergence of new terms in the academic and political debate of public health, such as ‘’global health’’, ‘’global public goods’’, ‘’global health governance’’, ‘’global public health’’, ‘’health diplomacy’’, 'international cooperation’’. In this study, we aimed to analyze the historical development of the concept of ‘global health’, as well as the prospects of this new concept in the research and public health practice. A comprehensive literature review was performed in Pubmed, Scielo, Scopus, and BVS. We also analyzed documents obtained from the websites of international health organizations. 514 publications were retrieved and 36 were selected for this study. In general, the concept of "global health" refers to health as a transnational phenomenon linked to globalization, which has as main challenge to think public health beyond international relations between countries. International health organizations are particularly important in the development of the concept of "global health" and its new application prospects in the field of public health are health diplomacy, international cooperation and global health governance.

  1. Emerging arboviruses and public health challenges in Brazil

    Directory of Open Access Journals (Sweden)

    Tamara Nunes Lima-Camara

    2016-01-01

    Full Text Available ABSTRACT Environmental modification by anthropogenic actions, disordered urban growth, globalization of international exchange and climate change are some factors that help the emergence and dissemination of human infectious diseases transmitted by vectors. This review discusses the recent entry of three arboviruses in Brazil: Chikungunya, West Nile, and Zika virus, focusing on the challenges for the Country’s public health. The Brazilian population is exposed to infections caused by these three arboviruses widely distributed on the national territory and associated with humans. Without effective vaccine and specific treatment, the maintainance and integration of a continuos entomological and epidemiological surveillance are important so we can set methods to control and prevent these arboviruses in the Country.

  2. Perinatal health in the Danube region

    DEFF Research Database (Denmark)

    Knudsen, Lisbeth E.; Andersen, Zorana J.; Sram, Radim J.

    2017-01-01

    In 2013-2015, a consortium of European scientists - NEWDANUBE - was established to prepare a birth cohort in the Danube region, including most of the countries with the highest air pollution in Europe, the area being one-fifth of the European Union's (EU's) territory, including 14 countries (nine...

  3. Photospheric Velocity Structures during the Emergence of Small Active Regions on the Sun

    International Nuclear Information System (INIS)

    Khlystova, Anna; Toriumi, Shin

    2017-01-01

    We study the plasma flows in the solar photosphere during the emergence of two small active regions, NOAA 9021 and 10768. Using Solar and Heliospheric Observatory /Michelson Doppler Imager data, we find that the strong plasma upflows appear at the initial stage of active region formation, with maximum upflow velocities of −1650 and −1320 m s −1 . The structures with enhanced upflows have size ∼8 Mm in diameter, and they exist for 1–2 hr. The parameters of the enhanced upflows are consistent with those of the large active region NOAA 10488, which may suggest the possibility that the elementary emerging magnetic loops that appear at the earliest phase of active region formation have similar properties, irrespective of scales of active regions. Comparison between the observations and a numerical simulation of magnetic flux emergence shows a striking consistency. We find that the driving force of the plasma upflow is at first the gas pressure gradient and later the magnetic pressure gradient.

  4. Photospheric Velocity Structures during the Emergence of Small Active Regions on the Sun

    Energy Technology Data Exchange (ETDEWEB)

    Khlystova, Anna [Institute of Solar-Terrestrial Physics SB RAS, Lermontov St., 126a, 664033 Irkutsk (Russian Federation); Toriumi, Shin, E-mail: hlystova@iszf.irk.ru, E-mail: shin.toriumi@nao.ac.jp [National Astronomical Observatory of Japan, 2-21-1 Osawa, Mitaka, Tokyo 181-8588 (Japan)

    2017-04-10

    We study the plasma flows in the solar photosphere during the emergence of two small active regions, NOAA 9021 and 10768. Using Solar and Heliospheric Observatory /Michelson Doppler Imager data, we find that the strong plasma upflows appear at the initial stage of active region formation, with maximum upflow velocities of −1650 and −1320 m s{sup −1}. The structures with enhanced upflows have size ∼8 Mm in diameter, and they exist for 1–2 hr. The parameters of the enhanced upflows are consistent with those of the large active region NOAA 10488, which may suggest the possibility that the elementary emerging magnetic loops that appear at the earliest phase of active region formation have similar properties, irrespective of scales of active regions. Comparison between the observations and a numerical simulation of magnetic flux emergence shows a striking consistency. We find that the driving force of the plasma upflow is at first the gas pressure gradient and later the magnetic pressure gradient.

  5. WHO global and regional strategies for health and environment

    International Nuclear Information System (INIS)

    Hisashi Ogawa

    1996-01-01

    This paper describes the WHO global and regional strategies for health and environment and discusses research needs on environmental health to support the implementation of the strategies. Particular emphasis on applied researches which generate information, for decision making, on health effects of development and environmental changes in specific locations

  6. Health Service Utilization in Amhara Region of Ethiopia | Fantahun ...

    African Journals Online (AJOL)

    Background: Information on health service utilization is crucial for planning, organizing and evaluation of health services. Objective: Assess perceived morbidity and examine the factors associated with utilization of health services by a sample of the population of the Amhara Region. Methods: Questionnaire was ...

  7. Perinatal health in the Danube region - new birth cohort justified.

    Czech Academy of Sciences Publication Activity Database

    Knudsen, L. E.; Andersen, Z.J.; Šrám, Radim; Braun Kohlová, M.; Gurzau, E.S.; Fucic, A.; Gribaldo, L.; Rössner ml., Pavel; Rössnerová, Andrea; Máca, V.; Zvěřinová, I.; Gajdošová, D.; Moshammer, H.; Rudnai, P.; Ščasný, M.

    2017-01-01

    Roč. 32, 1-2 (2017), s. 9-14 ISSN 2191-0308 Institutional support: RVO:68378041 Keywords : birth cohort * child health * Danube region * environmental exposures Subject RIV: DN - Health Impact of the Environment Quality OBOR OECD: Public and environmental health

  8. WHO global and regional strategies for health and environment

    Energy Technology Data Exchange (ETDEWEB)

    Ogawa, Hisashi [World Health Organization, Manila (Philippines). Regional Office for the Western Pacific

    1997-12-31

    This paper describes the WHO global and regional strategies for health and environment and discusses research needs on environmental health to support the implementation of the strategies. Particular emphasis on applied researches which generate information, for decision making, on health effects of development and environmental changes in specific locations.

  9. Italian regional health system structure and expected cancer survival.

    Science.gov (United States)

    Vercelli, Marina; Lillini, Roberto; Quaglia, Alberto; Capocaccia, Riccardo

    2014-01-01

    Few studies deal with the association of socioeconomic and health system resource variables with cancer survival at the Italian regional level, where the greatest number of decisions about social and health policies and resource allocations are taken. The present study aimed to describe the causal relationships between socioeconomic and health system resource factors and regional cancer survival and to compute the expected cancer survival at provincial, regional and area levels. Age-standardized relative survival at 5 years from diagnosis of cases incident in 1995-1998 and followed up to 2004 were derived by gender for 11 sites from the Italian Association of Cancer Registries data bank. The socioeconomic and health system resource variables, describing at a regional level the macro-economy, demography, labor market, and health resources for 1995-2005, came from the Health for All database. A principal components factor analysis was applied to the socioeconomic and health system resource variables. For every site, linear regression models were computed considering the relative survival at 5 years as a dependent variable and the principal components factor analysis factors as independent variables. The factors described the socioeconomic and health-related features of the regional systems and were causally related to the characteristics of the patient taken in charge. The models built by the factors allowed computation of the expected relative survival at 5 years with very good concordance with those observed at regional, macro-regional and national levels. In the regions without any cancer registry, survival was coherent with that of neighboring regions with similar socioeconomic and health system resources characteristics. The models highlighted the causal correlations between socioeconomic and health system resources and cancer survival, suggesting that they could be good evaluation tools for the efficiency of the resources allocation and use.

  10. Health Hazards Associated with Consumption of Roof-Collected Rainwater in Urban Areas in Emergency Situations

    Directory of Open Access Journals (Sweden)

    Carol Stewart

    2016-10-01

    Full Text Available The greater Wellington region, New Zealand, is highly vulnerable to large earthquakes because it is cut by active faults. Bulk water supply pipelines cross the Wellington Fault at several different locations, and there is considerable concern about severe disruption of the provision of reticulated water supplies to households and businesses in the aftermath of a large earthquake. A number of policy initiatives have been launched encouraging householders to install rainwater tanks to increase post-disaster resilience. However, little attention has been paid to potential health hazards associated with consumption of these supplies. To assess health hazards for householders in emergency situations, six 200-litre emergency water tanks were installed at properties across the Wellington region, with five tanks being allowed to fill with roof-collected rainwater and one tank being filled with municipal tapwater as a control. Such tanks are predominantly set aside for water storage and, once filled, feature limited drawdown and recharge. Sampling from these tanks was carried out fortnightly for one year, and samples were analysed for E. coli, pH, conductivity, a range of major and trace elements, and organic compounds, enabling an assessment of the evolution of water chemistry in water storage tanks over time. Key findings were that the overall rate of E. coli detections in the rain-fed tanks was 17.7%, which is low in relation to other studies. We propose that low incidences of may be due to biocidal effects of high zinc concentrations in tanks, originating from unpainted galvanised steel roof cladding. Lead concentrations were high compared to other studies, with 69% of rain-fed tank samples exceeding the World Health Organisation’s health-based guideline of 0.01 mg/L. Further work is required to determine risks of short-term consumption of this water in emergency situations.

  11. Health Hazards Associated with Consumption of Roof-Collected Rainwater in Urban Areas in Emergency Situations.

    Science.gov (United States)

    Stewart, Carol; Kim, Nick D; Johnston, David M; Nayyerloo, Mostafa

    2016-10-15

    The greater Wellington region, New Zealand, is highly vulnerable to large earthquakes because it is cut by active faults. Bulk water supply pipelines cross the Wellington Fault at several different locations, and there is considerable concern about severe disruption of the provision of reticulated water supplies to households and businesses in the aftermath of a large earthquake. A number of policy initiatives have been launched encouraging householders to install rainwater tanks to increase post-disaster resilience. However, little attention has been paid to potential health hazards associated with consumption of these supplies. To assess health hazards for householders in emergency situations, six 200-litre emergency water tanks were installed at properties across the Wellington region, with five tanks being allowed to fill with roof-collected rainwater and one tank being filled with municipal tapwater as a control. Such tanks are predominantly set aside for water storage and, once filled, feature limited drawdown and recharge. Sampling from these tanks was carried out fortnightly for one year, and samples were analysed for E. coli , pH, conductivity, a range of major and trace elements, and organic compounds, enabling an assessment of the evolution of water chemistry in water storage tanks over time. Key findings were that the overall rate of E. coli detections in the rain-fed tanks was 17.7%, which is low in relation to other studies. We propose that low incidences of may be due to biocidal effects of high zinc concentrations in tanks, originating from unpainted galvanised steel roof cladding. Lead concentrations were high compared to other studies, with 69% of rain-fed tank samples exceeding the World Health Organisation's health-based guideline of 0.01 mg/L. Further work is required to determine risks of short-term consumption of this water in emergency situations.

  12. A look at the ASEAN-NDI: building a regional health R&D innovation network.

    Science.gov (United States)

    Montoya, Jaime C; Rebulanan, Carina L; Parungao, Nico Angelo C; Ramirez, Bernadette

    2014-01-01

    Globally, there are growing efforts to address diseases through the advancement in health research and development (R&D), strengthening of regional cooperation in science and technology (particularly on product discovery and development), and implementation of the World Health Assembly Resolution 61.21 (WHA61.21) on the Global Strategy and Plan of Action on Public Health, Innovation, and Intellectual Property (GSPA-PHI). As such, the Association of Southeast Asian Nations (ASEAN) is responding to this through the establishment of the ASEAN-Network for Drugs, Diagnostics, Vaccines, and Traditional Medicines Innovation (ASEAN-NDI). This is important in the ASEAN considering that infectious tropical diseases remain prevalent, emerging, and reemerging in the region. This paper looks into the evolution of the ASEAN-NDI from its inception in 2009, to how it is at present, and its plans to mitigate public health problems regionally and even globally.

  13. 'BRICS without straw'? A systematic literature review of newly emerging economies' influence in global health.

    Science.gov (United States)

    Harmer, Andrew; Xiao, Yina; Missoni, Eduardo; Tediosi, Fabrizio

    2013-04-15

    Since 2010, five newly emerging economies collectively known as 'BRICS' (Brazil, India, Russia, China and South Africa) have caught the imagination, and scholarly attention, of political scientists, economists and development specialists. The prospect of a unified geopolitical bloc, consciously seeking to re-frame international (and global) health development with a new set of ideas and values, has also, if belatedly, begun to attract the attention of the global health community. But what influence, if any, do the BRICS wield in global health, and, if they do wield influence, how has that influence been conceptualized and recorded in the literature? We conducted a systematic literature review in (March-December 2012) of documents retrieved from the databases EMBASE, PubMed/Medline, Global Health, and Google Scholar, and the websites of relevant international organisations, research institutions and philanthropic organisations. The results were synthesised using a framework of influence developed for the review from the political science literature. Our initial search of databases and websites yielded 887 documents. Exclusion criteria narrowed the number of documents to 71 journal articles and 23 reports. Two researchers using an agreed set of inclusion criteria independently screened the 94 documents, leaving just 7 documents. We found just one document that provided sustained analysis of the BRICS' collective influence; the overwhelming tendency was to describe individual BRICS countries influence. Although influence was predominantly framed by BRICS countries' material capability, there were examples of institutional and ideational influence - particularly from Brazil. Individual BRICS countries were primarily 'opportunity seekers' and region mobilisers but with potential to become 'issue leaders' and region organisers. Though small in number, the written output on BRICS influence in global health has increased significantly since a similar review conducted in

  14. Phytosterols: natural compounds with established and emerging health benefits

    Directory of Open Access Journals (Sweden)

    Trautwein Elke A.

    2007-09-01

    Full Text Available Phytosterols (plant sterols and stanols are naturally occurring compounds which are found in all foods of plant origin. The term phytosterols refers to more than 200 different compounds. The most abundant ones in the human diet are sitosterol and campesterol. Their saturated counterparts, sitostanol and campestanol, are found in much lower amounts. Good food sources of phytosterols include vegetable oils, cereal grains, nuts, legumes, and fruits and vegetables. Phytosterols are structurally similar to cholesterol. Despite this structural similarity, they are not absorbed in significant quantities. Absorption is less than 2% for phytosterols, while it is 30-60% for cholesterol. Phytosterols are known to have various bioactive properties, which may have an impact on human health, and as such boosted interest in phytosterols in the past decade. The most important benefit is their blood cholesterol-lowering effect via partial inhibition of intestinal cholesterol absorption. The recommended daily intake of 2 g of phytosterols reduces cholesterol absorption by 30-40% and LDL-cholesterol by 10% on average. Other claimed benefits of phytosterols are possible anti-atherogenic effects as well as, particularly for beta-sitosterol, immune stimulating and anti-inflammatory activities. Furthermore, there is emerging evidence suggesting that particularly plant sterols may have beneficial effects against the development of different types of cancers, like colorectal, breast and prostate cancers. It is not clear whether mechanisms other than the established cholesterol-lowering action of phytosterols as such also contribute to these potential health benefits.

  15. Community Assessment Tool for Public Health Emergencies Including Pandemic Influenza

    Energy Technology Data Exchange (ETDEWEB)

    ORAU' s Oak Ridge Institute for Science Education (HCTT-CHE)

    2011-04-14

    The Community Assessment Tool (CAT) for Public Health Emergencies Including Pandemic Influenza (hereafter referred to as the CAT) was developed as a result of feedback received from several communities. These communities participated in workshops focused on influenza pandemic planning and response. The 2008 through 2011 workshops were sponsored by the Centers for Disease Control and Prevention (CDC). Feedback during those workshops indicated the need for a tool that a community can use to assess its readiness for a disaster - readiness from a total healthcare perspective, not just hospitals, but the whole healthcare system. The CAT intends to do just that - help strengthen existing preparedness plans by allowing the healthcare system and other agencies to work together during an influenza pandemic. It helps reveal each core agency partners (sectors) capabilities and resources, and highlights cases of the same vendors being used for resource supplies (e.g., personal protective equipment [PPE] and oxygen) by the partners (e.g., public health departments, clinics, or hospitals). The CAT also addresses gaps in the community's capabilities or potential shortages in resources. This tool has been reviewed by a variety of key subject matter experts from federal, state, and local agencies and organizations. It also has been piloted with various communities that consist of different population sizes, to include large urban to small rural communities.

  16. Implementing a national early awareness and alert system for new and emerging health technologies in Italy: the COTE Project.

    Science.gov (United States)

    Migliore, Antonio; Perrini, Maria Rosaria; Jefferson, Tom; Cerbo, Marina

    2012-07-01

    The aim of this study was to establish a national Early Awareness and Alert (EAA) system for the identification and assessment of new and emerging health technologies in Italy. In 2008, Agenas, a public body supporting Regions and the Ministry of Health (MoH) in health services research, started a project named COTE (Observatory of New and Emerging Health Technologies) with the ultimate aim of implementing a national EAA system. The COTE project involved all stakeholders (MoH, Regions, Industry, Universities, technical government bodies, and Scientific Societies), in defining the key characteristics and methods of the EAA system. Agreement with stakeholders was reached using three separate workshops. During the workshops, participants shared and agreed methods for identification of new and emerging health technologies, prioritization, and assessment. The structure of the Horizon Scanning (HS) reports was discussed and defined. The main channels for dissemination of outputs were identified as the EuroScan database, and the stakeholders' Web portals. During the final workshop, Agenas presented the first three HS reports produced at national level and proposed the establishment of a permanent national EAA system. The COTE Project created the basis for a permanent national EAA system in Italy. An infrastructure to enable the stakeholders network to grow was created, methods to submit new and emerging health technologies for possible evaluation were established, methods for assessment of the technologies selected were defined, and the stakeholders involvement was delineated (in the identification, assessment, and dissemination stages).

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

    Directory of Open Access Journals (Sweden)

    Leticia Florido Povinske Domingues

    2017-08-01

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

  18. Selection and construction of nuclear and radiation emergency medical center in a region

    International Nuclear Information System (INIS)

    Wang Guojun; He Xu; Liao Li; Gao Dong

    2014-01-01

    Three level of first-class comprehensive hospital is an important force of nuclear and radiation accident rescue, has a very rich experience in response to nuclear and radiation accidents and deal with large quantities of the sick and wounded. With the foundation and the ability of the construction and operation of medical emergency rescue center. This paper according to the median model location theory of emergency center, combined with the specific situation of the nuclear and radiation accident in Hunan Province, reference location, rescue experience, emergency allocation of resources, teaching and research capacity, establish regional medical emergency center of nuclear and radiation accidents based on three level of first-class comprehensive hospital, break the traditional concept that the center must be provincial capital,form a multi-level, three-dimensional, network of emergency hospital rescue system. The main duties of the center are accident emergency response, on-site treatment and technical guidance of accident, psychological grooming. The author propose building measures according to the duties of the center: increase national and provincial financial investment, carry out training, drills and first aid knowledge missionaries regularly, innovative materials management, speed up the construction of information platform, establish and improve the hospital rescue system, improve organization institution and system of plans, reengineering rescue process. (authors)

  19. EMERGENCY PERIPARTUM HYSTERECTOMY IN THE LAKES REGION OF TURKEY: INCIDENCE AND MATERNAL MORBIDITY

    Directory of Open Access Journals (Sweden)

    Mehmet Güney

    2006-06-01

    Full Text Available OBJECTIVE: To estimate the incidence, indications, risk factors, and complications of peripartum hysterectomy in a university clinic and a state hospital in the Lakes region of Anatolia.\tDesign: Retrospective clinical study.\tSetting: This retrospective study was conducted between December 1996 and December 2005 at the Süleyman Demirel University, Faculty of Medicine, Department of Obstetrics and Gynecology and Isparta Women’s and Children’s Hospital.\tPatients: Twenty-eight patients who underwent emergency peripartum hysterectomy.\tMain Outcome Measures: Twenty-eight patients with emergency peripartum hysterectomy were evaluated with respect to the demographic characteristics, clinical manifestation, state of parity and type of hysterectomy.\tRESULTS: In the study period, the incidence of emergency peripartum hysterectomy was 0.8 per 1000 deliveries. The main indications for emergency hysterectomy were uterine atony in 18 cases (64 %, rupture of uterus in 6 cases (21 % and placenta accreta in 4 cases (14 %. There were 20 (71 % multiparaous and 8 (28 % primiparaous women. There were 4 total abdominal hysterectomies and 24 subtotal hysterectomies.The rate of maternal mortality was 4% (1 cases.\tCONCLUSION: Our incidence of emergent peripartum hysterectomy was low when compared with most of the studies and uterine atony was the most common indication for emergent peripartum hysterectomy.

  20. [The contributions of local authorities to regional public health policy].

    Science.gov (United States)

    de Maria, Florence; Grémy, Isabelle

    2009-01-01

    Local authorities in France are key players in shaping public health policy by their action on the determinants of health and through their actions aimed at specific population groups. Since the public health act of 9 August 2004 establishing the first regional public health plans, their level of involvement and role continues to grow as coordinators, funders and project managers within the greater Paris metropolitan region. Their active participation in regional policy to improve population health and reduce inequalities in health has led to a better organization of the public health programs implemented (in terms of visibility, dialogue, coordination, transparency, and better awareness of context and integration of local issues). Their participation is also a source of innovation resulting in the proposal and use of new approaches (such as the development of health surveillance and observation for advising the local decision-making process). Within the current context of the "Hospitals, patients, health and territories" bill, which entrusts the governance of regional health policy to a specific agency, the role given to local authorities in this new organizational structure must be clearly defined to take into account all of their existing and potential contributions to public health policy.

  1. [Health-Promoting Schools Regional Initiative of the Americas].

    Science.gov (United States)

    Ippolito-Shepherd, Josefa; Cerqueira, Maria Teresa; Ortega, Diana Patricia

    2005-01-01

    In Latin America, comprehensive health promotion programmes and activities are being implemented in the school setting, which take into account the conceptual framework of the Health-Promoting Schools Regional Initiative of the Pan American Health Organization, Regional office of the World Health Organization (PAHO/WHO). These programmes help to strengthen the working relationships between the health and education sectors. The Health-Promoting Schools Regional Initiative, officially launched by PAHO/WHO in 1995, aims to form future generations to have the knowledge, abilities, and skills necessary for promoting and caring for their health and that of their family and community, as well as to create and maintain healthy environments and communities. The Initiative focuses on three main components: comprehensive health education, the creation and maintenance of healthy physical and psychosocial environments, and the access to health and nutrition services, mental health, and active life. In 2001, PAHO conducted a survey in 19 Latin American countries to assess the status and trends of Health-Promoting Schools in the Region, for the appropriate regional, subregional, and national planning of pertinent health promotion and health education programmes and activities. The results of this survey provided information about policies and national plans, multisectoral coordination mechanisms for the support of health promotion in the school settings, the formation and participation in national and international networks of Health-Promoting Schools and about the level of dissemination of the strategy. For the successful development of Health-Promoting Schools is essential to involve the society as a whole, in order to mobilise human resources and materials necessary for implementing health promotion in the school settings. Thus, the constitution and consolidation of networks has been a facilitating mechanism for the exchange of ideas, resources and experiences to strengthen

  2. [Estimating emergency hospital admissions to gauge short-term effects of air pollution: evaluation of health data quality].

    Science.gov (United States)

    Bois de Fer, Béatrice; Host, Sabine; Chardon, Benoît; Chatignoux, Edouard; Beaujouan, Laure; Brun-Ney, Dominique; Grémy, Isabelle

    2009-01-01

    The study of the short-term effects and health impact of air pollution is carrier out by the ERPURS regional surveillance program which utilizes hospitalization data obtained from the French hospital information system (PMSI) to determine these links. This system does not permit the distinction between emergency hospital admissions from scheduled ones, which cannot be related to short term changes in air pollution levels. This study examines how scheduled admissions affect the quality of the health indicators used to estimate air pollution effects. This indicator is compared to three new emergency hospitalisation indicators reconstructed based on data from the public hospitals in Paris, partly from the PMSI data and partly with data from an on-line emergency network that regroups all of the computerized emergency services. According to the pathology, scheduled admissions present a difficulty which affects the capacity to highlight the weakest risks with any precision.

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

    Science.gov (United States)

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

    2014-01-01

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

  4. Can public health registry data improve Emergency Medical Dispatch?

    DEFF Research Database (Denmark)

    Andersen, M S; Christensen, E F; Jepsen, S B

    2016-01-01

    BACKGROUND: Emergency Medical Dispatchers make decisions based on limited information. We aimed to investigate if adding demographic and hospitalization history information to the dispatch process improved precision. METHODS: This 30-day follow-up study evaluated time-critical emergencies...

  5. The public health emergency management system in China: trends from 2002 to 2012.

    Science.gov (United States)

    Sun, Mei; Xu, Ningze; Li, Chengyue; Wu, Dan; Zou, Jiatong; Wang, Ying; Luo, Li; Yu, Mingzhu; Zhang, Yu; Wang, Hua; Shi, Peiwu; Chen, Zheng; Wang, Jian; Lu, Yueliang; Li, Qi; Wang, Xinhua; Bi, Zhenqiang; Fan, Ming; Fu, Liping; Yu, Jingjin; Hao, Mo

    2018-04-11

    Public health emergencies have challenged the public health emergency management systems (PHEMSs) of many countries critically and frequently since this century. As the world's most populated country and the second biggest economy in the world, China used to have a fragile PHEMS; however, the government took forceful actions to build PHEMS after the 2003 SARS outbreak. After more than one decade's efforts, we tried to assess the improvements and problems of China's PHEMS between 2002 and 2012. We conducted two rounds of national surveys and collected the data of the year 2002 and 2012, including all 32 provincial, 139 municipal, and 489 county CDCs. The municipal and county CDCs were selected by systematic random sampling. Twenty-one indicators of four stages (preparation, readiness, response and recovery) from the National Assessment Criteria for CDC Performance were chosen to assess the ten-year trends. At the preparation stage, organization, mechanisms, workforce, and stockpile across all levels and regions were significantly improved after one decade's efforts. At the readiness stage, the capability for formulating an emergency plan was also significantly improved during the same period. At the response stage, internet-based direct reporting was 98.8%, and coping scores were nearly full points of ten in 2012. At the recovery stage, the capabilities were generally lower than expected. Due to forceful leadership, sounder regulations, and intensive resources, China's PHEMS has been improved at the preparation, readiness, and response stages; however, the recovery stage was still weak and could not meet the requirements of crisis management and preventive governance. In addition, CDCs in the Western region and counties lagged behind in performance on most indicators. Future priorities should include developing the recovery stage, establishing a closed feedback loop, and strengthening the capabilities of CDCs in Western region and counties.

  6. Best practices in managing child and adolescent behavioral health emergencies [digest].

    Science.gov (United States)

    Feuer, Vera; Rocker, Joshua; Saggu, Babar M; Andrus, Jason M; Wormley, Molly

    2018-01-22

    Behavioral health emergencies most commonly present as depression, suicidal behavior, aggression, and severe disorganization. Emergency clinicians should avoid relying solely on past medical history or previous psychiatric diagnoses that might prematurely rule out medical pathologies. Treatments for behavioral health emergencies consist of de-escalation interventions aimed at preventing agitation, aggression, and harm. This issue reviews medical pathologies and underlying causes that can result in psychiatric presentations and summarizes evidence-based practices to evaluate, manage, and refer patients with behavioral health emergencies. [Points & Pearls is a digest of Pediatric Emergency Medicine Practice].

  7. Occurrence and fate of emerging contaminants in municipal wastewater treatment plants from different geographical regions-a review.

    Science.gov (United States)

    Tran, Ngoc Han; Reinhard, Martin; Gin, Karina Yew-Hoong

    2018-04-15

    Emerging contaminants, such as antibiotics, pharmaceuticals, personal care products, hormones, and artificial sweeteners, are recognized as new classes of water contaminants due to their proven or potential adverse effects on aquatic ecosystems and human health. This review provides comprehensive data on the occurrence of 60 emerging contaminants (ECs) in influent, treated effluent, sludge, and biosolids in wastewater treatment plants (WWTPs). In particular, data on the occurrence of ECs in the influents and effluents of WWTPs are systematically summarized and categorized according to geographical regions (Asia, Europe, and North America). The occurrence patterns of ECs in raw influent and treated effluents of WWTPs between geographical regions were compared and evaluated. Concentrations of most ECs in raw influent in Asian region tend to be higher than those in European and North American countries. Many antibiotics were detected in the influents and effluents of WWTPs at concentrations close to or exceeding the predicted no-effect concentrations (PNECs) for resistance selection. The efficacy of EC removal by sorption and biodegradation during wastewater treatment processes are discussed in light of kinetics and parameters, such as sorption coefficients (K d ) and biodegradation constants (k biol ), and physicochemical properties (i.e. log K ow and pK a ). Commonly used sampling and monitoring strategies are critically reviewed. Analytical research needs are identified, and novel investigative approaches for future monitoring studies are proposed. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Can free open access resources strengthen knowledge-based emerging public health priorities, policies and programs in Africa?

    Science.gov (United States)

    Tambo, Ernest; Madjou, Ghislaine; Khayeka-Wandabwa, Christopher; Tekwu, Emmanuel N; Olalubi, Oluwasogo A; Midzi, Nicolas; Bengyella, Louis; Adedeji, Ahmed A; Ngogang, Jeanne Y

    2016-01-01

    Tackling emerging epidemics and infectious diseases burden in Africa requires increasing unrestricted open access and free use or reuse of regional and global policies reforms as well as timely communication capabilities and strategies. Promoting, scaling up data and information sharing between African researchers and international partners are of vital importance in accelerating open access at no cost. Free Open Access (FOA) health data and information acceptability, uptake tactics and sustainable mechanisms are urgently needed. These are critical in establishing real time and effective knowledge or evidence-based translation, proven and validated approaches, strategies and tools to strengthen and revamp health systems.  As such, early and timely access to needed emerging public health information is meant to be instrumental and valuable for policy-makers, implementers, care providers, researchers, health-related institutions and stakeholders including populations when guiding health financing, and planning contextual programs.

  9. CALCULATING ENERGY STORAGE DUE TO TOPOLOGICAL CHANGES IN EMERGING ACTIVE REGION NOAA AR 11112

    International Nuclear Information System (INIS)

    Tarr, Lucas; Longcope, Dana

    2012-01-01

    The minimum current corona model provides a way to estimate stored coronal energy using the number of field lines connecting regions of positive and negative photospheric flux. This information is quantified by the net flux connecting pairs of opposing regions in a connectivity matrix. Changes in the coronal magnetic field, due to processes such as magnetic reconnection, manifest themselves as changes in the connectivity matrix. However, the connectivity matrix will also change when flux sources emerge or submerge through the photosphere, as often happens in active regions. We have developed an algorithm to estimate the changes in flux due to emergence and submergence of magnetic flux sources. These estimated changes must be accounted for in order to quantify storage and release of magnetic energy in the corona. To perform this calculation over extended periods of time, we must additionally have a consistently labeled connectivity matrix over the entire observational time span. We have therefore developed an automated tracking algorithm to generate a consistent connectivity matrix as the photospheric source regions evolve over time. We have applied this method to NOAA Active Region 11112, which underwent a GOES M2.9 class flare around 19:00 on 2010 October 16th, and calculated a lower bound on the free magnetic energy buildup of ∼8.25 × 10 30 erg over 3 days.

  10. [Blood transfusion in emergency settings: French military health service experience].

    Science.gov (United States)

    Sailliol, A; Ausset, S; Peytel, E

    2010-12-01

    Blood transfusion is required in a number of emergency settings and the French military health service (FMHS) has issued specific guidelines for the treatment of war casualties. These guidelines take into account European standards and laws, NATO standards, and also public sentiment regarding transfusion. These guidelines reflect a determination to control the process and to avoid the improvisation frequently associated with wartime transfusion. The evolution in warfare (terrorism and bombing more frequent than gunshot) and the wide use of body armor have deeply changed the clinical presentation of war injuries. These now involve the extremities in 80% of cases, with extensive tissue damage and heavy blood loss. The FMHS recommends that war casualties with hemorrhagic shock be brought quickly to a medical treatment facility (MTF) after first-line treatment applied through buddy aid or by medics. In the MTF, before an early Medevac, a damage control surgery will be performed, with resuscitation using freeze-dried plasma, red blood cells and fresh whole blood. The French military blood bank is responsible for blood product supply, training and medical advice regarding transfusion therapy during wartime, as well as hemovigilance. All transfusion therapy practices are periodically assessed but research on whole blood pathogen reduction is being conducted in order to reduce the residual infectious risk associated with this product. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

  11. Migrants and emerging public health issues in a globalized world: threats, risks and challenges, an evidence-based framework.

    Science.gov (United States)

    Gushulak, Bd; Weekers, J; Macpherson, Dw

    2009-01-01

    International population mobility is an underlying factor in the emergence of public health threats and risks that must be managed globally. These risks are often related, but not limited, to transmissible pathogens. Mobile populations can link zones of disease emergence to lowprevalence or nonendemic areas through rapid or high-volume international movements, or both. Against this background of human movement, other global processes such as economics, trade, transportation, environment and climate change, as well as civil security influence the health impacts of disease emergence. Concurrently, global information systems, together with regulatory frameworks for disease surveillance and reporting, affect organizational and public awareness of events of potential public health significance. International regulations directed at disease mitigation and control have not kept pace with the growing challenges associated with the volume, speed, diversity, and disparity of modern patterns of human movement. The thesis that human population mobility is itself a major determinant of global public health is supported in this article by review of the published literature from the perspective of determinants of health (such as genetics/biology, behavior, environment, and socioeconomics), population-based disease prevalence differences, existing national and international health policies and regulations, as well as inter-regional shifts in population demographics and health outcomes. This paper highlights some of the emerging threats and risks to public health, identifies gaps in existing frameworks to manage health issues associated with migration, and suggests changes in approach to population mobility, globalization, and public health. The proposed integrated approach includes a broad spectrum of stakeholders ranging from individual health-care providers to policy makers and international organizations that are primarily involved in global health management, or are influenced

  12. Health promoting attitudes and behaviors of emergency physicians: exploring gender differences.

    Science.gov (United States)

    Rondeau, Kent V; Francescutti, Louis H; Cummings, Garnet E

    2006-01-01

    The purpose of this paper is to report on gender differences in emergency physicians with respect to their attitudes, knowledge, and practices concerning health promotion and disease prevention. A mail survey of 325 male and 97 female Canadian emergency physicians. Results suggest female emergency physicians report having greater knowledge of health promotion topics, spend more time with each of their patients in the emergency setting, and engage in more health promotion counseling in the emergency setting than do their male counterparts. The paper argues that in the future, educating and socializing emergency physicians, both male and female, in the practice of health promotion will enhance the potential of the emergency department to be a more effective resource for their community.

  13. Cancer among circumpolar populations: an emerging public health concern

    Directory of Open Access Journals (Sweden)

    T. Kue Young

    2016-01-01

    Full Text Available Objectives: To determine and compare the incidence of cancer among the 8 Arctic States and their northern regions, with special focus on 3 cross-national indigenous groups – Inuit, Athabaskan Indians and Sami. Methods: Data were extracted from national and regional statistical agencies and cancer registries, with direct age-standardization of rates to the world standard population. For comparison, the “world average” rates as reported in the GLOBOCAN database were used. Findings: Age-standardized incidence rates by cancer sites were computed for the 8 Arctic States and 20 of their northern regions, averaged over the decade 2000–2009. Cancer of the lung and colon/rectum in both sexes are the commonest in most populations. We combined the Inuit from Alaska, Northwest Territories, Nunavut and Greenland into a “Circumpolar Inuit” group and tracked cancer trends over four 5-year periods from 1989 to 2008. There has been marked increase in lung, colorectal and female breast cancers, while cervical cancer has declined. Compared to the GLOBOCAN world average, Inuit are at extreme high risk for lung and colorectal cancer, and also certain rare cancers such as nasopharyngeal cancer. Athabaskans (from Alaska and Northwest Territories share some similarities with the Inuit but they are at higher risk for prostate and breast cancer relative to the world average. Among the Sami, published data from 3 cohorts in Norway, Sweden and Finland show generally lower risk of cancer than non-Sami. Conclusions: Cancer among certain indigenous people in the Arctic is an increasing public health concern, especially lung and colorectal cancer.

  14. Preparedness for Zika virus testing in the World Health Organization Western Pacific Region

    Directory of Open Access Journals (Sweden)

    Raynal C Squires

    2016-03-01

    Full Text Available On 1 February 2016, the World Health Organization (WHO declared that clusters of microcephaly cases and other neurological disorders occurring in Zika virus (ZIKV-affected areas constituted a public health emergency of international concern. Increased surveillance of the virus, including the requirement for laboratory confirmation of infection, was recommended. The WHO Regional Office for the Western Pacific therefore initiated a rapid survey among national-level public health laboratories in 19 countries and areas to determine regional capacity for ZIKV detection. The survey indicated that 16/19 (84% countries had capacity for molecular detection of ZIKV while others facilitated testing through referral. These results suggest that robust laboratory capacity is in place to support ZIKV surveillance in the Western Pacific Region.

  15. Preparedness for Zika virus testing in the World Health Organization Western Pacific Region.

    Science.gov (United States)

    Squires, Raynal C; Konings, Frank

    2016-01-01

    On 1 February 2016, the World Health Organization (WHO) declared that clusters of microcephaly cases and other neurological disorders occurring in Zika virus (ZIKV)-affected areas constituted a public health emergency of international concern. Increased surveillance of the virus, including the requirement for laboratory confirmation of infection, was recommended. The WHO Regional Office for the Western Pacific therefore initiated a rapid survey among national-level public health laboratories in 19 countries and areas to determine regional capacity for ZIKV detection. The survey indicated that 16/19 (84%) countries had capacity for molecular detection of ZIKV while others facilitated testing through referral. These results suggest that robust laboratory capacity is in place to support ZIKV surveillance in the Western Pacific Region.

  16. Locating regional health policy: Institutions, politics, and practices

    Science.gov (United States)

    Riggirozzi, Pia; Yeates, Nicola

    2015-01-01

    Poverty reduction and health became central in the agendas of Southern regional organisations in the last two decades. Yet, little is known about how these organisations address poverty, inclusion and social inequality, and how Southern regional formations are engaging in power constellations, institutions, processes, interests and ideological positions within different spheres of governance. This article reviews academic literatures spanning global social policy, regional studies and diplomacy studies, and the state of knowledge and understanding of the ‘place’ of regional actors in health governance as a global political practice therein. It identifies theoretical and thematic points of connection between disparate literatures and how these can be bridged through research focusing on the social policies of regional organisations and regional integration processes. This framework hence locates the contributions of each of the research articles of this Special Issue of Global Social Policy on the regional dimension of health policy and diplomacy in relation to Southern Africa and South America. It also highlights the ways in which the articles bring new evidence about how social relations of welfare are being (re)made over larger scales and how regional actors may initiate new norms to improve health rights in international arenas engaging in new forms of ‘regional’ diplomacy. PMID:26635495

  17. Thoughts on the development of active regional public health systems.

    Science.gov (United States)

    Reis, Ademar Arthur Chioro Dos; Sóter, Ana Paula Menezes; Furtado, Lumena Almeida Castro; Pereira, Silvana Souza da Silva

    2017-04-01

    Decentralization and regionalization are strategic themes for reforms in the health system. This paper analyzes the complex process of health regionalization being developed in Brazil. This paper identifies that the normative framework from the Brazilian National Health System, SUS has made advances with respect to its institutionalization and overcoming the initial centrality involved in municipalization. This has strengthened the development of regionalization and the intergovernmental agreement on health but the evidence points to the need to promote a revision. Based on document analysis, literature review and the views given by the authors involved in management in SUS as well as generating radically different views, the challenges for the construction of a regionalization that is active, is debated. We also discuss: its relations with planning and the dimensioning of service networks, the production of active care networks and shared management spaces, the inter-federative agreements and regional regulations, the capacity to coordinate regional systems and financing and the impact of the political dimension and electoral cycles. Regionalization (and SUS itself) is an open book, therefore ways and possibilities on how to maintain an active form of regionalization can be recommended.

  18. Signature Optical Cues: Emerging Technologies for Monitoring Plant Health

    Directory of Open Access Journals (Sweden)

    Anand K. Asundi

    2008-05-01

    Full Text Available Optical technologies can be developed as practical tools for monitoring plant health by providing unique spectral signatures that can be related to specific plant stresses. Signatures from thermal and fluorescence imaging have been used successfully to track pathogen invasion before visual symptoms are observed. Another approach for noninvasive plant health monitoring involves elucidating the manner with which light interacts with the plant leaf and being able to identify changes in spectral characteristics in response to specific stresses. To achieve this, an important step is to understand the biochemical and anatomical features governing leaf reflectance, transmission and absorption. Many studies have opened up possibilities that subtle changes in leaf reflectance spectra can be analyzed in a plethora of ways for discriminating nutrient and water stress, but with limited success. There has also been interest in developing transgenic phytosensors to elucidate plant status in relation to environmental conditions. This approach involves unambiguous signal creation whereby genetic modification to generate reporter plants has resulted in distinct optical signals emitted in response to specific stressors. Most of these studies are limited to laboratory or controlled greenhouse environments at leaf level. The practical translation of spectral cues for application under field conditions at canopy and regional levels by remote aerial sensing remains a challenge. The movement towards technology development is well exemplified by the Controlled Ecological Life Support System under development by NASA which brings together technologies for monitoring plant status concomitantly with instrumentation for environmental monitoring and feedback control.

  19. Health status and health systems financing in the MENA region: roadmap to universal health coverage.

    Science.gov (United States)

    Asbu, Eyob Zere; Masri, Maysoun Dimachkie; Kaissi, Amer

    2017-01-01

    Since the declaration of the Millennium Development Goals (MDGs) in 1990, many countries of the Middle East and North Africa (MENA) region made some improvements in maternal and child health and in tackling communicable diseases. The transition to the global agenda of Sustainable Development Goals brings new opportunities for countries to move forward toward achieving progress for better health, well-being, and universal health coverage. This study provides a profile of health status and health financing approaches in the MENA region and their implications on universal health coverage. Time-series data on socioeconomics, health expenditures, and health outcomes were extracted from databases and reports of the World Health Organization, the World Bank and the United Nations Development Program and analyzed using Stata 12 statistical software. Countries were grouped according to the World Bank income categories. Descriptive statistics, tables and charts were used to analyze temporal changes and compare the key variables with global averages. Non-communicable diseases (NCDs) and injuries account for more than three quarters of the disability-adjusted life years in all but two lower middle-income countries (Sudan and Yemen). Prevalence of risk factors (raised blood glucose, raised blood pressure, obesity and smoking) is higher than global averages and counterparts by income group. Total health expenditure (THE) per capita in most of the countries falls short of global averages for countries under similar income category. Furthermore, growth rate of THE per capita has not kept pace with the growth rate of GDP per capita. Out-of-pocket spending (OOPS) in all but the high-income countries in the group exceeds the threshold for catastrophic spending implying that there is a high risk of households getting poorer as a result of paying for health care. The alarmingly high prevalence of NCDs and injuries and associated risk factors, health spending falling short of the GDP

  20. Development of a Work Climate Scale in Emergency Health Services.

    Science.gov (United States)

    Sanduvete-Chaves, Susana; Lozano-Lozano, José A; Chacón-Moscoso, Salvador; Holgado-Tello, Francisco P

    2018-01-01

    An adequate work climate fosters productivity in organizations and increases employee satisfaction. Workers in emergency health services (EHS) have an extremely high degree of responsibility and consequent stress. Therefore, it is essential to foster a good work climate in this context. Despite this, scales with a full study of their psychometric properties (i.e., validity evidence based on test content, internal structure and relations to other variables, and reliability) are not available to measure work climate in EHS specifically. For this reason, our objective was to develop a scale to measure the quality of work climates in EHS. We carried out three studies. In Study 1, we used a mixed-method approach to identify the latent conceptual structure of the construct work climate . Thus, we integrated the results found in (a) a previous study, where a content analysis of seven in-depth interviews obtained from EHS professionals in two hospitals in Gibraltar Countryside County was carried out; and (b) the factor analysis of the responses given by 113 EHS professionals from these same centers to 18 items that measured the work climate in health organizations. As a result, we obtained 56 items grouped into four factors (work satisfaction, productivity/achievement of aims, interpersonal relationships, and performance at work). In Study 2, we presented validity evidence based on test content through experts' judgment. Fourteen experts from the methodology and health fields evaluated the representativeness, utility, and feasibility of each of the 56 items with respect to their factor (theoretical dimension). Forty items met the inclusion criterion, which was to obtain an Osterlind index value greater than or equal to 0.5 in the three aspects assessed. In Study 3, 201 EHS professionals from the same centers completed the resulting 40-item scale. This new instrument produced validity evidence based on the internal structure in a second-order factor model with four

  1. Development of a Work Climate Scale in Emergency Health Services

    Directory of Open Access Journals (Sweden)

    Susana Sanduvete-Chaves

    2018-01-01

    Full Text Available An adequate work climate fosters productivity in organizations and increases employee satisfaction. Workers in emergency health services (EHS have an extremely high degree of responsibility and consequent stress. Therefore, it is essential to foster a good work climate in this context. Despite this, scales with a full study of their psychometric properties (i.e., validity evidence based on test content, internal structure and relations to other variables, and reliability are not available to measure work climate in EHS specifically. For this reason, our objective was to develop a scale to measure the quality of work climates in EHS. We carried out three studies. In Study 1, we used a mixed-method approach to identify the latent conceptual structure of the construct work climate. Thus, we integrated the results found in (a a previous study, where a content analysis of seven in-depth interviews obtained from EHS professionals in two hospitals in Gibraltar Countryside County was carried out; and (b the factor analysis of the responses given by 113 EHS professionals from these same centers to 18 items that measured the work climate in health organizations. As a result, we obtained 56 items grouped into four factors (work satisfaction, productivity/achievement of aims, interpersonal relationships, and performance at work. In Study 2, we presented validity evidence based on test content through experts' judgment. Fourteen experts from the methodology and health fields evaluated the representativeness, utility, and feasibility of each of the 56 items with respect to their factor (theoretical dimension. Forty items met the inclusion criterion, which was to obtain an Osterlind index value greater than or equal to 0.5 in the three aspects assessed. In Study 3, 201 EHS professionals from the same centers completed the resulting 40-item scale. This new instrument produced validity evidence based on the internal structure in a second-order factor model with

  2. Sports participation, physical activity, and health in the European regions.

    Science.gov (United States)

    Lera-López, Fernando; Marco, Rocio

    2018-08-01

    In a context of stagnation of the level of health-enhancing physical activity in Europe, this study examines the geographical stratification of sports participation and physical activity (PA) at the regional level in 28 European countries. While previous research has focused on the national approach, this study considers the regional level across 208 European regions. Individual survey data from the Eurobarometer 80.2 is combined with a regional-level approach to the 208 regions to quantify sports participation and PA at the regional level. The results show important differences and a geographical stratification of sports participation and PA among the European regions, albeit following different patterns. In particular, a north-south gap is identified in terms of PA rates and an east-west gap is detected in terms of sports participation levels. Applying the cluster technique, a taxonomy of four different European regions is developed considering both types of indicators. Finally, the existence of sports spatial spillovers among regions is verified, obtaining a positive autocorrelation among neighbouring regions for being involved in PA and sporting activities. The results may have significant implications in terms of policy measures to improve health through PA and sports participation at the regional level in Europe.

  3. Emerging arboviruses and public health challenges in Brazil.

    Science.gov (United States)

    Lima-Camara, Tamara Nunes

    2016-06-27

    Environmental modification by anthropogenic actions, disordered urban growth, globalization of international exchange and climate change are some factors that help the emergence and dissemination of human infectious diseases transmitted by vectors. This review discusses the recent entry of three arboviruses in Brazil: Chikungunya, West Nile, and Zika virus, focusing on the challenges for the Country's public health. The Brazilian population is exposed to infections caused by these three arboviruses widely distributed on the national territory and associated with humans. Without effective vaccine and specific treatment, the maintainance and integration of a continuos entomological and epidemiological surveillance are important so we can set methods to control and prevent these arboviruses in the Country. RESUMO A modificação do ambiente por ações antrópicas, o crescimento urbano desordenado, o processo de globalização do intercâmbio internacional e as mudanças climáticas são alguns fatores que vêm facilitando a emergência e disseminação de doenças infecciosas humanas transmitidas por vetores. Este comentário aborda a recente entrada de três arbovírus no Brasil, Chikungunya (CHIKV), West Nile (WNV) e Zika (ZIKV), com enfoque nos desafios para a Saúde Pública do País. Transmitidos por mosquitos vetores amplamente distribuídos no território nacional e associados ao homem, a população brasileira encontra-se exposta à infecção por esses três arbovírus. Na ausência de vacina eficaz e tratamento específico, são importantes a manutenção e integração de uma vigilância entomológica e epidemiológica contínua, a fim de direcionarmos métodos de controle e prevenção contra essas arboviroses no País.

  4. [Multidisciplinary health houses and regional development: a necessarily shared dyanamics.].

    Science.gov (United States)

    Autès, Michel; Dufay, Marie-Guite

    2009-03-29

    Many regional authorities (Conseils Régionaux) have taken up the issue of health houses by underlining their competence in dealing with regional development issues. This initiative is part of a broader process designed to ensure the continuity of healthcare at the different levels of provision as well as equal, universal access according to the specific needs of patients, from prevention to the most specialized forms of medical treatment. Health houses are one of the chief access points in this process, and are situated at the cross-roads of health and healthcare. The territorial health project must provide the fondations of the new health house model. According to the Health Committee of the Association of French Regions (Commission Santé de l'Association des Régions de France), there are three prerequisites: 1. a multidisciplinary offer of access to front-line healthcare services; 2. public healthcare activities: prevention, promotion of health...; 3. a network mode of organization with the local and regional hospital system to ensure optimum healthcare provision for patients. Yet a number of obstacles need to be overcome, particularly the risk of concentrating healthcare provision within a single center, thus depriving the surrounding area, but also the ill-adapted current framework of remuneration for independent medical practitioners. The purpose of regional authorities (i.e. Conseils Régionaux) is not to ensure the expansion of health houses, but rather to enable innovation by accompanying the different actors involved within the sector. Heeding the specific requirements of the local area and its needs, as well as the will of elected representatives and healthcare professionals, their aim is to develop a policy of exemplarity with all the actors involved in the sector and to uphold their legitimacy as agents of regional development. The ?Hospital, patients, health and territories' law (loi "Hôpital, patients, santé et territoires") may yet throw the

  5. Planning for a radiological emergency in health care institutions

    International Nuclear Information System (INIS)

    Jerez Vegueria, S.F.; Jerez Vegueria, P.F.

    1998-01-01

    The possible occurrence of accidents involving sources of ionizing radiation calls for response plans to mitigate the consequences of radiological accidents. An emergency planning framework is suggested for institutions which use medical applications of ionizing radiation. Bearing in mind that the prevention of accidents is of prime importance in dealing with radioactive materials and other sources of ionizing radiation, it is recommended that emergency instructions and procedures address certain aspects of the causes of these radiological events. Issues such as identification of radiological events in medical practices and their consequences, protective measures, planning for an emergency response and maintenance of emergency capacity are considered. (author)

  6. Integrating Oral Health with Non-Communicable Diseases as an Essential Component of General Health: WHO's Strategic Orientation for the African Region.

    Science.gov (United States)

    Varenne, Benoit

    2015-05-01

    In the context of the emerging recognition of non-communicable diseases (NCDs), it has never been more timely to explore the World Health Organization (WHO) strategic orientations on oral health in the WHO African region and to raise awareness of a turning point in the search for better oral health for everyone. The global initiative against NCDs provides a unique opportunity for the oral health community to develop innovative policies for better recognition of oral health, as well as to directly contribute to the fight against NCDs and their risk factors. The WHO African region has led the way in developing the first regional oral health strategy for the prevention and control of oral diseases integrated with NCDs. The support of the international oral health community in this endeavor is urgently needed for making a success story of this initiative of integrating oral health into NCDs.

  7. Integrating authorities and disciplines into the preparedness-planning process: a study of mental health, public health, and emergency management.

    Science.gov (United States)

    Robertson, Madeline; Pfefferbaum, Betty; Codispoti, Catherine R; Montgomery, Juliann M

    2007-01-01

    The process of integrating all necessary authorities and disciplines into an organized preparedness plan is complex, and the inclusion of disaster mental health poses specific challenges. The goals of this project were (1) to identify whether state mental health preparedness was included in state public health and emergency management preparedness plans, (2) to document barriers to entry and strategies reportedly used by state authorities in efforts to incorporate reasonable mental health preparedness into existing public health and emergency management preparedness planning, (3) to employ a theory for organizational change to organize and synthesize this information, and (4) to stimulate further discussion and research supporting coordinated preparedness efforts at the state level, particularly those inclusive of mental health. To accomplish these goals we (1) counted the number of state public health preparedness and emergency management plans that either included, mentioned, or omitted a mental health preparedness plan; (2) interviewed key officials from nine representative states for their reports on strategies used in seeking greater inclusion of mental health preparedness in public health and emergency management preparedness planning; and (3) synthesized these results to contribute to the national dialogue on coordinating disaster preparedness, particularly with respect to mental health preparedness. We found that 15 out of 29 publicly available public health preparedness plans (52 percent) included mental health preparedness, and eight of 43 publicly available emergency management plans (18 percent) incorporated mental health. Interviewees reported numerous barriers and strategies, which we cataloged according to a well-accepted eight-step plan for transforming organizations.

  8. A "one health" approach to address emerging zoonoses: the HALI project in Tanzania.

    OpenAIRE

    Jonna A K Mazet; Deana L Clifford; Peter B Coppolillo; Anil B Deolalikar; Jon D Erickson; Rudovick R Kazwala

    2009-01-01

    Jonna Mazet and colleagues describe their work in the Tanzania-based HALI Project, which adopts the ?One Health? approach to address emerging zoonoses and that recognizes the interconnectedness of human, animal, and environmental health.

  9. The Emergence of Regional Immigrant Concentrations in USA and Australia: A Spatial Relatedness Approach

    Science.gov (United States)

    Novotny, Josef; Hasman, Jiri

    2015-01-01

    This paper examines the patterns of the US and Australian immigration geography and the process of regional population diversification and the emergence of new immigrant concentrations at the regional level. It presents a new approach in the context of human migration studies, focusing on spatial relatedness between individual foreign-born groups as revealed from the analysis of their joint spatial concentrations. The approach employs a simple assumption that the more frequently the members of two population groups concentrate in the same locations the higher is the probability that these two groups can be related. Based on detailed data on the spatial distribution of foreign-born groups in US counties (2000–2010) and Australian postal areas (2006–2011) we firstly quantify the spatial relatedness between all pairs of foreign-born groups and model the aggregate patterns of US and Australian immigration systems conceptualized as the undirected networks of foreign-born groups linked by their spatial relatedness. Secondly, adopting a more dynamic perspective, we assume that immigrant groups with higher spatial relatedness to those groups already concentrated in a region are also more likely to settle in this region in future. As the ultimate goal of the paper, we examine the power of spatial relatedness measures in projecting the emergence of new immigrant concentrations in the US and Australian regions. The results corroborate that the spatial relatedness measures can serve as useful instruments in the analysis of the patterns of population structure and prediction of regional population change. More generally, this paper demonstrates that information contained in spatial patterns (relatedness in space) of population composition has yet to be fully utilized in population forecasting. PMID:25966371

  10. Development of a Head and Neck Regional Anesthesia Task Trainer for Emergency Medicine Learners

    Directory of Open Access Journals (Sweden)

    Diane L Gorgas

    2017-04-01

    Full Text Available Audience: This innovation is designed for medical students through senior residents. Introduction: Regional anesthesia increases the EM physician’s ability to provide effective pain relief and to complete procedures within the Emergency Department (ED. Studies consistently demonstrate that emergency physicians undertreat pain when performing basic procedures such as suturing lacerations.1,2 Regional anesthesia allows for effective pain relief, while avoiding the risks associated with systemic analgesia/anesthesia or the tissue distortion of local anesthesia.3 Knowledge of the anatomy involved in various nerve blocks is crucial to the development of proper technique and successful performance of this skill. Three dimensional (3-D model simulation-based mastery of procedural skills has been demonstrated to decrease resident anxiety, improve success rates, and decrease complications during the resident’s transition into the clinical setting.5,6 Similarly, use of a 3-D head and neck model to practice application of facial regional anesthesia is hypothesized to improve provider confidence and competence which will in turn provide an improved patient experience. Objectives: In participating in the educational session associated with this task trainer, the learner will: 1 Identify landmarks for the following nerve blocks: Infraorbital, Supraorbital (V1, Mental, Periauricular 2 Demonstrate the appropriate technique for anesthetic injection for each of these nerve blocks 3 Map the distribution of regional anesthesia expected from each nerve block 4 Apply the indications and contraindications for each regional nerve block Method: This low-fidelity task trainer allows residents and medical students to practice various nerve blocks on the face in order to improve learner confidence and proficiency in performing facial regional anesthesia.

  11. Developing regional workplace health and hazard surveillance in the Americas

    Directory of Open Access Journals (Sweden)

    Choi Bernard C. K.

    2001-01-01

    Full Text Available An objective of the Workers' Health Program at the Pan American Health Organization (PAHO is to strengthen surveillance in workers' health in the Region of the Americas in order to implement prevention and control strategies. To date, four phases of projects have been organized to develop multinational workplace health and hazard surveillance in the Region. Phase 1 was a workshop held in 1999 in Washington, D.C., for the purpose of developing a methodology for identifying and prioritizing the top three occupational sentinel health events to be incorporated into the surveillance systems in the Region. Three surveillance protocols were developed, one each for fatal occupational injuries, pesticide poisoning,4 and low back pain, which were identified in the workshop as the most important occupational health problems. Phase 2 comprised projects to disseminate the findings and recommendations of the Washington Workshop, including publications, pilot projects, software development, electronic communication, and meetings. Phase 3 was a sub-regional meeting in 2000 in Rosario, Argentina, to follow up on the progress in carrying out the recommendations of the Washington workshop and to create a Virtual Regional Center for Latin America that could coordinate the efforts of member countries. Currently phase 4 includes a number of projects to achieve the objectives of this Center, such as pilot projects, capacity building, editing a compact disk, analyzing legal systems and intervention strategies, software training, and developing an internet course on surveillance. By documenting the joint efforts made to initiate and develop Regional multinational surveillance of occupational injuries and diseases in the Americas, this paper aims to provide experience and guidance for others wishing to initiate and develop regional multinational surveillance for other diseases or in other regions.

  12. Emergence of Global Adaptive Governance for Stewardship of Regional Marine Resources

    Directory of Open Access Journals (Sweden)

    Henrik Österblom

    2013-06-01

    Full Text Available Overfishing has historically caused widespread stock collapses in the Southern Ocean. Until recently, illegal, unreported, and unregulated (IUU fishing threatened to result in the collapse of some of the few remaining valuable fish stocks in the region and vulnerable seabird populations. Currently, this unsustainable fishing has been reduced to less than 10% of former levels. We describe and analyze the emergence of the social-ecological governance system that made it possible to curb the fisheries crisis. For this purpose, we investigated the interplay between actors, social networks, organizations, and institutions in relation to environmental outcomes. We drew on a diversity of methods, including qualitative interviews, quantitative social network and survey data, and literature reviews. We found that the crisis triggered action of an informal group of actors over time, which led to a new organization (ISOFISH that connected two independent networks (nongovermental organizations and the fishing industry, and later (COLTO linked to an international body and convention (CCAMLR. The emergence of the global adaptive governance systems for stewardship of a regional marine resource took place over a 15-year period. We describe in detail the emergence process and illustrate the usefulness of analyzing four features of governance and understanding social-ecological processes, thereby describing structures and functions, and their link to tangible environmental outcomes.

  13. [Survey on a public health emergency event caused by norovirus].

    Science.gov (United States)

    Xing, Y; Jiang, C; Hua, W Y; Liu, F; Zhao, Z; Ding, Y J; Wang, L; Li, J

    2017-09-10

    Objective: To study the epidemiological characteristics of an outbreak caused by norovirus infection in a school in Haidian district, Beijing. Methods: Basic information of the school and data related to patients in the fields survey were collected and analyzed descriptively. Laboratory tests were performed to test the stool and anal swab specimens of both patients and cooks as well as the environmental specimens. Risk factors related to the incidence were analyzed through a case-control study. Results: A total number of 119 patients were identified in the school. Clinical symptoms were mild, mainly involving vomiting (94.1 % , 112/119), abdominal pain (46.2 % , 55/119), but no need of hospitalization. The average age of the student patients was 6.38, with minimum and maximum between 5 and 11. Patients were found in 22 classes, but mainly in grade 1 and class 7 where 35 patients were found (30.17 % ). A total of 134 specimens of rectal swabs and stool were collected, with 7 positive for norovirus and 6 for sappovirus. Salmonella, Shigella, lapactic Escherichia coli and Vibrio parahaemolyticus were not found in on dinner sets, residual foods, bottled water or in drinking fountains. Index on water hygiene was unsatisfactory in classrooms or dormitories where more cases were found. Accommodation, north-facing-classrooms, abnormal water hygiene indexes were found related to the occurance of the disease ( P <0.05). Conclusions: The outbreak was identified a gastroenteritis infection, caused by norovirus with symptoms as vomiting and abdominal pain. This event reached the reporting standards of public health emergencies-level Ⅳ. Discovery and isolation of the first case was not timely while transmission of the disease might be water-borne. Surveillance programs on symptoms, disinfection of vomit and stool in places like nurseries and schools should be strengthened to prevent the norovirus outbreak.

  14. Joint stockpiling and emergency sharing of oil: Arrangements for regional cooperation in East Asia

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Eui-soon, E-mail: shine@yonsei.ac.k [School of Economics, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-749 (Korea, Republic of); Savage, Tim, E-mail: seoul@nautilus.or [Nautilus Institute, 58-14 Shinmun-ro 1-ga, Hangeul Hall Room 503, Jongro-gu, Seoul 110-061 (Korea, Republic of)

    2011-05-15

    The East Asia region includes three of the world's top five oil-importing nations-China, Japan, and the Republic of Korea. As a consequence, international oil supply disruptions and oil price spikes, and their effects on the economies of the region, have historically been of significant concern. Each of these three nations, as well as other nations in East Asia, has developed or is developing their own strategic oil stockpiles, but regional coordination in stockpiling arrangements and sharing of oil stocks in an emergency could provide significant benefits. This article describes the overall oil supply security situation in East Asia, reviews the attributes of different stockpiling arrangements to address energy supply security concerns, summarizes ongoing national approaches to stockpiling in East Asia, describes the development of joint oil stockpile initiatives in the region, and suggests the most attractive options for regional cooperation on oil stockpiling issues. - Highlights: {yields} Rising oil consumption will make East Asia more vulnerable to energy insecurity. {yields} There have been various dialogs on the need for a joint regional oil stockpile. {yields} No serious joint oil stockpiling efforts have been made in East Asia to date. {yields} Despite various impediments, diverse benefits justify oil stockpile cooperation.

  15. Joint stockpiling and emergency sharing of oil: Arrangements for regional cooperation in East Asia

    International Nuclear Information System (INIS)

    Shin, Eui-soon; Savage, Tim

    2011-01-01

    The East Asia region includes three of the world's top five oil-importing nations-China, Japan, and the Republic of Korea. As a consequence, international oil supply disruptions and oil price spikes, and their effects on the economies of the region, have historically been of significant concern. Each of these three nations, as well as other nations in East Asia, has developed or is developing their own strategic oil stockpiles, but regional coordination in stockpiling arrangements and sharing of oil stocks in an emergency could provide significant benefits. This article describes the overall oil supply security situation in East Asia, reviews the attributes of different stockpiling arrangements to address energy supply security concerns, summarizes ongoing national approaches to stockpiling in East Asia, describes the development of joint oil stockpile initiatives in the region, and suggests the most attractive options for regional cooperation on oil stockpiling issues. - Highlights: → Rising oil consumption will make East Asia more vulnerable to energy insecurity. → There have been various dialogs on the need for a joint regional oil stockpile. → No serious joint oil stockpiling efforts have been made in East Asia to date. → Despite various impediments, diverse benefits justify oil stockpile cooperation.

  16. Emergency Child Aid. Child Health and Safety Series (Module VI).

    Science.gov (United States)

    Iscoe, Louise; And Others

    This manual for child care personnel in day care homes and centers provides a step by step review of what to do in common emergency situations. It is emphasized that the manual is not a substitute for the complete first aid course which every careperson should have. Initial sections of the manual focus on preparing for emergency conditions,…

  17. Theory-based approaches to understanding public emergency preparedness: implications for effective health and risk communication.

    Science.gov (United States)

    Paek, Hye-Jin; Hilyard, Karen; Freimuth, Vicki; Barge, J Kevin; Mindlin, Michele

    2010-06-01

    Recent natural and human-caused disasters have awakened public health officials to the importance of emergency preparedness. Guided by health behavior and media effects theories, the analysis of a statewide survey in Georgia reveals that self-efficacy, subjective norm, and emergency news exposure are positively associated with the respondents' possession of emergency items and their stages of emergency preparedness. Practical implications suggest less focus on demographics as the sole predictor of emergency preparedness and more comprehensive measures of preparedness, including both a person's cognitive stage of preparedness and checklists of emergency items on hand. We highlight the utility of theory-based approaches for understanding and predicting public emergency preparedness as a way to enable more effective health and risk communication.

  18. EDITORIAL Universal health coverage: A re-emerging paradigm?

    African Journals Online (AJOL)

    admin

    of earlier initiatives in global health that include the basic health ... the availability, accessibility (geographic, economic, cultural) and appropriateness ... public good nature of health leading to new .... fragmentation and towards universal.

  19. Regional emergencies, Bam, Kerman province, Iran Foreign Bodies from the Palm Tree

    Directory of Open Access Journals (Sweden)

    Setareh Asgarzadeh

    2015-02-01

    Full Text Available  One of the most common causes of emergency department (ED visits in Pasteur Hospital, Bam, Iran, is a foreign body from palm tree fronds entering different parts of body. This town is located in southeast Iran and has many palm tree orchards. Most of its residents are farmers or orchardists and many children play in these orchards. When palm harvest season approaches (about the end of summer, a considerable number of patients are presented to emergency department of this town with complaint of foreign bodies. These foreign bodies called “date thorns” among the locals (figure1 are wooden and can easily penetrate various body parts due to their needle-like, pointy shape. Some patients manipulate the foreign bodies before going to the ED and cause it to move deeper. Another group, delay going to the hospital and only reach ED a few days after the initiation of inflammation, redness, and evidence of infection. History and physical examination aid in finding the place of the foreign body, but sometimes they are not perceptible and diagnostic imaging is needed. Radiolucent objects such as wood cannot be detected in graphy but are visible in sonograms (1, 2. Removal of these bodies is usually performed under sterile conditions, using local anesthesia or regional nerve blockade, by making an incision and searching the region, finding and removing the foreign body, and finally suturing and bandaging. The procedure gets more difficult in children and patients who do not cooperate and occasionally, procedural sedation and analgesia is required, which leads to side effects such as nausea, vomiting, lethargy, agitation, and respiratory depression. Depending on the site of injury, patients are usually unable to use the affected organ for a few days after the procedure and need daily washing and bandage, and sometimes taking antibiotics. If tendon, joint, nerve, or vascular injuries are present, it gets more complicated and need for operation and

  20. ON THE FORMATION OF A STABLE PENUMBRA IN A REGION OF FLUX EMERGENCE IN THE SUN

    Energy Technology Data Exchange (ETDEWEB)

    Murabito, M.; Guglielmino, S. L.; Zuccarello, F. [Dipartimento di Fisica e Astronomia—Sezione Astrofisica, Università degli Studi di Catania, Via S. Sofia 78, I-95123 Catania (Italy); Romano, P., E-mail: mmurabito@oact.inaf.it [INAF—Osservatorio Astrofisico di Catania, Via S. Sofia 78, I-95123 Catania (Italy)

    2017-01-01

    We studied the formation of the first penumbral sector around a pore in the following polarity of the NOAA Active Region (AR) 11490. We used a high spatial, spectral, and temporal resolution data set acquired by the Interferometric BIdimensional Spectrometer operating at the NSO/Dunn Solar Telescope, as well as data taken by the Helioseismic and Magnetic Imager on board the Solar Dynamics Observatory satellite. On the side toward the leading polarity, elongated granules in the photosphere and an arch filament system (AFS) in the chromosphere are present, while the magnetic field shows a sea-serpent configuration, indicating a region of magnetic flux emergence. We found that the formation of a stable penumbra in the following polarity of the AR begins in the area facing the opposite polarity located below the AFS in the flux emergence region, different from what was found by Schlichenmaier and colleagues. Moreover, during the formation of the first penumbral sector, the area characterized by magnetic flux density larger than 900 G and the area of the umbra increase.

  1. DDX11L: a novel transcript family emerging from human subtelomeric regions

    Directory of Open Access Journals (Sweden)

    D'Urso Michele

    2009-05-01

    Full Text Available Abstract Background The subtelomeric regions of human chromosomes exhibit an extraordinary plasticity. To date, due to the high GC content and to the presence of telomeric repeats, the subtelomeric sequences are underrepresented in the genomic libraries and consequently their sequences are incomplete in the finished human genome sequence, and still much remains to be learned about subtelomere organization, evolution and function. Indeed, only in recent years, several studies have disclosed, within human subtelomeres, novel gene family members. Results During a project aimed to analyze genes located in the telomeric region of the long arm of the human X chromosome, we have identified a novel transcript family, DDX11L, members of which map to 1pter, 2q13/14.1, 2qter, 3qter, 6pter, 9pter/9qter, 11pter, 12pter, 15qter, 16pter, 17pter, 19pter, 20pter/20qter, Xpter/Xqter and Yqter. Furthermore, we partially sequenced the underrepresented subtelomeres of human chromosomes showing a common evolutionary origin. Conclusion Our data indicate that an ancestral gene, originated as a rearranged portion of the primate DDX11 gene, and propagated along many subtelomeric locations, is emerging within subtelomeres of human chromosomes, defining a novel gene family. These findings support the possibility that the high plasticity of these regions, sites of DNA exchange among different chromosomes, could trigger the emergence of new genes.

  2. [Regional health and autonomy conferences (CRSAs): the implications for medical democracy at a regional level].

    Science.gov (United States)

    Devictor, Bernadette

    2010-01-01

    The HPST law seeks to reorganize the governance of healthcare at a regional level and to maintain the existence of regional health conferences, now known as regional health and autonomy conferences (CRSAs). The purpose of this article is to examine the new duties attributed to the CRSAs and to consider the various issues raised by their practice. The article also provides an analysis of the preconditions required for the successful implementation of medical democracy at a regional level, ie.: the involvement of the CRSAs in the assessment of regional healthcare policies, the mobilization of funds, the composition of the CRSAs (including the full range of healthcare areas), the importance of providing adequate support for territorial conferences, and the elaboration of a communicative space for fostering exchanges between CRSAs.

  3. Risk-communication capability for public health emergencies varies by community diversity

    Directory of Open Access Journals (Sweden)

    Viswanath Kasisomayajula

    2008-03-01

    Full Text Available Abstract Background Public health emergencies heighten several challenges in risk-communication: providing trustworthy sources of information, reaching marginalized populations, and minimizing fear and public confusion. In emergencies, however, information may not diffuse equally among all social groups, and gaps in knowledge may increase. Such knowledge gaps vary by social structure and the size, socioeconomic status, and diversity of the population. This study explores the relationship between risk-communication capabilities, as perceived by public officials participating in emergency tabletop exercises, and community size and diversity. Findings For each of the three communication functions tested, risk-communication capabilities are perceived to be greater in communities with fewer then 10% of the population speaking a language other than English at home, decreasing as the percentage grows to 20% (ANOVA P ≤ 0.02. With respect to community size, however, we found an N-shaped relationship between perceived risk communication capabilities and population size. Capabilities are perceived highest in the largest communities and lowest in the smallest, but lower in communities with 20,000–49,999 inhabitants compared to those with 2,500–19,999. Conclusion The results of this study suggest the need to factor population diversity into risk communication plans and the need for improved state or regional risk-communication capabilities, especially for communities with limited local capacity.

  4. SMALL AND MEDIUM ENTERPRISES, REGIONAL DEVELOPMENT AND NETWORKING: THE EMERGING FRAMEWORK IN ROMANIA

    Directory of Open Access Journals (Sweden)

    Daniela Luminita Constantin

    2002-12-01

    Full Text Available Networking is a key word in the recent debates on SMEs and regional policies, pointing out the need and advantages of integrating these businesses in a coherent framework, which creates links, relations, exchanges between them and other actors within the region (banks, universities, research institutes, training centres, consulting firms, chambers of commerce, associations of producers, local public administration. This paper aims to explore the main features and significance of the SME sector development for addressing the regional question in Romania during the transition period and to identify the emerging evidence and perspectives of SME territorial networking phenomenon in the specific context induced by the European integration processes. Up to present the idea of creating and supporting regional networks has not been offered the adequate importance in Romania – being only partially, indirectly envisaged, so that this paper proposes some reflections that could be considered by the Romanian regional policy in the forthcoming years, as resulted from the analysis of the international experience and literature devoted to this subject.

  5. Championing mental health at work: emerging practice from innovative projects in the UK.

    Science.gov (United States)

    Robinson, Mark; Tilford, Sylvia; Branney, Peter; Kinsella, Karina

    2014-09-01

    This paper examines the value of participatory approaches within interventions aimed at promoting mental health and wellbeing in the workplace. Specifically the paper explores data from the thematic evaluation of the Mental Health and Employment project strand within the Altogether Better programme being implemented in England in the Yorkshire and Humber region, which was funded through the BIG Lottery and aimed to empower people across the region to lead better lives. The evaluation combined a systematic evidence review with semi-structured interviews across mental health and employment projects. Drawing on both evaluation elements, the paper examines the potential of workplace-based 'business champions' to facilitate organizational culture change within enterprises within a deprived regional socio-economic environment. First, the paper identifies key policy drivers for interventions around mental health and employment, summarizes evidence review findings and describes the range of activities within three projects. The role of the 'business champion' emerged as crucial to these interventions and therefore, secondly, the paper examines how champions' potential to make a difference depends on the work settings and their existing roles, skills and motivation. In particular, champions can proactively coordinate project strands, embed the project, encourage participation, raise awareness, encourage changes to work procedures and strengthen networks and partnerships. The paper explores how these processes can facilitate changes in organizational culture. Challenges of implementation are identified, including achieving leverage with senior management, handover of ownership to fellow employees, assessing impact and sustainability. Finally, implications for policy and practice are discussed, and conclusions drawn concerning the roles of champions within different workplace environments. © The Author (2013). Published by Oxford University Press. All rights reserved. For

  6. Manitoba Health's emerging work on wildland fire smoke

    Science.gov (United States)

    Jeffrey Joaquin; Darlene Oshanski

    2015-01-01

    Smoke caused by wildland fire events is an important public health issue, involving major risks to the health of people and the environment. Smoke from wildland fires can travel hundreds of kilometers, affecting air quality far from the flames. Through a partnership with Health Canada, Manitoba Health's Office of Disaster Management (ODM) has undertaken a number...

  7. How Multidimensional Health Locus of Control predicts utilization of emergency and inpatient hospital services.

    Science.gov (United States)

    Mautner, Dawn; Peterson, Bridget; Cunningham, Amy; Ku, Bon; Scott, Kevin; LaNoue, Marianna

    2017-03-01

    Health locus of control may be an important predictor of health care utilization. We analyzed associations between health locus of control and frequency of emergency department visits and hospital admissions, and investigated self-rated health as a potential mediator. Overall, 863 patients in an urban emergency department completed the Multidimensional Health Locus of Control instrument, and self-reported emergency department use and hospital admissions in the last year. We found small but significant associations between Multidimensional Health Locus of Control and utilization, all of which were mediated by self-rated health. We conclude that interventions to shift health locus of control may change patients' perceptions of their own health, thereby impacting utilization.

  8. Stray animal populations and public health in the South Mediterranean and the Middle East regions

    Directory of Open Access Journals (Sweden)

    Aristarhos Seimenis

    2014-06-01

    Full Text Available Uncontrolled urban growth in South Mediterranean and the Middle East regions involves city dwellers and stray animals (mainly dogs and cats creating a dense and downgraded environment, in which irregular street garbage collection disposes sufficient food for survival and proliferation of stray animals. Under such conditions serious public health hazards are expected due to the increase of animal bites, the multiplication of insects and rodents vectors of different viral, bacterial, fungal and parasitic agents to which humans are exposed. Traditional national stray animal eradication programs and occasional small animals' humane elimination campaigns are insufficient to avert human and veterinary health risks when not coupled with modern technologies. In such environments, multiple foci of emerging and re‑emerging zoonoses easily spread, i.e. rabies, hydatidosis, leishmaniasis and toxoplasmosis. Upgrading urban and peri-urban situations requires integrated/coordinated management programmes, in which public and animal health services as well as municipalities have a crucial role. Control and upgrading programmes should be flexible and able to adapt to the specific conditions of the given country/region. In this context, intersectoral/interprofessional collaborations and community participation are crucial for any national and regional development strategies. In this respect, a global approach considering both public health and socio-economic problems shows to be extremely adequate and effective.

  9. Converging requirements and emerging challenges to public health diseases surveillance and bio surveillance

    International Nuclear Information System (INIS)

    Rao, V.; Abel, T.

    2009-01-01

    Disease surveillance systems are a critical component of an early warning system for public health agencies to prepare and respond to major public health catastrophes. With a growing emphasis for more robust early indicator and warning systems to track emerging and dangerous diseases of suspicious nature, considerable emphasis is now placed on deployment of more expanded electronic disease surveillance systems. The architectural considerations for bio surveillance information system are based on collection, analysis and dissemination of human, veterinary and agricultural related disease surveillance to broader regional areas likely to be affected in the event of an emerging disease, or due to bioterrorism and better coordinate plans, preparations and response by governmental agencies and multilateral forums. The diseases surveillance systems architectures by intent and design could as well support biological threat monitoring and threat reduction initiatives. As an illustrative sample set, this paper will describe the comparative informatics requirements for a disease surveillance systems developed by CSC for the US Centers for Diseases Control and Prevention (CDC) currently operational nationwide, and biological weapons threat assessment developed as part of the Threat Agent Detection and Response (TADR) Network under the US Biological Threat Reduction Program and deployed at Uzbekistan, Kazakhstan, Georgia, and Azerbaijan.(author)

  10. Emerging Cross Border Tourism Region Macau-Zhuhai: Place in Play/Place to Play

    Directory of Open Access Journals (Sweden)

    Hendrik Tieben

    2012-12-01

    Full Text Available This paper explores the new tourism region Macau-Zhuhai which is emerging in the south-western part of the Pearl River Delta (PRD. Since Macau’s handover to the People’s Republic of China in 1999, the former Portuguese enclave is becoming increasingly integrated into the PRD. Together with its mainland neighbor Zhuhai it is creating a bi-city region; although without coordinated planning. Currently, both cities embark on a first joint project encouraged by the Chinese Central Government on the island Hengqin. The paper is investigating the attempts of both cities to reinvent themselves as places to play and how they find themselves on the playing field of global and national forces. The paper ends with the suggestion of an alternative understanding of tourism and destinations which learns from spatial practices of a new generation of tourists in Asia.

  11. Sustainability Strategies for Regional Health Information Organization Startups

    DEFF Research Database (Denmark)

    Winkler, Till J.; Ozturk, Pinar; Brown, Carol V.

    2016-01-01

    the population health of an underserved urban population, and an HIE capability to enable the transition to a healthcare landscape that rewards care coordination across suburban hospitals and physician practices. Conclusions: We propose two models of technology and sustainability strategies for developing bottom...... initiatives by states and regional health information organizations (HIOs). Given the high failure rates of regional U.S. HIOs in the past, our primary objective is to identify the key characteristics of HIO startups that became operational and demonstrated sustainability with non-renewable SHIECAP funding...

  12. Building a regional health equity movement: the grantmaking model of a local health department.

    Science.gov (United States)

    Baril, Nashira; Patterson, Meghan; Boen, Courtney; Gowler, Rebekah; Norman, Nancy

    2011-01-01

    The Boston Public Health Commission's Center for Health Equity and Social Justice provides grant funding, training, and technical assistance to 15 organizations and coalitions across New England to develop, implement, and evaluate community-based policy and systems change strategies that address social determinants of health and reduce racial and ethnic health inequities. This article describes Boston Public Health Commission's health equity framework, theory of change regarding the elimination of racial and ethnic health inequities, and current grantmaking model. To conclude, the authors evaluate the grant model and offer lessons learned from providing multiyear regional grants to promote health equity.

  13. An economic assessment of population health risk in region

    Directory of Open Access Journals (Sweden)

    Nina Vladimirovna Zaytseva

    2012-06-01

    Full Text Available This paper proposes a method of economic assessment of population health risk as a tool of life qualitymanagement and qualityof labor resources in the region (as factors of a region’s economic security. The technique is based on the cost of reducing the period of disability in the implementation of population health risk and takes into account the effects of risk prevention on levels of the budgetary system of the Russian Federation. The method intends to support making decisions on planning measures to reduce population health risk at the level of regions, territories and separate objects to assess their cost-performance, optimization of investment and operating costs to reduce the population health risk and sustainable development of the territory

  14. Nurse training in health in different regions in Brazil

    Directory of Open Access Journals (Sweden)

    Carinne Magnago

    Full Text Available Abstract Objectives: to identify on the one hand whether there has been any changes in the nurse training in Brazil and on the other if regionalizing health incurred interference in this process. Methods: an exploratory research of a multiple case study in a qualitative approach developed between November 2015 and March 2017, in seven regions in Brazil. The data were collected by in-depth interviews with 16 administrators of the undergraduate courses in nursing and by documentary analysis of the Projetos Políticos Pedagógicos (Political Pedagogical Projects. Content analysis was undertaken by having the theoretical references of the Diretrizes Curriculares Nacionais (National Curriculum Guidelines. Results: varied profiles of undergraduates were observed with higher tendency for the basic level in health practice or for hospital level with competencies in health care that is still fragmented and not interdisciplinary. The curricular structure of the courses focuses on isolated disciplines with little or no interdisciplinary integration and the pedagogical model is based on traditional teaching-learning strategies and additional evaluation process. There were no differences in health among the regions. Conclusions: it is necessary in concomitance with the changes that are required in the field of training to undertake efforts in the development of health units and training institutions, which has already proven to be a factor of professional retention and regional development.

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

    Science.gov (United States)

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

    2014-02-01

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

  16. Utilization of emergency medical transports and hospital admissions among persons with behavioral health conditions.

    Science.gov (United States)

    Cuddeback, Gary; Patterson, P Daniel; Moore, Charity Galena; Brice, Jane H

    2010-04-01

    Emergency medical services transport and emergency department misuse among persons with behavioral health conditions is a concern. Administrative data were used to examine medical transports and hospital admissions among persons with behavioral health conditions. Data on 70,126 medical transports to emergency departments in three southeastern counties were analyzed. Compared with general medical transports, fewer behavioral health transports resulted in a hospital admission. Among behavioral health transports, persons with schizophrenia were 2.62 times more likely than those with substance use disorders to be admitted, and persons with mood disorders were 4.36 times more likely than those with substance use disorders to be admitted. Also, among behavioral health transports, rural transports were less likely than more urban transports to result in a hospital admission. More training of emergency medical services personnel and more behavioral health crisis resources, especially targeting rural areas and substance use disorders, are needed.

  17. User violence towards nursing professionals in mental health services and emergency units

    Directory of Open Access Journals (Sweden)

    Bartolomé Llor-Esteban

    2017-01-01

    Full Text Available Workplace violence is present in many work sectors, but in the area of mental health, nurses have a higher risk due to the close relationship they have with users. This study analyzed hostile user statements against nursing professionals of Mental Health Services and Emergency Units in Health Service (MHS hospitals in Murcia, Spain, and determined the frequency of exposure to the different violent user behaviors. The study was carried out with a sample of 518 nursing professionals from four hospital services: Mental Health, Emergency Units, Medical Hospitalization, and Maternal-and-Child. The nursing staff of Mental Health and Emergency Units was the most exposed to violence. Non-physical violence was more frequent in Emergency Units, whereas physical violence was more frequent in Mental Health. Among the consequences of exposure to non-physical violence are workers’ emotional exhaustion and the presence of psychological distress.

  18. One Health approach: A platform for intervention in emerging public health challenges of Kerala state

    Directory of Open Access Journals (Sweden)

    A. Sukumaran

    2015-05-01

    Full Text Available The authors, key functionaries in the Kerala state public health system, review the communicable disease scenario of the state for the past 4 years, and in the background of the One Health concept, opines that the re-emerged discipline is perfectly in tune with the current challenges of the state. The unique model of Kerala state is witnessing newer challenges in its public health arena: The rapidly increasing migrant workforce from relatively poorer states of India, rapid urbanization and its consequent stress on public health, unsolved issues of urban waste disposal, reemergence of many communicable diseases like malaria, more so, the falciparum type, emergence of many zoonotic diseases like Lyme disease, scrub typhus, and Kyasanur forest disease etc. Conventional zoonotic infections such as anthrax and brucellosis remain potential threat for human health as well. Rabies continued to cause major concern from mortality point of view, as well as major drainer of state’s budget every year. Leptospirosis has remained major burden among the communicable disease for the past 10 years, and the annual incidence ranged from 2 to 7 per 100,000 population. Having a large section of its people working in various agriculture and animal rearing occupations, the state has all risk factors for propagation of Leptospirosis, but lacks interdisciplinary collaboration in its control and prevention area, the author highlights major avenues for collaboration. Japanese encephalitis appeared as an epidemic in 2011 in two of the southern districts in Kerala, one of the districts being famous tourist spot for both humans, as well as migrant birds. There is ample scope for collaborative research on the source of the virus, and in the subsequent years, the disease had been detected in more districts. Lyme disease was reported for the first time in India, from one of the districts in Kerala, promptly investigated by a joint team from Human Public Health and Veterinary

  19. [Satisfaction with health services in the North Bohemia Region].

    Science.gov (United States)

    Masopust, V; Rajman, K

    1989-04-01

    In May 1988 in the North Bohemian region an anonymous survey was made in which 3,767 respondents participated, i.e. 0.42% of the population living in the region. The survey was focused on the satisfaction with and attitudes of patients to the health services. 73.64% of the respondents evaluated the provided services positively, 24.39% had an ambivalent attitude and 1.97% evaluated them negatively. Material shortcomings in the health services were criticized by 54.05% of the respondents, 37.75% criticized long waiting periods and 23.17% shortage of health personnel. The greatest advantage of our health services is that they are free of charge (49.91% respondents); availability (48.23%) and good interpersonal relations (21.56%). The satisfaction with the health services was expressed by 85.72% respondents verbally, 5.57% by criticism, 1.57% by a bribe and 1.43% by complaints. The most pretentious group are young patients working in industry. A positive attitude to the health services correlates with a positive evaluation of health workers. Thus the necessity arises to guard the ethical and professional standard of the health workers.

  20. Expanded BPA residential weatherization program: summary of regional health effects

    International Nuclear Information System (INIS)

    Sandusky, W.F.; Thor, P.W.; Alton, C.C.; Mellinger, P.J.; Cross, F.T.

    1984-11-01

    The Final Environmental Impact Statement (FEIS) for the Bonneville Power Administration (BPA) Expanded Residential Weatherization Program has been completed, printed, and distributed. This document incorporates numerous revisions based on both oral and written comments received during the public comment of the Draft Environmental Impact Statement (DEIS). The estimates of regional health effects were revised to incorporate results of the second Pacific Northwest Residential Energy Survey (PNWRES). The FEIS now expresses the estimated regional health effects in terms of incidence of cancers per 100,000 people exposed, which allows comparison to be made to the annual average risk of fatality by other causes. The estimates of regional health effects are also compared to health effects resulting from supplying and operating a conventional coal plant at a power level equal to the amount of energy saved from installation of additional tightening measures. Numerical results for the estimated health effects described above are provided. A summary of the comments received on the DEIS is also provided, along with estimated health effects associated with the Environmentally Preferred and BPA Preferred Alternatives to the Proposed Action. 8 refs., 3 figs., 5 tabs

  1. Sustainable Model for Public Health Emergency Operations Centers for Global Settings

    OpenAIRE

    Balajee, S. Arunmozhi; Pasi, Omer G.; Etoundi, Alain Georges M.; Rzeszotarski, Peter; Do, Trang T.; Hennessee, Ian; Merali, Sharifa; Alroy, Karen A.; Phu, Tran Dac; Mounts, Anthony W.

    2017-01-01

    Capacity to receive, verify, analyze, assess, and investigate public health events is essential for epidemic intelligence. Public health Emergency Operations Centers (PHEOCs) can be epidemic intelligence hubs by 1) having the capacity to receive, analyze, and visualize multiple data streams, including surveillance and 2) maintaining a trained workforce that can analyze and interpret data from real-time emerging events. Such PHEOCs could be physically located within a ministry of health epidem...

  2. Public health response to radiation emergencies and the role of the Helsinki Project Office

    International Nuclear Information System (INIS)

    Baverstock, Keith F.

    1997-01-01

    This paper focuses on the public health element of nuclear emergency preparedness, defined as the mitigation of the long-term effects of radiation on exposed populations, as opposed to dealing with the health consequences of an exposure in an individual (termed medical aspects). The paper also approaches to the role of the Helsinki Project Office which is concerned with the protection of public health through effective response to nuclear emergencies, and falling into two categories, namely contingency planning or preparedness, and response

  3. Emergency contraception - Potential for women′s health

    Directory of Open Access Journals (Sweden)

    Suneeta Mittal

    2014-01-01

    Full Text Available Emergency contraception (EC is a safe and effective method which is used to prevent unwanted pregnancy after unprotected sexual intercourse. Many of the unwanted pregnancies end in unsafe abortions. The search for an ideal contraceptive, which does not interfere with spontaneity or pleasure of the sexual act, yet effectively controls the fertility, is still continuing. Numerous contraceptive techniques are available, yet contraceptive coverage continues to be poor in India. Thus, even when not planning for a pregnancy, exposure to unprotected sex takes place often, necessitating the use of emergency contraception. This need may also arise due to failure of contraceptive method being used (condom rupture, diaphragm slippage, forgotten oral pills or following sexual assault. Emergency contraception is an intervention that can prevent a large number of unwanted pregnancies resulting from failure of regular contraception or unplanned sexual activity, which in turn helps in reducing the maternal mortality and morbidity due to unsafe abortions. However, a concern has been expressed regarding repeated and indiscriminate usage of e-pill, currently the rational use of emergency contraception is being promoted as it is expected to make a significant dent in reducing the number of unwanted pregnancies and unsafe abortions. In fact, since the introduction of emergency contraception, the contribution of unsafe abortion towards maternal mortality has declined from 13 to 8 per cent.

  4. Regional Disparities in Romania. Contribution of the Regional Operational Program to Health Infrastructure

    Directory of Open Access Journals (Sweden)

    VICTOR PLATON

    2013-01-01

    Full Text Available Health infrastructure is one of the weaknesses of socio-economic development in Romania and in other European states. In order to get a better picture of the Romanian health system issues, this paper analyzes a number of statistical indicators considered representative for the national and European health infrastructure for a 20 years period, between 1990 and 2010. Our paper has three main objectives: (a to identify the main trends for health infrastructure in some of the European Union countries; (b to describe the evolution of the health system in Romania, the comparative situation at the European level as well as regional level indicators dynamics; (c to overview the Regional Operational Program in Romania, how much does it help the regional health infrastructure in our country. At the European level, there is a constant decrease in the number of hospital beds. For this indicator, Romania has slightly higher values than the European average. We must mention that the hospital beds indicator offers limited information on health infrastructure which also includes medical equipment and specific devices and practices. The number of hospitals in Romania increased with 18.9% during the last 20 years (1990-2010. During the observed timeline, the number of hospitals in Romania had a constant positive evolution at regional level. The number of doctors in hospitals has an increasing trend at the local as well as at the international level. Romania has a number of doctors twice lower than the European average (3.6 doctors for one thousand inhabitants. The Regional Operational Program (ROP has a limited influence in achieving the objectives stated in Applicants Guide for Priority Axis 3. Major Intervention Area 3.1. This happens because supporting infrastructure improvements will not create institutional modernization. The financial contribution through ROP will result in the modernization of 11% of the existing hospitals in Romania.

  5. The Frontlines of Medicine Project: a proposal for the standardized communication of emergency department data for public health uses including syndromic surveillance for biological and chemical terrorism.

    Science.gov (United States)

    Barthell, Edward N; Cordell, William H; Moorhead, John C; Handler, Jonathan; Feied, Craig; Smith, Mark S; Cochrane, Dennis G; Felton, Christopher W; Collins, Michael A

    2002-04-01

    The Frontlines of Medicine Project is a collaborative effort of emergency medicine (including emergency medical services and clinical toxicology), public health, emergency government, law enforcement, and informatics. This collaboration proposes to develop a nonproprietary, "open systems" approach for reporting emergency department patient data. The common element is a standard approach to sending messages from individual EDs to regional oversight entities that could then analyze the data received. ED encounter data could be used for various public health initiatives, including syndromic surveillance for chemical and biological terrorism. The interlinking of these regional systems could also permit public health surveillance at a national level based on ED patient encounter data. Advancements in the Internet and Web-based technologies could allow the deployment of these standardized tools in a rapid time frame.

  6. [Hospital emergencies arising from nursing homes in a region: evolution, characteristics and appropriateness].

    Science.gov (United States)

    Sánchez-Pérez, Inma; Comes Garcia, Nuri; Romero Piniella, Lola; Prats Martos, Gemma; Arnau Bataller, Gemma; Coderch, Jordi

    Hospital emergencies (HE) arising from nursing homes (NH) are on the rise. We analyse the evolution, characteristics and appropriateness of HE of NH residents in a region, as well as resulting hospital admissions. Retrospective descriptive study between 2010 and 2013 of institutionalised residents of 11 NH located in Baix Empordà (704 beds) and Palamós Hospital. Gender, age, morbidity and relative weight according to clinical risk groups (CRG), NH, length of stay, diagnosis of the emergency, appropriateness of HE according to Bermejo's criteria and the HE appropriateness protocol (HEAP), and appropriateness of hospitalisations according to the Appropriateness Evaluation Protocol (AEP). Sample to evaluate appropriateness: 159 HE and 91 hospitalisations. frequency, mean, standard deviation, percentiles, Fisher's exact test and ANOVA, with a confidence interval of 95% and using IBM SPSS Statistics 23. 1,474 people were enrolled, of which 73% were women. Group ≥85 years increased to 60.3% and the mean weight of morbidity was 3.2 to 4.0 (p <0.001). 1,805 HE were generated. The annual rate per 1,000 stays arising from NH increased from 1.64 to 2.05, of which 90.6% were appropriate according to Bermejo's criteria and 93.7% according to the HEAP. Of these, 502 involved hospitalisation. The annual rate per 10 emergencies fell from 2.96 to 2.64 and 98.9% were appropriate according to the AEP. Hospital emergencies and hospitalisations of NH residents are increasing and are appropriate. Increasing age and disease burden could explain this phenomenon. NH and hospitals should react appropriately, considering the specific needs of this population sector. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  7. Effect of price and in-store promotion on sales: a study of distinct regions in an emerging market

    OpenAIRE

    Sanchez, Juan Machado

    2016-01-01

    Increasing competition caused by globalization, high growth of some emerging markets and stagnation of developed economies motivate Consumer Packaged Goods (CPGs) manufacturers to drive their attention to emerging markets. These companies are expected to adapt their marketing activities to the particularities of these markets in order to succeed. In a country classified as emerging market, regions are not alike and some contrasts can be identified. In addition, divergences of marketing variab...

  8. Health Extension Workers' and Mothers' Attitudes to Maternal Health Service Utilization and Acceptance in Adwa Woreda, Tigray Region, Ethiopia.

    Directory of Open Access Journals (Sweden)

    Ruth Jackson

    Full Text Available The maternal health system in Ethiopia links health posts in rural communities (kebeles with district (woreda health centres, and health centres with primary hospitals. At each health post two Health Extension Workers (HEWs assist women with birth preparedness, complication readiness, and mobilize communities to facilitate timely referral to mid-level service providers. This study explored HEWs' and mother's attitudes to maternal health services in Adwa Woreda, Tigray Region.In this qualitative study, we trained 16 HEWs to interview 45 women to gain a better understanding of the social context of maternal health related behaviours. Themes included barriers to health services; women's social status and mobility; and women's perceptions of skilled birth attendant's care. All data were analyzed thematically.There have been substantial efforts to improve maternal health and reduce maternal mortality in Adwa Woreda. Women identified barriers to healthcare including distance and lack of transportation due to geographical factors; the absence of many husbands due to off-woreda farming; traditional factors such as zwar (some pregnant women are afraid of meeting other pregnant women, and discouragement from mothers and mothers-in-law who delivered their children at home. Some women experienced disrespectful care at the hospital. Facilitators to skilled birth attendance included: identification of pregnant women through Women's Development Groups (WDGs, and referral by ambulance to health facilities either before a woman's Expected Due Date (EDD or if labour started at home.With the support of WDGs, HEWs have increased the rate of skilled birth attendance by calling ambulances to transfer women to health centres either before their EDD or when labour starts at home. These findings add to the growing body of evidence that health workers at the community level can work with women's groups to improve maternal health, thus reducing the need for emergency

  9. Differences and similarities of motivating and demotivating factors of emergency nursing care in rural and urban emergency units – A study of selected rural and urban emergency units in the Volta Region of Ghana

    Directory of Open Access Journals (Sweden)

    Confidence Alorse Atakro

    Full Text Available Objective: The objective of this study was to explore differences and similarities of motivating and demotivating factors of emergency nursing care in selected rural and urban emergency units in the Volta Region of Ghana. Materials and methods: This study was conducted at selected rural and urban emergency units in the Volta Region of Ghana. The study utilised qualitative exploratory descriptive design. Purposive sampling technique was employed in selecting emergency units and nurses. Data were collected through semi-structured interviews of 30 nurses. Data saturation was determined after interviewing 30 participants. Data analysis was done through qualitative content analysis. Results: Twenty-six (26 out of a total of thirty (30 participants were between the ages of twenty-five (25 and twenty-nine (29. Nurses working in the emergency units studied general nursing at the Nurses Training Colleges (NTCs. None of the respondents studied emergency nursing as a degree programme. Twenty four (24 out of thirty (30 participants had worked for about two years in emergency units. Four thematic categories that represented differences and similarities of motivating and demotivating factors for nurses in rural and urban emergency units were extracted from data. The thematic categories are: a Support from hospital management for provision of material resources; b Task shifting to nurses; c Stimulant for learning; d Interpersonal relations. Discussions: Evidence available in this study suggests that there are differences as well as similarities of motivating and demotivating factors within emergency units of rural and urban settings in the Volta Region of Ghana. Differences in resource allocation and task shifting was identified. Stimulating environments of emergency unit for learning and excellent interpersonal relations were found to be common motivations for both rural and urban emergency unit nurses. Keywords: Motivating, Demotivating, Emergency

  10. Factors associated with the utilization of primary care emergency centers in a Spanish region with high population dispersion: a mixed-methods study.

    Science.gov (United States)

    Sanz-Barbero, Belén; Otero-García, Laura; Blasco-Hernández, Teresa; San Sebastián, Miguel

    2014-09-03

    Adequate access to primary care emergency centers is particularly important in rural areas isolated from urban centers. However, variability in utilization of emergency services located in primary care centers among inhabitants of nearby geographical areas is understudied. The objectives of this study are twofold: 1) to analyze the association between the availability of municipal emergency care centers and utilization of primary care emergency centers (PCEC), in a Spanish region with high population dispersion; and 2) to determine healthcare providers' perceptions regarding PCEC utilization. A mixed-methods study was conducted. Quantitative phase: multilevel logistic regression modeling using merged data from the 2003 Regional Health Survey of Castile and Leon and the 2001 census data (Spain). Qualitative phase:14 in-depth- interviews of rural-based PCEC providers. Having PCEC as the only emergency center in the municipality was directly associated with its utilization (p use. PCEC users were considered to be predominantly workers and students with scheduling conflicts with rural primary care opening hours. The location of emergency care centers is associated with PCEC utilization. Increasing access to primary care by extending hours may be an important step toward optimal PCEC utilization. Further research would determine whether lower PCEC use by certain groups is associated with disparities in access to care.

  11. Research culture in a regional allied health setting.

    Science.gov (United States)

    Borkowski, Donna; McKinstry, Carol; Cotchett, Matthew

    2017-07-01

    Research evidence is required to guide best practice, inform policy and improve the health of communities. Current indicators consider allied health research culture to be low. This study aimed to measure the allied health research culture and capacity in a Victorian regional health service. The Research Capacity and Culture tool was used to evaluate research capacity and culture across individual, team and organisation domains. One-way ANOVA was used to determine differences between allied health professions, whereas responses to open-ended questions were themed using open coding. One hundred thirty-six allied health professionals completed the survey. There were statistically significant differences in the organisation domain between social work, physiotherapy and occupational therapy professions; in the team domain, between social work and all other professions. Motivators for conducting research included providing a high-quality service, developing skills and increasing job satisfaction. Barriers included other work roles taking priority, a lack of time and limited research skills. Multi-layered strategies including establishing conjoint research positions are recommended to increase allied health research culture in this regional area.

  12. Regional South Australia Health (RESONATE) survey: study protocol

    Science.gov (United States)

    Jones, Martin; Gillam, Marianne; May, Esther

    2018-01-01

    Introduction Access to quality healthcare services is considered a moral right. However, for people living in regional locations, timely access to the services that they need may not always be possible because of structural and attitudinal barriers. This suggests that people living in regional areas may have unmet healthcare needs. The aim of this research will be to examine the healthcare needs, expectations and experiences of regional South Australians. Methods and analysis The Regional South Australia Health (RESONATE) survey is a cross-sectional study of adult health consumers living in any private or non-private dwelling, in any regional, rural, remote or very remote area of South Australia and with an understanding of written English. Data will be collected using a 45-item, multidimensional, self-administered instrument, designed to measure healthcare need, barriers to healthcare access and health service utilisation, attitudes, experiences and satisfaction. The instrument has demonstrated acceptable psychometric properties, including good content validity and internal reliability, good test–retest reliability and a high level of acceptability. The survey will be administered online and in hard-copy, with at least 1832 survey participants to be recruited over a 12-month period, using a comprehensive, multimodal recruitment campaign. Ethics and dissemination The study has been reviewed and approved by the Human Research Ethics Committee of the University of South Australia. The results will be actively disseminated through peer-reviewed journals, conference presentations, social media, broadcast media, print media, the internet and various community/stakeholder engagement activities. PMID:29654014

  13. [Health and globalization in the San Diego-Tijuana region].

    Science.gov (United States)

    Villa-Caballero, Leonel; Caballero-Solano, Víctor Manuel; Andrade-Barreto, Olga Alicia

    2008-01-01

    The international process of trading goods and services with significant reduction in barriers known as globalization is clearly observed at the San Diego-Tijuana region. This essay addresses issues arising at this unique geographical area associated with the globalization process and its public health consequences. Social, cultural and political aspects have very important implications on the health status of the U.S-Mexican population and in the health care systems on both sides of the border. One of the most powerful world economies borders a developing country resulting in a dramatic comparison that has negative outcomes such as health disparities, high prevalence of chronic diseases and new epidemiological risks. Poverty and migration are a few of the contributing factors triggering this asymmetrical relationship. Challenges in border health require a comprehensive binational participation and the solutions are yet to be determined.

  14. Trade in health services in the ASEAN region.

    Science.gov (United States)

    Arunanondchai, Jutamas; Fink, Carsten

    2006-12-01

    Promoting quality health services to large population segments is a key ingredient to human and economic development. At its core, healthcare policymaking involves complex trade-offs between promoting equitable and affordable access to a basic set of health services, creating incentives for efficiencies in the healthcare system and managing constraints in government budgets. International trade in health services influences these trade-offs. It presents opportunities for cost savings and access to better quality care, but it also raises challenges in promoting equitable and affordable access. This paper offers a discussion of trade policy in health services for the ASEAN region. It reviews the existing patterns of trade and identifies policy measures that could further harness the benefits from trade in health services and address potential pitfalls that deeper integration may bring about.

  15. emergency psychiatry and mental health policy: an international ...

    African Journals Online (AJOL)

    psychiatric care such as clinical implications, care in large cities, the rights of the patients and deinstitutionalisation. Further chapters examine care on different continents. Emergency psychiatric services in the United States, Canada, the Netherlands, France, Italy, Denmark, Belgium, Germany,. Spain, Greece and South ...

  16. Adoption of One Health in Thailand's National strategic plan for emerging infectious diseases.

    Science.gov (United States)

    Sommanustweechai, Angkana; Iamsirithaworn, Sopon; Patcharanarumol, Walaiporn; Kalpravidh, Wantanee; Tangcharoensathien, Viroj

    2017-02-01

    This study illustrates how Thailand adopted the One Health concept. Massive socio-economic and health consequences of emerging infectious diseases, especially Avian Influenza in 2004, led to recognition of the importance of and need for One Health. Based on collaboration and consultative meetings between the national actors and international development partners, Thailand adopted One Health to drive more effective containment of Emerging Infectious Diseases. This concept gained support from the non-governmental and civil society organizations through processes of the National Health Assembly. In 2012, a Cabinet resolution endorsed a National Strategic Plan for Emerging Infectious Diseases (2013-2016), in which One Health appeared as a core principle. Collaboration among multi-disciplinary groups of professionals, particularly epidemiologists trained in Field Epidemiology Training Programs (FETP), including FETP, FETP-veterinarian, and FETP-wildlife veterinarians, promoted implementation of One Health.

  17. Sustainable Model for Public Health Emergency Operations Centers for Global Settings.

    Science.gov (United States)

    Balajee, S Arunmozhi; Pasi, Omer G; Etoundi, Alain Georges M; Rzeszotarski, Peter; Do, Trang T; Hennessee, Ian; Merali, Sharifa; Alroy, Karen A; Phu, Tran Dac; Mounts, Anthony W

    2017-10-01

    Capacity to receive, verify, analyze, assess, and investigate public health events is essential for epidemic intelligence. Public health Emergency Operations Centers (PHEOCs) can be epidemic intelligence hubs by 1) having the capacity to receive, analyze, and visualize multiple data streams, including surveillance and 2) maintaining a trained workforce that can analyze and interpret data from real-time emerging events. Such PHEOCs could be physically located within a ministry of health epidemiology, surveillance, or equivalent department rather than exist as a stand-alone space and serve as operational hubs during nonoutbreak times but in emergencies can scale up according to the traditional Incident Command System structure.

  18. Examining the importance of incorporating emergency preparedness and disaster training core competencies into allied health curricula.

    Science.gov (United States)

    Curtis, Tammy

    2015-01-01

    Preparation for responding to emergency events that does not warrant outside help beyond the local community resources or responding to disaster events that is beyond the capabilities of the local community both require first responders and healthcare professionals to have interdisciplinary skills needed to function as a team for saving lives. To date, there is no core emergency preparedness and disaster planning competencies that have been standardized at all levels across the various allied health curricula disciplines. To identify if emergency preparedness and disaster training content are currently being taught in allied health program courses, to identify possible gaps within allied health curricula, and to explore the perceptions of allied health college educators for implementing emergency preparedness and disaster training core competencies into their existing curricula, if not already included. A quantitative Internet-based survey was conducted in 2013. Convenient sample. Fifty-one allied health college educators completed the survey. Descriptive statistics indicated that the majority of allied health college instructors do not currently teach emergency preparedness and disaster training core competency content within their current allied health discipline; however, their perceived level of importance for inclusion of the competencies was high. The results of this study supported the need for developing and establishing a basic national set of standardized core emergency preparedness and disaster planning competencies at all levels across various allied health curricula disciplines to ensure victims receive the best patient care and have the best possible chance of survival.

  19. Health for all: a fundamental goal of public health in our region.

    Science.gov (United States)

    Binns, Colin; Lee, Mi Kyung

    2015-01-01

    Since its foundation 30 years ago, the mission of the Asia-Pacific Academic Consortium for Public Health has been promoting "health for all" through public health. "Health for all" became the theme of Walter Patrick's public health career and inspired his contribution to APACPH. However, the universality of health care is now under threat, more from economists and politicians than public health workers. Health for all remains a continuing challenge for all public health workers in our region. Progress is being made toward this goal as life expectancy in the Western Pacific has increased from 64 to 78 in the past 3 decades. Prof Walter Patrick was strong public health advocate, and this review was written as a tribute to good friend and inspiring colleague who believed in, and worked for "health for all." © 2014 APJPH.

  20. Emergency Contraception Education for Health and Human Service Professionals: An Evaluation of Knowledge and Attitudes

    Science.gov (United States)

    Colarossi, Lisa; Billowitz, Marissa; Breitbart, Vicki

    2010-01-01

    Objective: To assess the knowledge and attitudes of health care providers, health educators, and social service providers before and after a training session on emergency contraceptive pills. Design: A survey study using pre-post training measurements. Setting: Two hundred and twenty-three medical, social service, and health education providers in…

  1. A Review of State Public Health Emergency Declarations in Peru: 2014-2016.

    Science.gov (United States)

    Bambarén, Celso; Alatrista, Maria Del Socorro

    2018-04-01

    Peru has different legal mechanisms of emergency, one of which is the Public Health Emergency that is applicable when: there is high-risk for, or the existence of an outbreak, epidemic, or pandemic; the occurrence of cases of a disease classified as eliminated or eradicated; the occurrence of emerging or re-emerging infectious diseases with high epidemic potential; the occurrence of rapid disseminated epidemics that simultaneously affect more than one department; as well as the existence of an event that affects the continuity of health services. From July 2014 to December 2016, 23 Public Health Emergencies were declared, out of which 57% were in the high-risk or existence of epidemics, 30% were due to some natural or anthropic events that generate a sudden decrease in the operative capacity of health services, and 13% were due to the existence of a rapid spreading epidemic that could affect more than one department in the country. The risk or occurrence of epidemiological outbreaks, mainly of Dengue, was the main cause of emergency declaration. One-hundred and forty million US dollars were allocated to implement the action plans that were part of the declaration, of which 72% was used to keep the operational capacity of health services and 28% to vector and epidemiological control measures. Bambarén C , Alatrista MdS . A review of state public health emergency declarations in Peru: 2014-2016. Prehosp Disaster Med. 2018;33(2):197-200.

  2. Addressing the gap between public health emergency planning and incident response

    Science.gov (United States)

    Freedman, Ariela M; Mindlin, Michele; Morley, Christopher; Griffin, Meghan; Wooten, Wilma; Miner, Kathleen

    2013-01-01

    Objectives: Since 9/11, Incident Command System (ICS) and Emergency Operations Center (EOC) are relatively new concepts to public health, which typically operates using less hierarchical and more collaborative approaches to organizing staff. This paper describes the 2009 H1N1 influenza outbreak in San Diego County to explore the use of ICS and EOC in public health emergency response. Methods: This study was conducted using critical case study methodology consisting of document review and 18 key-informant interviews with individuals who played key roles in planning and response. Thematic analysis was used to analyze data. Results: Several broad elements emerged as key to ensuring effective and efficient public health response: 1) developing a plan for emergency response; 2) establishing the framework for an ICS; 3) creating the infrastructure to support response; 4) supporting a workforce trained on emergency response roles, responsibilities, and equipment; and 5) conducting regular preparedness exercises. Conclusions: This research demonstrates the value of investments made and that effective emergency preparedness requires sustained efforts to maintain personnel and material resources. By having the infrastructure and experience based on ICS and EOC, the public health system had the capability to surge-up: to expand its day-to-day operation in a systematic and prolonged manner. None of these critical actions are possible without sustained funding for the public health infrastructure. Ultimately, this case study illustrates the importance of public health as a key leader in emergency response. PMID:28228983

  3. Tocopherols and Tocotrienols in Common and Emerging Dietary Sources: Occurrence, Applications, and Health Benefits.

    Science.gov (United States)

    Shahidi, Fereidoon; de Camargo, Adriano Costa

    2016-10-20

    Edible oils are the major natural dietary sources of tocopherols and tocotrienols, collectively known as tocols. Plant foods with low lipid content usually have negligible quantities of tocols. However, seeds and other plant food processing by-products may serve as alternative sources of edible oils with considerable contents of tocopherols and tocotrienols. Tocopherols are among the most important lipid-soluble antioxidants in food as well as in human and animal tissues. Tocopherols are found in lipid-rich regions of cells (e.g., mitochondrial membranes), fat depots, and lipoproteins such as low-density lipoprotein cholesterol. Their health benefits may also be explained by regulation of gene expression, signal transduction, and modulation of cell functions. Potential health benefits of tocols include prevention of certain types of cancer, heart disease, and other chronic ailments. Although deficiencies of tocopherol are uncommon, a continuous intake from common and novel dietary sources of tocopherols and tocotrienols is advantageous. Thus, this contribution will focus on the relevant literature on common and emerging edible oils as a source of tocols. Potential application and health effects as well as the impact of new cultivars as sources of edible oils and their processing discards are presented. Future trends and drawbacks are also briefly covered.

  4. Tocopherols and Tocotrienols in Common and Emerging Dietary Sources: Occurrence, Applications, and Health Benefits

    Science.gov (United States)

    Shahidi, Fereidoon; de Camargo, Adriano Costa

    2016-01-01

    Edible oils are the major natural dietary sources of tocopherols and tocotrienols, collectively known as tocols. Plant foods with low lipid content usually have negligible quantities of tocols. However, seeds and other plant food processing by-products may serve as alternative sources of edible oils with considerable contents of tocopherols and tocotrienols. Tocopherols are among the most important lipid-soluble antioxidants in food as well as in human and animal tissues. Tocopherols are found in lipid-rich regions of cells (e.g., mitochondrial membranes), fat depots, and lipoproteins such as low-density lipoprotein cholesterol. Their health benefits may also be explained by regulation of gene expression, signal transduction, and modulation of cell functions. Potential health benefits of tocols include prevention of certain types of cancer, heart disease, and other chronic ailments. Although deficiencies of tocopherol are uncommon, a continuous intake from common and novel dietary sources of tocopherols and tocotrienols is advantageous. Thus, this contribution will focus on the relevant literature on common and emerging edible oils as a source of tocols. Potential application and health effects as well as the impact of new cultivars as sources of edible oils and their processing discards are presented. Future trends and drawbacks are also briefly covered. PMID:27775605

  5. Regional Geographic Information Systems of Health and Environmental Monitoring

    Directory of Open Access Journals (Sweden)

    Kurolap Semen A.

    2016-12-01

    Full Text Available The article describes a new scientific and methodological approach to designing geographic information systems of health and environmental monitoring for urban areas. Geographic information systems (GIS are analytical tools of the regional health and environmental monitoring; they are used for an integrated assessment of the environmental status of a large industrial centre or a part of it. The authors analyse the environmental situation in Voronezh, a major industrial city, located in the Central Black Earth Region with a population of more than 1 million people. The proposed research methodology is based on modern approaches to the assessment of health risks caused by adverse environmental conditions. The research work was implemented using a GIS and multicriteria probabilistic and statistical evaluation to identify cause-and-effect links, a combination of action and reaction, in the dichotomy ‘environmental factors — public health’. The analysis of the obtained statistical data confirmed an increase in childhood diseases in some areas of the city. Environmentally induced diseases include congenital malformations, tumors, endocrine and urogenital pathologies. The main factors having an adverse impact on health are emissions of carcinogens into the atmosphere and the negative impact of transport on the environment. The authors identify and characterize environmentally vulnerable parts of the city and developed principles of creating an automated system of health monitoring and control of environmental risks. The article offers a number of measures aimed at the reduction of environmental risks, better protection of public health and a more efficient environmental monitoring.

  6. Globalisation, health and foreign policy: emerging linkages and interests

    Science.gov (United States)

    Owen, John Wyn; Roberts, Olivia

    2005-01-01

    A discussion of the growing links between the issues of globalisation, health and foreign policy. This article examines the effect this has on health, development and foreign policy communities in the UK and internationally and considers what steps the policy community must take to address the challenges and opportunities of this new relationship. PMID:16053520

  7. Suicide Prevention: An Emerging Priority For Health Care.

    Science.gov (United States)

    Hogan, Michael F; Grumet, Julie Goldstein

    2016-06-01

    Suicide is a significant public health problem. It is the tenth leading cause of death in the United States, and the rate has risen in recent years. Many suicide deaths are among people recently seen or currently under care in clinical settings, but suicide prevention has not been a core priority in health care. In recent years, new treatment and management strategies have been developed, tested, and implemented in some organizations, but they are not yet widely used. This article examines the feasibility of improving suicide prevention in health care settings. In particular, we consider Zero Suicide, a model for better identification and treatment of patients at risk for suicide. The approach incorporates new tools for screening, treatment, and support; it has been deployed with promising results in behavioral health programs and primary care settings. Broader adoption of improved suicide prevention care may be an effective strategy for reducing deaths by suicide. Project HOPE—The People-to-People Health Foundation, Inc.

  8. [Field epidemiological study on news reports that related to public health emergencies].

    Science.gov (United States)

    Zhang, Shun-xiang; Li, Xue-mei; Luo, Nian-ci; Mei, Shu-jiang; Jiang, Li-juan

    2013-12-01

    All news reports (NR) that were related to public health emergency (PHE) were collected from the Southern Metropolis Daily (SMD) to explore the characteristics of epidemiology in the fields. Based on the theory of communication that including both case and text analysis, qualitative analysis on all the NR regarding PHE published in SMD from the years of 2008 to 2012, was carried out and input to database using the EpiData. Numbers of articles as indicators were compared to show the yearly change of different types of events. Various features of the NR including coverage, source of information, location of the incident, style and size of news, with or without editorials etc. were statistically analyzed by SPSS version 18.0. Among all the 998 reports related to PHE, higher proportion was found in the events of Infectious diseases (35.3%) and food safety (34.1%)respectively. Events on vaccines and drugs used for disease prevention and control (8.9%), environmental pollution caused incidents (8.0%)appeared to be less frequent. Events related to occupational disease, poisoning, bioterrorism and biochemical events were rare. Looking at the monthly distribution of reports, we noticed that the peaks occurred in 2008 and in 2009, which were caused by the Melamine-contamination events and the 2009 H1N1 pandemic. Between 2010 and 2012, figures of monthly reports were smooth, including some critical events from the interests of the media. Most events took place in Guangdong province (34.3%) and other provinces (50.9%), with some were from Hong Kong, Macao and Taiwan regions (9.5%). However, international events (5.2%)were less seen. Extensive coverage accounted for 17.6% of all of reports, and 11.5% allotted the editorials or other forms of in-depth reports. Most of the source of reports on infectious diseases and food safety were from the official release, however. The main sources of occupational diseases and poisoning, vaccines and drug incidents, environmental pollution

  9. The approach of prehospital health care personnel working at emergency stations towards forensic cases

    OpenAIRE

    Ozlem Asci; Guleser Hazar; Isa Sercan

    2015-01-01

    Objectives: The objective of this study is to determine the states of health care personnel, working at 112 emergency stations in the province of Artvin, to encounter with regarding forensic cases and determine their practices aimed at recognizing, protecting, and reporting the evidences that may affect the forensic process. Materials and methods: This descriptive study was conducted with nurses and emergency medicine technicians working at 112 emergency stations in Artvin between January 201...

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

    Science.gov (United States)

    Meier, Benjamin Mason; Ayala, Ana S

    2014-01-01

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

  11. From Emergence to Eruption: The Physics and Diagnostics of Solar Active Regions

    Science.gov (United States)

    Cheung, Mark

    2017-08-01

    The solar photosphere is continuously seeded by the emergence of magnetic fields from the solar interior. In turn, photospheric evolution shapes the magnetic terrain in the overlying corona. Magnetic fields in the corona store the energy needed to power coronal mass ejections (CMEs) and solar flares. In this talk, we recount a physics-based narrative of solar eruptive events from cradle to grave, from emergence to eruption, from evaporation to condensation. We review the physical processes which are understood to transport magnetic flux from the interior to the surface, inject free energy and twist into the corona, disentangle the coronal field to permit explosive energy release, and subsequently convert the released energy into observable signatures. Along the way, we review observational diagnostics used to constrain theories of active region evolution and eruption. Finally, we discuss the opportunities and challenges enabled by the large existing repository of solar observations. We argue that the synthesis of physics and diagnostics embodied in (1) data-driven modeling and (2) machine learning efforts will be an accelerating agent for scientific discovery.

  12. [Regional differences in the health care of basal cell carcinoma].

    Science.gov (United States)

    Augustin, J; Schäfer, I; Thiess, P; Reusch, M; Augustin, M

    2016-10-01

    Basal cell carcinoma (BCC) is the most common type of skin cancer in Germany. So far, it is unclear whether regional variations exist in the health care of the BCC. Analysis of regional variations in health care (e. g., skin cancer screening) and their causes using the example of BCC. Qualitative and quantitative analysis of the regional health care situation of BCC based on three studies was undertaken. These studies include the analysis of n = 7015 histopathological indications whose average tumor thickness is regarded as a characteristic of the quality of care, and a secondary data analysis of GK insured (n = 6.1 million DAK-insured persons), and a nationwide survey (FORSA) of n = 1004 participants focusing on the use of skin cancer screening. Analysis of the histopathological examination showed regional variations in average tumor depth of penetration. These are associated with the rural/urban characteristics of the region and individual sociodemographic indicators (e. g., employment sector or education). The results for age- and gender-specific use (DAK data) showed higher participation rates regarding skin cancer screening in western than in eastern federal states (Bundesländer). Moreover, it was revealed that the trend for using skin cancer screening was higher in urban than in rural areas. The results of population-related surveys confirm this trend. Although it is not possible to compare the studies directly, all three showed an association between city/state and the use of skin cancer screenings. In addition, sociodemographic characteristics that are related to the quality of health care were identified.

  13. Expert forecast on emerging psychosocial risks related to occupational safety and health

    NARCIS (Netherlands)

    Milczarek, M.; Brun, E.; Houtman, I.; Goudswaard, A.; Evers, M.; Bovenkamp, M. van de; Roskams, N.; Op de Beeck, R.; Pahkin, K.; Berthet, M.; Morvan, E.; Kuhn, K.; Kaluza, K.; Hupke, M.; Hauke, A.; Reinert, D.; Widerszal-Bazyl, M.; Perez, J.; Oncins de Frutos, M.

    2007-01-01

    This report is in cooperation with TNO Work and Employment and the European Agency for Safety and Health at Work. The expert forecast on emerging psychosocial risks was carried out by means of the Delphi method. The main emerging psychosocial risks revealed were related to new forms of employment

  14. Regional coordination in medical emergencies and major incidents; plan, execute and teach

    Directory of Open Access Journals (Sweden)

    Hedelin Annika

    2009-07-01

    Full Text Available Abstract Background Although disasters and major incidents are difficult to predict, the results can be mitigated through planning, training and coordinated management of available resources. Following a fire in a disco in Gothenburg, causing 63 deaths and over 200 casualties, a medical disaster response centre was created. The center was given the task to coordinate risk assessments, disaster planning and training of staff within the region and on an executive level, to be the point of contact (POC with authority to act as "gold control," i.e. to take immediate strategic command over all medical resources within the region if needed. The aim of this study was to find out if the centre had achieved its tasks by analyzing its activities. Methods All details concerning alerts of the regional POC was entered a web-based log by the duty officer. The data registered in this database was analyzed during a 3-year period. Results There was an increase in number of alerts between 2006 and 2008, which resulted in 6293 activities including risk assessments and 4473 contacts with major institutions or key persons to coordinate or initiate actions. Eighty five percent of the missions were completed within 24 h. Twenty eight exercises were performed of which 4 lasted more than 24 h. The centre also offered 145 courses in disaster and emergency medicine and crisis communication. Conclusion The data presented in this study indicates that the center had achieved its primary tasks. Such regional organization with executive, planning, teaching and training responsibilities offers possibilities for planning, teaching and training disaster medicine by giving immediate feed-back based on real incidents.

  15. EcoHealth Student: Emerging Researcher Awards encourages ...

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

    Addressing critical population health and environment issues through an ecohealth approach is a common ... Students' work was evaluated based on its contribution to science and ecohealth. .... La recherche, clé d'une meilleure nutrition.

  16. Emerging Issues and Models in College Mental Health Services

    Science.gov (United States)

    Locke, Ben; Wallace, David; Brunner, Jon

    2016-01-01

    This chapter provides a brief overview of the psychological issues facing today's college students, information about students receiving mental health services, and an evidence-based model describing the practice and functions of today's counseling centers.

  17. Microbial Threats to Health: Emergence, Detection, and Response

    National Research Council Canada - National Science Library

    Smolinski, Mark S; Hamburg, Margaret A; Lederberg, Joshua

    2003-01-01

    .... The recent SARS outbreak is a prime example. Knowing neither geographic nor political borders, often arriving silently and lethally, microbial pathogens constitute a grave threat to the health of humans...

  18. Emerging health problems among women: Inactivity, obesity, and metabolic syndrome

    Directory of Open Access Journals (Sweden)

    Yi-Ju Tsai

    2014-02-01

    Full Text Available The increase in obesity and metabolic syndrome has been documented worldwide. However, few studies have investigated the risk of inactivity, obesity, and metabolic syndrome specifically in women. Hormone balance plays a crucial role in regulating metabolism and helps to maintain optimal health. It is likely that the sex difference in obesity may be due to the variation in hormone concentration throughout a woman's life, which predisposes them to weight gain. This paper reviews previous literature and discusses factors that influence the risk of adiposity-related health consequences among women for three critical biological transitions throughout a woman's life: puberty, menopause, and pregnancy. To improve quality of life and metabolic health for women, interventions are needed to target women at different transition stages and provide tailored health education programs. Interventions should raise awareness of physical inactivity, obesity, and metabolic syndrome, and promote healthy behavioral change in women.

  19. Implementation and integration of regional health care data networks in the Hellenic National Health Service.

    Science.gov (United States)

    Lampsas, Petros; Vidalis, Ioannis; Papanikolaou, Christos; Vagelatos, Aristides

    2002-12-01

    Modern health care is provided with close cooperation among many different institutions and professionals, using their specialized expertise in a common effort to deliver best-quality and, at the same time, cost-effective services. Within this context of the growing need for information exchange, the demand for realization of data networks interconnecting various health care institutions at a regional level, as well as a national level, has become a practical necessity. To present the technical solution that is under consideration for implementing and interconnecting regional health care data networks in the Hellenic National Health System. The most critical requirements for deploying such a regional health care data network were identified as: fast implementation, security, quality of service, availability, performance, and technical support. The solution proposed is the use of proper virtual private network technologies for implementing functionally-interconnected regional health care data networks. The regional health care data network is considered to be a critical infrastructure for further development and penetration of information and communication technologies in the Hellenic National Health System. Therefore, a technical approach was planned, in order to have a fast cost-effective implementation, conforming to certain specifications.

  20. Emerging sustainable/green cleaning products: health and environmental risks

    OpenAIRE

    Aydin, Mehmet Cihan; Işik, Ercan; Ulu, Ali Emre

    2016-01-01

    Sustainable development aims to bring a new perspective to our lives without compromising customer needs and quality. Along with sustainable development many innovative solutions came out. One of them is sustainable green cleaning products and techniques. Today, emissions from conventional cleaning products may cause severe health and environmental issues. Especially sick building syndromes such as eye, skin and respiratory irritations are main health effects of them. They may also contrib...

  1. Emerging uses of patient generated health data in clinical research.

    Science.gov (United States)

    Wood, William A; Bennett, Antonia V; Basch, Ethan

    2015-05-01

    Recent advancements in consumer directed personal computing technology have led to the generation of biomedically-relevant data streams with potential health applications. This has catalyzed international interest in Patient Generated Health Data (PGHD), defined as "health-related data - including health history, symptoms, biometric data, treatment history, lifestyle choices, and other information-created, recorded, gathered, or inferred by or from patients or their designees (i.e. care partners or those who assist them) to help address a health concern."(Shapiro et al., 2012) PGHD offers several opportunities to improve the efficiency and output of clinical trials, particularly within oncology. These range from using PGHD to understand mechanisms of action of therapeutic strategies, to understanding and predicting treatment-related toxicity, to designing interventions to improve adherence and clinical outcomes. To facilitate the optimal use of PGHD, methodological research around considerations related to feasibility, validation, measure selection, and modeling of PGHD streams is needed. With successful integration, PGHD can catalyze the application of "big data" to cancer clinical research, creating both "n of 1" and population-level observations, and generating new insights into the nature of health and disease. Copyright © 2014 Federation of European Biochemical Societies. Published by Elsevier B.V. All rights reserved.

  2. Air Quality and Heart Health: Managing an Emerging ...

    Science.gov (United States)

    Dr. Cascio will share with a broad range of federal agencies current understanding of the links between air quality and cardiovascular health. The key facts include that air pollution contributes a high attributable health burden. That certain well-defined vulnerable subpopulations are at higher risk. At-risk populations include those with heart disease, lung disease and diabetes, older adults, children and individuals living in low socioeconomic neighborhoods. There is no established threshold level for safe long-term exposure to air particle pollution, and some of the basic biological mechanisms that account for adverse health effects are now known. This knowledge is giving us insight into how we might mitigate the effects apart from the regulatory efforts to improve overall air quality. Moreover, the work that each State has done to improve air quality has resulted in improved health outcomes including cardiovascular outcomes, and longer lives. The presentation will address: 1) What do we know? 2) Who are the at-risk populations? 3) What can communities do to reduce risk? 4) What can healthcare professionals do to reduce risk of the at-risk population? And 5) What tools are available to help healthcare professionals and their patients reduce exposure and risk from air pollutants? The talk will feature a description of the Air Quality Index and associated EPA tools and health information that can be used by health care providers to educate their at-ris

  3. Health-related Culinary Education: A Summary of Representative Emerging Programs for Health Professionals and Patients.

    Science.gov (United States)

    Polak, Rani; Phillips, Edward M; Nordgren, Julia; La Puma, John; La Barba, Julie; Cucuzzella, Mark; Graham, Robert; Harlan, Timothy S; Burg, Tracey; Eisenberg, David

    2016-01-01

    Beneficial correlations are suggested between food preparation and home food preparation of healthy choices. Therefore, there is an emergence of culinary medicine (CM) programs directed at both patients and medical professionals which deliver education emphasizing skills such as shopping, food storage, and meal preparation. The goal of this article is to provide a description of emerging CM programs and to imagine how this field can mature. During April 2015, 10 CM programs were identified by surveying CM and lifestyle medicine leaders. Program directors completed a narrative describing their program's structure, curricula, educational design, modes of delivery, funding, and cost. Interviews were conducted in an effort to optimize data collection. All 10 culinary programs deliver medical education curricula educating 2654 health professionals per year. Educational goals vary within the domains of (1) provider's self-behavior, (2) nutritional knowledge and (3) prescribing nutrition. Six programs deliver patients' curricula, educating 4225 individuals per year. These programs' content varies and focuses on either specific diets or various culinary behaviors. All the programs' directors are health professionals who are also either credentialed chefs or have a strong culinary background. Nine of these programs offer culinary training in either a hands-on or visual demonstration within a teaching kitchen setting, while one delivers remote culinary tele-education. Seven programs track outcomes using various questionnaires and biometric data. There is currently no consensus about learning objectives, curricular domains, staffing, and facility requirements associated with CM, and there has been little research to explore its impact. A shared strategy is needed to collectively overcome these challenges.

  4. Health-related Culinary Education: A Summary of Representative Emerging Programs for Health Professionals and Patients

    Science.gov (United States)

    Phillips, Edward M.; Nordgren, Julia; La Puma, John; La Barba, Julie; Cucuzzella, Mark; Graham, Robert; Harlan, Timothy S.; Burg, Tracey; Eisenberg, David

    2016-01-01

    Background: Beneficial correlations are suggested between food preparation and home food preparation of healthy choices. Therefore, there is an emergence of culinary medicine (CM) programs directed at both patients and medical professionals which deliver education emphasizing skills such as shopping, food storage, and meal preparation. Objective: The goal of this article is to provide a description of emerging CM programs and to imagine how this field can mature. Methods: During April 2015, 10 CM programs were identified by surveying CM and lifestyle medicine leaders. Program directors completed a narrative describing their program's structure, curricula, educational design, modes of delivery, funding, and cost. Interviews were conducted in an effort to optimize data collection. Results: All 10 culinary programs deliver medical education curricula educating 2654 health professionals per year. Educational goals vary within the domains of (1) provider's self-behavior, (2) nutritional knowledge and (3) prescribing nutrition. Six programs deliver patients' curricula, educating 4225 individuals per year. These programs' content varies and focuses on either specific diets or various culinary behaviors. All the programs' directors are health professionals who are also either credentialed chefs or have a strong culinary background. Nine of these programs offer culinary training in either a hands-on or visual demonstration within a teaching kitchen setting, while one delivers remote culinary tele-education. Seven programs track outcomes using various questionnaires and biometric data. Conclusions: There is currently no consensus about learning objectives, curricular domains, staffing, and facility requirements associated with CM, and there has been little research to explore its impact. A shared strategy is needed to collectively overcome these challenges. PMID:26937315

  5. Addressing the gap between public health emergency planning and incident response

    OpenAIRE

    Freedman, Ariela M; Mindlin, Michele; Morley, Christopher; Griffin, Meghan; Wooten, Wilma; Miner, Kathleen

    2013-01-01

    Objectives: Since 9/11, Incident Command System (ICS) and Emergency Operations Center (EOC) are relatively new concepts to public health, which typically operates using less hierarchical and more collaborative approaches to organizing staff. This paper describes the 2009 H1N1 influenza outbreak in San Diego County to explore the use of ICS and EOC in public health emergency response. Methods:?This study was conducted using critical case study methodology consisting of document review and 18 k...

  6. Ebola: Emergency preparedness and perceived response of Malaysian health care providers.

    Science.gov (United States)

    Rajiah, Kingston; Maharajan, Mari Kannan; Binti Samsudin, Sarah Zakiah; Tan, Choo Lin; Tan Yen Pei, Adeline; Wong San Ying, Audrey

    2016-12-01

    We studied the emergency preparedness and perceived response for Ebola virus disease among various health care providers in Malaysia using a self-report questionnaire. Most of the health care providers felt that they were able to respond to Ebola virus disease and were aware of the level of preparedness needed during emergency. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  7. Is there a duty for private employers to provide emergency mental health care services?

    Science.gov (United States)

    Langlieb, Tammara F; Langlieb, Alan M; Everly, George S

    2006-01-01

    This article presents a discussion of whether employers in private companies have a duty to provide an emergency action plan with a mental health component for its employees. It discusses basic negligence concepts and focuses mainly on the "duty of care" component of negligence. It then applies the negligence concepts to private employers and discusses how private companies arguably might have a duty under the laws of negligence to provide employees with an emergency action plan, specifically a plan including mental health provisions.

  8. Geographic Access Modeling of Emergency Obstetric and Neonatal Care in Kigoma Region, Tanzania: Transportation Schemes and Programmatic Implications.

    Science.gov (United States)

    Chen, Yi No; Schmitz, Michelle M; Serbanescu, Florina; Dynes, Michelle M; Maro, Godson; Kramer, Michael R

    2017-09-27

    Access to transportation is vital to reducing the travel time to emergency obstetric and neonatal care (EmONC) for managing complications and preventing adverse maternal and neonatal outcomes. This study examines the distribution of travel times to EmONC in Kigoma Region, Tanzania, using various transportation schemes, to estimate the proportion of live births (a proxy indicator of women needing delivery care) with poor geographic access to EmONC services. The 2014 Reproductive Health Survey of Kigoma Region identified 4 primary means of transportation used to travel to health facilities: walking, cycling, motorcycle, and 4-wheeled motor vehicle. A raster-based travel time model was used to map the 2-hour travel time catchment for each mode of transportation. Live birth density distributions were aggregated by travel time catchments, and by administrative council, to estimate the proportion of births with poor access. Of all live births in Kigoma Region, 13% occurred in areas where women can reach EmONC facilities within 2 hours on foot, 33% in areas that can be reached within 2 hours only by motorized vehicles, and 32% where it is impossible to reach EmONC facilities within 2 hours. Over 50% of births in 3 of the 8 administrative councils had poor estimated access. In half the councils, births with poor access could be reduced to no higher than 12% if all female residents had access to motorized vehicles. Significant differences in geographic access to EmONC in Kigoma Region, Tanzania, were observed both by location and by primary transportation type. As most of the population may only have good EmONC access when using mechanized or motorized vehicles, bicycles and motorcycles should be incorporated into the health transportation strategy. Collaboration between private transportation sectors and obstetric service providers could improve access to EmONC services among most populations. In areas where residents may not access EmONC facilities within 2 hours

  9. Emergence of differentially regulated pathways associated with the development of regional specificity in chicken skin.

    Science.gov (United States)

    Chang, Kai-Wei; Huang, Nancy A; Liu, I-Hsuan; Wang, Yi-Hui; Wu, Ping; Tseng, Yen-Tzu; Hughes, Michael W; Jiang, Ting Xin; Tsai, Mong-Hsun; Chen, Chien-Yu; Oyang, Yen-Jen; Lin, En-Chung; Chuong, Cheng-Ming; Lin, Shau-Ping

    2015-01-23

    Regional specificity allows different skin regions to exhibit different characteristics, enabling complementary functions to make effective use of the integumentary surface. Chickens exhibit a high degree of regional specificity in the skin and can serve as a good model for when and how these regional differences begin to emerge. We used developing feather and scale regions in embryonic chickens as a model to gauge the differences in their molecular pathways. We employed cosine similarity analysis to identify the differentially regulated and co-regulated genes. We applied low cell techniques for expression validation and chromatin immunoprecipitation (ChIP)-based enhancer identification to overcome limited cell availabilities from embryonic chicken skin. We identified a specific set of genes demonstrating a high correlation as being differentially expressed during feather and scale development and maturation. Some members of the WNT, TGF-beta/BMP, and Notch family known to be involved in feathering skin differentiation were found to be differentially regulated. Interestingly, we also found genes along calcium channel pathways that are differentially regulated. From the analysis of differentially regulated pathways, we used calcium signaling pathways as an example for further verification. Some voltage-gated calcium channel subunits, particularly CACNA1D, are expressed spatio-temporally in the skin epithelium. These calcium signaling pathway members may be involved in developmental decisions, morphogenesis, or epithelial maturation. We further characterized enhancers associated with histone modifications, including H3K4me1, H3K27ac, and H3K27me3, near calcium channel-related genes and identified signature intensive hotspots that may be correlated with certain voltage-gated calcium channel genes. We demonstrated the applicability of cosine similarity analysis for identifying novel regulatory pathways that are differentially regulated during development. Our study

  10. An Emerging Wine Region in Nova Scotia, Canada: Terroir Trials and Tribulations

    Science.gov (United States)

    Cameron, B. I.; Ketter, B. S.; Karakis, S.

    2012-12-01

    Nova Scotia, strategically located on Canada's east coast, is an emerging wine region, whose distinctive wines are garnering international acclaim. Nova Scotia has a long and rich tradition of growing grapes for wine dating back as far as 1611. Nova Scotia's mesoclimates, glacial soils, and proximity to the Atlantic Ocean form a complex alliance to create a unique and expressive terroir. Tidal Bay is a new appellation wine for Nova Scotia stylistically defined as a fresh, crisp and high-acid blend of white grapes. There are four main wine-growing regions in Nova Scotia, all influenced by the warming effects of the Bay of Fundy and Atlantic Ocean: Malagash Peninsula, Annapolis Valley, Bear River Valley and the South Shore. Nova Scotia currently has 14 producing wineries with many more in the development stage. Nova Scotia grape growers not only have had success developing mature and consistent hybrids, but in recent years several vinifera have flourished in this cool climate area. The white hybrids include L'Acadie Blanc, New York Muscat, Seyval Blanc, and Vidal Blanc. The white vinifera include chardonnay, riesling, pinot gris, and sauvignon blanc. Red hybrids are Baco Noir, Leon Millet, Lucie Kuhlmann, and Marechal Foch, whereas the only red vinifera is pinot noir. Nova Scotia has nearly perfect climatic conditions for making world class icewines and sparkling wines. A preliminary GIS analysis of climate, topographic, geology and soil data helps to define Nova Scotia's terroir. Annual precipiatation varies from 10 to 21.6 cm/year with a vast majority of the wineries located in regions with the lowest rainfall. Daily average temperature ranges from 5.5 to 7.5°C, degree growing days above 5°C from 1382 to 1991, and mean August temperature from 15.6 to 19.3 °C. Wineries cluster in the warmest regions based on these temperature measures to assist grape ripening. Soils in these diverse wine regions can range from silty, sandy and clay loams to more gravel-rich sandy

  11. The role of the Swiss EIR Health Physics Division in the national and the Institute's radiological emergency organizations

    International Nuclear Information System (INIS)

    Nagel, E.; Brunner, H.

    1986-01-01

    Owing to the geographical concentration in Switzerland of the activities related to radioactivity (power plants, research, industry, transport) in a relatively small region between the Alps and the Rhine, it was a logical consequence to centralize the emergency organization for nuclear accidents in this area. Since 1984 the Swiss emergency organization has had an operational, well-equipped national emergency control centre. In the handling of radiation accidents the new organization can call on specialized laboratories and make use of experience and material from over the whole country. Of these facilities the Federal Institute for Reactor Research (EIR) is of major importance due to its activities and experience in research and radiation protection. Its Health Physics Division takes an active part in the emergency organization of the EIR itself. Both its well-equipped radioanalytical laboratory and trained personnel are at the disposal of the national emergency organization. Frequent training of the whole emergency organization and parts of it have improved preparedness. The evaluation of the exercises always reveals new problems to be solved in which rapid action and safe communications are of major importance. (author)

  12. Education and training of public health professionals in the European Region: variation and convergence.

    Science.gov (United States)

    Bjegovic-Mikanovic, Vesna; Vukovic, Dejana; Otok, Robert; Czabanowska, Katarzyna; Laaser, Ulrich

    2013-12-01

    To assess the exit competences of public health graduates across a diverse European landscape. The target population comprised 80 full institutional members of the Association of Schools of Public Health in the European Region with a participation rate 82.5 %. The web-based questionnaire covered institutional profiles and the ranking of exit competences for master of public health programmes, grouped according to WHO Essential Public Health Operations. European schools and departments usually are small units, funded from tax money. A total of 130 programmes have been indicated, together releasing 3,035 graduates in the last year before the survey. All competence groups showed high reliability and high internal consistency (α > 0.75, p teaching output has been assessed for health promotion, followed by disease prevention and identification of health hazards in the community, the least in emergency preparedness. Given the fragmentation of the institutional infrastructure, the harmonisation of programme content and thinking is impressive. However, the educational capacity in the European Region is far from being sufficient if compared to aspired US levels.

  13. Access to health services in Western Newfoundland, Canada: Issues, barriers and recommendations emerging from a community-engaged research project

    Directory of Open Access Journals (Sweden)

    Janelle Hippe

    2014-06-01

    Full Text Available Research indicates that people living in rural and remote areas of Canada face challenges to accessing health services. This article reports on a community-engaged research project conducted by investigators at Memorial University of Newfoundland in collaboration with the Rural Secretariat Regional Councils and Regional Partnership Planners for the Corner Brook–Rocky Harbour and Stephenville–Port aux Basques Rural Secretariat Regions of Newfoundland and Labrador. The aim of this research was to gather information on barriers to accessing health services, to identify solutions to health services’ access issues and to inform policy advice to government on enhancing access to health services. Data was collected through: (1 targeted distribution of a survey to communities throughout the region, and (2 informal ‘kitchen table’ discussions to discuss health services’ access issues. A total of 1049 surveys were collected and 10 kitchen table discussions were held. Overall, the main barriers to care listed in the survey included long wait times, services not available in the area and services not available at time required. Other barriers noted by survey respondents included transportation problems, financial concerns, no medical insurance coverage, distance to travel and weather conditions. Some respondents reported poorer access to maternal/child health and breast and cervical screening services and a lack of access to general practitioners, pharmacy services, dentists and nurse practitioners. Recommendations that emerged from this research included improving the recruitment of rural physicians, exploring the use of nurse practitioners, assisting individuals with travel costs,  developing specialist outreach services, increasing use of telehealth services and initiating additional rural and remote health research. Keywords: rural, remote, healthcare, health services, social determinants of health

  14. INCUBATORS AND GOVERNMENT POLICY FOR DEVELOPING IT INDUSTRY AND REGION IN EMERGING ECONOMIES

    Directory of Open Access Journals (Sweden)

    Nur Atiqah Abdullah

    2012-01-01

    Full Text Available Incubation, a concept supported by a variety of economic cluster theories, is a vital element in economic development in developed countries. The entrepreneurial businesses that they house often improve the developed economies in terms of not only jobs but also wealth creation. The question that this article embraces is as follows: "Do incubators play the same vital role in economic development in developing regions of the world?" We use the case study methodology to develop this query in a focus area of regional development in an emerging economy. We examine the implementation of three incubators located in designated cybercities. The cybercity concept is one of the Malaysian government's initiatives to encourage the development of the IT industry within the Multimedia Super Corridor (MSC Program. This study takes advantage of the 10-year development of cybercities by performing a longitudinal study. We found that these incubators did well in achieving their initial performance objectives, but they need to catch up with developed countries' continued rapid progress.

  15. Update on emerging regional techniques and novel local anesthetics in ambulatory anesthesia

    Directory of Open Access Journals (Sweden)

    Szafran MJ

    2015-12-01

    Full Text Available Martin J Szafran, Eldhose Abrahams, Tong Joo Gan Department of Anesthesiology, Stony Brook University, Stony Brook, NY, USA Abstract: New regional anesthetic techniques have been incorporated into the multimodal approach to postoperative analgesia. Blocks such as the transversus abdominis plane block, adductor canal block, and pectoral nerves blocks all show promise as potential tools used in opioid-sparing techniques, but at the same time have significant limitations to their utility. Novel long-acting formulations of local anesthetics further add to the possible benefit of these blocks, but their application to peripheral nerve blocks is currently being investigated and is not well defined. This review focuses on evaluating the relevant anatomy, technique, and indications of several newer peripheral nerve blocks, the emerging evidence supporting the use of liposomal bupivacaine and SABER®-Bupivacaine, and the application of both in ambulatory anesthesia. Keywords: transversus abdominis plane (TAP block, adductor canal block, pectoral nerves block, regional anesthesia, liposomal bupivacaine, SABER®-Bupivacaine

  16. Health Economics in Medical Nutrition: An Emerging Science.

    Science.gov (United States)

    Nuijten, Mark

    2015-01-01

    The objective of this paper is to describe the applications of health economic theory to medical nutrition. The published literature provides evidence that medical nutrition, e.g. oral nutritional supplements, is an effective treatment for patients with disease related malnutrition. Malnutrition is associated with mortality risk and complication rates, including infections. Malnutrition is not a new problem and with an ageing population it continues to become a major public health concern as increasing age is associated with an increased risk of malnutrition. This overview shows that in the case RCTs are providing the clinical evidence, there is no methodological difference between a cost-effectiveness analysis for pharmaceutical or nutrition. However, in nutrition the evidence may not always come from RCT data, but will be more often based on observational data. Therefore the clinical evidence of nutrition in itself is not the issue, but the handling of clinical evidence from observational studies. As the link between the consumption of a food product and a resulting health status is often more difficult to establish than the effect of a drug treatment it requires the further development of adapted methodologies in order to correctly predict the impact of food-related health effects and health economic outcomes from a broader perspective. © 2015 Nestec Ltd., Vevey/S. Karger AG, Basel.

  17. Childhood constipation as an emerging public health problem.

    Science.gov (United States)

    Rajindrajith, Shaman; Devanarayana, Niranga Manjuri; Crispus Perera, Bonaventure Jayasiri; Benninga, Marc Alexander

    2016-08-14

    Functional constipation (FC) is a significant health problem in children and contrary to common belief, has serious ramifications on the lives of children and their families. It is defined by the Rome criteria which encourage the use of multiple clinical features for diagnosis. FC in children has a high prevalence (0.7%-29%) worldwide, both in developed and developing countries. Biopsychosocial risk factors such as psychological stress, poor dietary habits, obesity and child maltreatment are commonly identified predisposing factors for FC. FC poses a significant healthcare burden on the already overstretched health budgets of many countries in terms of out-patient care, in-patient care, expenditure for investigations and prescriptions. Complications are common and range from minor psychological disturbances, to lower health-related quality of life. FC in children also has a significant impact on families. Many paediatric clinical trials have poor methodological quality, and drugs proved to be useful in adults, are not effective in relieving symptoms in children. A significant proportion of inadequately treated children have similar symptoms as adults. These factors show that constipation is an increasing public health problem across the world with a significant medical, social and economic impact. This article highlights the potential public health impact of FC and the possibility of overcoming this problem by concentrating on modifiable risk factors rather than expending resources on high cost investigations and therapeutic modalities.

  18. Occupational Safety and Health System for Workers Engaged in Emergency Response Operations in the USA.

    Science.gov (United States)

    Toyoda, Hiroyuki; Kubo, Tatsuhiko; Mori, Koji

    2016-12-03

    To study the occupational safety and health systems used for emergency response workers in the USA, we performed interviews with related federal agencies and conducted research on related studies. We visited the Federal Emergency Management Agency (FEMA) and National Institute for Occupational Safety and Health (NIOSH) in the USA and performed interviews with their managers on the agencies' roles in the national emergency response system. We also obtained information prepared for our visit from the USA's Occupational Safety and Health Administration (OSHA). In addition, we conducted research on related studies and information on the website of the agencies. We found that the USA had an established emergency response system based on their National Incident Management System (NIMS). This enabled several organizations to respond to emergencies cooperatively using a National Response Framework (NRF) that clarifies the roles and cooperative functions of each federal agency. The core system in NIMS was the Incident Command System (ICS), within which a Safety Officer was positioned as one of the command staff supporting the commander. All ICS staff were required to complete a training program specific to their position; in addition, the Safety Officer was required to have experience. The All-Hazards model was commonly used in the emergency response system. We found that FEMA coordinated support functions, and OSHA and NIOSH, which had specific functions to protect workers, worked cooperatively under NRF. These agencies employed certified industrial hygienists that play a professional role in safety and health. NIOSH recently executed support activities during disasters and other emergencies. The USA's emergency response system is characterized by functions that protect the lives and health of emergency response workers. Trained and experienced human resources support system effectiveness. The findings provided valuable information that could be used to improve the

  19. Access to In-Network Emergency Physicians and Emergency Departments Within Federally Qualified Health Plans in 2015

    Directory of Open Access Journals (Sweden)

    Stephen C. Dorner, MSc

    2016-01-01

    Full Text Available Introduction: Under regulations established by the Affordable Care Act, insurance plans must meet minimum standards in order to be sold through the federal Marketplace. These standards to become a qualified health plan (QHP include maintaining a provider network sufficient to assure access to services. However, the complexity of emergency physician (EP employment practices – in which the EPs frequently serve as independent contractors of emergency departments, independently establish insurance contracts, etc... – and regulations governing insurance repayment may hinder the application of network adequacy standards to emergency medicine. As such, we hypothesized the existence of QHPs without in-network access to EPs. The objective is to identify whether there are QHPs without in-network access to EPs using information available through the federal Marketplace and publicly available provider directories. Results: In a national sample of Marketplace plans, we found that one in five provider networks lacks identifiable in-network EPs. QHPs lacking EPs spanned nearly half (44% of the 34 states using the federal Marketplace. Conclusion: Our data suggest that the present regulatory framework governing network adequacy is not generalizable to emergency care, representing a missed opportunity to protect patient access to in-network physicians. These findings and the current regulations governing insurance payment to EPs dis-incentivize the creation of adequate physician networks, incentivize the practice of balance billing, and shift the cost burden to patients.

  20. What’s in a word? The framing of health at the regional level: ASEAN, EU, SADC and UNASUR

    Science.gov (United States)

    Amaya, Ana B; Rollet, Vincent; Kingah, Stephen

    2015-01-01

    The Association of Southeast Asian Nations, the European Union, the Southern African Development Community and the Union of South American Nations have increasingly been involved in health diplomacy in the past decade, yet little is known about how they frame health as a foreign policy issue and how this has an impact on their prioritisation of policies. For this, we conducted a review of existing grey and peer-reviewed literature that address regional integration and health, as well as a documentary review according to security, development, trade, human rights, moral/ethical reasonings and global public goods frames identified in the literature. The policy frames identified responded to the challenges these regions currently face. The Association of Southeast Asian Nation’s struggle with re-emerging diseases has led to favouring a securitisation approach to health, the European Union approaches health as a cross-cutting policy issue, the Southern African Development Community presents health as a driver for development, and while the Union of South American Nations emphasises health as a human right and addresses the social determinants of health as an ethical imperative. Overall, these policy frames were useful in analysing the framing of health in foreign policy at the regional level. However, within our analysis, we identified a new frame that approaches health as an intersectoral issue. The impact of regional organisations’ forward will depend on their ability to harness their convening power and speak in a coherent voice on health matters. PMID:26635496

  1. What's in a word? The framing of health at the regional level: ASEAN, EU, SADC and UNASUR.

    Science.gov (United States)

    Amaya, Ana B; Rollet, Vincent; Kingah, Stephen

    2015-12-01

    The Association of Southeast Asian Nations, the European Union, the Southern African Development Community and the Union of South American Nations have increasingly been involved in health diplomacy in the past decade, yet little is known about how they frame health as a foreign policy issue and how this has an impact on their prioritisation of policies. For this, we conducted a review of existing grey and peer-reviewed literature that address regional integration and health, as well as a documentary review according to security, development, trade, human rights, moral/ethical reasonings and global public goods frames identified in the literature. The policy frames identified responded to the challenges these regions currently face. The Association of Southeast Asian Nation's struggle with re-emerging diseases has led to favouring a securitisation approach to health, the European Union approaches health as a cross-cutting policy issue, the Southern African Development Community presents health as a driver for development, and while the Union of South American Nations emphasises health as a human right and addresses the social determinants of health as an ethical imperative. Overall, these policy frames were useful in analysing the framing of health in foreign policy at the regional level. However, within our analysis, we identified a new frame that approaches health as an intersectoral issue. The impact of regional organisations' forward will depend on their ability to harness their convening power and speak in a coherent voice on health matters.

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

    Science.gov (United States)

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

    2016-11-01

    following an ED visit. The block of enabling factors was the strongest predictor of hospitalization following an ED visit compared to predisposing and need factors. Our findings also provide evidence of disparities in hospitalization of the uninsured and racial and ethnic minority patients with ED visits for behavioral health conditions. Thus, improved access to community-based behavioral health services and an increased capacity for inpatient psychiatric hospitals for treating indigent patients may be needed to improve the efficiency of ED services in our region for patients with behavioral health conditions. Among need factors, a discharge diagnosis of schizophrenia/psychotic spectrum disorder, an affective disorder, a personality disorder, an impulse control disorder, or dementia as well as secondary diagnoses of suicidal ideation and/or suicidal behavior increased the likelihood of hospitalization following an ED visit, also suggesting an opportunity for improving the efficiency of ED care through the provision of psychiatric services to stabilize and treat patients with serious mental illness. © 2016 by the Society for Academic Emergency Medicine.

  3. Report on Health Manpower and Programs in Ohio: Part Two. Allied Health, Area Health Education Centers, Dentistry, Emergency Medical Services, Nursing, Optometry, Pharmacy, Podiatry, and Veterinary Medicine.

    Science.gov (United States)

    Ohio Board of Regents, Columbus.

    Information on health occupations educational programs in Ohio and current and projected employment needs for health professionals are presented. The following health fields are examined: allied health, dentistry, emergency medical service, nursing, optometry, pharmacy, podiatry, and veterinary medicine. Issues and trends affecting each field are…

  4. 'Mind the gap!' rethinking the role of health in the emergency and development divide.

    Science.gov (United States)

    O'Dempsey, Tim; Munslow, Barry

    2009-10-01

    The 'Emergency Relief-Rehabilitation-Development' model is highly problematic, especially in fragile states which fluctuate in and out of crisis. Lack of definition as to what constitutes a humanitarian emergency and the absence of rules of engagement of NGOs and donors further complicates the problem. Restricted mandates and budgets of institutions and funding bodies lead to gaps in the provision of health services for affected populations. Reducing the gap between emergency and developmental healthcare requires approaching the issue from both sides, recognizing that the emergency-development gap is not a single uniform entity but a complex dynamic of heterogeneous gaps. Copyright (c) 2009 John Wiley & Sons, Ltd.

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

    Science.gov (United States)

    Ben-Assuli, Ofir; Leshno, Moshe

    2016-09-01

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

  6. Emergency management in health: key issues and challenges in the UK.

    Science.gov (United States)

    Lee, Andrew C K; Phillips, Wendy; Challen, Kirsty; Goodacre, Steve

    2012-10-19

    Emergency planning in the UK has grown considerably in recent years, galvanised by the threat of terrorism. However, deficiencies in NHS emergency planning were identified and the evidence-base that underpins it is questionable. Inconsistencies in terminologies and concepts also exist. Different models of emergency management exist internationally but the optimal system is unknown. This study examines the evidence-base and evidence requirements for emergency planning in the UK health context. The study involved semi-structured interviews with key stakeholders and opinion leaders. Purposive sampling was used to obtain a breadth of views from various agencies involved in emergency planning and response. Interviews were then analysed using a grounded approach using standard framework analysis techniques. We conducted 17 key informant interviews. Interviewees identified greater gaps in operational than technical aspects of emergency planning. Social and behavioural knowledge gaps were highlighted with regards to how individuals and organisations deal with risk and behave in emergencies. Evidence-based approaches to public engagement and for developing community resilience to disasters are lacking. Other gaps included how knowledge was developed and used. Conflicting views with regards to the optimal configuration and operation of the emergency management system were voiced. Four thematic categories for future research emerged:(i) Knowledge-base for emergency management: Further exploration is needed of how knowledge is acquired, valued, disseminated, adopted and retained.(ii) Social and behavioural issues: Greater understanding of how individuals approach risk and behave in emergencies is required.(iii) Organisational issues in emergencies: Several conflicting organisational issues were identified; value of planning versus plans, flexible versus standardized procedures, top-down versus bottom-up engagement, generic versus specific planning, and reactive versus

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

    Science.gov (United States)

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

    2017-04-28

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

  8. Production of Stone Spades and Emergence of the First State in the Yiluo region, China

    Directory of Open Access Journals (Sweden)

    Li Liu

    2009-09-01

    Full Text Available social changes during the Bronze Age (c. 2000-200 BC. This is a heartland of Chinese civilisation, as the earliest state emerged at the Erlitou site (c. 1900-1500 BC in the centre of the Yiluo basin. Our Yiluo archaeology project, initiated in 1997, is a long-term internationally collaborative and interdisciplinary programme, which holds a key position in the quest for the origins of early states in China. We have employed a number of methods and approaches to investigate many aspects relating to social change in the region. The full-coverage regional survey has helped us to reveal settlement patterns, and identify important regional centres, some of which were craft production sites. Spades were utilitarian in function and may have been primarily used by commoners for agricultural or other purposes. However, the sources of raw material were not widely available to every village, and some communities/social groups may have taken advantage of their settlement locations to control access to the raw material. Based on our research, production of stone tools most likely operated on a household basis, and the products were not only meant to fulfil the subsistence needs of makers and their neighbours, but also helped some individuals to gain higher social status and wealth through trade. The fact that dolomite spades found their way up to 100km away from their place of manufacture indicates the existence of region-wide trade networks in the Erlitou hinterland. Through these networks, not only utilitarian items but also elite goods (e.g., white pottery drinking vessels, were circulated, suggesting that lesser elite and commoners in the Erlitou hinterland created their own opportunities in the competition for power, prestige and wealth. From this perspective, the social formation of early states in China was not only hierarchical (Liu and Chen 2003, but heterarchical at a regional level. Stonemasons at Huizui were most likely independent craftsmen, whom

  9. Major emerging vector-borne zoonotic diseases of public health importance in Canada.

    Science.gov (United States)

    Kulkarni, Manisha A; Berrang-Ford, Lea; Buck, Peter A; Drebot, Michael A; Lindsay, L Robbin; Ogden, Nicholas H

    2015-06-10

    In Canada, the emergence of vector-borne diseases may occur via international movement and subsequent establishment of vectors and pathogens, or via northward spread from endemic areas in the USA. Re-emergence of endemic vector-borne diseases may occur due to climate-driven changes to their geographic range and ecology. Lyme disease, West Nile virus (WNV), and other vector-borne diseases were identified as priority emerging non-enteric zoonoses in Canada in a prioritization exercise conducted by public health stakeholders in 2013. We review and present the state of knowledge on the public health importance of these high priority emerging vector-borne diseases in Canada. Lyme disease is emerging in Canada due to range expansion of the tick vector, which also signals concern for the emergence of human granulocytic anaplasmosis, babesiosis, and Powassan virus. WNV has been established in Canada since 2001, with epidemics of varying intensity in following years linked to climatic drivers. Eastern equine encephalitis virus, Jamestown Canyon virus, snowshoe hare virus, and Cache Valley virus are other mosquito-borne viruses endemic to Canada with the potential for human health impact. Increased surveillance for emerging pathogens and vectors and coordinated efforts among sectors and jurisdictions will aid in early detection and timely public health response.

  10. Rigorous Clinical Trial Design in Public Health Emergencies Is Essential

    DEFF Research Database (Denmark)

    Ellenberg, Susan S; Keusch, Gerald T; Babiker, Abdel G

    2018-01-01

    Randomized clinical trials are the most reliable approaches to evaluating the effects of new treatments and vaccines. During the 2014-15 West African Ebola epidemic, many argued that such trials were neither ethical nor feasible in an environment of limited health infrastructure and severe disease...

  11. Motorcycle injuries as an emerging public health problem in ...

    African Journals Online (AJOL)

    Key words: motorcycle injuries; prevalence, treatment outcome, injury pattern, Tanzania .... Data was analyzed using SPSS computer software version 11.5. ... the Weill Bugando University College of Health Sciences/Bugando Medical Centre ..... to helmet use include impaired rider vision, attenuation of critical traffic sounds, ...

  12. Childhood constipation as an emerging public health problem

    NARCIS (Netherlands)

    Rajindrajith, Shaman; Devanarayana, Niranga Manjuri; Crispus Perera, Bonaventure Jayasiri; Benninga, Marc Alexander

    2016-01-01

    Functional constipation (FC) is a significant health problem in children and contrary to common belief, has serious ramifications on the lives of children and their families. It is defined by the Rome criteria which encourage the use of multiple clinical features for diagnosis. FC in children has a

  13. EcoHealth Student: Emerging Researcher Awards encourages ...

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

    2011-05-10

    May 10, 2011 ... ... who were paired with EcoHealth board members or journal editors to score ... Students' work was evaluated based on its contribution to science and ecohealth. ... Through her previous epidemiological and medical research, and ... Her research findings have been surprising and run counter to global ...

  14. STREET KETAMINE-ASSOCIATED BLADDER DYSFUNCTION: AN EMERGING HEALTH PROBLEM

    Directory of Open Access Journals (Sweden)

    TEH GC

    2009-08-01

    Full Text Available Introduction: Ketamine is frequently abused nowadays as a recreational drug. Case reports are emerging since 2007 to describe a new clinical entity of severe bladder dysfunction associated with chronic abuse of street ketamine. Clinical presentation: Severe lower urinary tract symptoms of urinary frequency and urgency which are refractory to conventional treatment. Quality of life is adversely affected as a consequence. Chronic kidney disease will develop in advanced cases. Investigation findings: The urine is sterile on culture. Ultrasound will show reduced bladder capacity with thickened bladder wall. In advanced stage, hydronephrosis and renal impairment will develop. Treatment: Patients should be advised to stop street ketamine use immediately. Anticholinergic medication could be tried to alleviate the symptoms. Refractory cases with dilatation of the upper urinary tract might need urinary diversion. Conclusion: Awareness of this new condition is essential in diagnosis. Early intervention offers better treatment outcome.

  15. Robustness in practice--the regional planning of health services.

    Science.gov (United States)

    Best, G; Parston, G; Rosenhead, J

    1986-05-01

    Earlier work has criticized the dominant tendencies in operational research contributions to health services planning as characterized by optimization, implausible demands for data, depoliticization, hierarchy and inflexibility. This paper describes an effort which avoids at least some of these pitfalls. The project was to construct a planning system for a regional health council in Ontario, Canada, which would take account of the possible alternative future states of the health-care system's environment and would aim to keep options for future development open. The planning system devised is described in the paper. It is based on robustness analysis, which evaluates alternative initial action sets in terms of the useful flexibility they preserve. Other features include the explicit incorporation of pressures for change generated outside the health-care system, and a satisficing approach to the identification of both initial action sets and alternative future configurations of the health-care system. It was found possible to borrow and radically 're-use' techniques or formulations from the mainstream of O.R. contributions. Thus the 'reference projection' method was used to identify inadequacies in performance which future health-care system configurations must repair. And Delphi analysis, normally a method for generating consensus, was used in conjunction with cluster analysis of responses to generate meaningfully different alternative futures.

  16. The economic role of the Emergency Department in the health care continuum: applying Michael Porter's five forces model to Emergency Medicine.

    Science.gov (United States)

    Pines, Jesse M

    2006-05-01

    Emergency Medicine plays a vital role in the health care continuum in the United States. Michael Porters' five forces model of industry analysis provides an insight into the economics of emergency care by showing how the forces of supplier power, buyer power, threat of substitution, barriers to entry, and internal rivalry affect Emergency Medicine. Illustrating these relationships provides a view into the complexities of the emergency care industry and offers opportunities for Emergency Departments, groups of physicians, and the individual emergency physician to maximize the relationship with other market players.

  17. Health transition in Brazil: regional variations and divergence/convergence in mortality.

    Science.gov (United States)

    Borges, Gabriel Mendes

    2017-08-21

    This study analyzes the main characteristics of the health transition in Brazil and its five major regions, using a framework that accounts for regional inequalities in mortality trends. The regional mortality divergence/convergence process is described and discussed by considering the specific contributions of age groups and causes of death in life expectancy variations. Results show that mortality change in Brazil has follow the epidemiologic transition theory to some extent during the period under analysis - for instance, the sharp decline in infant mortality in all regions (first from infectious and parasitic diseases and then from causes associated with the perinatal period) and the increase in the participation of chronic and degenerative diseases as the main cause of death. However, some features of Brazilian transition have not followed the linear and unidirectional pattern proposed by the epidemiologic transition theory, which helps to understand the periods of regional divergence in life expectancy, despite the long-term trends showing reducing regional inequalities. The emergence of HIV/AIDS, the persistence of relatively high levels of other infections and parasitic diseases, the regional differences in the unexpected mortality improvements from cardiovascular diseases, and the rapid and strong variations in mortality from external causes are some of the examples.

  18. Emerging mHealth and eHealth interventions for serious mental illness: a review of the literature.

    Science.gov (United States)

    Naslund, John A; Marsch, Lisa A; McHugo, Gregory J; Bartels, Stephen J

    2015-01-01

    Serious mental illness (SMI) is one of the leading causes of disability worldwide. Emerging mobile health (mHealth) and eHealth interventions may afford opportunities for reaching this at-risk group. To review the evidence on using emerging mHealth and eHealth technologies among people with SMI. We searched MEDLINE, PsychINFO, CINAHL, Scopus, Cochrane Central, and Web of Science through July 2014. Only studies which reported outcomes for mHealth or eHealth interventions, defined as remotely delivered using mobile, online, or other devices, targeting people with schizophrenia, schizoaffective disorder, or bipolar disorder, were included. Forty-six studies spanning 12 countries were included. Interventions were grouped into four categories: (1) illness self-management and relapse prevention; (2) promoting adherence to medications and/or treatment; (3) psychoeducation, supporting recovery, and promoting health and wellness; and (4) symptom monitoring. The interventions were consistently found to be highly feasible and acceptable, though clinical outcomes were variable but offered insight regarding potential effectiveness. Our findings confirm the feasibility and acceptability of emerging mHealth and eHealth interventions among people with SMI; however, it is not possible to draw conclusions regarding effectiveness. Further rigorous investigation is warranted to establish effectiveness and cost benefit in this population.

  19. The One Plan Project: A cooperative effort of the National Response Team and the Region 6 Regional Response Team to simplify facility emergency response planning

    International Nuclear Information System (INIS)

    Staves, J.; McCormick, K.

    1997-01-01

    The National Response Team (NRT) in coordination with the Region 6 Response Team (RRT) have developed a facility contingency plan format which would integrate all existing regulatory requirements for contingency planning. This format was developed by a multi-agency team, chaired by the USEPA Region 6, in conjunction with various industry, labor, and public interest groups. The impetus for this project came through the USEPA Office of Chemical Emergency Preparedness and Prevention (CEPPO). The current national oil and hazardous material emergency preparedness and response system is an amalgam of federal, state, local, and industrial programs which are often poorly coordinated. In a cooperative effort with the NRT, the CEPPO conducted a Presidential Review of federal agency authorities and coordination responsibilities regarding release prevention, mitigation, and response. Review recommendations led to a Pilot Project in USEPA Region 6. The Region 6 Pilot Project targeted end users in the intensely industrialized Houston Ship Channel (HSC) area, which is comprised of petroleum and petrochemical companies

  20. [Lateral hostilities among emergency and critical care nurses. Survey in five hospitals of the Tuscany Region].

    Science.gov (United States)

    Bambi, Stefano; Becattini, Giovanni; Pronti, Fabio; Lumini, Enrico; Rasero, Laura

    2013-01-01

    Lateral hostilities among emergency and critical care nurses. Survey in five hospitals of Tuscany Region. Introduction. Lateral hostilities (LHs) are a kind of workplace violence. They are defined as varieties of cruel, rude, antagonistic interactions between people at the same hierarchical level. Nurses are affected by LH from 5.7% to 65%, leading to reduced work motivation, psycho-physical disorders, and in some cases, drop out of the nursing profession. Objective. To quantify the LHs among nurses in the emergency departments (ED) and intensive care units (ICU) in 5 hospitals of Tuscany (Italy). To show the impact on the quality of their psycho-physical and professional lives. Method. Exploratory-descriptive study, through closed-ended questionnaire. Results. 360/444 nurses (81%); 294 (81.6%) were victims of LHs during the past 12 months. Gossiping, complaints shared with others without discussing with the concerned person, and sarcastic comments were the most reported LHs. LHs occur more in EDs than ICUs (respectively 90% and 77%; p=0.0038). No statistically significant differences were observed for gender, age, or years of experience. The 17.7% of nurses asked to be moved from the ward, and 6.9% left it; 6.9% respondents had thought to leave the nursing profession; 235 (65.2%) experienced at least one LHs related disorder during the last year. Most reported symptoms were low morale, anxiety, and sleep disturbances. Conclusions. The incidence of LH and related disorders is high in EDs and ICUs, determining a low professional and psycho-physical quality of life.

  1. The Pediatric Emergency Care Applied Research Network Registry: A Multicenter Electronic Health Record Registry of Pediatric Emergency Care.

    Science.gov (United States)

    Deakyne Davies, Sara J; Grundmeier, Robert W; Campos, Diego A; Hayes, Katie L; Bell, Jamie; Alessandrini, Evaline A; Bajaj, Lalit; Chamberlain, James M; Gorelick, Marc H; Enriquez, Rene; Casper, T Charles; Scheid, Beth; Kittick, Marlena; Dean, J Michael; Alpern, Elizabeth R

    2018-04-01

     Electronic health record (EHR)-based registries allow for robust data to be derived directly from the patient clinical record and can provide important information about processes of care delivery and patient health outcomes.  A data dictionary, and subsequent data model, were developed describing EHR data sources to include all processes of care within the emergency department (ED). ED visit data were deidentified and XML files were created and submitted to a central data coordinating center for inclusion in the registry. Automated data quality control occurred prior to submission through an application created for this project. Data quality reports were created for manual data quality review.  The Pediatric Emergency Care Applied Research Network (PECARN) Registry, representing four hospital systems and seven EDs, demonstrates that ED data from disparate health systems and EHR vendors can be harmonized for use in a single registry with a common data model. The current PECARN Registry represents data from 2,019,461 pediatric ED visits, 894,503 distinct patients, more than 12.5 million narrative reports, and 12,469,754 laboratory tests and continues to accrue data monthly.  The Registry is a robust harmonized clinical registry that includes data from diverse patients, sites, and EHR vendors derived via data extraction, deidentification, and secure submission to a central data coordinating center. The data provided may be used for benchmarking, clinical quality improvement, and comparative effectiveness research. Schattauer.

  2. Antimicrobial resistance: A global emerging threat to public health systems.

    Science.gov (United States)

    Ferri, Maurizio; Ranucci, Elena; Romagnoli, Paola; Giaccone, Valerio

    2017-09-02

    Antimicrobial resistance (AMR) became in the last two decades a global threat to public health systems in the world. Since the antibiotic era, with the discovery of the first antibiotics that provided consistent health benefits to human medicine, the misuse and abuse of antimicrobials in veterinary and human medicine have accelerated the growing worldwide phenomenon of AMR. This article presents an extensive overview of the epidemiology of AMR, with a focus on the link between food producing-animals and humans and on the legal framework and policies currently implemented at the EU level and globally. The ways of responding to the AMR challenges foresee an array of measures that include: designing more effective preventive measures at farm level to reduce the use of antimicrobials; development of novel antimicrobials; strengthening of AMR surveillance system in animal and human populations; better knowledge of the ecology of resistant bacteria and resistant genes; increased awareness of stakeholders on the prudent use of antibiotics in animal productions and clinical arena; and the public health and environmental consequences of AMR. Based on the global nature of AMR and considering that bacterial resistance does not recognize barriers and can spread to people and the environment, the article ends with specific recommendations structured around a holistic approach and targeted to different stakeholders.

  3. [Evaluation of new and emerging health technologies. Proposal for classification].

    Science.gov (United States)

    Prados-Torres, J D; Vidal-España, F; Barnestein-Fonseca, P; Gallo-García, C; Irastorza-Aldasoro, A; Leiva-Fernández, F

    2011-01-01

    Review and develop a proposal for the classification of health technologies (HT) evaluated by the Health Technology Assessment Agencies (HTAA). Peer review of AETS of the previous proposed classification of HT. Analysis of their input and suggestions for amendments. Construction of a new classification. Pilot study with physicians. Andalusian Public Health System. Spanish HTAA. Experts from HTAA. Tutors of family medicine residents. HT Update classification previously made by the research team. Peer review by Spanish HTAA. Qualitative and quantitative analysis of responses. Construction of a new and pilot study based on 12 evaluation reports of the HTAA. We obtained 11 thematic categories that are classified into 6 major head groups: 1, prevention technology; 2, diagnostic technology; 3, therapeutic technologies; 4, diagnostic and therapeutic technologies; 5, organizational technology, and 6, knowledge management and quality of care. In the pilot there was a good concordance in the classification of 8 of the 12 reports reviewed by physicians. Experts agree on 11 thematic categories of HT. A new classification of HT with double entry (Nature and purpose of HT) is proposed. APPLICABILITY: According to experts, the classification of the work of the HTAA may represent a useful tool to transfer and manage knowledge. Moreover, an adequate classification of the HTAA reports would help clinicians and other potential users to locate them and this can facilitate their dissemination. Copyright © 2010 SECA. Published by Elsevier Espana. All rights reserved.

  4. [Current situation of pediatric emergency in tertiary and teaching hospitals in 15 provinces, municipalities and autonomous regions in China Mainland].

    Science.gov (United States)

    2014-12-01

    Pre-hospital care, emergency department and critical care medicine are the key components of emergency medical service system. Two investigations about the pediatric critical care medicine in China mainland showed great progress. In recent years, most hospitals in China mainland have established emergency department, hardware configuration and staff status were gradually standardized. But most of the emergency departments mainly provide service to adult patients and pediatric emergency medicine lags behind. The purpose of this investigation was to understand the current situation and main problems of pediatric emergency in China mainland. A questionnaire developed by the Subspecialty Group of Pediatrics, Chinese Society of Emergency Medicine and the Subspecialty Group of Emergency Medicine, Chinese Society of Pediatrics was e-mailed to the members of the above-mentioned two subspecialty groups. The contents of the questionnaire included 46 items which were divided into 5 categories: the general situation of the hospital, the pediatric emergency setting and composition, key equipments and techniques, staff status, training program and running data from 2011 to 2012. Sixty-three questionnaires were delivered and 27 (42.9%) hospitals responded which located in 15 different provinces, municipalities and autonomous regions. Among the 27 hospitals, 10 (37.0%) had no pediatric resuscitation room; 25 (92.6%) had no equipments for cardiac output monitor and gastric lavage; 13 (48.1%) had no bedside fibrolaryngoscope or fiberbronchoscope; 5 (18.5%) had no blood gas analyzer; 4 (14.8%) without respirator, defibrillator, bedside radiography or ultrasonic equipment; 2 (7.4%) had no neonatal incubator; 9 (33.3%) could not do intraossous infusion. The average ratio of professional emergency pediatricians to all physicians was 43.5%. Twenty hospitals incompletely filled in the pediatric emergency running data. The main problems existing in pediatric emergency include: imperfect

  5. Ministry of Health and regional health agency measures for medical imaging

    International Nuclear Information System (INIS)

    Podeur, Annie

    2011-01-01

    The issues in imaging are the appropriate use of equipment and optimising the organisation of imaging facilities, through a pooling of medical resources. The Ministry responsible for health has confirmed its desire to increase the number of MRI devices in order to better address patient needs in compliance with best practices, especially in dealing with strokes and cancers. The primary need is to reinforce radiation protection, essentially with regard to children. The steps taken are designed to speed up the replacement of irradiating techniques. According to the SROS-PRS (regional health care organisation scheme - regional health care project), the ARS (regional health agencies) are required to mobilize all resources in order to meet the national objectives for improving access to imaging and reducing disparities in access and efficiency. It is up to the ARS to define the territorial distribution of supply, with appropriate gradation of imaging facilities, in particular to ensure a permanent supply of care. (author)

  6. Emerging Adults' Stress and Health: The Role of Parent Behaviors and Cognitions

    Science.gov (United States)

    Donnelly, Reesa; Renk, Kimberly; McKinney, Cliff

    2013-01-01

    Although parent behaviors and cognitions are important for stress/health outcomes throughout development, little research examines whether cognitions mediate the relationship between parent behaviors and stress/health outcomes. As a result, the current study examined the reports of 160 emerging adults regarding their mothers' and fathers'…

  7. Hurricane Hugo: Emergency Preparedness Planning and Response for Mental Health Services.

    Science.gov (United States)

    Carter, Nancy C.; And Others

    This report describes how, in the aftermath of Hurricane Hugo, the South Carolina Department of Mental Health activated its Emergency Preparedness Plan to assist mental health centers and their staff in providing crisis counseling services to the general public. The first section explains the history and structure of the involvement by the…

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

    Science.gov (United States)

    Gustavsson, Maria; Ekberg, Kerstin

    2015-01-01

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

  9. Happy but unhealthy: The relationship between social ties and health in an emerging network.

    NARCIS (Netherlands)

    Howell, Jennifer L.; Koudenburg, Namkje; Loschelder, David D.; Weston, Dale; Fransen, Katrien; De Dominices, Stefano; Gallagher, Stephen; Haslam, S. Alexander

    2014-01-01

    Social connections are essential to health and well-being. However, when pursing social acceptance, people may sometimes engage in behavior that is detrimental to their health. Using a multi-time-point design, we examined whether the structure of an emerging network of students in an academic summer

  10. 78 FR 24153 - Notice of Emergency Approval of an Information Collection; National Animal Health Monitoring...

    Science.gov (United States)

    2013-04-24

    ...In accordance with the Paperwork Reduction Act of 1995, this notice announces that the Animal and Plant Health Inspection Service has requested and received emergency approval of an information collection for a National Animal Health Monitoring System Equine Herpesvirus Myeloencephalopathy Study to support the equine industry in the United States.

  11. Mental Health Literacy in Emerging Adults in a University Setting: Distinctions between Symptom Awareness and Appraisal

    Science.gov (United States)

    Gagnon, Michelle M.; Gelinas, Bethany L.; Friesen, Lindsay N.

    2017-01-01

    Despite the high prevalence of mental health concerns in university populations, students are unlikely to seek formal help. The current study examined help-seeking behaviors among emerging adults in a university setting using a mental health literacy framework. Responses from 122 university undergraduates were examined. Students ranged in age from…

  12. Research into Australian emergency services personnel mental health and wellbeing: An evidence map.

    Science.gov (United States)

    Varker, Tracey; Metcalf, Olivia; Forbes, David; Chisolm, Katherine; Harvey, Sam; Van Hooff, Miranda; McFarlane, Alexander; Bryant, Richard; Phelps, Andrea J

    2018-02-01

    Evidence maps are a method of systematically characterising the range of research activity in broad topic areas and are a tool for guiding research priorities. 'Evidence-mapping' methodology was used to quantify the nature and distribution of recent peer-reviewed research into the mental health and wellbeing of Australian emergency services personnel. A search of the PsycINFO, EMBASE and Cochrane Library databases was performed for primary research articles that were published between January 2011 and July 2016. In all, 43 studies of primary research were identified and mapped. The majority of the research focused on organisational and individual/social factors and how they relate to mental health problems/wellbeing. There were several areas of research where very few studies were detected through the mapping process, including suicide, personality, stigma and pre-employment factors that may contribute to mental health outcomes and the use of e-health. No studies were detected which examined the prevalence of self-harm and/or harm to others, bullying, alcohol/substance use, barriers to care or experience of families of emergency services personnel. In addition, there was no comprehensive national study that had investigated all sectors of emergency services personnel. This evidence map highlights the need for future research to address the current gaps in mental health and wellbeing research among Australian emergency services personnel. Improved understanding of the mental health and wellbeing of emergency services personnel, and the factors that contribute, should guide organisations' wellbeing policies and procedures.

  13. EMERGENCE OF GRANULAR-SIZED MAGNETIC BUBBLES THROUGH THE SOLAR ATMOSPHERE. III. THE PATH TO THE TRANSITION REGION

    Energy Technology Data Exchange (ETDEWEB)

    Ortiz, Ada; Hansteen, Viggo H.; Pontieu, Bart De; Carlsson, Mats; Voort, Luc Rouppe van der [Institute of Theoretical Astrophysics, University of Oslo, P.O. Box 1029 Blindern, NO-0315 Oslo (Norway); Rubio, Luis Ramón Bellot [Instituto de Astrofísica de Andalucía (CSIC), Apdo. 3040, E-18080 Granada (Spain); Rodríguez, Jaime de la Cruz, E-mail: ada@astro.uio.no [Institute for Solar Physics, Dept. of Astronomy, Stockholm University, Albanova University Center, SE-10691 Stockholm (Sweden)

    2016-07-10

    We study, for the first time, the ascent of granular-sized magnetic bubbles from the solar photosphere through the chromosphere into the transition region and above. Such events occurred in a flux emerging region in NOAA 11850 on 2013 September 25. During that time, the first co-observing campaign between the Swedish 1-m Solar Telescope (SST) and the Interface Region Imaging Spectrograph (IRIS) spacecraft was carried out. Simultaneous observations of the chromospheric H α 656.28 nm and Ca ii 854.2 nm lines, plus the photospheric Fe i 630.25 nm line, were made with the CRISP spectropolarimeter at the Spitzer Space Telescope ( SST ) reaching a spatial resolution of 0.″14. At the same time, IRIS was performing a four-step dense raster of the emerging flux region, taking slit jaw images at 133 (C ii, transition region), 140 (Si iv, transition region), 279.6 (Mg ii k, core, upper chromosphere), and 283.2 nm (Mg ii k, wing, photosphere). Spectroscopy of several lines was performed by the IRIS spectrograph in the far- and near-ultraviolet, of which we have used the Si iv 140.3 and the Mg ii k 279.6 nm lines. Coronal images from the Atmospheric Imaging Assembly of the Solar Dynamics Observatory were used to investigate the possible coronal signatures of the flux emergence events. The photospheric and chromospheric properties of small-scale emerging magnetic bubbles have been described in detail in Ortiz et al. Here we are able to follow such structures up to the transition region. We describe the properties, including temporal delays, of the observed flux emergence in all layers. We believe this may be an important mechanism of transporting energy and magnetic flux from subsurface layers to the transition region and corona.

  14. Partially wrong? Partial equilibrium and the economic analysis of public health emergencies of international concern.

    Science.gov (United States)

    Beutels, P; Edmunds, W J; Smith, R D

    2008-11-01

    We argue that traditional health economic analysis is ill-equipped to estimate the cost effectiveness and cost benefit of interventions that aim at controlling and/or preventing public health emergencies of international concern (such as pandemic influenza or severe acute respiratory syndrome). The implicit assumption of partial equilibrium within both the health sector itself and--if a wider perspective is adopted--the economy as a whole would be violated by such emergencies. We propose an alternative, with the specific aim of accounting for the behavioural changes and capacity problems that are expected to occur when such an outbreak strikes. Copyright (c) 2008 John Wiley & Sons, Ltd.

  15. A regional-scale Ocean Health Index for Brazil.

    Science.gov (United States)

    Elfes, Cristiane T; Longo, Catherine; Halpern, Benjamin S; Hardy, Darren; Scarborough, Courtney; Best, Benjamin D; Pinheiro, Tiago; Dutra, Guilherme F

    2014-01-01

    Brazil has one of the largest and fastest growing economies and one of the largest coastlines in the world, making human use and enjoyment of coastal and marine resources of fundamental importance to the country. Integrated assessments of ocean health are needed to understand the condition of a range of benefits that humans derive from marine systems and to evaluate where attention should be focused to improve the health of these systems. Here we describe the first such assessment for Brazil at both national and state levels. We applied the Ocean Health Index framework, which evaluates ten public goals for healthy oceans. Despite refinements of input data and model formulations, the national score of 60 (out of 100) was highly congruent with the previous global assessment for Brazil of 62. Variability in scores among coastal states was most striking for goals related to mariculture, protected areas, tourism, and clean waters. Extractive goals, including Food Provision, received low scores relative to habitat-related goals, such as Biodiversity. This study demonstrates the applicability of the Ocean Health Index at a regional scale, and its usefulness in highlighting existing data and knowledge gaps and identifying key policy and management recommendations. To improve Brazil's ocean health, this study suggests that future actions should focus on: enhancing fisheries management, expanding marine protected areas, and monitoring coastal habitats.

  16. [Organizational wellbeing in the health sector: the Piemonte Region experience].

    Science.gov (United States)

    Converso, Daniela; Baratti, Alberto

    2010-01-01

    In 2007, the Health Councillorship of the Piedmont region announced, in convention with the Psychology Department of the University of Turin, of the creation of "Workgroup for Safeguard of Organizational Wellbeing" composed by psychologists, occupational doctors, and superintendents for Prevention and Protection services. This group is aimed at promoting pilot experiences in the Health Units in order to prevent and combat psychosocial discomfort and to sustain workers' wellbeing. A complex intervention started in January 2009 and involved the personnel from Services for the Organization and Development of Human Resources, Personnel Services, Services for Occupational Medicine, Services of Communication, Quality Services, belonging to all of the Health Units from Piedmont, and of some structures operating within the national health service, for a total of 23 work groups. Based on the results produced and/or from the shared reflections in the classroom between the 23 groups, four main themes were singled out, corresponding to different levels and fields of interventions, in order to favour the contrast of psychosocial distress and to promote a culture of wellbeing, were adopted taking into account needs and cultural specificity of different Units' realities. The activities embarked on, inside every main theme represent, in the expectations of all the participants, good practices that could be spread to the different Local Health Units.

  17. EMERGING ANTIMICROBIAL RESISTANCE IN HOSPITAL A THREAT TO PUBLIC HEALTH

    Directory of Open Access Journals (Sweden)

    Vichal Rastogi

    2013-01-01

    Full Text Available Background: Antimicrobial resistance(AMR threatens the health of many throughout the world, since both old and new infectious diseases remain a formidable public health threat. When pathogenic microorganisms can multiply beyond some critical mass in the face of invading antimicrobials, treatment outcome is compromised. This phenomenon is referred as antimicrobial resistance (AMR. Objective: This retrospective study was conducted to assess the overall antimicrobial resistance in bacterial isolates from tertiary care hospitals as majority of patients here receive empirical antibiotics therapy. Method: This retrospective study was carried out in teaching hospital, Greater Noida to determine prevalence of multidrug resistance in patients in relation to empirical antibiotic therapy in hospital. Various samples (pus,urine,blood were collected for bacterial culture and antibiotic sensitivity. Results: Total 500 bacterial strains isolated from ICU, surgery, obstetrics & gynaecology and orthopaedics and their sensitivity pattern was compared in this study. The highest number of resistant bacterias were of pseudomonas sp. i.e. 21(33.87% followed by 16(25.80% of staphylococcus aureus, 12(19.35% of Escherichia coli, Klebseilla sp & Proteus vulgaris were 05(8.06% each & Citrobacter sp. 03(4.83%. Total 62(12.4% bacterial isolates were found to be resistant to multiple drugs. The 31 (50% of these resistant bacteria were prevalent in ICU, 12(19.35% in Surgery, 11(17.74% in Gynaecology, 08(12.90% in Orthopaedics.. All the bacterial strains were resistant to common antibiotics like Penicillin, Amoxicillin, Doxycycline & Cotrimoxazole and some were even resistant to Imipenem. Conclusion: Therefore we have outlined the nature of the antimicrobial resistance problem as an important health issue for national and international community. It is advised to avoid use of empirical antibiotics therapy.

  18. Relations of Behavioral Autonomy to Health Outcomes Among Emerging Adults With and Without Type 1 Diabetes

    Science.gov (United States)

    Reynolds, Kerry A.; Becker, Dorothy; Escobar, Oscar; Siminerio, Linda

    2014-01-01

    Objective To examine the relation of behavioral autonomy to psychological, behavioral, and physical health among emerging adults with and without type 1 diabetes. Methods High school seniors with (n = 118) and without type 1 diabetes (n = 122) completed online questionnaires for three consecutive years. Behavioral autonomy, psychological health, risk behaviors, and diabetes outcomes were assessed. Regression analyses were conducted to predict Time 2 and 3 outcomes, controlling for Time 1 outcomes. Results There were no group differences in behavioral autonomy. Behavioral autonomy predicted better psychological health but only for emerging adults without diabetes. Behavioral autonomy was related to increased risk behavior for both groups. Behavioral autonomy was unrelated to self-care but predicted better glycemic control for females. Conclusions Behavioral autonomy may be beneficial for psychological health, but is related to increased risk behavior. The implications of behavioral autonomy for emerging adults with type 1 diabetes require careful consideration. PMID:25157070

  19. 78 FR 60283 - Guidance for Temporary Reassignment of State and Local Personnel During a Public Health Emergency

    Science.gov (United States)

    2013-10-01

    ... Personnel During a Public Health Emergency AGENCY: Department of Health and Human Services, Office of the... and Local Personnel during a Public Health Emergency.'' Section 201 of the Pandemic and All-Hazards Preparedness Reauthorization Act of 2013 (PAHPRA), Public Law 113-5, amends section 319 of the Public Health...

  20. Emerging photovoltaic technologies: Environmental and health issues update

    Science.gov (United States)

    Fthenakis, Vasilis M.; Moskowitz, Paul D.

    1997-02-01

    New photovoltaic (PV) technologies promise low-cost, reliable PV modules and have the potential for significant PV penetration into the energy market. These prospects for commercialization have attracted renewed interest in the advantageous environmental impact of using PV and also in the potential environmental, health and safety (EHS) burdens in PV manufacturing and decommissioning. In this paper, we highlight recent studies on EHS issues: a) An integrated energy-environmental-economic analysis which shows that large-scale use of PV can significantly contribute to alleviating the greenhouse effect; in the United States alone, it could displace 450 million tons of carbon emissions by the year 2030, b) Recycling of the spent modules and scarp is economically feasible; current research centers on improving the efficiency and economics of recycling CdTe and CIS modules, c) Toxicological studies conducted by the National Institute of Environmental Health Sciences (NIEHS) compared the acute toxicity of CdTe, CIS, and CGS; CdTe was the most toxic, and CGS the least toxic of the three. Additional studies are now comparing the systemic toxicity of these compounds with the toxicity of their precursors.

  1. Emerging photovoltaic technologies: Environmental and health issues update

    Energy Technology Data Exchange (ETDEWEB)

    Fthenakis, V.M.; Moskowitz, P.D. [Biomedical and Environmental Assessment Group, Department of Applied Science, Brookhaven National Laboratory, Upton, New York 11973 (United States)

    1997-02-01

    New photovoltaic (PV) technologies promise low-cost, reliable PV modules and have the potential for significant PV penetration into the energy market. These prospects for commercialization have attracted renewed interest in the advantageous environmental impact of using PV and also in the potential environmental, health and safety (EHS) burdens in PV manufacturing and decommissioning. In this paper, we highlight recent studies on EHS issues: (a) An integrated energy-environmental-economic analysis which shows that large-scale use of PV can significantly contribute to alleviating the greenhouse effect; in the United States alone, it could displace 450 million tons of carbon emissions by the year 2030, (b) Recycling of the spent modules and scarp is economically feasible; current research centers on improving the efficiency and economics of recycling CdTe and CIS modules, (c) Toxicological studies conducted by the National Institute of Environmental Health Sciences (NIEHS) compared the acute toxicity of CdTe, CIS, and CGS; CdTe was the most toxic, and CGS the least toxic of the three. Additional studies are now comparing the systemic toxicity of these compounds with the toxicity of their precursors. {copyright} {ital 1997 American Institute of Physics.}

  2. Health care providers' knowledge of, attitudes toward and provision of emergency contraceptives in Lagos, Nigeria.

    Science.gov (United States)

    Ebuehi, Olufunke Margaret; Ebuehi, Osaretin A T; Inem, Victor

    2006-06-01

    Emergency contraception can play an important role in reducing the rate of unintended pregnancies in Nigeria. Although it is included in the national family planning guidelines, there is limited awareness of this method among clients. In 2003-2004, a sample of 256 health care providers within Lagos State were surveyed about their knowledge of, attitudes toward and provision of emergency contraceptives, using a 25-item, self-administered questionnaire. Frequencies were calculated for the various measures, and chi-square tests were used to determine significant differences. Nine in 10 providers had heard of emergency contraception, but many lacked specific knowledge about the method. Only half of them knew the correct time frame for effective use of emergency contraceptive pills, and three-fourths knew that the pills prevent pregnancy; more than a third incorrectly believed that they may act as an abortifacient. Fewer than a third of respondents who had heard of the pills knew that they are legal in Nigeria. Of those who had heard about emergency contraception, 58% had provided clients with emergency contraceptive pills, yet only 10% of these providers could correctly identify the drug, dose and timing of the first pill in the regimen. Furthermore, fewer than one in 10 of those who knew of emergency contraception said they always provided information to clients, whereas a fourth said they never did so. Nigerian health care providers urgently need education about emergency contraception; training programs should target the types of providers who are less knowledgeable about the method.

  3. Transnational health care: from a global terminology towards transnational health region development.

    Science.gov (United States)

    Mainil, Tomas; Van Loon, Francis; Dinnie, Keith; Botterill, David; Platenkamp, Vincent; Meulemans, Herman

    2012-11-01

    Within European cross-border health care, recent studies have identified several types of international patients. Within the Anglo-Saxon setting, the specific terminology of medical tourism is used. The analytical purpose of the paper is to resolve this semantic difference by suggesting an alternative terminology, 'transnational health care' that is understood as a 'context-controlled and coordinated network of health services'. For demand-driven trans-border access seekers and cross-border access searchers, there is a need to opt for regional health-policy strategies. For supply-driven sending context actors and receiving context actors, there would be organizational benefits to these strategies. Applying the terminology of trans-border access seekers, cross-border access searchers, sending context and receiving context actors results in a transnational patient mobility typology of twelve types of international patients, based on the criteria of geographical distance, cultural distance and searching efforts, public/private/no cover and private/public provision of health services. Finally, the normative purpose of the paper is to encourage the use of this terminology to promote a policy route for transnational health regions. It is suggested that the development of transnational health regions, each with their own medical and supportive service characteristics, could enhance governmental context-controlled decision power in applying sustainable health destination management. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  4. Health policy and integrated mental health care in the SADC region: strategic clarification using the Rainbow Model.

    Science.gov (United States)

    van Rensburg, André Janse; Fourie, Pieter

    2016-01-01

    Mental illness is a well-known challenge to global development, particularly in low-to-middle income countries. A key health systems response to mental illness is different models of integrated health care, especially popular in the South African Development Community (SADC) region. This complex construct is often not well-defined in health policy, hampering implementation efforts. A key development in this vein has been the Rainbow Model of integrated care, a comprehensive framework and taxonomy of integrated care based on the integrative functions of primary care. The purpose of this study was to explore the nature and strategic forms of integrated mental health care in selected SADC countries, specifically how integrated care is outlined in state-driven policies. Health policies from five SADC countries were analysed using the Rainbow Model as framework. Electronic copies of policy documents were transferred into NVivo 10, which aided in the framework analysis on the different types of integrated mental health care promoted in the countries assessed. Several Rainbow Model components were emphasised. Clinical integration strategies (coordination of person-focused care) such as centrality of client needs, case management and continuity were central considerations, while others such as patient education and client satisfaction were largely lacking. Professional integration (inter-professional partnerships) was mentioned in terms of agreements on interdisciplinary collaboration and performance management, while organisational integration (inter-organisational relationships) emerged under the guise of inter-organisational governance, population needs and interest management. Among others, available resources, population management and stakeholder management fed into system integration strategies (horizontally and vertically integrated systems), while functional integration strategies (financial, management and information system functions) included human resource

  5. Public health and health promotion capacity at national and regional level: a review of conceptual frameworks

    Directory of Open Access Journals (Sweden)

    Christoph Aluttis

    2014-04-01

    Full Text Available The concept of capacity building for public health has gained much attention during the last decade. National as well as international organizations increasingly focus their efforts on capacity building to improve performance in the health sector. During the past two decades, a variety of conceptual frameworks have been developed which describe relevant dimensions for public health capacity. Notably, these frameworks differ in design and conceptualization. This paper therefore reviews the existing conceptual frameworks and integrates them into one framework, which contains the most relevant dimensions for public health capacity at the country or regional level. A comprehensive literature search was performed to identify frameworks addressing public health capacity building at the national or regional level. We content-analysed these frameworks to identify the core dimensions of public health capacity. The dimensions were subsequently synthesized into a set of thematic areas to construct a conceptual framework which describes the most relevant dimensions for capacities at the national or regional level. The systematic review resulted in the identification of seven core domains for public health capacity: resources, organizational structures, workforce, partnerships, leadership and governance, knowledge development and country specific context. Accordingly, these dimensions were used to construct a framework, which describes these core domains more in detail. Our research shows that although there is no generally agreed upon model of public health capacity, a number of key domains for public health and health promotion capacity are consistently recurring in existing frameworks, regardless of their geographical location or thematic area. As only little work on the core concepts of public health capacities has yet taken place, this study adds value to the discourse by identifying these consistencies across existing frameworks and by synthesising

  6. Emergency Contraceptive Pills: A 10-Year Follow-up Survey of Use and Experiences at College Health Centers in the Mid-Atlantic United States

    Science.gov (United States)

    Miller, Laura McKeller; Sawyer, Robin G.

    2006-01-01

    The authors conducted a 10-year follow-up study using a telephone survey to investigate the availability of emergency contraceptive pills (ECPs) at college health centers in the mid-Atlantic region of the United States. They also examined related issues, such as distribution procedure, existence of a written protocol, personnel involved,…

  7. Regionalizing Immigration, Health and Inequality: Iraqi Refugees in Australia

    Directory of Open Access Journals (Sweden)

    Lenore Manderson

    2012-01-01

    Full Text Available Humanitarian immigrants and refugees face multiple adjustment tasks and post-settlement support services concentrated in metropolitan areas play an important role. As part of an ongoing commitment, the Australian Government has increasingly supported resettlement in rural and regional areas of the country. Drawing on the experience of Iraqi migrants in Victoria, Australia, we examine some of the conditions that characterize regional resettlement and raise key questions for public health policy. Structural vulnerabilities and discriminations impact upon physical, mental and social wellbeing, leading to further exclusion, with negative long-term implications. The discussion throws light on the issues that migrants and refugees may encounter in other parts within Australia, but are also germane in many countries and highlight the resulting complexity for policy-making.

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

    Science.gov (United States)

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

    2014-07-01

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

  9. [Prehospital emergency care injuries from external causes in a region of Venezuela].

    Science.gov (United States)

    Herrera, Rafael; Bastidas, Daniel; Arteaga, Everilda; Bastidas, Gilberto

    2017-01-01

    Worldwide, approximately 3 500 000 people die every year as a result of injuries from external causes, in Venezuela these arte the third leading cause of overall morbidity. Nevertheless, in the country there are no records of the defining aspects of prehospital emergency care as a tool to address this socio-health problem, the aim of this investigation. A descriptive, transversal, field study based on the information recorded daily for a year paramedics was performed. A total 1493 injured by external causes were reported, with a mean age of 29.5 ± 12 years, 84.5% male. Injuries mostly less-moderate (69.4%) were due to severe land transport accidents (70.9%) occurred during the day (75.9%), between monday and friday (72.9%), attended in 20 minutes or less, and transferred in 97.3% of cases. The economically productive young men in areas with higher population density and urbanism are mostly affected by injuries from external causes. In both genres land transport accidents are the most common causes of injury with lower-moderate severity. The care that paramedics provide can be considered adequate.

  10. Attending to scalar ethical issues in emerging approaches to environmental health research and practice.

    Science.gov (United States)

    Buse, Chris G; Smith, Maxwell; Silva, Diego S

    2018-06-04

    Accelerated changes to the planet have created novel spaces to re-imagine the boundaries and foci of environmental health research. Climate change, mass species extinction, ocean acidification, biogeochemical disturbance, and other emergent environmental issues have precipitated new population health perspectives, including, but not limited to, one health, ecohealth, and planetary health. These perspectives, while nuanced, all attempt to reconcile broad global challenges with localized health impacts by attending to the reciprocal relationships between the health of ecosystems, animals, and humans. While such innovation is to be encouraged, we argue that a more comprehensive engagement with the ethics of these emerging fields of inquiry will add value in terms of the significance and impact of associated interventions. In this contribution, we highlight how the concept of spatial and temporal scale can be usefully deployed to shed light on a variety of ethical issues common to emerging environmental health perspectives, and that the potential of scalar analysis implicit to van Potter's conceptualization of bioethics has yet to be fully appreciated. Specifically, we identify how scale interacts with key ethical issues that require consideration and clarification by one health, ecohealth, and planetary health researchers and practitioners to enhance the effectiveness of research and practice, including justice and governance.

  11. Integration services to enable regional shared electronic health records.

    Science.gov (United States)

    Oliveira, Ilídio C; Cunha, João P S

    2011-01-01

    eHealth is expected to integrate a comprehensive set of patient data sources into a coherent continuum, but implementations vary and Portugal is still lacking on electronic patient data sharing. In this work, we present a clinical information hub to aggregate multi-institution patient data and bridge the information silos. This integration platform enables a coherent object model, services-oriented applications development and a trust framework. It has been instantiated in the Rede Telemática de Saúde (www.RTSaude.org) to support a regional Electronic Health Record approach, fed dynamically from production systems at eight partner institutions, providing access to more than 11,000,000 care episodes, relating to over 350,000 citizens. The network has obtained the necessary clearance from the Portuguese data protection agency.

  12. Responding to Public Health Emergencies on Tribal Lands: Jurisdictional Challenges and Practical Solutions.

    Science.gov (United States)

    Barnard, Justin B

    2015-01-01

    Response to public health emergencies on tribal lands poses a unique challenge for state and tribal public health officials. The complexity and intensely situation-specific nature of federal Indian jurisprudence leaves considerable question as to which government entity, state or tribal, has jurisdiction on tribal lands to undertake basic emergency measures such as closure of public spaces, quarantine, compulsory medical examination, and investigation. That jurisdictional uncertainty, coupled with cultural differences and an often troubled history of tribal-state relations, threatens to significantly impede response to infectious disease outbreaks or other public health emergencies on tribal lands. Given that tribal communities may be disproportionately impacted by public health emergencies, it is critical that tribal, state, and local governments engage with each other in coordinated planning for public health threats. This Article is offered as a catalyst for such planning efforts. The Article identifies some of the most pressing jurisdictional issues that may confront governments responding to a public health emergency on tribal lands, with the aim of highlighting the nature of the problem and the need for action. The Article goes on to examine the most promising means of addressing jurisdictional uncertainty: intergovernmental agreements. Already utilized in many areas of shared interest between tribe and state, intergovernmental agreements offer neighboring state, local, and tribal governments a vehicle for delineating roles and authorities in an emergency, and may lay the groundwork for sharing resources. The Article surveys various representative tribal public health intergovernmental agreements, and concludes with suggestions for tribes and state or local governments looking to craft their own agreements.

  13. National and Regional Representativeness of Hospital Emergency Department Visit Data in the National Syndromic Surveillance Program, United States, 2014

    Science.gov (United States)

    Coates, Ralph J.; Pérez, Alejandro; Baer, Atar; Zhou, Hong; English, Roseanne; Coletta, Michael; Dey, Achintya

    2016-01-01

    Objective We examined the representativeness of the nonfederal hospital emergency department (ED) visit data in the National Syndromic Surveillance Program (NSSP). Methods We used the 2012 American Hospital Association Annual Survey Database, other databases, and information from state and local health departments participating in the NSSP about which hospitals submitted data to the NSSP in October 2014. We compared ED visits for hospitals submitting 15 data with all ED visits in all 50 states and Washington, DC. Results Approximately 60.4 million of 134.6 million ED visits nationwide (~45%) were reported to have been submitted to the NSSP. ED visits in 5 of 10 regions and the majority of the states were substantially underrepresented in the NSSP. The NSSP ED visits were similar to national ED visits in terms of many of the characteristics of hospitals and their service areas. However, visits in hospitals with the fewest annual ED visits, in rural trauma centers, and in hospitals serving populations with high percentages of Hispanics and Asians were underrepresented. Conclusions NSSP nonfederal hospital ED visit data were representative for many hospital characteristics and in some geographic areas but were not very representative nationally and in many locations. Representativeness could be improved by increasing participation in more states and among specific types of hospitals. PMID:26883318

  14. The evaluation of the patients who admitted to a regional hospital emergency service with suspect of rabies

    Directory of Open Access Journals (Sweden)

    Nurettin Tunç

    2012-09-01

    Full Text Available Objectives: Rabies is one of the highest mortality ratesinfectious disease. The aim was the evaluation of the patientswho admitted to The Batman Regional State HospitalEmergency Service with suspect of rabies in the datesbetween June 2011 and November 2011.Materials and methods: Totally, 166 cases who admittedto our center was recorded according to the followingdata: place of residence (rural/urban, contact type andwound information, time after the contact, whether vaccineor immunoglobulin is applied or not and also the species,breed and being owned of suspected animal.Results: Our study population consisted of a total of 166cases including 38 women (23%, 128 men (77% withthe mean age of 22.01 ± 17.90 years. Of all subjects, 105(63% lived in urban and 61 (37% lived in rural areas.Eighty-five percent of suspicious animals (51% had anowner, while 81 animals were unattended.Conclusions: Our results showed that all admitted patientswere vaccinated and the ones contacted with petsor had a surface wound were vaccinated with 3 doses.Moreover, since the 49% of our cases were contactedwith animals which cannot be follow-up, our study obviouslyreveals that in our country deficiencies in the controlof waifs still is a public health problem and increases thecost of vaccination. J Clin Exp Invest 2012; 3 (3: 383-386Key words: Rabies, suspected bite, rabies prophylaxis

  15. Health risks of climate change in the World Health Organization South-East Asia Region.

    Science.gov (United States)

    Bowen, Kathryn J; Ebi, Kristie L

    2017-09-01

    Countries in the World Health Organization (WHO) South-East Asia Region are particularly vulnerable to a changing climate. Changes in extreme weather events, undernutrition and the spread of infectious diseases are projected to increase the number of deaths due to climate change by 2030, indicating the need to strengthen activities for adaptation and mitigation. With support from the WHO Regional Office for South-East Asia and others, countries have started to include climate change as a key consideration in their national public health policies. Further efforts are needed to develop evidence-based responses; garner the necessary support from partner ministries; and access funding for activities related to health and climate change. National action plans for climate change generally identify health as one of their priorities; however, limited information is available on implementation processes, including which ministries and departments would be involved; the time frame; stakeholder responsibilities; and how the projects would be financed. While progress is being made, efforts are needed to increase the capacity of health systems to manage the health risks of climate change in South-East Asia, if population health is to be protected and strengthened while addressing changing weather and climate patterns. Enhancing the resilience of health systems is key to ensuring a sustainable path to improved planetary and population health.

  16. The Emergent Terrains of "Higher Education Regionalism": How and Why Higher Education Is an Interesting Case for Comparative Regionalism

    Science.gov (United States)

    Chou, Meng-Hsuan; Ravinet, Pauline

    2016-01-01

    The introduction of regional political initiatives in the higher education sector symbolizes one of the many aspects of the changing global higher education landscape. Remarkably, these processes have generally escaped comparative scrutiny by scholars researching higher education policy cooperation or regional integration. In this article, we…

  17. [SARS: a new emergency in the world health].

    Science.gov (United States)

    Calza, Leonardo; Manfredi, Roberto; Verucchi, Gabriella; Chiodo, Francesco

    2003-01-01

    The Severe Acute Respiratory Syndrome (SARS) is a new life-threatening respiratory disease which has its origins in Guangdong province, China, where the earliest known cases were identified in November 2002. Since then, probable cases of SARS have been reported in 30 countries and the current cumulative number of cases is 8,240 with 745 deaths and a global fatality rate of 9%. The most frequently involved areas include China, Hong Kong, Singapore, Canada, Vietnam and Philippines. Most cases of SARS to date have occurred in young adults and this disease appears to spread most commonly by close person-to-person contact, involving exposure to infectious droplets and body fluids. This transmission pattern generally involves household members, health care workers and international travellers, while a large and sudden cluster of almost simultaneous cases in an housing estate of Hong Kong has raised the possibility of transmission from an environmental source. The most common presenting symptoms are fever, malaise, non-productive cough and dyspnea, associated with pulmonary interstitial infiltrates on chest radiography. A novel coronavirus is associated with this outbreak, and the laboratory evidences indicate that this virus has an etiologic role in SARS, but the role of other concurrent viral agents (such as metapneumovirus) identified in these patients requires further investigation.

  18. Emergency control center of the nuclear Regulatory Authority: a national, regional and international tool to coordinate the response to radiological and nuclear emergencies

    International Nuclear Information System (INIS)

    Jordan, Osvaldo; Hernandez, Daniel; Telleria, Diego; Bruno, Hector; Boutet, Luis; Kunst, Juan; Sadaniowski, Ivana; Rey, Hugo

    2008-01-01

    Full text: In the year 1998, with the regulation of the Nuclear Law, the Nuclear Regulatory Authority (ARN) is constituted as the national coordinator of the response in case of nuclear or radiological emergencies. The ARN builds his first operative center installed in his Head quarter in Buenos Aires. Likewise, from the obligations that come with the Convention of Early Notification of a Nuclear Accident and Convention on Assistance in the Case of a Nuclear Accident or Radiological Emergency, the ARN is the National Warning Point and the National Competent Authority. Therefore, the operative capacity of the center needs to be expanded to cover not only the national territory but also its link with the region and the IAEA, as an access point to the International community, as the conventions demand. For the purpose of giving ARN capacities which reflect the state of art at the international level on Nuclear Emergency Centers and warrant that its equipment and technology will be compatible with those abroad (mainly with IAEA), the ARN made an arrangements with Department of Energy of United States, in the framework of an existing bilateral Argentine Foreign Office/US Government agreement (Joint Standing Committee on Nuclear Cooperation). This agreement allows a deep experience exchange, high level specialists support and last generation equipment access. As a result, the center of ARN can be considerate as the most advanced civil nuclear emergency center in the region. This work describes the implementation process of the emergency center and the technical features, like the physical distribution, hardware and software resources, communication equipment, Geographic Information Systems, etc. (author)

  19. Health effects of training laypeople to deliver emergency care in underserviced populations: a systematic review protocol

    OpenAIRE

    Orkin, Aaron M; Curran, Jeffrey D; Fortune, Melanie K; McArthur, Allison; Mew, Emma J; Ritchie, Stephen D; Van de Velde, Stijn; VanderBurgh, David

    2016-01-01

    Introduction The Disease Control Priorities Project recommends emergency care training for laypersons in low-resource settings, but evidence for these interventions has not yet been systematically reviewed. This review will identify the individual and community health effects of educating laypeople to deliver prehospital emergency care interventions in low-resource settings. Methods and analysis This systematic review addresses the following question: in underserviced populations and low-reso...

  20. Emergency mental health nursing for self-harming refugees and asylum seekers.

    Science.gov (United States)

    Procter, Nicholas G

    2005-09-01

    This article describes the structure and function of emergency mental health nursing practice for self-harming refugees and asylum seekers on Temporary Protection Visas. Emergency nurses working in accident and emergency departments or as part of crisis intervention teams will see self-harming refugees and asylum seekers at the very point of their distress. This clinical paper is intended to support nurses in their practice should they encounter an adult asylum seeker needing emergency mental health care. Practical strategies are highlighted to help mental health nurses assess, care, and comfort refugees and asylum seekers in this predicament. Mental health nurses should, where possible, work closely with asylum seekers, their support workers, and accredited interpreters and translators to ensure the appropriate use of language when dealing with mental and emotional health issues without further isolating the asylum seeker from appropriate services. To help strengthen continuity and integration of mental health supports for refugees and asylum seekers, well-resourced care must be experienced as coherent and connected. A coherent, interdisciplinary and team-orientated approach will synthesize different viewpoints to shape clinical practice and create workable solutions in local situations.

  1. ‘BRICS without straw’? A systematic literature review of newly emerging economies’ influence in global health

    Science.gov (United States)

    2013-01-01

    Background Since 2010, five newly emerging economies collectively known as ‘BRICS’ (Brazil, India, Russia, China and South Africa) have caught the imagination, and scholarly attention, of political scientists, economists and development specialists. The prospect of a unified geopolitical bloc, consciously seeking to re-frame international (and global) health development with a new set of ideas and values, has also, if belatedly, begun to attract the attention of the global health community. But what influence, if any, do the BRICS wield in global health, and, if they do wield influence, how has that influence been conceptualized and recorded in the literature? Methods We conducted a systematic literature review in (March-December 2012) of documents retrieved from the databases EMBASE, PubMed/Medline, Global Health, and Google Scholar, and the websites of relevant international organisations, research institutions and philanthropic organisations. The results were synthesised using a framework of influence developed for the review from the political science literature. Results Our initial search of databases and websites yielded 887 documents. Exclusion criteria narrowed the number of documents to 71 journal articles and 23 reports. Two researchers using an agreed set of inclusion criteria independently screened the 94 documents, leaving just 7 documents. We found just one document that provided sustained analysis of the BRICS’ collective influence; the overwhelming tendency was to describe individual BRICS countries influence. Although influence was predominantly framed by BRICS countries’ material capability, there were examples of institutional and ideational influence - particularly from Brazil. Individual BRICS countries were primarily ‘opportunity seekers’ and region mobilisers but with potential to become ‘issue leaders’ and region organisers. Conclusion Though small in number, the written output on BRICS influence in global health has

  2. Emerging nicotine delivery products. Implications for public health.

    Science.gov (United States)

    Benowitz, Neal L

    2014-02-01

    The idea of clean nicotine delivery systems that would satisfy nicotine craving and promote smoking cessation has been considered as a possible public health tool for many years. Nicotine medications have been useful for smoking cessation but have not found widespread popularity among smokers, perhaps because of slow nicotine delivery and other sensory characteristics that differ from cigarettes. Traditional smokeless tobacco delivers as much nicotine as cigarettes and has been advocated for harm reduction but contains carcinogenic nitrosamines and has not been proven to promote cessation. Furthermore, there is concern that dual use of smokeless tobacco and cigarettes may inhibit quitting smoking. Newer oral dissolvable tobacco products contain lower levels of toxicants than other smokeless tobacco but also deliver much less nicotine and have not been popular with consumers. Electronic cigarettes that aerosolize nicotine without generating toxic tobacco combustion products have become quite popular and hold promise as a way to attract smokers away from cigarettes, although efficacy in promoting smoking cessation has not yet been demonstrated. There are concerns about safety of long-term use, and there is evidence that youth, including nonsmokers, are taking up e-cigarette use. E-cigarettes are marketed for use when one cannot smoke conventional cigarettes, and such use might result in more persistent cigarette smoking. Although their benefits and risks are being vigorously debated, e-cigarettes or other clean nicotine delivery devices could play an important role as an adjunct to a U.S. Food and Drug Administration regulatory intervention to make cigarettes less addictive and in this context could contribute to the end of cigarette smoking and smoking-induced disease.

  3. Health conditions and role limitation in three European Regions: a public-health perspective.

    Science.gov (United States)

    Barbaglia, Gabriela; Adroher, Núria D; Vilagut, Gemma; Bruffaerts, Ronny; Bunting, Brentan; Caldas de Almeida, José Miguel; Florescu, Silvia; de Girolamo, Giovanni; de Graaf, Ron; Haro, Josep Maria; Hinkov, Hristo; Kovess-Masfety, Vivianne; Matschinger, Herbert; Alonso, Jordi

    To describe the distribution of role limitation in the European population aged 18-64 years and to examine the contribution of health conditions to role limitation using a public-health approach. Representative samples of the adult general population (n=13,666) aged 18-64 years from 10 European countries of the World Mental Health (WMH) Surveys Initiative, grouped into three regions: Central-Western, Southern and Central-Eastern. The Composite International Diagnostic Interview (CIDI 3.0) was used to assess six mental disorders and standard checklists for seven physical conditions. Days with full and with partial role limitation in the month previous to the interview were reported (WMH-WHODAS). Population Attributable Fraction (PAFs) of full and partial role limitation were estimated. Health conditions explained a large proportion of full role limitation (PAF=62.6%) and somewhat less of partial role limitation (46.6%). Chronic pain was the single condition that consistently contributed to explain both disability measures in all European Regions. Mental disorders were the most important contributors to full and partial role limitation in Central-Western and Southern Europe. In Central-Eastern Europe, where mental disorders were less prevalent, physical conditions, especially cardiovascular diseases, were the highest contributors to disability. The contribution of health conditions to role limitation in the three European regions studied is high. Mental disorders are associated with the largest impact in most of the regions. There is a need for mainstreaming disability in the public health agenda to reduce the role limitation associated with health conditions. The cross-regional differences found require further investigation. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  4. Rating the Efficiency of Regional Health Systems and Compulsory Health Insurance

    Directory of Open Access Journals (Sweden)

    Tatyana Nikolayevna Russkikh

    2015-12-01

    Full Text Available In the face of increasing of the regional differentiation of the health systems and compulsory health insurance, the comparative analysis and efficiency assessment of their performance in the context of the subjects of the Russian Federation becomes particularly relevant. Therefore, the research is focused on the regional health systems and compulsory health insurance (CHI, and the subject matter of the study is the analysis of the system performance. In the article, the comparative analysis of the authors’ approaches to the formation of efficiency criteria of the performance of regional health systems and CHI, as well as to the development of a typology of the constituent entities of the Russian Federation based on these criteria is conducted. The authors propose a system of indicators to measure the economic, medical and social efficiency of the systems under consideration. Moreover, a set of indicators of economic efficiency forms two groups of indicators. The first group of indicators reflects the financial performance, and the second — the structural efficiency. A methodological approach to the formation of the rating for subjects of the Russian Federation according to the levels of efficiency, based on the procedures of cluster analysis and fuzzy mathematics are developed. A feature of the proposed approach to the construction of a typology of the subjects in terms of efficiency is the introduction of a reference subject with the national average performance indicators system that allows to qualitatively assess the effectiveness of regional health systems and CHI by comparing them with the «reference subject». The results of the empirical research have indicated a high differentiation of the subjects of the Russian Federation in terms of economic efficiency, have allowed to identify the subjects-outsiders. The theoretical and practical results can be used for the rational choice of priorities of the state policy in the field of the

  5. How Thailand's greater convergence created sustainable funding for emerging health priorities caused by globalization

    Science.gov (United States)

    Charoenca, Naowarut; Kungskulniti, Nipapun; Mock, Jeremiah; Hamann, Stephen; Vathesatogkit, Prakit

    2015-01-01

    Background Global health is shifting gradually from a limited focus on individual communicable disease goals to the formulation of broader sustainable health development goals. A major impediment to this shift is that most low- and middle-income countries (LMICs) have not established adequate sustainable funding for health promotion and health infrastructure. Objective In this article, we analyze how Thailand, a middle-income country, created a mechanism for sustainable funding for health. Design We analyzed the progression of tobacco control and health promotion policies over the past three decades within the wider political-economic and sociocultural context. We constructed a parallel longitudinal analysis of statistical data on one emerging priority – road accidents – to determine whether policy shifts resulted in reduced injuries, hospitalizations and deaths. Results In Thailand, the convergence of priorities among national interest groups for sustainable health development created an opportunity to use domestic tax policy and to create a semi-autonomous foundation (ThaiHealth) to address a range of pressing health priorities, including programs that substantially reduced road accidents. Conclusions Thailand's strategic process to develop a domestic mechanism for sustainable funding for health may provide LMICs with a roadmap to address emerging health priorities, especially those caused by modernization and globalization. PMID:26328948

  6. How Thailand's greater convergence created sustainable funding for emerging health priorities caused by globalization.

    Science.gov (United States)

    Charoenca, Naowarut; Kungskulniti, Nipapun; Mock, Jeremiah; Hamann, Stephen; Vathesatogkit, Prakit

    2015-01-01

    Global health is shifting gradually from a limited focus on individual communicable disease goals to the formulation of broader sustainable health development goals. A major impediment to this shift is that most low- and middle-income countries (LMICs) have not established adequate sustainable funding for health promotion and health infrastructure. In this article, we analyze how Thailand, a middle-income country, created a mechanism for sustainable funding for health. We analyzed the progression of tobacco control and health promotion policies over the past three decades within the wider political-economic and sociocultural context. We constructed a parallel longitudinal analysis of statistical data on one emerging priority - road accidents - to determine whether policy shifts resulted in reduced injuries, hospitalizations and deaths. In Thailand, the convergence of priorities among national interest groups for sustainable health development created an opportunity to use domestic tax policy and to create a semi-autonomous foundation (ThaiHealth) to address a range of pressing health priorities, including programs that substantially reduced road accidents. Thailand's strategic process to develop a domestic mechanism for sustainable funding for health may provide LMICs with a roadmap to address emerging health priorities, especially those caused by modernization and globalization.

  7. How Thailand's greater convergence created sustainable funding for emerging health priorities caused by globalization

    Directory of Open Access Journals (Sweden)

    Naowarut Charoenca

    2015-08-01

    Full Text Available Background: Global health is shifting gradually from a limited focus on individual communicable disease goals to the formulation of broader sustainable health development goals. A major impediment to this shift is that most low- and middle-income countries (LMICs have not established adequate sustainable funding for health promotion and health infrastructure. Objective: In this article, we analyze how Thailand, a middle-income country, created a mechanism for sustainable funding for health. Design: We analyzed the progression of tobacco control and health promotion policies over the past three decades within the wider political-economic and sociocultural context. We constructed a parallel longitudinal analysis of statistical data on one emerging priority – road accidents – to determine whether policy shifts resulted in reduced injuries, hospitalizations and deaths. Results: In Thailand, the convergence of priorities among national interest groups for sustainable health development created an opportunity to use domestic tax policy and to create a semi-autonomous foundation (ThaiHealth to address a range of pressing health priorities, including programs that substantially reduced road accidents. Conclusions: Thailand's strategic process to develop a domestic mechanism for sustainable funding for health may provide LMICs with a roadmap to address emerging health priorities, especially those caused by modernization and globalization.

  8. The approach of prehospital health care personnel working at emergency stations towards forensic cases.

    Science.gov (United States)

    Asci, Ozlem; Hazar, Guleser; Sercan, Isa

    2015-09-01

    The objective of this study is to determine the states of health care personnel, working at 112 emergency stations in the province of Artvin, to encounter with regarding forensic cases and determine their practices aimed at recognizing, protecting, and reporting the evidences that may affect the forensic process. This descriptive study was conducted with nurses and emergency medicine technicians working at 112 emergency stations in Artvin between January 2013 and February 2014. Of 141 health personnel that constituted sample of the study, 48.9% were nurses, 9.9% emergency medicine technicians, and 41.1% ambulance and emergency care technicians. The rate of feeling sufficient in coping with forensic cases and incidents was 20.6%. There was a lower rate of receiving education about the approach towards forensic cases (15.6%). In the study, the frequency of encountering with at least one forensic case was 88.7%. Traffic accidents (72.5%), suicides (41.5%) and assaults (41.5%) were among the most frequent reasons of forensic cases. The practices of nurses were more successful in woundings by firearms compared to other health personnel (p forensic cases. The personnel with higher educational level and nurses have more successful practices in forensic cases. Health personnel have approaches that may negatively affect the solution of forensic cases.

  9. A world wide public health problem: the principal re-emerging infectious diseases.

    Science.gov (United States)

    De Luca D'Alessandro, E; Giraldi, G

    2011-01-01

    The extraordinary progress in the knowledge of infectious disease, the discovery of antibiotics and effective vaccines are among the great achievement of the nineteenth and twentieth centuries. These achievement have led to a dramatic reduction in the levels of mortality from these diseases. According to the World Health Organization, the term "re-emerging infectious diseases" refers to infectious diseases, which although well known, have not been of recent public health importance. However, climate change, migration, changes in health services, antibiotic resistance, population increase, international travel, the increase in the number of immune-depressed patients ,etc have lead to the re-emergence of these diseases. The climate changes are exposing sectors of the population to inadequate fresh air, water, food and resources for survival which, in consequence, provoke increases in both internal and international migration. In this particular period in which we find ourselves, characterized by globalization, the international community has become aware that the re-emergence of these diseases poses an important risk for public health underlines the necessity to adopt appropriate strategies for their prevention and control. The re-emerging diseases of the twenty-first century are a serious problem for public health and even though there has been enormous progress in medical science and in the battle against infectious diseases, they are still a long way from being really brought under control. A well organized monitoring system would enable the epidemiological characteristics of the infectious diseases to be analyzed and the success or otherwise of preventive interventions to be precisely evaluated. For this reason, the World Health Organization and the European Union have discussed the formation of a collaborative network for the monitoring and control of re-emerging diseases and has initiated special programmes. The battle between humanity and infectious disease

  10. Health-care users, key community informants and primary health care workers' views on health, health promotion, health assets and deficits: qualitative study in seven Spanish regions.

    Science.gov (United States)

    Pons-Vigués, Mariona; Berenguera, Anna; Coma-Auli, Núria; Pombo-Ramos, Haizea; March, Sebastià; Asensio-Martínez, Angela; Moreno-Peral, Patricia; Mora-Simón, Sara; Martínez-Andrés, Maria; Pujol-Ribera, Enriqueta

    2017-06-13

    Although some articles have analysed the definitions of health and health promotion from the perspective of health-care users and health care professionals, no published studies include the simultaneous participation of health-care users, primary health care professionals and key community informants. Understanding the perception of health and health promotion amongst these different stakeholders is crucial for the design and implementation of successful, equitable and sustainable measures that improve the health and wellbeing of populations. Furthermore, the identification of different health assets and deficits by the different informants will generate new evidence to promote healthy behaviours, improve community health and wellbeing and reduce preventable inequalities. The objective of this study is to explore the concept of health and health promotion and to compare health assets and deficits as identified by health-care users, key community informants and primary health care workers with the ultimate purpose to collect the necessary data for the design and implementation of a successful health promotion intervention. A descriptive-interpretive qualitative research was conducted with 276 participants from 14 primary care centres of 7 Spanish regions. Theoretical sampling was used for selection. We organized 11 discussion groups and 2 triangular groups with health-care users; 30 semi-structured interviews with key community informants; and 14 discussion groups with primary health care workers. A thematic content analysis was carried out. Health-care users and key community informants agree that health is a complex, broad, multifactorial concept that encompasses several interrelated dimensions (physical, psychological-emotional, social, occupational, intellectual, spiritual and environmental). The three participants' profiles consider health promotion indispensable despite defining it as complex and vague. In fact, most health-care users admit to having

  11. 7 CFR Exhibit J to Subpart G of... - Locations and Telephone Numbers of Federal Emergency Management Administration's Regional Offices

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 13 2010-01-01 2009-01-01 true Locations and Telephone Numbers of Federal Emergency Management Administration's Regional Offices J Exhibit J to Subpart G of Part 1940 Agriculture Regulations of... REGULATIONS (CONTINUED) GENERAL Environmental Program Pt. 1940, Subpt. G, Exh. J Exhibit J to Subpart G of...

  12. An Examination of Hurricane Emergency Preparedness Planning at Institutions of Higher Learning of the Gulf South Region Post Hurricane Katrina

    Science.gov (United States)

    Ventura, Caterina Gulli

    2010-01-01

    The purpose of the study was to examine hurricane emergency preparedness planning at institutions of higher learning of the Gulf South region following Hurricane Katrina. The problem addressed the impact of Hurricane Katrina on decision-making and policy planning processes. The focus was on individuals that administer the hurricane emergency…

  13. Population health and status of epidemiology: WHO European Region I.

    Science.gov (United States)

    Rahu, Mati; Vlassov, Vasiliy V; Pega, Frank; Andreeva, Tatiana; Ay, Pinar; Baburin, Aleksei; Bencko, Vladimír; Csépe, Péter; Gebska-Kuczerowska, Anita; Ondrusová, Martina; Ribak, Joseph

    2013-06-01

    This article of the International Epidemiological Association commissioned paper series stocktakes the population health and status of epidemiology in 21 of the 53 countries of the WHO European Region. By United Nations geographical classification, these countries belong to Eastern Europe, Western Asia and South-Central Asia. Published data were used to describe population health indicators and risk factors. Epidemiological training and research was assessed based on author knowledge, information searches and E-mail survey of experts. Bibliometric analyses determined epidemiological publication outputs. Between-country differences in life expectancy, amount and profile of disease burden and prevalence of risk factors are marked. Epidemiological training is affected by ongoing structural reforms of educational systems. Training is advanced in Israel and several Eastern European countries. Epidemiological research is mainly university-based in most countries, but predominantly conducted by governmental research institutes in several countries of the former Soviet Union. Funding is generally external and limited, partially due to competition from and prioritization of biomedical research. Multiple relevant professional societies exist, especially in Poland, the Czech Republic and Hungary. Few of the region's 39 epidemiological academic journals have international currency. The number of epidemiological publications per population is highest for Israel and lowest for South-Central Asian countries. Epidemiological capacity will continue to be heterogeneous across the region and depend more on countries' individual historical, social, political and economic conditions and contexts than their epidemiologists' successive efforts. National and international research funding, and within- and between-country collaborations should be enhanced, especially for South-Central Asian countries.

  14. How do we capture the emergency nurse practitioners' contribution to value in health service delivery?

    Science.gov (United States)

    Jennings, Natasha; Lutze, Matthew; Clifford, Stuart; Maw, Michael

    2017-03-01

    The emergency nurse practitioner is now a well established and respected member of the healthcare team. Evaluation of the role has focused on patient safety, effectiveness and quality of care outcomes. Comparisons of the role continue to focus on cost, with findings based on incomplete and almost impossible to define, recognition of contribution to service delivery by paralleled practitioners. Currently there is no clear definition as to how nurse practitioners contribute to value in health service delivery. Robust and rigorous research needs to be commissioned taking into consideration the unique hybrid nature of the emergency nurse practitioner role and focusing on the value they contribute to health care delivery.

  15. Protecting Public Health in Nuclear Emergencies-the Need to Broaden the Process

    International Nuclear Information System (INIS)

    Carr, Z.; Roebbel, N.; Weiss, W.; Abrahams, J.

    2016-01-01

    It is necessary for the radiation protection system to broaden beyond radioactive dose, the view on impact of nuclear accidents, taking in consideration the psychological, social and economic determinants impacting the vulnerability of the exposed population, as well as the impacts of emergency countermeasures. It is strongly recommended to pursue strategies, approaches and services that will address these aspects within the general health protection system and will be applied before, during and after an emergency. The paper raises awareness and proposes a three-step development process for an integrated framework based on the social determinants of health approach. (authors)

  16. Application of Satellite Remote Sensing to Identify Climatic and Anthropogenic Changes Related to Water and Health Conditions in Emerging Megacities

    Science.gov (United States)

    Akanda, A. S.; Serman, E. A.; Jutla, A.

    2014-12-01

    By 2050, more than 70% of the world's population is expected to be living in a city. In many of the urbanizing regions in Asia and Africa, most new development is taking place without adequate urban or regional planning, and a majority population is crowded into densely populated unplanned settlements, also known as slums. During the same period, precipitation and temperature patterns are likely to see significant changes in many of these regions while coastal megacities will have to accommodate sea-level rise in their ecosystems. The rapid increase in population is usually observed in fringes of the urban sprawl without adequate water or sanitation facilities or access to other municipal amenities (such as utilities, healthcare, and education). Collectively, these issues make the ever increasing slum dwellers in emerging megacities significantly vulnerable to a combination of climatic and anthropogenic threats. However, how the growth of unplanned urban and peri-urban sprawl and simultaneous change in climatic patterns have impacted public health in the emerging megacities remain largely unexplored due to lack of readily available and usable data. We employ a number of Remote Sensing products (GRACE, LANDSAT, MODIS) to bridge above knowledge gaps and to identify relevant hydrologic and anthropogenic changes in emerging megacities that are most vulnerable due to the climate-water-health nexus. We explore one of the largest and the fastest growing megacities in the world - Dhaka, Bangladesh - on identifying and investigating the changes in the water environment and growth of slum areas, and impact on water services and health outcomes. The hydroclimatology of South Asia is highly seasonal and the asymmetric availability of water affects vast areas of Bangladesh differently in space and time, exposing the population of Dhaka region to both droughts and floods and periodic spring-fall outbreaks of diarrheal diseases, such as cholera and rotavirus. This research

  17. Persistent polar depletion of stratospheric ozone and emergent mechanisms of ultraviolet radiation-mediated health dysregulation.

    Science.gov (United States)

    Dugo, Mark A; Han, Fengxiang; Tchounwou, Paul B

    2012-01-01

    Year 2011 noted the first definable ozone "hole" in the Arctic region, serving as an indicator to the continued threat of dangerous ultraviolet radiation (UVR) exposure caused by the deterioration of stratospheric ozone in the northern hemisphere. Despite mandates of the Montreal Protocol to phase out the production of ozone-depleting chemicals (ODCs), the relative stability of ODCs validates popular notions of persistent stratospheric ozone for several decades. Moreover, increased UVR exposure through stratospheric ozone depletion is occurring within a larger context of physiologic stress and climate change across the biosphere. In this review, we provide commentaries on stratospheric ozone depletion with relative comparisons between the well-known Antarctic ozone hole and the newly defined ozone hole in the Arctic. Compared with the Antarctic region, the increased UVR exposure in the Northern Hemisphere poses a threat to denser human populations across North America, Europe, and Asia. In this context, we discuss emerging targets of UVR exposure that can potentially offset normal biologic rhythms in terms of taxonomically conserved photoperiod-dependent seasonal signaling and entrainment of circadian clocks. Consequences of seasonal shifts during critical life history stages can alter fitness and condition, whereas circadian disruption is increasingly becoming associated as a causal link to increased carcinogenesis. We further review the significance of genomic alterations via UVR-induced modulations of phase I and II transcription factors located in skin cells, the aryl hydrocarbon receptor (AhR), and the nuclear factor (erythroid-derived 2)-related factor 2 (Nrf2), with emphasis on mechanism that can lead to metabolic shifts and cancer. Although concern for adverse health consequences due to increased UVR exposure are longstanding, recent advances in biochemical research suggest that AhR and Nrf2 transcriptional regulators are likely targets for UVR

  18. Characteristics of Emergency Services for the Elderly—A Regional Hospital Example

    Directory of Open Access Journals (Sweden)

    Ching-Lin Huang

    2009-12-01

    Conclusion: This study's primary goal was to investigate the most common clinical signs and symptoms of the various diseases most common in elderly patients, who presented to the emergency service, and the care of these patients in Hsinchu County to facilitate a more efficient and useful emergency medical service.

  19. The Evolution of Public Health Emergency Management as a Field of Practice.

    Science.gov (United States)

    Rose, Dale A; Murthy, Shivani; Brooks, Jennifer; Bryant, Jeffrey

    2017-09-01

    The health impacts of recent global infectious disease outbreaks and other disasters have demonstrated the importance of strengthening public health systems to better protect communities from naturally occurring and human-caused threats. Public health emergency management (PHEM) is an emergent field of practice that draws on specific sets of knowledge, techniques, and organizing principles necessary for the effective management of complex health events. We highlight how the nascent field of PHEM has evolved in recent years. We explore this development by first examining multiple sites of intersection between the fields of public health and emergency management. We then analyze 2 of the principal pillars on which PHEM was built: organizational and programmatic (i.e., industry) standards and the incident management system. This is followed by a sketch of the key domains, or functional areas, of PHEM and their application to the emergency management cycle. We conclude with some observations about PHEM in a global context and discuss how the field might continue to evolve.

  20. Integración regional andina en salud Health in Andean regional integration

    Directory of Open Access Journals (Sweden)

    Carlos A. Agudelo

    2007-01-01

    Full Text Available A pesar su historia compartida, los países de la Región Andina presentan una diversidad social y política que genera realidades sanitarias heterogéneas y procesos de integración complejos. Se han dado por décadas procesos generales, como la Asociación Latinoamericana de Libre Comercio y la Asociación Latinoamericana de Integración, o de alcance regional como la Comunidad Andina de Naciones, la Comunidad del Caribe y el Mercado Común Centroamericano. En el campo específico de la salud se cuenta con un instrumento en la Región Andina, el Convenio Hipólito Unánue, creado en 1971. Estos procesos de integración se han concentrado en los aspectos económicos, con base en acuerdos de preferencias arancelarias, los cuales han generado, en el largo plazo, un intercambio comercial apreciable. En el campo de la salud se ha avanzado menos, en términos de procesos que ponen en común experiencias nacionales, conocimientos y capacidades. El análisis de las experiencias de integración en salud muestra que esta depende de las fortalezas de cada país y, en gran parte, de los procesos políticos nacionales.Despite their shared history, the Andean countries are socially and politically diverse, with heterogeneous health realities and complex integration processes. General developments such as the Latin American Free Trade Association and Latin American Integration Association have existed for decades, along with others of a regional scope, like the Andean Community of Nations, Caribbean Community, and Central American Common Market. The health field has a specific instrument in the Andean Region called the Hipólito Unánue Agreement, created in 1971. Integration processes have concentrated on economic aspects, based on preferential customs agreements that have led to an important long-term increase in trade. Less progress has been made in the field of health in terms of sharing national experiences, knowledge, and capabilities. Analysis of

  1. Objectives and actions of Public Health Authorities in external radiological emergency

    International Nuclear Information System (INIS)

    Herrera V, L.; Aguilar P, M.C.

    1991-01-01

    Here are discussed actions and objectives that the public health authorities could think about uncontrolled liberation of radioactive materials. The approaches on the more convenient actions to continue are established upon assimilating the Chernobyl experience. We will enumerate problems that, they could arise with the foregone actions in order to diminish the population detriment. In the face of the uncontrolled liberation of radioactive material in the Nuclear power plant of Laguna Verde, Veracruz, classified like external radiological emergency, the objective of these serious authorities reduce the deleterious effect to the health of the inhabitants around the CNLV, due to the radioactive material liberated to the atmosphere. In consequence, it is necessary carry out actions of protection for the population affected directly by the external irradiation, for the contamination deposited on inhabited areas, cultivation zones, shepherding, manufacturing and farms. The early actions or immediate are in order to limit deterministic damages to the population and give attendance to people with radio lesions. And the intermediate or they of recuperation are in order to maintain for under an acceptable value the risk to the population due to radiation stochastic effects. In the recuperation phase the plan of water and foods control should consider: foods destined to the self consume in the affected region for the liberation and foods processed for the sale or exportation. We will discuss the stage in a mediate phase after the evacuation of the population. The general tasks could be: 1. Actions in order to impede the contamination propagation. 2. Sampling of waters and foods, contamination situation and its quantification. And acceptance quality in elaborated foods. 3. Safeguard of the material and polluted areas. 4. Election of the actions to continue in function of the reference levels and the comparison of the risk of several alternatives. (Author)

  2. Public Health System Research in Public Health Emergency Preparedness in the United States (2009-2015): Actionable Knowledge Base.

    Science.gov (United States)

    Savoia, Elena; Lin, Leesa; Bernard, Dottie; Klein, Noah; James, Lyndon P; Guicciardi, Stefano

    2017-09-01

    In 2008, the Institute of Medicine released a letter report identifying 4 research priority areas for public health emergency preparedness in public health system research: (1) enhancing the usefulness of training, (2) improving timely emergency communications, (3) creating and maintaining sustainable response systems, and (4) generating effectiveness criteria and metrics. To (1) identify and characterize public health system research in public health emergency preparedness produced in the United States from 2009 to 2015, (2) synthesize research findings and assess the level of confidence in these findings, and (3) describe the evolution of knowledge production in public health emergency preparedness system research. Search Methods and Selection Criteria. We reviewed and included the titles and abstracts of 1584 articles derived from MEDLINE, EMBASE, and gray literature databases that focused on the organizational or financial aspects of public health emergency preparedness activities and were grounded on empirical studies. We included 156 articles. We appraised the quality of the studies according to the study design. We identified themes during article analysis and summarized overall findings by theme. We determined level of confidence in the findings with the GRADE-CERQual tool. Thirty-one studies provided evidence on how to enhance the usefulness of training. Results demonstrated the utility of drills and exercises to enhance decision-making capabilities and coordination across organizations, the benefit of cross-sector partnerships for successfully implementing training activities, and the value of integrating evaluation methods to support training improvement efforts. Thirty-six studies provided evidence on how to improve timely communications. Results supported the use of communication strategies that address differences in access to information, knowledge, attitudes, and practices across segments of the population as well as evidence on specific

  3. eHealth for Remote Regions: Findings from Central Asia Health Systems Strengthening Project.

    Science.gov (United States)

    Sajwani, Afroz; Qureshi, Kiran; Shaikh, Tehniat; Sayani, Saleem

    2015-01-01

    Isolated communities in remote regions of Afghanistan, Kyrgyz Republic, Pakistan and Tajikistan lack access to high-quality, low-cost health care services, forcing them to travel to distant parts of the country, bearing an unnecessary financial burden. The eHealth Programme under Central Asia Health Systems Strengthening (CAHSS) Project, a joint initiative between the Aga Khan Foundation, Canada and the Government of Canada, was initiated in 2013 with the aim to utilize Information and Communication Technologies to link health care institutions and providers with rural communities to provide comprehensive and coordinated care, helping minimize the barriers of distance and time. Under the CAHSS Project, access to low-cost, quality health care is provided through a regional hub and spoke teleconsultation network of government and non-government health facilities. In addition, capacity building initiatives are offered to health professionals. By 2017, the network is expected to connect seven Tier 1 tertiary care facilities with 14 Tier 2 secondary care facilities for teleconsultation and eLearning. From April 2013 to September 2014, 6140 teleconsultations have been provided across the project sites. Additionally, 52 new eLearning sessions have been developed and 2020 staff members have benefitted from eLearning sessions. Ethics and patient rights are respected during project implementation.

  4. For two regional health foundations, returns from the Kentucky Health Issues Poll are worth the investments.

    Science.gov (United States)

    Walsh, Sarah E; Myers, Gail; Chubinski, Jennifer; Zepeda, Susan G

    2014-09-01

    With finite resources to advance their missions, regional health foundations should critically evaluate the investments they make. This article reviews the costs and associated benefits of large-scale public opinion polling--specifically, the annual Kentucky Health Issues Poll, which is sponsored by the Foundation for a Healthy Kentucky and Interact for Health, formerly the Health Foundation of Greater Cincinnati. In addition to the information generated by the poll, the sponsoring foundations have benefited from increased name recognition and credibility with key stakeholders, including state policy makers and the media. Furthermore, jointly funding the poll has strengthened the relationship between the sponsoring foundations and has fostered other key collaborations. We find that the benefits from this poll more than justify its modest costs ($120,000 per year) and hope that this assessment may prove informative for other funders considering similar investments. Project HOPE—The People-to-People Health Foundation, Inc.

  5. The emergence of a health insurance system in a developing country: the case of South Korea.

    Science.gov (United States)

    Cho, S

    1989-12-01

    In an attempt to understand the social forces and the economic and political conditions under which new social policies emerge in developing countries, this study outlines factors affecting the introduction of the health insurance system in South Korea. The emergence of the South Korean health insurance system was influenced by changing labor needs of the industrial sector, increasing social expectations, external and international pressures, increasing medical costs, and class conflict. These pressures compelled the South Korean government to respond to demands for the introduction of new social welfare policies in the 1970s. In the case of South Korea, the new health insurance system resulted from the government's attempts to cope with political, economic, and social pressures rather than from an ideological commitment to the well-being of the population. The resulting insurance system was a way to maintain the social order and legitimacy of the regime, and a means to promote the health of groups important to defense or production.

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

    Science.gov (United States)

    2005-05-13

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

  7. Preparations for Severe Winter Conditions by Emergency Health Personnel in Turkey.

    Science.gov (United States)

    Calışkan, Cüneyt; Algan, Aysun; Koçak, Hüseyin; Biçer, Burcu Küçük; Sengelen, Meltem; Cakir, Banu

    2014-04-23

    Emergency and core ambulance personnel work under all environmental conditions, including severe weather condtions. We evaluated emergency medical personnel in Çanakkale, Turkey, for their degree of preparedness. A descriptive study was conducted in Çanakkale, Turkey, within 112 emergency service units and their 17 district stations. Surveys were developed to measure the level of preparedness for serious winter conditions that individual workers made for themselves, their homes, and their cars. Of the 167 survey participants, the mean age was 29.8 ± 7.9 years; 52.7% were women; more than half (54.75%) were emergency medical technicians; and 53.3% were married. Only 10.4% of those who heated their homes with natural gas had carbon monoxide detectors. Scores relating to household and individual preparation for severe winter conditions increased by participants' age (P tires (P winter conditions (P = .016). Many of the surveyed emergency health personel demonstrated insufficient preparations for serious winter conditions. To increase the safety and efficiency of emergency medical personnel, educational training programs should be rountinely conducted. (Disaster Med Public Health Preparedness. 2014;0:1-4).

  8. The emergence of a global right to health norm--the unresolved case of universal access to quality emergency obstetric care.

    Science.gov (United States)

    Hammonds, Rachel; Ooms, Gorik

    2014-02-27

    The global response to HIV suggests the potential of an emergent global right to health norm, embracing shared global responsibility for health, to assist policy communities in framing the obligations of the domestic state and the international community. Our research explores the extent to which this global right to health norm has influenced the global policy process around maternal health rights, with a focus on universal access to emergency obstetric care. In examining the extent to which arguments stemming from a global right to health norm have been successful in advancing international policy on universal access to emergency obstetric care, we looked at the period from 1985 to 2013 period. We adopted a qualitative case study approach applying a process-tracing methodology using multiple data sources, including an extensive literature review and limited key informant interviews to analyse the international policy agenda setting process surrounding maternal health rights, focusing on emergency obstetric care. We applied John Kingdon's public policy agenda setting streams model to analyse our data. Kingdon's model suggests that to succeed as a mobilising norm, the right to health could work if it can help bring the problem, policy and political streams together, as it did with access to AIDS treatment. Our analysis suggests that despite a normative grounding in the right to health, prioritisation of the specific maternal health entitlements remains fragmented. Despite United Nations recognition of maternal mortality as a human rights issue, the relevant policy communities have not yet managed to shift the policy agenda to prioritise the global right to health norm of shared responsibility for realising access to emergency obstetric care. The experience of HIV advocates in pushing for global solutions based on right to health principles, including participation, solidarity and accountability; suggest potential avenues for utilising right to health based

  9. Examination of health status of population from Uranium contaminated regions

    International Nuclear Information System (INIS)

    Milacic, S.; Jovicic, D.; Pantelic, G.; Kovacevic, R.; Pavlovic, M.; Tanaskovic, I.

    2002-01-01

    malignant diseases and congenital malformations, and they develop after 5-20 years. Health surveillance of potentially exposed population from the contaminated regions, based on the Health program for occupationally exposed individuals and monitoring of biological parameters indicative of internal radioactive contamination, the disease may be anticipated and treated in time. Therefore, we proposed surveillance program targeted at population of contaminated regions of our country and the initial results of the research are presented in this paper

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

    Science.gov (United States)

    Nguh, Jonas

    2013-01-01

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

  11. Model of Emergency and Observation Nursing Services at the Community Health Center in East Java

    Directory of Open Access Journals (Sweden)

    Dwi Ananto Wibrata

    2017-07-01

    Full Text Available Public health centers as the spearhead of health services, also provide 'emergency and observation' nursing services, due to the high number of accidents in East Java. The purpose of this study was to develop the nurse's performance model in providing 'emergency and obeservation' nursing services at Puskesgadarsi ('Emergency and Observation' Community Health Center in East Java, using cross sectional design. The subjects of 120 nurses were selected by multi stage sampling technique. Data were collected through questionnaires and FGDs, and then analyzed using structural equation modeling to produce an model of ‘emergency and observation’ nursing service for nurses at Puskesgadarsi. Components of the model were reinforcing factors, personal factors, cognition factors, affection factors, commitment, interpersonal, reinforcement and nurse performance. Nurses can use this model in providing nursing services with due regard to their knowledge and skills, facilities and infrastructure, as well as interaction and self-reinforcement, so as to be able to perform nursing services 'emergency and observation' well.

  12. Mental Health and Job Burnout Among Pre-Hospital Emergency Care Personnel

    Directory of Open Access Journals (Sweden)

    Mahsa Haji Mohammad Hoseini

    2017-01-01

    Full Text Available Background: Work environment dictates physical, social and mental tensions each of which affect the staff’s health. Likewise, pre-hospital emergency care staff, due to the special nature of their job, are exposed to the tensions of emergency situations which can affect their health. Therefore, this study was conducted to scrutinize the relationship between the job burnout and mental health in pre-hospital emergencies of Qom Province. Materials and Methods: In this descriptive sectional study, 150 employed personnel of Qom 115 Emergency Care entered the study using census method. Data were gathered using questionnaires of “Background and Clinical Information”, “Mental Health”, and “Job Burnout”, and then based on central indices, Pearson correlation test and multiple linear regression statistical tests were run through software SPSS13 and then analyzed. Results: The average age of the participants was 30.8±5.8. The averages of the values of burnout and mental health were 69.43±12.4 and 60±14.1, respectively. According to Pearson correlation test, the values of the burnout and mental health have a significant negative correlation (r=-0.8. The results of multiple linear regression test showed that the correlation of the burnout and mental health considering the confounding variables is significant. (P=0.05 Conclusion: Pre-hospital employed personnel have desirable mental health and [low] burnout. Furthermore, improved mental health results in decreasing job burnout. Therefore, it is advisable to consider necessary facilities for caring for oneself.

  13. Dynamic Integration of Mobile JXTA with Cloud Computing for Emergency Rural Public Health Care

    OpenAIRE

    Rajkumar, Rajasekaran; Sriman Narayana Iyengar, Nallani Chackravatula

    2013-01-01

    Objectives The existing processes of health care systems where data collection requires a great deal of labor with high-end tasks to retrieve and analyze information, are usually slow, tedious, and error prone, which restrains their clinical diagnostic and monitoring capabilities. Research is now focused on integrating cloud services with P2P JXTA to identify systematic dynamic process for emergency health care systems. The proposal is based on the concepts of a community cloud for preventati...

  14. MANAGEMENT OF INNOVATION IN HEALTH CARE AT THE REGIONAL LEVEL

    Directory of Open Access Journals (Sweden)

    Ye. G. Totskaya

    2014-01-01

    Full Text Available The paper reviews topical issues of organization and management of innovative activity in the regional health care system.Objective. Development and scientific substantiation of a conceptual model of managing innovation in the regional health care system, introduction of institutional mechanisms for its implementation, and evaluation of their efficacy in using diagnosis and treatment technologies. Objectives of the study included reviewing the organization status and problems hampering the development, identification of prospects, and justification for appropriate changes in innovation in healthcare system and medical science at the regional level.Material and methods. To conduct a comprehensive assessment of the status and meet challenges of innovation promotion, a methodology for social-hygienic research was worked out including bibliographic and analytical methods, situational analysis, sociological and economic methods, expert assessment, methods for quality management system audit in accordance with ISO 19011:2002, IDEFO function modeling (RD IDEF0-2000, and organizational modeling. The study was based on the analysis of foreign and domestic literature, statistics, methods for managerial modeling, as well as management experience (including innovative methodological approaches gained by Novosibirsk Research Institute of Traumatology and Orthopedics named after Ya.L. Tsivyan which meets the requirements for a platform for research and innovative product reproduction, including research, clinical, organizational, and managerial aspects. Other facilities were considered in conjunction with the leading innovative platform.Results. The paper presents a scientifically based model of innovative medical environment with its elements as subjects, each with a set of functions. Conceptual model for management includes structuring (resource, processes, and quality management; application of international standards and strategic management mechanisms

  15. Public health challenges and emerging diseases: the case of São Paulo

    Directory of Open Access Journals (Sweden)

    Silva Luiz Jacintho da

    2001-01-01

    Full Text Available The author discusses the challenges posed by emerging infectious diseases in 100 years of public health in the state of São Paulo, Brazil. With an advanced and organized public health system, São Paulo responded to the emergence of infectious diseases by creating research institutions and control programs. The late 19th century witnessed the first modern research institution in microbiology, in response to the bubonic plague. A changing economy led to constant changes in ecosystems. The late 20th century presents a wide array of both emerging and rapidly changing infectious diseases. The present situation calls for creative solutions. Ecosystem analysis and more agile epidemiological surveillance are seen as the best alternatives.

  16. A Conceptual Framework for Allocation of Federally Stockpiled Ventilators During Large-Scale Public Health Emergencies.

    Science.gov (United States)

    Zaza, Stephanie; Koonin, Lisa M; Ajao, Adebola; Nystrom, Scott V; Branson, Richard; Patel, Anita; Bray, Bruce; Iademarco, Michael F

    2016-01-01

    Some types of public health emergencies could result in large numbers of patients with respiratory failure who need mechanical ventilation. Federal public health planning has included needs assessment and stockpiling of ventilators. However, additional federal guidance is needed to assist states in further allocating federally supplied ventilators to individual hospitals to ensure that ventilators are shipped to facilities where they can best be used during an emergency. A major consideration in planning is a hospital's ability to absorb additional ventilators, based on available space and staff expertise. A simple pro rata plan that does not take these factors into account might result in suboptimal use or unused scarce resources. This article proposes a conceptual framework that identifies the steps in planning and an important gap in federal guidance regarding the distribution of stockpiled mechanical ventilators during an emergency.

  17. Preventing Absenteeism and Promoting Resilience Among Health Care Workers In Biological Emergencies

    Energy Technology Data Exchange (ETDEWEB)

    Lesperance, Ann M.; Miller, James S.

    2009-05-08

    The ability to ensure adequate numbers of medical staff represents a crucial part of the medical response to any disaster. However, healthcare worker absenteeism during disasters, especially in the event of an attack of biological terrorism or an epidemic such as pandemic influenza, is a serious concern. Though a significant rate of absenteeism is often included as a baseline assumption in emergency planning, published reports on strategies to minimize absenteeism are comparatively few. This report documents interviews with managers and emergency response planners at hospitals and public health agencies and reviews existing survey data on healthcare worker absenteeism and studies of disasters to glean lessons about the needs of healthcare workers during those disasters. Based on this research, expected rates of absenteeism and individual determinants of absenteeism are presented along with recommendations of steps that hospitals, emergency medical services departments, public health organizations, and government agencies can take to meet the needs of healthcare workers and minimize absenteeism during a biological event.

  18. Assessing the integration of health center and community emergency preparedness and response planning.

    Science.gov (United States)

    Wineman, Nicole V; Braun, Barbara I; Barbera, Joseph A; Loeb, Jerod M

    2007-11-01

    To assess the state of health center integration into community preparedness, we undertook a national study of linkages between health centers and the emergency preparedness and response planning initiatives in their communities. The key objectives of this project were to gain a better understanding of existing linkages in a nationally representative sample of health centers, and identify health center demographic and experience factors that were associated with strong linkages. The objectives of the study were to gain a baseline understanding of existing health center linkages to community emergency preparedness and response systems and to identify factors that were associated with strong linkages. A 60-item questionnaire was mailed to the population of health centers supported by the Health Resources and Services Administration's Bureau of Primary Health Care in February 2005. Results were aggregated and a chi square analysis identified factors associated with stronger linkages. Overall performance on study-defined indicators of strong linkages was low: 34% had completed a hazard vulnerability analysis in collaboration with the community emergency management agency, 30% had their role documented in the community plan, and 24% participated in community-wide exercises. Stronger linkages were associated with experience responding to a disaster and a perception of high risk for experiencing a disaster. The potential for health centers to participate in an integrated response is not fully realized, and their absence from community-based planning leaves an already vulnerable population at greater risk. Community planners should be encouraged to include health centers in planning and response and centers should receive more targeted resources for community integration.

  19. Public health awareness of emerging zoonotic viruses of bats: A European perspective

    NARCIS (Netherlands)

    Poel, van der W.H.M.; Lina, P.H.C.; Kramps, J.A.

    2006-01-01

    Bats classified in the order Chiroptera are the most abundant and widely distributed non-human mammalian species in the world. Several bat species are reservoir hosts of zoonotic viruses and therefore can be a public health hazard. Lyssaviruses of different genotypes have emerged from bats in

  20. Perceived Parental Relationships and Health-Risk Behaviors in College-Attending Emerging Adults

    Science.gov (United States)

    Schwartz, Seth J.; Zamboanga, Byron L.; Ravert, Russell D.; Kim, Su Yeong; Weisskirch, Robert S.; Williams, Michelle K.; Bersamin, Melina; Finley, Gordon E.

    2009-01-01

    The present study investigated the association of perceived parenting with health-risk behaviors in an ethnically diverse sample of 1,728 college-attending emerging adults. Participants completed retrospective measures of perceived maternal and paternal nurturance, connection, psychological control, and disrespect and reported their frequency of…

  1. Effects of armed conflict on access to emergency health care in Palestinian West Bank

    DEFF Research Database (Denmark)

    Rytter, Maren Johanne Heilskov; Kjaeldgaard, Anne-Lene; Brønnum-Hansen, Henrik

    2006-01-01

    , delay in access to hospital, and course of hospital contact. SETTING: Three hospital emergency departments in Bethlehem and Nablus, in the occupied Palestinian West Bank, during one week in each hospital. PARTICIPANTS: All patients seeking health care in the three hospitals during the study period...

  2. A Systematic Review on Recent Advances in mHealth Systems: Deployment Architecture for Emergency Response.

    Science.gov (United States)

    Gonzalez, Enrique; Peña, Raul; Avila, Alfonso; Vargas-Rosales, Cesar; Munoz-Rodriguez, David

    2017-01-01

    The continuous technological advances in favor of mHealth represent a key factor in the improvement of medical emergency services. This systematic review presents the identification, study, and classification of the most up-to-date approaches surrounding the deployment of architectures for mHealth. Our review includes 25 articles obtained from databases such as IEEE Xplore, Scopus, SpringerLink, ScienceDirect, and SAGE. This review focused on studies addressing mHealth systems for outdoor emergency situations. In 60% of the articles, the deployment architecture relied in the connective infrastructure associated with emergent technologies such as cloud services, distributed services, Internet-of-things, machine-to-machine, vehicular ad hoc network, and service-oriented architecture. In 40% of the literature review, the deployment architecture for mHealth considered traditional connective infrastructure. Only 20% of the studies implemented an energy consumption protocol to extend system lifetime. We concluded that there is a need for more integrated solutions specifically for outdoor scenarios. Energy consumption protocols are needed to be implemented and evaluated. Emergent connective technologies are redefining the information management and overcome traditional technologies.

  3. A Systematic Review on Recent Advances in mHealth Systems: Deployment Architecture for Emergency Response

    Directory of Open Access Journals (Sweden)

    Enrique Gonzalez

    2017-01-01

    Full Text Available The continuous technological advances in favor of mHealth represent a key factor in the improvement of medical emergency services. This systematic review presents the identification, study, and classification of the most up-to-date approaches surrounding the deployment of architectures for mHealth. Our review includes 25 articles obtained from databases such as IEEE Xplore, Scopus, SpringerLink, ScienceDirect, and SAGE. This review focused on studies addressing mHealth systems for outdoor emergency situations. In 60% of the articles, the deployment architecture relied in the connective infrastructure associated with emergent technologies such as cloud services, distributed services, Internet-of-things, machine-to-machine, vehicular ad hoc network, and service-oriented architecture. In 40% of the literature review, the deployment architecture for mHealth considered traditional connective infrastructure. Only 20% of the studies implemented an energy consumption protocol to extend system lifetime. We concluded that there is a need for more integrated solutions specifically for outdoor scenarios. Energy consumption protocols are needed to be implemented and evaluated. Emergent connective technologies are redefining the information management and overcome traditional technologies.

  4. Injury Severity Score coding: Data analyst v. emerging m-health ...

    African Journals Online (AJOL)

    benchmarking and quality improvement initiatives in the trauma ... We hypothesised that emerging mobile health (mhealth) technology could offer a costeffective alternative to the .... 33.98), including a mortality rate of 4.6% (95% CI 2.71 7.57).

  5. Digital Twins in Health Care : Ethical Implications of an Emerging Engineering Paradigm

    NARCIS (Netherlands)

    Bruynseels, K.R.C.; Santoni De Sio, F.; van den Hoven, M.J.

    2018-01-01

    Personalized medicine uses fine grained information on individual persons, to pinpoint deviations from the normal. ‘Digital Twins’ in engineering provide a conceptual framework to analyze these emerging data-driven health care practices, as well as their conceptual and ethical implications for

  6. Global Warming and the Political Ecology of Health: Emerging Crisis and Systemic Solutions

    Directory of Open Access Journals (Sweden)

    Kate Smith

    2012-06-01

    Full Text Available Review of Global Warming and the Political Ecology of Health: Emerging Crisis and Systemic Solutions. Hans Baer and Merrill Singer. 2008. Left Coast Press, Inc., Walnut Creek, CA. Pp. 238. $32.95 (paperback. ISBN 978-1-59874-354-8.

  7. Air Quality and Heart Health: An Emerging Topic for Heart Month

    Science.gov (United States)

    Air Quality and Heart Health: An Emerging Topic for Heart Month: Ambient air particle pollution increases short- and long-term cardiovascular morbidity and mortality. Older-people, those with pre-existing heart disease and lung disease and diabetes are at higher risk. Mechanism...

  8. Global health and emergency care: a resuscitation research agenda--part 1

    NARCIS (Netherlands)

    Aufderheide, Tom P.; Nolan, Jerry P.; Jacobs, Ian G.; van Belle, Gerald; Bobrow, Bentley J.; Marshall, John; Finn, Judith; Becker, Lance B.; Bottiger, Bernd; Cameron, Peter; Drajer, Saul; Jung, Julianna J.; Kloeck, Walter; Koster, Rudolph W.; Huei-Ming Ma, Matthew; Shin, Sang Do; Sopko, George; Taira, Breena R.; Timerman, Sergio; Eng Hock Ong, Marcus

    2013-01-01

    At the 2013 Academic Emergency Medicine global health consensus conference, a breakout session on a resuscitation research agenda was held. Two articles focusing on cardiac arrest and trauma resuscitation are the result of that discussion. This article describes the burden of disease and outcomes,

  9. The Emerging Role of the Republic of South Africa as a Regional Power

    National Research Council Canada - National Science Library

    Zabek, Anthony

    2003-01-01

    Since 1994 the Republic of South Africa has emerged from the limited role of an isolated government, governed by apartheid programs, to a democracy where apartheid has been rejected and a new republic...

  10. The Emerging Role of Social Work in Primary Health Care: A Survey of Social Workers in Ontario Family Health Teams.

    Science.gov (United States)

    Ashcroft, Rachelle; McMillan, Colleen; Ambrose-Miller, Wayne; McKee, Ryan; Brown, Judith Belle

    2018-05-01

    Primary health care systems are increasingly integrating interprofessional team-based approaches to care delivery. As members of these interprofessional primary health care teams, it is important for social workers to explore our experiences of integration into these newly emerging teams to help strengthen patient care. Despite the expansion of social work within primary health care settings, few studies have examined the integration of social work's role into this expanding area of the health care system. A survey was conducted with Canadian social work practitioners who were employed within Family Health Teams (FHTs), an interprofessional model of primary health care in Ontario emerging from a period of health care reform. One hundred and twenty-eight (N = 128) respondents completed the online survey. Key barriers to social work integration in FHTs included difficulties associated with a medical model environment, confusion about social work role, and organizational barriers. Facilitators for integration of social work in FHTs included adequate education and competencies, collaborative engagement, and organizational structures.

  11. Standardization and Implementation of a Standard Emergency Code Call System within Estern Region Medical Command

    Science.gov (United States)

    2009-03-01

    ACHs) exist the same way that Kaiser has established different levels of services within a geographical region ( Hawaii : Hilo , Kona, Honolulu, Maui...California, Hawaii , etc., the Army MHS is divided into regions. Within these regions, Army Medical Centers (MEDCENSs) and Army Community Hospitals

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

    Science.gov (United States)

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

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

  13. Information support for health information management in regional Sri Lanka: health managers' perspectives.

    Science.gov (United States)

    Ranasinghe, Kaduruwane Indika; Chan, Taizan; Yaralagadda, Prasad

    Good management, supported by accurate, timely and reliable health information, is vital for increasing the effectiveness of Health Information Systems (HIS). When it comes to managing the under-resourced health systems of developing countries, information-based decision making is particularly important. This paper reports findings of a self-report survey that investigated perceptions of local health managers (HMs) of their own regional HIS in Sri Lanka. Data were collected through a validated, pre-tested postal questionnaire, and distributed among a selected group of HMs to elicit their perceptions of the current HIS in relation to information generation, acquisition and use, required reforms to the information system and application of information and communication technology (ICT). Results based on descriptive statistics indicated that the regional HIS was poorly organised and in need of reform; that management support for the system was unsatisfactory in terms of relevance, accuracy, timeliness and accessibility; that political pressure and community and donor requests took precedence over vital health information when management decisions were made; and use of ICT was unsatisfactory. HIS strengths included user-friendly paper formats, a centralised planning system and an efficient disease notification system; weaknesses were lack of comprehensiveness, inaccuracy, and lack of a feedback system. Responses of participants indicated that HIS would be improved by adopting an internationally accepted framework and introducing ICT applications. Perceived barriers to such improvements were high initial cost of educating staff to improve computer literacy, introduction of ICTs, and HIS restructure. We concluded that the regional HIS of Central Province, Sri Lanka had failed to provide much-needed information support to HMs. These findings are consistent with similar research in other developing countries and reinforce the need for further research to verify causes of

  14. The mechanisms of regional branching: An investigation of the emerging fuel cell industry

    DEFF Research Database (Denmark)

    Tanner, Anne Nygaard

    The growth of evolutionary thinking in economic geography has brought about the proposition that new industries are place dependent and tend to develop in regions where the pre-existing industry is technologically related to the knowledge base of the new industry, a phenomena that is termed...... ?regional branching?. What is still lacking, however, is a more thorough understanding of the mechanisms through which regional branching operates: firm diversification, spinoffs, labor mobility, and social networking. This paper analyzes which mechanisms dominate the current regional branching process...... such as universities and network organizations play a role in the creation of new knowledge-intensive industrial paths in regions....

  15. The Quality of Online Health-Related Information – an Emergent Consumer Health Issue

    Directory of Open Access Journals (Sweden)

    Nădăşan Valentin

    2016-12-01

    Full Text Available The Internet has become one of the main means of communication used by people who search for health-related information. The quality of online health-related information affects the users’ knowledge, their attitude, and their risk or health behaviour in complex ways and influences a substantial number of users in their decisions regarding diagnostic and treatment procedures.

  16. Changes in public health preparedness services provided to local health departments by regional offices in North Carolina: a comparison of two cross-sectional studies.

    Science.gov (United States)

    Donovan, Catherine V; Markiewicz, Milissa; Horney, Jennifer A

    2014-05-28

    In 2011, seven decentralized Public Health Regional Surveillance Teams (PHRSTs) were restructured into four centralized Public Health Preparedness and Response (PHP&R) regional offices to realign preparedness priorities and essential services with appropriate infrastructure; field-based staff was reduced, saving approximately $1 million. The objective of this study was to understand the impact that restructuring had on services provided to local health departments (LHDs) throughout North Carolina. A survey to document services that regional offices provide to LHDs in North Carolina was administered by the North Carolina Preparedness and Emergency Response Research Center in 2013. The results were compared to a similar survey from 2009, which identified services provided by regional teams prior to restructuring. Of 69 types of assistance, 14 (20%) were received by 50% or more LHDs in 2012. Compared to 2009, there was a significant decrease in the proportion of LHDs receiving 67% (n = 47) of services. The size of the region served by regional offices was shown to inversely impact the proportion of LHDs receiving services for 25% of services. There was a slight significant decline in perceived quality of the services provided by regional teams in 2012 as comparison to 2009. Following a system-wide review of preparedness in North Carolina, the state's regional teams were reorganized to refine their focus to planning, exercises, and training. Some services, most notably under the functions of epidemiology and surveillance and public health event response, are now provided by other state offices. However, the study results indicate that several services that are still under the domain of the regional offices were received by fewer LHDs in 2012 than 2009. This decrease may be due to the larger number of counties now served by the four regional offices.

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

    Science.gov (United States)

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

    2006-01-01

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

  18. Personal Protective Equipment Supply Chain: Lessons Learned from Recent Public Health Emergency Responses.

    Science.gov (United States)

    Patel, Anita; D'Alessandro, Maryann M; Ireland, Karen J; Burel, W Greg; Wencil, Elaine B; Rasmussen, Sonja A

    Personal protective equipment (PPE) that protects healthcare workers from infection is a critical component of infection control strategies in healthcare settings. During a public health emergency response, protecting healthcare workers from infectious disease is essential, given that they provide clinical care to those who fall ill, have a high risk of exposure, and need to be assured of occupational safety. Like most goods in the United States, the PPE market supply is based on demand. The US PPE supply chain has minimal ability to rapidly surge production, resulting in challenges to meeting large unexpected increases in demand that might occur during a public health emergency. Additionally, a significant proportion of the supply chain is produced off-shore and might not be available to the US market during an emergency because of export restrictions or nationalization of manufacturing facilities. Efforts to increase supplies during previous public health emergencies have been challenging. During the 2009 H1N1 influenza pandemic and the 2014 Ebola virus epidemic, the commercial supply chain of pharmaceutical and healthcare products quickly became critical response components. This article reviews lessons learned from these responses from a PPE supply chain and systems perspective and examines ways to improve PPE readiness for future responses.

  19. Exploring the determinants of health and wellbeing in communities living in proximity to coal seam gas developments in regional Queensland.

    Science.gov (United States)

    Mactaggart, Fiona; McDermott, Liane; Tynan, Anna; Gericke, Christian A

    2017-08-03

    There is some concern that coal seam gas mining may affect health and wellbeing through changes in social determinants such as living and working conditions, local economy and the environment. The onward impact of these conditions on health and wellbeing is often not monitored to the same degree as direct environmental health impacts in the mining context, but merits attention. This study reports on the findings from a recurrent theme that emerged from analysis of the qualitative component of a comprehensive Health Needs Assessment (HNA) conducted in regional Queensland: that health and wellbeing of communities was reportedly affected by nearby coal seam gas (CSG) development beyond direct environmental impacts. Qualitative analysis was initially completed using the Framework Method to explore key themes from 11 focus group discussions, 19 in-depth interviews, and 45 key informant interviews with health and wellbeing service providers and community members. A key theme emerged from the analysis that forms the basis of this paper. This study is part of a larger comprehensive HNA involving qualitative and quantitative data collection to explore the health and wellbeing needs of three communities living in proximity to CSG development in regional Queensland, Australia. Communities faced social, economic and environmental impacts from the rapid growth of CSG development, which were perceived to have direct and indirect effects on individual lifestyle factors such as alcohol and drug abuse, family relationships, social capital and mental health; and community-level factors including social connectedness, civic engagement and trust. Outer regional communities discussed the effects of mining activity on the fabric of their town and community, whereas the inner regional community that had a longer history of industrial activity discussed the impacts on families and individual health and wellbeing. The findings from this study may inform future health service planning in

  20. Exploring the determinants of health and wellbeing in communities living in proximity to coal seam gas developments in regional Queensland

    Directory of Open Access Journals (Sweden)

    Fiona Mactaggart

    2017-08-01

    Full Text Available Abstract Background There is some concern that coal seam gas mining may affect health and wellbeing through changes in social determinants such as living and working conditions, local economy and the environment. The onward impact of these conditions on health and wellbeing is often not monitored to the same degree as direct environmental health impacts in the mining context, but merits attention. This study reports on the findings from a recurrent theme that emerged from analysis of the qualitative component of a comprehensive Health Needs Assessment (HNA conducted in regional Queensland: that health and wellbeing of communities was reportedly affected by nearby coal seam gas (CSG development beyond direct environmental impacts. Methods Qualitative analysis was initially completed using the Framework Method to explore key themes from 11 focus group discussions, 19 in-depth interviews, and 45 key informant interviews with health and wellbeing service providers and community members. A key theme emerged from the analysis that forms the basis of this paper. This study is part of a larger comprehensive HNA involving qualitative and quantitative data collection to explore the health and wellbeing needs of three communities living in proximity to CSG development in regional Queensland, Australia. Results Communities faced social, economic and environmental impacts from the rapid growth of CSG development, which were perceived to have direct and indirect effects on individual lifestyle factors such as alcohol and drug abuse, family relationships, social capital and mental health; and community-level factors including social connectedness, civic engagement and trust. Conclusions Outer regional communities discussed the effects of mining activity on the fabric of their town and community, whereas the inner regional community that had a longer history of industrial activity discussed the impacts on families and individual health and wellbeing. The

  1. Turkey's ambitions to emerge as a regional power : example or counter-example for potential aspiring competitors

    OpenAIRE

    BALTOS, Georgios; VIDAKIS, Ioannis G.; BALODIS, Janis

    2017-01-01

    CC BY 3.0 Copyright © MCSER-Mediterranean Center of Social and Educational Research This paper aims to provide a functional assessment of a country’s dynamics at a regional power level, through the development of a tool which shall examine the working hypothesis of a given country’s “candidacy” to emerge as a regional power. The power equation applied in order to have such an evaluation has been formulated in a visually enriched and prototype format, given that particularly the geopolitics...

  2. Enablers and Barriers to Community Engagement in Public Health Emergency Preparedness: A Literature Review.

    Science.gov (United States)

    Ramsbottom, Anna; O'Brien, Eleanor; Ciotti, Lucrezio; Takacs, Judit

    2018-04-01

    Public health emergency preparedness (PHEP) all too often focusses only on institutional capabilities, including their technical expertise and political influence, while overlooking community capabilities. However, the success of institutional emergency preparedness plans depends upon communities and institutions working together to ensure successful anticipation, response and recovery. Broader community engagement is therefore recommended worldwide. This literature review was carried out to identify enablers and barriers to community and institutional synergies in emergency preparedness. Searches were undertaken across bibliographic databases and grey literature sources. The literature identified was qualitative in nature. A qualitative, 'best fit' framework approach using a pre-existing framework was used to analyse the literature, whereby themes were added and changed as analysis progressed. A working definition of community was identified, based on a 'whole community' approach, inclusive of the whole multitude of stakeholders including community residents and emergency management staff. Given the diversity in community make-up, the types of emergencies that could be faced, the socio-economic, environmental and political range of communities, there are no set practices that will be effective for all communities. The most effective way of engaging communities in emergency preparedness is context-dependent and the review did draw out some important key messages for institutions to consider.

  3. Development of regional atmospheric dynamic and air pollution models for nuclear emergency response system WSPEEDI

    International Nuclear Information System (INIS)

    Furuno, Akiko; Yamazawa, Hiromi; Lee, Soon-Hwan; Tsujita, Yuichi; Takemiya, Hiroshi; Chino, Masamichi

    2000-01-01

    WSPEEDI (Worldwide version of System for Prediction of Environmental Emergency Dose Information) is a computer-based emergency response system to predict long-range atmospheric dispersion of radionuclides discharged into the atmosphere due to a nuclear accident. WSPEEDI has been applied to several international exercises and real events. Through such experiences, the new version of WSPEEDI aims to employ a combination of an atmospheric dynamic model and a particle random walk model for more accurate predictions. This paper describes these models, improvement of prediction and computational techniques for quick responses. (author)

  4. A Swedish co-operation programme for radiological emergency planning activities in the Baltic Sea region

    International Nuclear Information System (INIS)

    Petersson, B.

    1998-01-01

    Short overview of the Swedish cooperation projects with Baltic countries in the field of radiological emergency preparedness is presented. Cooperation programme is going since 1993 and is divided into following sections: sub-projects on planning, training and exercises, sub-projects on measurement strategies, including early warning systems, sub-project on information to the public and the media, sub-projects on review of the Ignalina NPP on-site emergency preparedness and planning of on-site rescue operations. Total budget amount allocated for these projects is 9 million Swedish crowns

  5. Reverse quality management: developing evidence-based best practices in health emergency management.

    Science.gov (United States)

    Lynch, Tim; Cox, Paul

    2006-01-01

    The British Columbia Ministry of Health's Framework for Core Functions in Public Health was the catalyst that inspired this review of best practices in health emergency management. The fieldwork was conducted in the fall of 2005 between hurricane Katrina and the South Asia earthquake. These tragedies, shown on 24/7 television news channels, provided an eyewitness account of disaster management, or lack of it, in our global village world. It is not enough to just have best practices in place. There has to be a governance structure that can be held accountable. This review of best practices lists actions in support of an emergency preparedness culture at the management, executive, and corporate/governance levels of the organization. The methodology adopted a future quality management approach of the emergency management process to identify the corresponding performance indictors that correlated with practices or sets of practices. Identifying best practice performance indictors needed to conduct a future quality management audit is described as reverse quality management. Best practices cannot be assessed as stand-alone criteria; they are influenced by organizational culture. The defining of best practices was influenced by doubt about defining a practice it is hoped will never be performed, medical staff involvement, leadership, and an appreciation of the resources required and how they need to be managed. Best practice benchmarks are seen as being related more to "measures" of performance defined locally and agreed on by 2 or more parties rather than to achieving industrial standards. Relating practices to performance indicators and then to benchmarks resulted in the development of a Health Emergency Management Best Practices Matrix that lists specific practice in the different phases of emergency management.

  6. Landscape of Research on Older Adults' Health in the Arab Region: Is It Demography-Driven or Development-Dependent?

    Science.gov (United States)

    Sibai, Abla Mehio; Rizk, Anthony; Costanian, Christy; Beard, John Roland

    2017-07-01

    To describe the quantity, methods, themes, and collaboration profiles of research on older adults' health in the Arab world, and map research productivity against demographic, economic, and development indicators. A scoping review of research on older adults' health drawing from 7 databases and covering the period 1994-2013. Aging research output has increased 6-fold over the study period, with middle-income countries showing the sharpest rise. The majority of the reviewed publications are descriptive in nature, oriented toward examining the extent of disease or factors associated with various morbidity and mortality outcomes (88.5%). Despite the increasing regional instability, there is a dearth of studies on "seniors in emergencies." Collaboration with international coauthors (16.0%) has been more frequent than with regional coauthors (4.2%). Correlation analysis suggests that research production has been more strongly influenced by literacy rates than by population aging indicators, Gross Domestic Product, or government investment in research and development. This study lays the basis for a "roadmap" for research on older adults' health in the Arab region. It calls for cooperation among various stakeholders to produce a targeted and well-informed research agenda that is more responsive to emerging and context-specific needs of older adults in the region. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  7. Promoting public health legal preparedness for emergencies: review of current trends and their relevance in light of the Ebola crisis

    OpenAIRE

    Cohen, Odeya; Feder-Bubis, Paula; Bar-Dayan, Yaron; Adini, Bruria

    2015-01-01

    Background: Public health legal preparedness (PHLP) for emergencies is a core component of the health system response. However, the implementation of health legal preparedness differs between low- and middle-income countries (LMIC) and developed countries.Objective: This paper examines recent trends regarding public health legal preparedness for emergencies and discusses its role in the recent Ebola outbreak.Design: A rigorous literature review was conducted using eight electronic databases a...

  8. Epidemiology of road traffic injuries in qassim region, saudi arabia: consistency of police and health data.

    Science.gov (United States)

    Barrimah, Issam; Midhet, Farid; Sharaf, Fawzi

    2012-01-01

    In Saudi Arabia, road traffic accidents (RTA) are becoming a serious public health problem. Police reports are designed for legal purposes with very little information on the health consequences. Also, health system data include detailed health information, but not related or linked to the data obtained police reports. Examining the consistency of these sources is vital to build an accurate surveillance system that can track the risk factors and the health consequences, as well as establishing and evaluating prevention interventions. This study is intended to: ▪ Examine the consistency of health -registration data with the data gathered by the traffic police department.▪ Elucidate the magnitude, risk factors and outcome of RTI in Qassim region of Saudi Arabia,▪ Compare the pattern of accidents in Qassim with those at different regions of the Kingdom. Health care information was collected on visits of victims of road traffic accidents to emergency and outpatients' departments of the major hospitals in Qassim region during the year 2010. The information included the patients' demographics, and clinical characteristics. Traffic Police Department information was also collected on all accidents that occurred in the study region. A Questionnaire was also developed and pilot tested to collect data from a random sample of population attending hospital outpatient and Primary Health Care clinics. Data included previous involvement in road traffic accident, and information about any injury; fatality or disability due to these RTI. During the study period, road traffic death rate based on death registration data was almost twice as high as the rate reported by the police (P police-reported data during the study period, as opposed to a non-significant increase of 8% according to health registration data during the same period. Population Survey Information showed the overall age-sex-adjusted rate for non-fatal RTI was 20.7 (95% CI, 20.0 - 21.3)/100 persons/year. The rate

  9. Turkey's role as a regional and global player and its power capacity: Turkey's engagement with other emerging states

    Directory of Open Access Journals (Sweden)

    Aylin Gürzel

    2014-06-01

    Full Text Available Turkey's role as a regional power has increased since Justice and Development Party (AKP came to power. AKP leadership not only aspired to become a regional power but also a global player. Turkey has, therefore, assumed different roles: the "natural leader" of the region; a historical "big brother;" and the "protector" of the Muslim minorities. Turkey has also assumed a "mediator" and a "facilitator" role by trying to negotiate a deal with an emerging power such as Brazil in order to attempt to resolve the controversial Iranian nuclear issue. By making use of recent developments, Turkey tried to solidify its long desired role as a "rising power" by increasing its influence in its neighborhood and engaging with other emerging powers. The concept "regional power" is a context-based notion. In other words, the location and geography are contesting and disputed approaches. Notwithstanding the fact that concepts such as "region" and "power" are social constructed reality, this paper analyzes the notion of 'regional power' as a subcategory of 'power'. In this context, this paper will make use of Stefan Schim's criteria while analyzing Turkey's power capacity in the region. Schim posits that the "regional power" needs to have a "role definition," and it should possess material power (hard power. It should also have economic as well as diplomatic and organizational capacity. Its power whether it is 'soft power' (attraction of ones idea's and or the ability to set the political agenda in a way that shapes the preferences of other actors or 'hard power' (material power that can be measured-economic and military power needs to be acknowledged by other actors in the region. It should also be accepted by great powers and emerging powers that are determinant in the international system. dditionally, the regional power (and/ or global power needs to have leverage, thus its power projection needs to yield results. Kalevi Holsti's role theory will be used as

  10. Decreasing influenza impact in lodges: 1997-2000 Calgary Regional Health Authority.

    Science.gov (United States)

    McLeod, L; Lau, W W

    2001-01-01

    Influenza causes high morbidity and hospitalization rates in residents of seniors lodges, I causing increased pressure on emergency departments and hospital beds every winter. This quasi-experimental study assessed the prevention of influenza outbreaks and their consequences in Calgary lodges. A multidisciplinary team worked to improve communication between health professionals, increase resident and staff immunization coverage, obtain weights and creatinines prior to influenza season, and facilitate amantadine prophylaxis during influenza A outbreaks. We had an increase in standing orders for amantadine and up to 56% of residents from one lodge had documented creatinine levels. Amantadine was administered to residents within two days of outbreak notification. Influenza morbidity in lodge outbreaks decreased from a rate of 37% to 9% over the three years and hospitalization rates decreased from 9% to 1%. We recommend that other regions consider a similar approach to decreasing influenza morbidity and hospitalization in lodge residents.