WorldWideScience

Sample records for health regional coordination

  1. Regional transit coordination guidebook.

    Science.gov (United States)

    2009-01-01

    Constant growth in rural areas and extensive suburban development have contributed to increasingly more people needing seamless and adequate public transportation into and from nearby cities. Coordinating existing services or determining the need for...

  2. Coordination as a best practice from the polio eradication initiative: Experiences from five member states in the African region of the World Health Organization.

    Science.gov (United States)

    Okeibunor, Joseph; Nsubuga, Peter; Salla, Mbaye; Mihigo, Richard; Mkanda, Pascal

    2016-10-10

    As part of the efforts to eradicate polioviruses in the African Region, structures were put in place to ensure coordinated mobilization and deployment of resources within the framework of the global polio eradication initiative (PEI). The successes of these structures made them not only attractive to other public health interventions, but also caused them to be deployed to the response efforts of other diseases interventions, without any systematic documentation. This article documents the contributions of PEI coordination units to other public health interventions in the African Region of World Health Organization METHODS: We reviewed the contributions of PEI coordination units to other public health interventions in five countries in the African Region. The analysis identified significant involvement of PEI coordination structures in the implementation of routine immunization programs in all the countries analyzed. Similarly, maternal and child health programs were planned, implemented, monitored and evaluation the Inter-Agency Coordination Committees of the PEI programs in the different countries. The hubs system used in PEI in Chad facilitated the efficient coordination of resources for immunization and other public health interventions in Chad. Similarly, in the Democratic Republic of Congo PEI led coordination activities benefited other public health programs like disease control and the national nutrition program, the national malaria control program, and the tuberculosis control program. In Nigeria, the polio Expert Review Committee effectively deployed the Emergency Operation Center for the implementation of prioritized strategies and activities of the National Polio Eradication Emergency Plan, and it was utilized in the response to Ebola Virus Disease outbreak in the country. The PEI-led coordination systems are thus recognized as having made significant contribution to the coordination and delivery of other public health interventions in the African

  3. Regional health workforce monitoring as governance innovation: a German model to coordinate sectoral demand, skill mix and mobility.

    Science.gov (United States)

    Kuhlmann, E; Lauxen, O; Larsen, C

    2016-11-28

    As health workforce policy is gaining momentum, data sources and monitoring systems have significantly improved in the European Union and internationally. Yet data remain poorly connected to policy-making and implementation and often do not adequately support integrated approaches. This brings the importance of governance and the need for innovation into play. The present case study introduces a regional health workforce monitor in the German Federal State of Rhineland-Palatinate and seeks to explore the capacity of monitoring to innovate health workforce governance. The monitor applies an approach from the European Network on Regional Labour Market Monitoring to the health workforce. The novel aspect of this model is an integrated, procedural approach that promotes a 'learning system' of governance based on three interconnected pillars: mixed methods and bottom-up data collection, strong stakeholder involvement with complex communication tools and shared decision- and policy-making. Selected empirical examples illustrate the approach and the tools focusing on two aspects: the connection between sectoral, occupational and mobility data to analyse skill/qualification mixes and the supply-demand matches and the connection between monitoring and stakeholder-driven policy. Regional health workforce monitoring can promote effective governance in high-income countries like Germany with overall high density of health workers but maldistribution of staff and skills. The regional stakeholder networks are cost-effective and easily accessible and might therefore be appealing also to low- and middle-income countries.

  4. Health Coordination Manual. Head Start Health Services.

    Science.gov (United States)

    Administration for Children, Youth, and Families (DHHS), Washington, DC. Head Start Bureau.

    Part 1 of this manual on coordinating health care services for Head Start children provides an overview of what Head Start health staff should do to meet the medical, mental health, nutritional, and/or dental needs of Head Start children, staff, and family members. Offering examples, lists, action steps, and charts for clarification, part 2…

  5. Promoting coordination in Norwegian health care

    Directory of Open Access Journals (Sweden)

    Tor I. Romøren

    2011-10-01

    Full Text Available   Introduction: The Norwegian health care system is well organized within its two main sectors - primary health and long term care on the one hand, and hospitals and specialist services on the other. However, the relation between them lacks mediating structures.Policy practice: Enhancing coordination between primary and secondary health care has been central in Norwegian health care policy the last decade. In 2003 a committee was appointed to identify coordination problems and proposed a lot of practical and organisational recommendations. It relied on an approach challenging primary and secondary health care in shared geographical regions to take action. However, these proposals were not implemented. In 2008 a new Minister of Health and Care worked out plans under the key term "Coordination Reform". These reform plans superseded and expanded the previous policy initiatives concerning cooperation, but represented also a shift in focus to a regulative and centralised strategy, including new health legislation, structural reforms and use of economic incentives that are now about to be implemented.Discussion: The article analyses the perspectives and proposals of the previous and the recent reform initiatives in Norway and discusses them in relation to integrated care measures implemented in Denmark and Sweden.

  6. CORDEX Coordinated Output for Regional Evaluation

    Science.gov (United States)

    Gutowski, William; Giorgi, Filippo; Lake, Irene

    2017-04-01

    The Science Advisory Team for the Coordinated Regional Downscaling Experiment (CORDEX) has developed a baseline framework of specified regions, resolutions and simulation periods intended to provide a foundation for ongoing regional CORDEX activities: the CORDEX Coordinated Output for Regional Evaluation, or CORDEX-CORE. CORDEX-CORE was conceived in part to be responsive to IPCC needs for coordinated simulations that could provide regional climate downscaling (RCD) that yields fine-scale climate information beyond that resolved by GCMs. For each CORDEX region, a matrix of GCM-RCD experiments is designed based on the need to cover as much as possible different dimensions of the uncertainty space (e.g., different emissions and land-use scenarios, GCMs, RCD models and techniques). An appropriate set of driving GCMs can allow a program of simulations that efficiently addresses key scientific issues within CORDEX, while facilitating comparison and transfer of results and lessons learned across different regions. The CORDEX-CORE program seeks to provide, as much as possible, homogeneity across domains, so it is envisioned that a standard set of regional climate models (RCMs) and empirical statistical downscaling (ESD) methods will downscale a standard set of GCMs over all or at least most CORDEX domains for a minimum set of scenarios (high and low end). The focus is on historical climate simulations for the 20th century and projections for 21st century, implying that data would be needed minimally for the period 1950-2100 (but ideally 1900-2100). This foundational ensemble can be regionally enriched with further contributions (additional GCM-RCD pairs) by individual groups over their selected domains of interest. The RCM model resolution for these core experiments will be in the range of 10-20 km, a resolution that has been shown to provide substantial added value for a variety of climate variables and that represents a significant forward step compared in the CORDEX

  7. Coordinating health care: lessons from Norway

    Directory of Open Access Journals (Sweden)

    Trond Tjerbo

    2005-11-01

    Full Text Available Objective: What influences the coordination of care between general practitioners and hospitals? In this paper, general practitioner satisfaction with hospital—GP interaction is revealed, and related to several background variables. Method: A questionnaire was sent to all general practitioners in Norway (3388, asking their opinion on the interaction and coordination of health care in their district. A second questionnaire was sent to all the somatic hospitals in Norway (59 regarding formal routines and structures. The results were analysed using ordinary least squares regression. Results: General practitioners tend to be less satisfied with the coordination of care when their primary hospital is large and cost-effective with a high share of elderly patients. Together with the degree to which the general practitioner is involved in arenas where hospital physicians and general practitioners interact, these factors turned out to be good predictors of general practitioner satisfaction. Implication: To improve coordination between general practitioners and specialists, one should focus upon the structural traits within the hospitals in different regions as well as creating common arenas where the physicians can interact.

  8. Medical-legal partnerships: the role of mental health providers and legal authorities in the development of a coordinated approach to supporting mental health clients' legal needs in regional and rural settings.

    Science.gov (United States)

    Speldewinde, Christopher A; Parsons, Ian

    2015-01-01

    Medical-legal partnerships (MLP) are a model in which medical and legal practitioners are co-located and work together to support the health and wellbeing of individuals by identifying and resolving legal issues that impact patients' health and wellbeing. The aim of this article is to analyse the benefits of this model, which has proliferated in the USA, and its applicability in the context of rural and remote Australia. This review was undertaken with three research questions in mind: What is an MLP? Is service provision for individuals with mental health concerns being adequately addressed by current service models particularly in the rural context? Are MLPs a service delivery channel that would benefit individuals experiencing mental health issues? The combined searches from all EBSCO Host databases resulted in 462 citations. This search aggregated academic journals, newspapers, book reviews, magazines and trade publications. After several reviews 38 papers were selected for the final review based on their relevance to this review question: How do MLPs support mental health providers and legal service providers in the development of a coordinated approach to supporting mental health clients' legal needs in regional and rural Australia? There is considerable merit in pursuing the development of MLPs in rural and remote Australia particularly as individuals living in rural and remote areas have far fewer opportunities to access support services than those people living in regional and metropolitan locations. MLPS are important channels of service delivery to assist in early invention of legal problems that can exacerbate mental health problems.

  9. Politics of coordination in environmental health

    DEFF Research Database (Denmark)

    Holm, Jesper; Kjærgård, Bente; Jelsøe, Erling

    2015-01-01

    on environmental policy integration, for studying the efforts and paradoxes in sector co-ordination, in order to reflect on the pro et cons of integrative approaches to environment and public health. We will give an overview of the various approaches to coordinative efforts from an international to a national...

  10. Health Sector Coordination in Disasters: Barriers & Facilitators

    Directory of Open Access Journals (Sweden)

    Mohammadkarim Bahadori

    2016-07-01

    Full Text Available Background: Coordination is a critical factor in successful organization and appropriate response to disasters. In this regard, a centralized coordination mechanism is the first step towards an effective, efficient, and sustainable response in order to be ensured of the short- and long-term recovery. Thus, this study aimed to identify and prioritize the barriers and facilitators of coordination in disasters. Materials and Methods: This research was a descriptive and cross-sectional study, conducted in 2016. The participants comprised 22 experts in field of disaster. Data collection tool was a researcher-made questionnaire according to the analytical hierarchy process approach. For data analysis, we used Expert Choice software. Results: Based on the results, “dominance of organizational approach instead of national points of view when addressing the health management during disasters,” took the first priority rank, earning the score of 0.344 among the barriers. Furthermore, among the facilitators, “having a processive and organizational view in health management during disasters,” took the first priority rank, earning the score of 0.374. Conclusion: To increase the effective coordination in health area, we should develop infrastructure and structural measures, which include bolstering authorities’ belief about the health system’s role in the response to disasters, reinforcing the national approach rather than organizational approach in the field of health at disasters, implementing the coordination requirements, attending sufficiently and specifically to public participation, reducing the organizational friction in the health field for sharing resources and information, raising the level of readiness with a focus on people and training programs, and finally creating an evolutionary process in the health field at disasters.

  11. Regional Coordination: A Point of View.

    Science.gov (United States)

    Faibisoff, Sylvia G.

    To more adequately provide for newly perceived user needs, New York State libraries have adopted the philosophy of regionalism through which public, academic, and special libraries can cooperate and share resources. The state's 22 public library systems and 9 3R regions (Reference and Research Library Resources Councils) are organized…

  12. Coordinated School Health and the Contribution of a District Wellness Coordinator

    Science.gov (United States)

    Westrich, Lisa; Sanchez, Monika; Strobel, Karen

    2015-01-01

    Background: A San Francisco Bay Area school health initiative was established in fall 2010 to improve wellness programs in 4 local school districts using the Coordinated School Health (CSH) model. This study examines the role of district-wide wellness coordinators and the ways in which they contribute to intentional coordination of health and…

  13. Regionalism and Statewide Coordination of Postsecondary Education. Report No. 26.

    Science.gov (United States)

    Martorana, S. V.; McGuire, W. Gary

    Initial findings are reported of a continuing study of a new American postsecondary educational planning and coordination concept and its implementation: regionalism and regionalization. Regionalism is defined as that view of a geographic subsection of a state or of several adjoining states that considers all or a number of the postsecondary…

  14. Policy Approach to Coordinated Regional Development

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    <正>1. Introduction A "region" refers to a given area where the economic interrelation is close and the social interaction is frequent, which can be regarded as an economic community at different levels including local, national, and international. Here in this

  15. Health care agreements as a tool for coordinating health and social services

    Directory of Open Access Journals (Sweden)

    Andreas Rudkjøbing

    2014-12-01

    Full Text Available Introduction: In 2007, a substantial reform changed the administrative boundaries of the Danish health care system and introduced health care agreements to be signed between municipal and regional authorities. To assess the health care agreements as a tool for coordinating health and social services, a survey was conducted before (2005–2006 and after the reform (2011.Theory and methods: The study was designed on the basis of a modified version of Alter and Hage's framework for conceptualising coordination. Both surveys addressed all municipal level units (n = 271/98 and a random sample of general practitioners (n = 700/853.Results: The health care agreements were considered more useful for coordinating care than the previous health plans. The power relationship between the regional and municipal authorities in drawing up the agreements was described as more equal. Familiarity with the agreements among general practitioners was higher, as was the perceived influence of the health care agreements on their work.Discussion: Health care agreements with specific content and with regular follow-up and systematic mechanisms for organising feedback between collaborative partners exemplify a useful tool for the coordination of health and social services.Conclusion: There are substantial improvements with the new health agreements in terms of formalising a better coordination of the health care system.

  16. Regional variation in interhemispheric coordination of intrinsic hemodynamic fluctuations.

    Science.gov (United States)

    Stark, David E; Margulies, Daniel S; Shehzad, Zarrar E; Reiss, Philip; Kelly, A M Clare; Uddin, Lucina Q; Gee, Dylan G; Roy, Amy K; Banich, Marie T; Castellanos, F Xavier; Milham, Michael P

    2008-12-17

    Electrophysiological studies have long demonstrated a high degree of correlated activity between the left and right hemispheres, however little is known about regional variation in this interhemispheric coordination. Whereas cognitive models and neuroanatomical evidence suggest differences in coordination across primary sensory-motor cortices versus higher-order association areas, these have not been characterized. Here, we used resting-state functional magnetic resonance imaging data acquired from 62 healthy volunteers to examine interregional correlation in spontaneous low-frequency hemodynamic fluctuations. Using a probabilistic atlas, we correlated probability-weighted time series from 112 regions comprising the entire cerebrum. We then examined regional variation in correlated activity between homotopic regions, contrasting primary sensory-motor cortices, unimodal association areas, and heteromodal association areas. Consistent with previous studies, robustly correlated spontaneous activity was noted between all homotopic regions, which was significantly higher than that between nonhomotopic (heterotopic and intrahemispheric) regions. We further demonstrated substantial regional variation in homotopic interhemispheric correlations that was highly consistent across subjects. Specifically, there was a gradient of interhemispheric correlation, with highest correlations across primary sensory-motor cortices (0.758, SD=0.152), significantly lower correlations across unimodal association areas (0.597, SD=0.230) and still lower correlations across heteromodal association areas (0.517, SD=0.226). These results demonstrate functional differences in interhemispheric coordination related to the brain's hierarchical subdivisions. Synchrony across primary cortices may reflect networks engaged in bilateral sensory integration and motor coordination, whereas lower coordination across heteromodal association areas is consistent with functional lateralization of these regions

  17. Health care agreements as a tool for coordinating health and social services

    DEFF Research Database (Denmark)

    Rudkjøbing, Andreas; Strandberg-Larsen, Martin; Vrangbaek, Karsten

    2014-01-01

    of general practitioners (n = 700/853). RESULTS: The health care agreements were considered more useful for coordinating care than the previous health plans. The power relationship between the regional and municipal authorities in drawing up the agreements was described as more equal. Familiarity......INTRODUCTION: In 2007, a substantial reform changed the administrative boundaries of the Danish health care system and introduced health care agreements to be signed between municipal and regional authorities. To assess the health care agreements as a tool for coordinating health and social...... with the agreements among general practitioners was higher, as was the perceived influence of the health care agreements on their work. DISCUSSION: Health care agreements with specific content and with regular follow-up and systematic mechanisms for organising feedback between collaborative partners exemplify...

  18. Evaluation of the National School Health Coordinator Leadership Institute

    Science.gov (United States)

    Ottoson, Judith M.; Streib, Greg; Thomas, John Clayton; Rivera, Mark; Stevenson, Beth

    2004-01-01

    In 1999 the American Cancer Society (ACS) launched the National School Health Coordinator Leadership Institute, a groundbreaking initiative designed to enhance and invigorate school health in the nation's schools by training individual school health coordinators to act as change agents. The Institute consisted of three, week-long summer training…

  19. How to achieve care coordination inside health care organizations

    DEFF Research Database (Denmark)

    Prætorius, Thim; C. Becker, Markus

    2015-01-01

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

  20. Advantages of Coordinated School Health Portfolios: Documenting and Showcasing Achievements

    Science.gov (United States)

    Shipley, Meagan; Lohrmann, David; Barnes, Priscilla; O'Neill, Jim

    2013-01-01

    Background: Thirteen school district teams from Michigan and Indiana participated in the Michiana Coordinated School Health Leadership Institute with the intent of Coordinated School Health Program (CSHP) implementation. The purpose of this study was to determine if portfolios served as an effective approach for documenting teams' accomplishments…

  1. Coordination of nuclear developments in the Asia-Pacific region

    International Nuclear Information System (INIS)

    Wakabayashi, H.; An, S.

    1984-01-01

    Healthy, coordinated development of nuclear energy in the Asia-Pacific region requires the securing of human resources. This is an important component of development and should be well designed in advance, notwithstanding the fact that each country and area has its own unique system for nuclear research, education, and training. Differences are even more pronounced where preparedness for nuclear abnormal occurrences are concerned, despite the international impact of such incidents. From this point of view, we examine the current situation in international education and training of nuclear specialists, encompassing nuclear education and training systems, IAEA efforts, bilateral and multilateral transregional cooperation, and matters relating to national and transnational preparedness for nuclear abnormal occurrences. We present a proposal to create a regional center that would establish cooperation in nuclear research, education, training, and preparedness for abnormal occurrences. (author)

  2. Coordinated Optimal Operation Method of the Regional Energy Internet

    Directory of Open Access Journals (Sweden)

    Rishang Long

    2017-05-01

    Full Text Available The development of the energy internet has become one of the key ways to solve the energy crisis. This paper studies the system architecture, energy flow characteristics and coordinated optimization method of the regional energy internet. Considering the heat-to-electric ratio of a combined cooling, heating and power unit, energy storage life and real-time electricity price, a double-layer optimal scheduling model is proposed, which includes economic and environmental benefit in the upper layer and energy efficiency in the lower layer. A particle swarm optimizer–individual variation ant colony optimization algorithm is used to solve the computational efficiency and accuracy. Through the calculation and simulation of the simulated system, the energy savings, level of environmental protection and economic optimal dispatching scheme are realized.

  3. 75 FR 32472 - Office of the National Coordinator for Health Information Technology; HIT Standards Committee...

    Science.gov (United States)

    2010-06-08

    ... Coordinator for Health Information Technology AGENCY: Office of the National Coordinator for Health Information Technology, HHS. ACTION: Notice of committee recommendations and invitation for public input... Coordinator for Health Information Technology (ONC). Name of Committee: HIT Standards Committee. General...

  4. Stakeholder Knowledge Levels of Coordinated School Health Programs

    Science.gov (United States)

    Minor, Lisa Crouch

    2012-01-01

    Acute and chronic health conditions may be important factors impacting absenteeism and student achievement in schools. Coordinated school health programs can support students who have these conditions. Although such programs have had documented success, implementation can be costly and time consuming. The local problem addressed in this project…

  5. Impact of a School Health Coordinator Intervention on Health-Related School Policies and Student Behavior

    Science.gov (United States)

    O'Brien, Liam M.; Polacsek, Michele; MacDonald, Pamela B.; Ellis, Jacqueline; Berry, Susan; Martin, Maurice

    2010-01-01

    Background: Health-related, school-based interventions may serve to prevent disease and improve academic performance. The Healthy Maine Partnerships (HMP) initiative funded local school health coordinators (SHCs) as a part of Maine's Coordinated School Health Program (CSHP) beginning in January 2001. SHCs established school health leadership teams…

  6. 76 FR 23543 - The Jobs and Innovation Accelerator Challenge; a Coordinated Initiative To Advance Regional...

    Science.gov (United States)

    2011-04-27

    ... Jobs and Innovation Accelerator Challenge; a Coordinated Initiative To Advance Regional Competitiveness... Federal resources to support regional innovation and sustainable economic prosperity. Knowing that regional innovation clusters provide a globally proven approach for developing economic prosperity, this...

  7. Coordinated Management of Academic Health Centers.

    Science.gov (United States)

    Balser, Jeffrey R; Stead, William W

    2017-01-01

    Academic health centers (AHCs) are the nation's primary resource for healthcare discovery, innovation, and training. US healthcare revenue growth has declined sharply since 2009, and is forecast to remain well below historic levels for the foreseeable future. As the cost of education and research at nearly all AHCs is heavily subsidized through large transfers from clinical care margins, our institutions face a mounting crisis. Choices centering on how to increase the cost-effectiveness of the AHC enterprise require unprecedented levels of alignment to preserve an environment that nurtures creativity. Management processes require governance models that clarify decision rights while harnessing the talents and the intellectual capital of a large, diverse enterprise to nimbly address unfamiliar organizational challenges. This paper describes key leadership tactics aimed at propelling AHCs along this journey - one that requires from all leaders a commitment to resilience, optimism, and willingness to embrace change.

  8. Health Care Reform, Care Coordination, and Transformational Leadership.

    Science.gov (United States)

    Steaban, Robin Lea

    2016-01-01

    This article is meant to spur debate on the role of the professional nurse in care coordination as well as the role of nursing leaders for defining and leading to a future state. This work highlights the opportunity and benefits associated with transformation of professional nursing practice in response to the mandates of the Affordable Care Act of 2010. An understanding of core concepts and the work of care coordination are used to propose a model of care coordination based on the population health pyramid. This maximizes the roles of nurses across the continuum as transformational leaders in the patient/family and nursing relationship. The author explores the role of the nurse in a transactional versus transformational relationship with patients, leading to actualization of the nurse in care coordination. Focusing on the role of the nurse leader, the challenges and necessary actions for optimization of the professional nurse role are explored, using principles of transformational leadership.

  9. Coordinators for health science libraries in the Midwest Health Science Library Network.

    Science.gov (United States)

    Holtum, E A; McKloskey, J; Mahan, R

    1977-04-01

    In the summer of 1973 one resource library in each of the six states of the Midwest Health Science Library Network received funding from the National Library of Medicine to hire a coordinator for health science libraries. The development of the role of coordinator is examined and evaluated. The coordinators have proved valuable in the areas of consortium formation, basic unit development, communication facilitation, and program initiation. The function of the coordinators in the extensive planning effort now being undertaken by the network and the future need for the coordinator positions are discussed.

  10. Monitoring Resource Utilization in a Health Care Coordination Program.

    Science.gov (United States)

    Popejoy, Lori L; Jaddoo, Julie; Sherman, Jan; Howk, Christopher; Nguyen, Raymond; Parker, Jerry C

    2015-01-01

    This initial article describes the development of a health care coordination intervention and documentation system designed using the Agency for Healthcare Research and Quality (AHRQ) Care Coordination Atlas framework for Centers for Medicare & Medicaid-funded innovation project, Leveraging Information Technology to Guide High-Tech, High-Touch Care (LIGHT). The study occurred at an academic medical center that serves 114 counties. Twenty-five registered nurse care managers (NCMs) were hired to work with 137 providers in 10 family community and internal medicine clinics. Patients were allocated into one of the four tiers on the basis of their chronic medical conditions and health care utilization. Using a documentation system on the basis of the AHRQ domains developed for this study, time and touch data were calculated for 8,593 Medicare, Medicaid, or dual-eligible patients. We discovered through the touch and time analysis that the majority of health care coordination activity occurred in the AHRQ domains of communication, assess needs and goals, and facilitate transitions, accounting for 79% of the NCM time and 61% of the touches. As expected, increasing tier levels resulted in increased use of NCM resources. Tier 3 accounted for roughly 16% of the patients and received 159 minutes/member (33% of total minutes), and Tier 4 accounted for 4% of patients and received 316 minutes/member (17% of all minutes). In contrast Tier 2, which did not require routine touches per protocol, had 5,507 patients (64%), and those patients received 5,246 hours of health care coordination, or 57 minutes/member, and took 48% of NCM time. 1. The AHRQ Care Coordination Atlas offered a systematic way to build a documentation system that allowed for the extraction of data that was used to calculate the amount of time and the number of touches that NCMs delivered per member. 2. Using a framework to systematically guide the work of health care coordination helped NCMs to think strategically

  11. 29 CFR 42.20 - Regional Farm Labor Coordinated Enforcement Committee.

    Science.gov (United States)

    2010-07-01

    ... Coordinated Enforcement Committee. (a) Under the leadership of the ESA Regional Administrator, each region... Committee shall: (1) Meet regularly on at least a quarterly basis; (2) Exchange information on enforcement...

  12. Louisville region demonstration of travel management coordination center : system pre-deployment preparation.

    Science.gov (United States)

    2013-03-01

    The purpose of the Greater Louisville Region Demonstration of Travel Management Coordination Center (TMCC): System Pre-Deploy-ment Preparation grant was to further phased implementation of the regions TMCC design by focusing on two major component...

  13. 29 CFR 42.10 - Farm labor contact persons and regional coordinators (OSHA).

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Farm labor contact persons and regional coordinators (OSHA... contact persons and regional coordinators (OSHA). (a) OSHA Area Directors shall be responsible for... taken; and (2) migrant farmworker camp inspections are scheduled promptly. (b) OSHA Area Directors shall...

  14. Micro practices of coordination based on complex adaptive systems: user needs and strategies for coordinating public health in Denmark

    Directory of Open Access Journals (Sweden)

    Morten Deleuran Terkildsen

    2015-09-01

    Full Text Available Introduction: Many highly formalised approaches to coordination poorly fit public health and recent studies call for coordination based on complex adaptive systems. Our contribution is two-fold. Empirically, we focus on public health, and theoretically we build on the patient perspective and treat coordination as a process of contingent, two-level negotiations of user needs.Theory and Methods: The paper draws on the concept of user needs-based coordination and sees coordination as a process, whereby needs emerging from the life world of the user are made amenable to the health system through negotiations. The analysis is based on an explorative case study of a health promotion initiative in Denmark. It adopts an anthropological qualitative approach and uses a range of qualitative data.Results: The analysis identifies four strategies of coordination: the coordinator focusing on the individual user or on relations with other professionals; and the manager coaching the coordinator or providing structural support. Crucially, the coordination strategies by management remain weak as they do not directly relate to specific user needs.Discussion: In process of bottom-up negotiations user needs become blurred and this is especially a challenge for management. The study therefore calls for an increased focus on the level nature of negotiations to bridge the gap that currently weakens coordination strategies by management.

  15. Micro practices of coordination based on complex adaptive systems: user needs and strategies for coordinating public health in Denmark.

    Science.gov (United States)

    Terkildsen, Morten Deleuran; Wittrup, Inge; Burau, Viola

    2015-01-01

    Many highly formalised approaches to coordination poorly fit public health and recent studies call for coordination based on complex adaptive systems. Our contribution is two-fold. Empirically, we focus on public health, and theoretically we build on the patient perspective and treat coordination as a process of contingent, two-level negotiations of user needs. The paper draws on the concept of user needs-based coordination and sees coordination as a process, whereby needs emerging from the life world of the user are made amenable to the health system through negotiations. The analysis is based on an explorative case study of a health promotion initiative in Denmark. It adopts an anthropological qualitative approach and uses a range of qualitative data. The analysis identifies four strategies of coordination: the coordinator focusing on the individual user or on relations with other professionals; and the manager coaching the coordinator or providing structural support. Crucially, the coordination strategies by management remain weak as they do not directly relate to specific user needs. In process of bottom-up negotiations user needs become blurred and this is especially a challenge for management. The study therefore calls for an increased focus on the level nature of negotiations to bridge the gap that currently weakens coordination strategies by management.

  16. 29 CFR 1625.32 - Coordination of retiree health benefits with Medicare and State health benefits.

    Science.gov (United States)

    2010-07-01

    ... order to maintain a competitive advantage in the marketplace—using these and other benefits to attract... Coordination of retiree health benefits with Medicare and State health benefits. (a) Definitions. (1) Employee...

  17. Coordinated Regional Benefit Studies of Coastal Ocean Observing Systems

    National Research Council Canada - National Science Library

    Kite-Powell, Hauke L; Colgan, Charles S; Luger, Michael; Wieand, Ken; Pulsipher, Allan; Pendleton, Linwood; Wellman, Katherine; Pelsoci, Tom

    2003-01-01

    .... The authors will first produce regional "inventories" of ocean observation user sectors, including information about the physical and economic scale of their activities, how products from improved...

  18. Beyond leadership: political strategies for coordination in health policies.

    Science.gov (United States)

    Greer, Scott L; Lillvis, Denise F

    2014-05-01

    Health in All Policies (HiAP) promises to improve population health by harnessing the energies and activities of various sectors. Nevertheless, it faces well-documented bureaucratic obstacles and appears to require intersectoral governance if it is to be established. The basic problems of establishing intersectoral governance for HiAP are known to public administration and political science. On reading that literature, we find that the difficulty of establishing intersectoral governance for HiAP breaks down into two kinds of problems: that of establishing coordinated actions at all (coordination); and ensuring that they endure in changed political circumstances (durability). We further find that policymakers' solutions fall into three categories: visible ones of political will (e.g., plans and targets); bureaucratic changes such as the introduction of Health Impact Assessment or reorganization; and indirect methods such as data publication and support from outside groups to put pressure on the government. It can seem that Health in All Policies, like much of public health, depends on effective and committed policymakers but is vulnerable to changing political winds. The three kinds of strategies suggest how policymakers can, and do, create intersectoral governance that functions and persists, expanding the range of effective policy recommendations. Copyright © 2014. Published by Elsevier Ireland Ltd.

  19. 77 FR 70444 - Office of the National Coordinator for Health Information Technology; Health Information...

    Science.gov (United States)

    2012-11-26

    ... Technology; Health Information Technology; HIT Policy Committee: Request for Comment Regarding the Stage 3 Definition of Meaningful Use of Electronic Health Records (EHRs) AGENCY: Health Information Technology (HIT) Policy Committee, Office of the National Coordinator for Health Information Technology (ONC), Department...

  20. Photocatalytic activity of PANI loaded coordination polymer composite materials: Photoresponse region extension and quantum yields enhancement via the loading of PANI nanofibers on surface of coordination polymer

    International Nuclear Information System (INIS)

    Cui, Zhongping; Qi, Ji; Xu, Xinxin; Liu, Lu; Wang, Yi

    2013-01-01

    To enhance photocatalytic property of coordination polymer in visible light region, polyaniline (PANI) loaded coordination polymer photocatalyst was synthesized through in-situ chemical oxidation of aniline on the surface of coordination polymer. The photocatalytic activity of PANI loaded coordination polymer composite material for degradation of Rhodamine B (RhB) was investigated. Compared with pure coordination polymer photocatalyst, which can decompose RhB merely under UV light irradiation, PANI loaded coordination polymer photocatalyst displays more excellent photocatalytic activity in visible light region. Furthermore, PANI loaded coordination polymer photocatalyst exhibits outstanding stability during the degradation of RhB. - Graphical abstract: PANI loaded coordination polymer composite material, which displays excellent photocatalytic activity under visible light was firstly synthesized through in-situ chemical oxidation of aniline on surface of coordination polymer. Display Omitted - Highlights: • This PANI loaded coordination polymer composite material represents the first conductive polymer loaded coordination polymer composite material. • PANI/coordination polymer composite material displays more excellent photocatalytic activity for the degradation of MO in visible light region. • The “combination” of coordination polymer and PANI will enable us to design high-activity, high-stability and visible light driven photocatalyst in the future

  1. Creating Collaborative Advantages Through Coordination of Regional Development Activities

    OpenAIRE

    Sumpor, Marijana

    2006-01-01

    Through the increasing importance of networking and use of participatory strategic planning approaches in the regional development practice, it seems that local and regional development theory moves from the concept of competitive advantages towards collaborative advantages. This conceptual move implies a redefinition of inter- and intra-institutional relations of the public and private sector, and therefore, calls for defining new forms of governance. The exploration of the concept of collab...

  2. Model Orlando regionally efficient travel management coordination center (MORE TMCC), phase II : final report.

    Science.gov (United States)

    2012-09-01

    The final report for the Model Orlando Regionally Efficient Travel Management Coordination Center (MORE TMCC) presents the details of : the 2-year process of the partial deployment of the original MORE TMCC design created in Phase I of this project...

  3. 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.

  4. 75 FR 76986 - Office of the National Coordinator for Health Information Technology; Health Information...

    Science.gov (United States)

    2010-12-10

    ... Technology; Health Information Technology; Request for Information Regarding the President's Council of... Information Technology To Improve Healthcare for Americans: The Path Forward'' AGENCY: Office of the National Coordinator for Health Information Technology (ONC), Department of Health and Human Services (HHS). ACTION...

  5. Supporting Student Mental Health: The Role of the School Nurse in Coordinated School Mental Health Care

    Science.gov (United States)

    Bohnenkamp, Jill H.; Stephan, Sharon H.; Bobo, Nichole

    2015-01-01

    School nurses play a critical role in the provision of mental health services in the school environment and are valuable members of the coordinated student mental health team. They possess expertise to navigate in today's complicated educational and health care systems, and it is estimated that school nurses spend 33% of their time addressing…

  6. Assessing Regional Sustainability Using a Model of Coordinated Development Index: A Case Study of Mainland China

    Directory of Open Access Journals (Sweden)

    Qing Yang

    2014-12-01

    Full Text Available From a holistic view, this paper addresses a perspective of coordinated development of economy, society, and environment for regional sustainability assessment. Firstly, a comprehensive indicator system for co-evaluating the level of economic, social, and environmental subsystems is presented based on a holistic understanding of regional sustainability. Then, a coordinated development index model focusing on the level of coordination among the subsystems as well as their comprehensive development level is established. Furthermore, an empirical study of all the provinces and municipalities is conducted by collecting the panel data from 2004 to 2010. The result shows that: (1 the coordinated developments of the most developed and the most underdeveloped regions stay stable while the regions with medium development level possess more fluctuant trends during the study years; (2 regional disparities are indicated according to the grading of CDI (the coordinated development index, which are further analyzed to be related to the local economic development patterns; (3 the conditions and causes of economic, social, and environmental development in real situations under different grades of CDI are discussed through detailed case studies of typical regions, which indicate specific suggestions of sustainable development for regions in the same pattern.

  7. 76 FR 58006 - Office of the National Coordinator for Health Information Technology; Delegation of Authority

    Science.gov (United States)

    2011-09-19

    ... for Health Information Technology; Delegation of Authority Notice is hereby given that I have delegated to the National Coordinator for Health Information Technology (National Coordinator), or his or... information technology as it relates to health information and health promotion, preventive health services...

  8. Mental health outcomes of developmental coordination disorder in late adolescence.

    Science.gov (United States)

    Harrowell, Ian; Hollén, Linda; Lingam, Raghu; Emond, Alan

    2017-09-01

    To assess the relationship between developmental coordination disorder (DCD) and mental health outcomes in late adolescence. Data were analyzed from the Avon Longitudinal Study of Parents and Children. Moderate-to-severe DCD was defined at 7 to 8 years according to the DSM-IV-TR criteria. Mental health was assessed at 16 to 18 years using self-reported questionnaires: Strengths and Difficulties Questionnaire, Short Moods and Feelings Questionnaire, and the Warwick-Edinburgh Mental Well-being Scale. Logistic and linear regressions assessed the associations between DCD and mental health, using multiple imputation to account for missing data. Adjustments were made for socio-economic status, IQ, and social communication difficulties. Adolescents with DCD (n=168) had an increased risk of mental health difficulties (total Strengths and Difficulties Questionnaire score) than their peers (n=3750) (odds ratio 1.78, 95% confidence interval 1.12-2.83, adjusted for socio-economic status and IQ). This was, in part, mediated through poor social communication skills. Adolescent females with DCD (n=59) were more prone to mental health difficulties than males. Greater mental well-being was associated with better self-esteem (β 0.82, pcommunication skills and self-esteem. © 2017 The Authors. Developmental Medicine & Child Neurology published by John Wiley & Sons Ltd on behalf of Mac Keith Press.

  9. [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.

  10. 75 FR 16126 - Office of the National Coordinator for Health Information Technology; HIT Standards Committee...

    Science.gov (United States)

    2010-03-31

    ... Coordinator for Health Information Technology, HHS. ACTION: Notice of meeting. This notice announces a... Information Technology (ONC). The meeting will be open to the public. Name of Committee: HIT Standards... and Coordination, Office of the National Coordinator for Health Information Technology. [FR Doc. 2010...

  11. 75 FR 151 - Office of the National Coordinator for Health Information Technology; HIT Standards Committee...

    Science.gov (United States)

    2010-01-04

    ... Coordinator for Health Information Technology, HHS. ACTION: Notice of meeting. This notice announces a... Information Technology (ONC). The meeting will be open to the public. Name of Committee: HIT Standards... Programs and Coordination Office of the National Coordinator for Health Information Technology. [FR Doc. E9...

  12. 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.

  13. 75 FR 17744 - Office of the National Coordinator for Health Information Technology HIT Policy Committee...

    Science.gov (United States)

    2010-04-07

    ... Coordinator for Health Information Technology, HHS. ACTION: Notice of change of location for meetings. This... Coordinator for Health Information Technology (ONC). The meeting will be open to the public. Name of Committee... health information technology infrastructure that permits the electronic exchange and use of health...

  14. MediCoordination: a practical approach to interoperability in the Swiss health system.

    Science.gov (United States)

    Müller, Henning; Schumacher, Michael; Godel, David; Omar, Abu Khaled; Mooser, Francois; Ding, Sandrine

    2009-01-01

    Interoperability and data exchange between partners in the health sector is seen as one of the important domains that can improve care processes and in the long run also decrease costs of the health care system. Data exchange can assure that the data on the patient are as complete as possible avoiding potential mistreatments, and it can avoid double examinations if the data required are already available. On the other hand, health data is a sensible point for many people and strong protection needs to be implemented to protect patient data against misuse as well as tools to let the patient manage his/her own data. Many countries have eHealth initiatives in preparation or already implemented. However, health data exchange on a large scale still has a fairly long way to go as the political processes for global solutions are often complicated. In the MediCoordination project a pragmatic approach is selected trying to integrate several partners in health care on a regional scale. In parallel with the Swiss eHealth strategy that is currently being elaborated by the Swiss confederation, particularly medium-sized hospitals and external partners are targeted in MediCoordination to implement concrete added-value scenarios of information exchange between hospitals and external medical actors.

  15. 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

  16. 75 FR 42448 - Board of Scientific Counselors (BSC), Coordinating Center for Health Promotion (CCHP): Notice of...

    Science.gov (United States)

    2010-07-21

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention (CDC) Board of Scientific Counselors (BSC), Coordinating Center for Health Promotion (CCHP): Notice of Charter Amendment... Disease Prevention and Health Promotion (NCCDPHP). [[Page 42449

  17. Impact of Inter- and Intra-Regional Coordination in Markets With a Large Renewable Component

    DEFF Research Database (Denmark)

    Delikaraoglou, Stefanos; Morales González, Juan Miguel; Pinson, Pierre

    2016-01-01

    counterproductive or inefficient under uncertain supply, e.g., from weather-driven renewable power generation. In the absence of a specific target model for the common balancing market in Europe, we introduce a framework to compare different coordination schemes and market organizations. The proposed models......The establishment of the single European day-ahead market has accomplished a crucial step towards the spatial integration of the European power system. However, this new arrangement does not consider any intra-regional coordination of day-ahead and balancing markets and thus may become...... are formulated as stochastic equilibrium problems and compared against an optimal market setup. The simulation results reveal significant efficiency loss in case of partial coordination and diversity of market structure among regional power systems....

  18. Coordinated school health program and dietetics professionals: partners in promoting healthful eating.

    Science.gov (United States)

    Gross, Sandra M; Cinelli, Bethann

    2004-05-01

    Although research indicates that school meal programs contribute to improved academic performance and healthier eating behaviors for students who participate, fewer than 60% of students choose the National School Lunch Program or School Breakfast Program. School meal programs have a difficult time competing with foods that are marketed to young people through sophisticated advertising campaigns. Youth's preferences for fast foods, soft drinks, and salty snacks; mixed messages sent by school personnel; school food preparation and serving space limitations; inadequate meal periods; and lack of education standards for school foodservice directors challenge school meal programs as well. A coordinated school health program offers a framework for meeting these challenges and provides children and adolescents with the knowledge and skills necessary for healthful eating. This article identifies challenges facing school foodservice directors in delivering healthful meals and acquaints dietetics professionals with the coordinated school health program to be used as a tool for addressing unhealthful weight gain and promoting healthful eating.

  19. Improving Service Coordination and Reducing Mental Health Disparities Through Adoption of Electronic Health Records.

    Science.gov (United States)

    McGregor, Brian; Mack, Dominic; Wrenn, Glenda; Shim, Ruth S; Holden, Kisha; Satcher, David

    2015-09-01

    Despite widespread support for removing barriers to the use of electronic health records (EHRs) in behavioral health care, adoption of EHRs in behavioral health settings lags behind adoption in other areas of health care. The authors discuss barriers to use of EHRs among behavioral health care practitioners, suggest solutions to overcome these barriers, and describe the potential benefits of EHRs to reduce behavioral health care disparities. Thoughtful and comprehensive strategies will be needed to design EHR systems that address concerns about policy, practice, costs, and stigma and that protect patients' privacy and confidentiality. However, these goals must not detract from continuing to challenge the notion that behavioral health and general medical health should be treated as separate and distinct. Ultimately, utilization of EHRs among behavioral health care providers will improve the coordination of services and overall patient care, which is essential to reducing mental health disparities.

  20. Assessing regional sustainability using a model of coordinated development index : a case study of mainland China

    NARCIS (Netherlands)

    Yang, Q.; Ding, Y.; Vries, de B.; Han, Q.; Ma, H.

    2014-01-01

    From a holistic view, this paper addresses a perspective of coordinated development of economy, society, and environment for regional sustainability assessment. Firstly, a comprehensive indicator system for co-evaluating the level of economic, social, and environmental subsystems is presented based

  1. Quality and Innovation: Redesigning a Coordinated and Connected Health System.

    Science.gov (United States)

    Vaughan, Peter W

    2017-01-01

    Nova Scotia's consolidated health system was launched on April 1, 2015. This new approach to organizing health administration and services in the province arose out of necessity. When planning began, Nova Scotia was spending 41% of its annual budget on health services. In comparison to other provinces and territories, our per capita health-related spending was among the highest in the country, we had one of Canada's oldest populations and we had some of the worst health outcomes. Clearly, we could not continue to do the same things and expect different results. Both the life sciences and technology are changing at breakneck speed, while design of healthcare delivery has barely moved beyond a mid-twentieth century paternalistic provider-centric model. Nova Scotia's transformation journey was facilitated by a major policy effort 20 years earlier that had integrated emergency health services across the province. Our aim was to build on that foundation by integrating administration in order to build primary care networks with enhanced regional specialty services, with tertiary services located in Halifax. The goal of health system innovation in Nova Scotia was - and is - based firmly on the dimensions of quality: safe care that avoids harming patients; effective care that is based on levels of evidence to achieve scalability; access to care that is focused on individuals; efficient care that reduces waste, time, energy and supplies; and equitable care that ensures a system is in place that mitigates differences in geography and social economic status. The author offers a sketch of the principal initiatives, challenges, considerations, approaches and lessons involved in this multi-factorial, multi-stakeholder innovation process.

  2. 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,…

  3. 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...

  4. COORDINATION IN MULTILEVEL NETWORK-CENTRIC CONTROL SYSTEMS OF REGIONAL SECURITY: APPROACH AND FORMAL MODEL

    Directory of Open Access Journals (Sweden)

    A. V. Masloboev

    2015-01-01

    Full Text Available The paper deals with development of methods and tools for mathematical and computer modeling of the multilevel network-centric control systems of regional security. This research is carried out under development strategy implementation of the Arctic zone of the Russian Federation and national safeguarding for the period before 2020 in the Murmansk region territory. Creation of unified interdepartmental multilevel computer-aided system is proposed intended for decision-making information support and socio-economic security monitoring of the Arctic regions of Russia. The distinctive features of the investigated system class are openness, self-organization, decentralization of management functions and decision-making, weak hierarchy in the decision-making circuit and goal generation capability inside itself. Research techniques include functional-target approach, mathematical apparatus of multilevel hierarchical system theory and principles of network-centric control of distributed systems with pro-active components and variable structure. The work considers network-centric management local decisions coordination problem-solving within the multilevel distributed systems intended for information support of regional security. The coordination problem-solving approach and problem formalization in the multilevel network-centric control systems of regional security have been proposed based on developed multilevel recurrent hierarchical model of regional socio-economic system complex security. The model provides coordination of regional security indexes, optimized by the different elements of multilevel control systems, subject to decentralized decision-making. The model specificity consists in application of functional-target technology and mathematical apparatus of multilevel hierarchical system theory for coordination procedures implementation of the network-centric management local decisions. The work-out and research results can find further

  5. An Integrative Behavioral Health Care Model Using Automated SBIRT and Care Coordination in Community Health Care.

    Science.gov (United States)

    Dwinnells, Ronald; Misik, Lauren

    2017-10-01

    Efficient and effective integration of behavioral health programs in a community health care practice emphasizes patient-centered medical home principles to improve quality of care. A prospective, 3-period, interrupted time series study was used to explore which of 3 different integrative behavioral health care screening and management processes were the most efficient and effective in prompting behavioral health screening, identification, interventions, and referrals in a community health practice. A total of 99.5% ( P < .001) of medical patients completed behavioral health screenings; brief intervention rates nearly doubled to 83% ( P < .001) and 100% ( P < .001) of identified at-risk patients had referrals made using a combination of electronic tablets, electronic medical record, and behavioral health care coordination.

  6. 75 FR 33811 - Office of the National Coordinator for Health Information Technology; HIT Policy Committee's...

    Science.gov (United States)

    2010-06-15

    ... Technology; HIT Policy Committee's Privacy & Security Tiger Team Meeting; Notice of Meeting AGENCY: Office of the National Coordinator for Health Information Technology, HHS. ACTION: Notice of meeting. This... National Coordinator for Health Information Technology (ONC). The meeting will be open to the public. Name...

  7. Health-Related Physical Fitness in Dutch Children With Developmental Coordination Disorder

    NARCIS (Netherlands)

    van der Hoek, Frouwien D.; Stuive, Ilse; Reinders-Messelink, Heleen A.; Holty, Lian; de Blecourt, Alida C. E.; Maathuis, Carel G. B.; van Weert, Ellen

    2012-01-01

    Objective: To compare components of health-related physical fitness between Dutch children with clinically diagnosed developmental coordination disorder (DCD) and typically developing children (TDC), and to examine associations between motor performance problems and components of health-related

  8. Ebola Preparedness in the Netherlands: The Need for Coordination Between the Public Health and the Curative Sector.

    Science.gov (United States)

    Swaan, Corien M; Öry, Alexander V; Schol, Lianne G C; Jacobi, André; Richardus, Jan Hendrik; Timen, Aura

    During the Ebola outbreak in West Africa in 2014-2015, close cooperation between the curative sector and the public health sector in the Netherlands was necessary for timely identification, referral, and investigation of patients with suspected Ebola virus disease (EVD). In this study, we evaluated experiences in preparedness among stakeholders of both curative and public health sectors to formulate recommendations for optimizing preparedness protocols. Timeliness of referred patients with suspected EVD was used as indicator for preparedness. In focus group sessions and semistructured interviews, experiences of curative and public health stakeholders about the regional and national process of preparedness and response were listed. Timeliness recordings of all referred patients with suspected EVD (13) were collected from first date of illness until arrival in the referral academic hospital. Ebola preparedness was considered extensive compared with the risk of an actual patient, however necessary. Regional coordination varied between regions. More standardization of regional preparation and operational guidelines was requested, as well as nationally standardized contingency criteria, and the National Centre for Infectious Disease Control was expected to coordinate the development of these guidelines. For the timeliness of referred patients with suspected EVD, the median delay between first date of illness until triage was 2.0 days (range: 0-10 days), and between triage and arrival in the referral hospital, it was 5.0 hours (range: 2-7.5 hours). In none of these patients Ebola infection was confirmed. Coordination between the public health sector and the curative sector needs improvement to reduce delay in patient management in emerging infectious diseases. Standardization of preparedness and response practices, through guidelines for institutional preparedness and blueprints for regional and national coordination, is necessary, as preparedness for emerging infectious

  9. Care coordination in primary health care: an evaluative study in a municipality in the Northeast of Brazil.

    Science.gov (United States)

    Aleluia, Italo Ricardo Santos; Medina, Maria Guadalupe; Almeida, Patty Fidelis de; Vilasbôas, Ana Luiza Queiroz

    2017-06-01

    International and Brazilian studies have highlighted the importance of the coordination of care for the organization of local health systems. This study aimed to analyze the coordination of care by Primary Health Care (PHC) in a municipal health system in the State of Bahia. This study was conducted in the lead municipality of the macro-region and involved two levels of analysis: PHC team and municipal management. Outlining conditions for the study were defined (hypertension and diabetes mellitus) and an objective image corresponding to the coordination of care was developed based on current national and international literature review. Semi-structured interviews with professionals, managers of PHC services were conducted and current documentary sources were also used. It was demonstrated that the coordination of care has not been met by municipal systems, where only 14 of the 22 proposed criteria have been met. The main difficulties and reasons were: a lack of health care protocols and the non-implementation of computer systems and telecommunication technologies. The results and the conceptual framework to assess the coordination of care are relevant contributions to this study, which can be applied to other contexts with similar characteristics.

  10. 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

  11. WCRP COordinated Regional Downscaling EXperiment (CORDEX: a diagnostic MIP for CMIP6

    Directory of Open Access Journals (Sweden)

    W. J. Gutowski Jr.

    2016-11-01

    Full Text Available The COordinated Regional Downscaling EXperiment (CORDEX is a diagnostic model intercomparison project (MIP in CMIP6. CORDEX builds on a foundation of previous downscaling intercomparison projects to provide a common framework for downscaling activities around the world. The CORDEX Regional Challenges provide a focus for downscaling research and a basis for making use of CMIP6 global climate model (GCM output to produce downscaled projected changes in regional climates and assess sources of uncertainties in the projections, all of which can potentially be distilled into climate change information for vulnerability, impacts and adaptation studies. CORDEX Flagship Pilot Studies advance regional downscaling by targeting one or more of the CORDEX Regional Challenges. A CORDEX-CORE framework is planned that will produce a baseline set of homogeneous high-resolution, downscaled projections for regions worldwide. In CMIP6, CORDEX coordinates with ScenarioMIP and is structured to allow cross comparisons with HighResMIP and interaction with the CMIP6 VIACS Advisory Board.

  12. Optimal Coordination Strategy of Regional Vertical Emission Abatement Collaboration in a Low-Carbon Environment

    Directory of Open Access Journals (Sweden)

    Daming You

    2018-02-01

    Full Text Available This study introduces a time factor into a low-carbon context, and supposes the contamination control state of local government and the ability of polluting enterprise to abate emissions as linear increasing functions in a regional low-carbon emission abatement cooperation chain. The local government effectuates and upholds the low-carbon development within the jurisdiction that is primarily seeking to transform regional economic development modes, while the polluting enterprise abates the amounts of emitted carbon in the entire period of product through simplifying production, facilitating decontamination, and adopting production technology, thus leading to less contamination. On that basis, we infer that the coordinated joint carbon reduction model and two decentralization contracts expound the dynamic coordination strategy for a regional cooperation chain in terms of vertical carbon abatement. Furthermore, feedback equilibrium strategies that are concerned with several diverse conditions are compared and analyzed. The main results show that a collaborative centralized contract is able to promote the regional low-carbon cooperation chain in order to achieve a win–win situation in both economic and environmental performance. Additionally, the optimal profits of the entire regional low-carbon cooperation channel under an integration scenario evidently outstrip that of two non-collaborative decentralization schemes. Eventually, the validity of the conclusions is verified with a case description and numerical simulation, and the sensitivity of the relevant parameters is analyzed in order to lay a theoretical foundation and thus facilitate the sustainable development of a regional low-carbon environment.

  13. 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.

  14. 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.

  15. 42 CFR 431.636 - Coordination of Medicaid with the Children's Health Insurance Program (CHIP).

    Science.gov (United States)

    2010-10-01

    ... Insurance Program (CHIP). 431.636 Section 431.636 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES...'s Health Insurance Program (CHIP). (a) Statutory basis. This section implements— (1) Section 2102(b... coordination between a State child health program and other public health insurance programs. (b) Obligations...

  16. 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.

  17. [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

  18. 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.

  19. Barriers and Facilitators to Sustaining School Health Teams in Coordinated School Health Programs.

    Science.gov (United States)

    Cheung, Karen; Lesesne, Catherine A; Rasberry, Catherine N; Kroupa, Elizabeth; Fisher, Deborah; Robin, Leah; Pitt Barnes, Seraphine

    2017-05-01

    Coordinated school health (CSH) programs address multiple factors related to students' overall health, thereby increasing their physical and mental readiness to learn. A formative evaluation of three school districts in 2010-2011 examined strategies for sustaining the school health teams (SHTs) that lead CSH efforts. Qualitative data from 39 interviews and 13 focus groups revealed facilitators and barriers for sustaining SHTs. Quantitative data from 68 questionnaires completed by SHT members and school principals examined factors associated with having more active SHTs and district and school characteristics SHT members believed to be important to their schools' efforts to implement CSH. Facilitators of sustaining SHTs included administrative support, staff engagement in the SHT, and shared goals and responsibility. Barriers to sustaining SHTs included limited time and competing priorities, budget and funding constraints, and staff turnover. Findings provide valuable insight into challenges and potential solutions for improving the sustainability of SHTs to enable them to better support CSH efforts.

  20. 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.

  1. Strengthening human resources for health through information, coordination and accountability mechanisms: the case of the Sudan.

    Science.gov (United States)

    Badr, Elsheikh; Mohamed, Nazar A; Afzal, Muhammad Mahmood; Bile, Khalif Mohamud

    2013-11-01

    Human resources for health (HRH) in the Sudan were limited by shortages and the maldistribution of health workers, poor management, service fragmentation, poor retention of health workers in rural areas, and a weak health information system. A "country coordination and facilitation" process was implemented to strengthen the national HRH observatory, provide a coordination platform for key stakeholders, catalyse policy support and HRH planning, harmonize the mobilization of resources, strengthen HRH managerial structures, establish new training institutions and scale up the training of community health workers. The national government of the Sudan sanctioned state-level governance of the health system but many states lacked coherent HRH plans and policies. A paucity of training institutions constrained HRH production and the adequate and equitable deployment of health workers in rural areas. The country coordination and facilitation process prompted the establishment of a robust HRH information system and the development of the technical capacities and tools necessary for data analysis and evidence-based participatory decision-making and action. The success of the country coordination and facilitation process was substantiated by the stakeholders' coordinated support, which was built on solid evidence of the challenges in HRH and shared accountability in the planning and implementation of responses to those challenges. The support led to political commitment and the mobilization of resources for HRH. The leadership that was promoted and the educational institutions that were opened should facilitate the training, deployment and retention of the health workers needed to achieve universal health coverage.

  2. Increasing Equitable Care for Youth through Coordinated School Health

    Science.gov (United States)

    Sanetti, Lisa M. Hagermoser

    2017-01-01

    Nearly a quarter of the students in the U.S. education system have a chronic health condition, disability, or special healthcare need. Students living in poverty and those at risk for or with disabilities have higher rates of health issues and encounter more barriers to accessing appropriate health care than their peers. The reciprocal influences…

  3. 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

  4. 76 FR 9782 - Office of the National Coordinator for Health Information Technology; HIT Policy Committee's...

    Science.gov (United States)

    2011-02-22

    ... Coordinator for Health Information Technology, HHS. ACTION: Notice of meetings. This notice announces... for Health Information Technology (ONC). The meetings will be open to the public via dial-in access... policy framework for the development and adoption of a nationwide health information technology...

  5. The Coordinated School Health Program: Implementation in a Rural Elementary School District

    Science.gov (United States)

    Miller, Kim H.; Bice, Matthew R.

    2014-01-01

    Child health is a complex issue that requires a comprehensive approach to address the many factors that influence it and are influenced by it. In light of the complexity of children's health, the Coordinated School Health Program (CSHP) was developed as a framework for a systems approach to planning and implementing school-based children's health…

  6. Quantifying Collaboration Using Himmelman's Strategies for Working Together: Findings from the Tennessee Coordinated School Health Program

    Science.gov (United States)

    Quinn, Megan A; Southerland, Jodi L.; Richards, Kasie; Slawson, Deborah L; Behringer, Bruce; Johns-Womack, Rebecca; Smith, Sara

    2016-01-01

    Purpose: Coordinated school health programs (CSHPs), a type of health promoting school (HPS) program adopted by Canada and the USA, were developed to provide a comprehensive approach to school health in the USA. Community partnerships are central to CSHP and HPS efforts, yet the quality of collaboration efforts is rarely assessed. The purpose of…

  7. Lower Savannah aging, disability & transportation resource center : regional travel management and coordination center (TMCC) model and demonstration project.

    Science.gov (United States)

    2014-10-01

    This report details the deployed technology and implementation experiences of the Lower Savannah Aging, Disability & Transportation : Resource Center in Aiken, South Carolina, which served as the regional Travel Management and Coordination Center (TM...

  8. [A social-health care coordination reference in the fields of mental health and child abuse].

    Science.gov (United States)

    García-Panal, Leticia; García-Panal, Javier; Delgado-Mata, Eulalia

    2016-01-01

    The intervention in families with children at risk of abuse stays as a clear example of the need for intersectional coordination mechanisms within the socio-health care framework. Different health services (such as primary care, paediatrics, mental health, community and social services, family support teams and schools) create a network in order to link their main goals in the interest of ensuring children's welfare and improving familieś situation. This essay aims at describing a performance based on the mentioned guidelines, even though there is no accepted and widespread protocol in this regard. We start our research with a one parent family with two children. The mother suffers from a mental health disorder and she fails to adhere to treatment. Both the father of the two children and his family took advantage of this situation to discredit the mother's capability of taking care of her children. This perception had a great impact in her self-esteem and therefore in her willingness and strength to recover. Meetings were held to share relevant information about both the family's general situation, the children's quality of life and the mother's health. Based on this information, the main goals were set in each professional field in order to develop the intervention project. This example of intersectional coordination shows the importance of its standardization for the sake of ensuring a comprehensive attention towards situations that involve initially individuals but that ends up affecting the whole family. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  9. 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.

  10. Care coordinators: a controlled evaluation of an inpatient mental health service innovation.

    Science.gov (United States)

    Stewart, Malcolm W; Wilson, Michael; Bergquist, Karla; Thorburn, John

    2012-02-01

    The study aimed to evaluate the impact of introducing designated care coordinators into an acute mental health inpatient unit in terms of service delivery, clinical outcomes, and service user and significant other perceptions. A pre-post-controlled design was implemented with a consecutive sample of 292 service users admitted and staying more than 5 days in two wards, with care coordinators introduced in one ward. Data were obtained from clinical records, standard measures, and service user and significant other surveys. Care coordinator input was associated with significant improvements in service delivery and stronger involvement of significant others and community resources. Care-coordinated clients showed significantly better clinical outcomes, including the Health of Nations Outcome Scales behaviour subscale, less time in the intensive care subunit, less community crisis team input in the week following discharge, and lower rates of readmission in the month following discharge. Care-coordinated service users and their significant others gave higher ratings of service delivery, outcome, and satisfaction. The results indicate that designated care coordinators significantly improve care processes, outcomes, and service user experience in acute inpatient mental health settings. © 2011 The Authors. International Journal of Mental Health Nursing © 2011 Australian College of Mental Health Nurses Inc.

  11. The Dynamic Coordinated Development of a Regional Environment-Tourism-Economy System: A Case Study from Western Hunan Province, China

    Directory of Open Access Journals (Sweden)

    Yaoqing Yuan

    2014-08-01

    Full Text Available Based on regional coordination theory and system theory, the authors constructed an evaluation index system for the coordinated development of a regional environment-tourism-economy system with a pressure-state-response (PSR model. With a coordinated development model, it further empirically analyzed the coordinated development state of an environment-tourism-economy system in western Hunan from 2001 to 2012. The results showed that, although this environment-tourism-economy system failed to achieve a high benefit index, inter-subsystem coupling extent, and coordinated development index, the three indices presented an increasing overall trend. This outcome suggested that the sub-systems in this system were developing towards their optimal proportions: the development of these sub-systems (environmental, tourism, and economic was unbalanced in western Hunan. The environment therein sees only slow development although provided with a favorable ecological foundation. Economic development, which has long been lagging, acted as the main factor restricting the coordinated development of a regional environment-tourism-economy system. To promote its coordinated development in western Hunan, the following recommendations were proposed: strengthen the prediction and warnings on the evolution of the whole system; optimize the industry’s structure; reinforce environmental management.

  12. Care coordination and unmet specialty care among children with special health care needs.

    Science.gov (United States)

    Boudreau, Alexy Arauz; Perrin, James M; Goodman, Elizabeth; Kurowski, Daniel; Cooley, W Carl; Kuhlthau, Karen

    2014-06-01

    Care coordination and the medical home may ensure access to specialty care. Children with special health care needs (CSHCN) have higher rates of specialty care use and unmet need compared with the general pediatric population. We hypothesized that care coordination, regardless of whether it was provided in a medical home, would decrease unmet specialty care needs among CSHCN and that the effect of care coordination would be greater among low-income families. Secondary data analysis of participants in the 2009–2010 National Survey of CSHCN who reported unmet specialty care needs and for whom care coordination and medical home status could be determined (n = 18 905). Logistic regression models explored the association of unmet need with care coordination and medical home status adjusting for household income. Approximately 9% of CSHCN reported having unmet specialty care needs. Care coordination was associated with reduced odds of unmet specialty care need (without a medical home, odds ratio: 0.63, 95% confidence interval: 0.47–0.86; within a medical home, odds ratio: 0.22, 95% confidence interval: 0.16–0.29) with a greater reduction among those receiving care coordination within a medical home versus those receiving care coordination without a medical home. We did not find differences in the impact of care coordination by percentage of the federal poverty level. Care coordination is associated with family report of decreased unmet specialty care needs among CSHCN independent of household income. The effect of care coordination is greater when care is received in a medical home.

  13. 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.

  14. Coordinated robotic system for civil structural health monitoring

    Directory of Open Access Journals (Sweden)

    Qidwai Uvais

    2017-01-01

    Full Text Available With the recent advances in sensors, robotics, unmanned aerial vehicles, communication, and information technologies, it is now feasible to move towards the vision of ubiquitous cities, where virtually everything throughout the city is linked to an information system through technologies such as wireless networking and radio-frequency identification (RFID tags, to provide systematic and more efficient management of urban systems, including civil and mechanical infrastructure monitoring, to achieve the goal of resilient and sustainable societies. In this proposed system, unmanned aerial vehicle (UAVs is used to ascertain the coarse defect signature using panoramic imaging. This involves image stitching and registration so that a complete view of the surface is seen with reference to a common reference or origin point. Thereafter, crack verification and localization has been done using the magnetic flux leakage (MFL approach which has been performed with the help of a coordinated robotic system. In which the first robot is placed at the top of the structure whereas the second robot is equipped with the designed MFL sensory system. With the initial findings, the proposed system identifies and localize the crack in the given structure.

  15. 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.

  16. 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...

  17. 75 FR 6398 - Office of the National Coordinator for Health Information Technology; HIT Policy Committee's...

    Science.gov (United States)

    2010-02-09

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Office of the National Coordinator for Health Information Technology; HIT Policy Committee's Adoption/Certification Workgroup Meeting; Notice of Meeting AGENCY: Office... of Committee: HIT Policy Committee's Adoption/Certification Workgroup. General Function of the...

  18. 75 FR 8078 - Office of the National Coordinator for Health Information Technology; HIT Policy Committee's...

    Science.gov (United States)

    2010-02-23

    ... Technology; HIT Policy Committee's Workgroup Meetings; Notice of Meetings AGENCY: Office of the National Coordinator for Health Information Technology, HHS. ACTION: Notice of meetings. This notice announces... for Health Information Technology (ONC). The meetings will be open to the public via dial-in access...

  19. 76 FR 1432 - Office of the National Coordinator for Health Information Technology; HIT Policy Committee's...

    Science.gov (United States)

    2011-01-10

    ... Technology; HIT Policy Committee's Workgroup Meetings; Notice of Meetings AGENCY: Office of the National Coordinator for Health Information Technology, HHS. ACTION: Notice of meetings. This notice announces... for Health Information Technology (ONC). The meetings will be open to the public via dial-in access...

  20. 75 FR 369 - Office of the National Coordinator for Health Information Technology; HIT Policy Committee's...

    Science.gov (United States)

    2010-01-05

    ... Technology; HIT Policy Committee's Workgroup Meetings; Notice of Meetings AGENCY: Office of the National Coordinator for Health Information Technology, HHS. ACTION: Notice of meetings. This notice announces... for Health Information Technology (ONC). The meetings will be open to the public via dial-in access...

  1. 75 FR 51818 - Office of the National Coordinator for Health Information Technology; HIT Standards Committee's...

    Science.gov (United States)

    2010-08-23

    ... Technology; HIT Standards Committee's Workgroup Meetings; Notice of Meetings AGENCY: Office of the National Coordinator for Health Information Technology, HHS. ACTION: Notice of meetings. This notice announces... for Health Information Technology (ONC). The meetings will be open to the public via dial-in access...

  2. 75 FR 12752 - Office of the National Coordinator for Health Information Technology; HIT Policy Committee's...

    Science.gov (United States)

    2010-03-17

    ... Technology; HIT Policy Committee's Workgroup Meetings; Notice of Meetings AGENCY: Office of the National Coordinator for Health Information Technology, HHS. ACTION: Notice of Meetings. This notice announces... for Health Information Technology (ONC). The meetings will be open to the public via dial-in access...

  3. 75 FR 65486 - Office of the National Coordinator for Health Information Technology; HIT Standards Committee's...

    Science.gov (United States)

    2010-10-25

    ... Technology; HIT Standards Committee's Workgroup Meetings; Notice of Meetings AGENCY: Office of the National Coordinator for Health Information Technology, HHS. ACTION: Notice of meetings. This notice announces... for Health Information Technology (ONC). The meetings will be open to the public via dial-in access...

  4. 75 FR 21630 - Office of the National Coordinator for Health Information Technology; HIT Policy Committee's...

    Science.gov (United States)

    2010-04-26

    ... Technology; HIT Policy Committee's Workgroup Meetings; Notice of Meetings AGENCY: Office of the National Coordinator for Health Information Technology, HHS. ACTION: Notice of meetings. This notice announces... for Health Information Technology (ONC). The meetings will be open to the public via dial-in access...

  5. 75 FR 57025 - Office of the National Coordinator for Health Information Technology; HIT Standards Committee's...

    Science.gov (United States)

    2010-09-17

    ... Technology; HIT Standards Committee's Workgroup Meetings; Notice of Meetings AGENCY: Office of the National Coordinator for Health Information Technology, HHS. ACTION: Notice of meetings. This notice announces... for Health Information Technology (ONC). The meetings will be open to the public via dial-in access...

  6. 75 FR 36658 - Office of the National Coordinator for Health Information Technology; HIT Policy Committee's...

    Science.gov (United States)

    2010-06-28

    ... Technology; HIT Policy Committee's Workgroup Meetings; Notice of Meetings AGENCY: Office of the National Coordinator for Health Information Technology, HHS. ACTION: Notice of meetings. This notice announces... for Health Information Technology (ONC). The meetings will be open to the public via dial-in access...

  7. 75 FR 8079 - Office of the National Coordinator for Health Information Technology; HIT Standards Committee's...

    Science.gov (United States)

    2010-02-23

    ... Technology; HIT Standards Committee's Workgroup Meetings; Notice of Meetings AGENCY: Office of the National Coordinator for Health Information Technology, HHS. ACTION: Notice of meetings. This notice announces... for Health Information Technology (ONC). The meetings will be open to the public via dial-in access...

  8. 76 FR 4353 - Office of the National Coordinator for Health Information Technology; HIT Standards Committee's...

    Science.gov (United States)

    2011-01-25

    ... Technology; HIT Standards Committee's Workgroup Meetings; Notice of Meetings AGENCY: Office of the National Coordinator for Health Information Technology, HHS. ACTION: Notice of meetings. This notice announces... for Health Information Technology (ONC). The meetings will be open to the public via dial-in access...

  9. 75 FR 12753 - Office of the National Coordinator for Health Information Technology; HIT Standards Committee's...

    Science.gov (United States)

    2010-03-17

    ... Technology; HIT Standards Committee's Workgroup Meetings; Notice of Meetings AGENCY: Office of the National Coordinator for Health Information Technology, HHS. ACTION: Notice of meetings. This notice announces... for Health Information Technology (ONC). The meetings will be open to the public via dial-in access...

  10. 75 FR 36657 - Office of the National Coordinator for Health Information Technology; HIT Standards Committee's...

    Science.gov (United States)

    2010-06-28

    ... Technology; HIT Standards Committee's Workgroup Meetings; Notice of Meetings AGENCY: Office of the National Coordinator for Health Information Technology, HHS. ACTION: Notice of meetings. This notice announces... for Health Information Technology (ONC). The meetings will be open to the public via dial-in access...

  11. 76 FR 1433 - Office of the National Coordinator for Health Information Technology HIT Standards Committee's...

    Science.gov (United States)

    2011-01-10

    ... Technology HIT Standards Committee's Workgroup Meetings; Notice of Meetings AGENCY: Office of the National Coordinator for Health Information Technology, HHS. ACTION: Notice of meetings. This notice announces... for Health Information Technology (ONC). The meetings will be open to the public via dial-in access...

  12. 75 FR 70925 - Office of the National Coordinator for Health Information Technology; HIT; Standards Committee's...

    Science.gov (United States)

    2010-11-19

    ... Technology; HIT; Standards Committee's Workgroup Meetings; Notice of Meetings AGENCY: Office of the National Coordinator for Health Information Technology, HHS. ACTION: Notice of meetings. This notice announces... for Health Information Technology (ONC). The meetings will be open to the public via dial-in access...

  13. 75 FR 29761 - Office of the National Coordinator for Health Information Technology; HIT Standards Committee's...

    Science.gov (United States)

    2010-05-27

    ... Technology; HIT Standards Committee's Workgroup Meetings; Notice of Meetings AGENCY: Office of the National Coordinator for Health Information Technology, HHS. ACTION: Notice of meetings. This notice announces... for Health Information Technology (ONC). The meetings will be open to the public via dial-in access...

  14. 75 FR 368 - Office of the National Coordinator for Health Information Technology; HIT Standards Committee's...

    Science.gov (United States)

    2010-01-05

    ... Technology; HIT Standards Committee's Workgroup Meetings; Notice of Meetings AGENCY: Office of the National Coordinator for Health Information Technology, HHS. ACTION: Notice of meetings. This notice announces... for Health Information Technology (ONC). The meetings will be open to the public via dial-in access...

  15. 75 FR 3905 - Office of the National Coordinator for Health Information Technology; HIT Standards Committee's...

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    2010-01-25

    ... Technology; HIT Standards Committee's Workgroup Meetings; Notice of Meetings AGENCY: Office of the National Coordinator for Health Information Technology, HHS. ACTION: Notice of meetings. This notice announces... for Health Information Technology (ONC). The meetings will be open to the public via dial-in access...

  16. 75 FR 70924 - Office of the National Coordinator for Health Information Technology; HIT Policy Committee's...

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    2010-11-19

    ... Technology; HIT Policy Committee's Workgroup Meetings; Notice of Meetings AGENCY: Office of the National Coordinator for Health Information Technology, HHS. ACTION: Notice of meetings. This notice announces... for Health Information Technology (ONC). The meetings will be open to the public via dial-in access...

  17. 75 FR 34141 - Office of the National Coordinator for Health Information Technology; HIT Policy Committee's...

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    2010-06-16

    ... Technology; HIT Policy Committee's Workgroup Meetings; Notice of Meetings AGENCY: Office of the National Coordinator for Health Information Technology, HHS. ACTION: Notice of meetings. This notice announces... for Health Information Technology (ONC). The meetings will be open to the public via dial-in access...

  18. 75 FR 16126 - Office of the National Coordinator for Health Information Technology; HIT Policy Committee...

    Science.gov (United States)

    2010-03-31

    ... Coordinator for Health Information Technology, HHS. ACTION: Notice of meeting. This notice announces a... Information Technology (ONC). The meeting will be open to the public. Name of Committee: HIT Policy Committee... framework for the development and adoption of a nationwide health information technology infrastructure that...

  19. 75 FR 151 - Office of the National Coordinator for Health Information Technology; HIT Policy Committee...

    Science.gov (United States)

    2010-01-04

    ... Coordinator for Health Information Technology, HHS. ACTION: Notice of meeting. This notice announces a... Information Technology (ONC). The meeting will be open to the public. Name of Committee: HIT Policy Committee... framework for the development and adoption of a nationwide health information technology infrastructure that...

  20. 76 FR 9784 - Office of the National Coordinator for Health Information Technology; HIT Policy Committee...

    Science.gov (United States)

    2011-02-22

    ... Coordinator for Health Information Technology, HHS. ACTION: Notice of meeting. This notice announces a... Information Technology (ONC). The meeting will be open to the public. Name of Committee: HIT Policy Committee... framework for the development and adoption of a nationwide health information technology infrastructure that...

  1. Lessons Learned from the Whole Child and Coordinated School Health Approaches

    Science.gov (United States)

    Rasberry, Catherine N.; Slade, Sean; Lohrmann, David K.; Valois, Robert F.

    2015-01-01

    Background: The new Whole School, Whole Community, Whole Child (WSCC) model, designed to depict links between health and learning, is founded on concepts of coordinated school health (CSH) and a whole child approach to education. Methods: The existing literature, including scientific articles and key publications from national agencies and…

  2. 75 FR 65486 - Office of the National Coordinator for Health Information Technology; HIT Policy Committee...

    Science.gov (United States)

    2010-10-25

    ... Coordinator for Health Information Technology, HHS. ACTION: Notice of meeting. This notice announces a... Information Technology (ONC). The meeting will be open to the public. Name of Committee: HIT Policy Committee... framework for the development and adoption of a nationwide health information technology infrastructure that...

  3. 75 FR 29762 - Office of the National Coordinator for Health Information Technology; HIT Policy Committee...

    Science.gov (United States)

    2010-05-27

    ... Coordinator for Health Information Technology, HHS. ACTION: Notice of meeting. This notice announces a... Information Technology (ONC). The meeting will be open to the public. Name of Committee: HIT Policy Committee... framework for the development and adoption of a nationwide health information technology infrastructure that...

  4. 75 FR 51820 - Office of the National Coordinator for Health Information Technology; HIT Policy Committee...

    Science.gov (United States)

    2010-08-23

    ... Coordinator for Health Information Technology, HHS. ACTION: Notice of meeting. This notice announces a... Information Technology (ONC). The meeting will be open to the public. Name of Committee: HIT Policy Committee... framework for the development and adoption of a nationwide health information technology infrastructure that...

  5. 75 FR 8953 - Office of the National Coordinator for Health Information Technology HIT Policy Committee...

    Science.gov (United States)

    2010-02-26

    ... Coordinator for Health Information Technology, HHS. ACTION: Notice of meeting. This notice announces a... Information Technology (ONC). The meeting will be open to the public. Name of Committee: HIT Policy Committee... a policy framework for the development and adoption of a nationwide health information technology...

  6. 76 FR 4352 - Office of the National Coordinator for Health Information Technology; HIT Policy Committee...

    Science.gov (United States)

    2011-01-25

    ... Coordinator for Health Information Technology, HHS. ACTION: Notice of meeting. This notice announces a... Information Technology (ONC). The meeting will be open to the public. Name of Committee: HIT Policy Committee... framework for the development and adoption of a nationwide health information technology infrastructure that...

  7. 75 FR 5595 - Office of the National Coordinator for Health Information Technology; HIT Policy Committee...

    Science.gov (United States)

    2010-02-03

    ... Coordinator for Health Information Technology, HHS. ACTION: Notice of meeting. This notice announces a... Information Technology (ONC). The meeting will be open to the public. Name of Committee: HIT Policy Committee... framework for the development and adoption of a nationwide health information technology infrastructure that...

  8. 75 FR 51819 - Office of the National Coordinator for Health Information Technology; HIT Policy Committee...

    Science.gov (United States)

    2010-08-23

    ... Coordinator for Health Information Technology, HHS. ACTION: Notice of meeting. This notice announces a... Information Technology (ONC). The meeting will be open to the public. Name of Committee: HIT Policy Committee... framework for the development and adoption of a nationwide health [[Page 51820

  9. 75 FR 57026 - Office of the National Coordinator for Health Information Technology; HIT Policy Committee...

    Science.gov (United States)

    2010-09-17

    ... Coordinator for Health Information Technology, HHS. ACTION: Notice of meeting. This notice announces a... Information Technology (ONC). The meeting will be open to the public. Name of Committee: HIT Policy Committee... framework for the development and adoption of a nationwide health information technology infrastructure that...

  10. 75 FR 42091 - Office of the National Coordinator for Health Information Technology; HIT Policy Committee...

    Science.gov (United States)

    2010-07-20

    ... Coordinator for Health Information Technology, HHS. ACTION: Notice of meeting. This notice announces a... Information Technology (ONC). The meeting will be open to the public. Name of Committee: HIT Policy Committee... framework for the development and adoption of a nationwide health information technology infrastructure that...

  11. The importance of health information technology in care coordination and transitional care.

    Science.gov (United States)

    Cipriano, Pamela F; Bowles, Kathryn; Dailey, Maureen; Dykes, Patricia; Lamb, Gerri; Naylor, Mary

    2013-01-01

    Care coordination and transitional care services are strategically important for achieving the priorities of better care, better health, and reduced costs embodied in the National Strategy for Quality Improvement in Health Care (National Quality Strategy [NQS]). Some of the most vulnerable times in a person’s care occur with changes in condition as well as movement within and between settings of care. The American Academy of Nursing (AAN) believes it is essential to facilitate the coordination of care and transitions by using health information technology (HIT) to collect, share, and analyze data that communicate patient-centered information among patients, families, and care providers across communities. HIT makes information accessible, actionable, timely, customizable, and portable. Rapid access to information also creates efficiencies in care by eliminating redundancies and illuminating health history and prior care. The adoption of electronic health records (EHRs) and information systems can enable care coordination to be more effective but only when a number of essential elements are addressed to reflect the team-based nature of care coordination as well as a focus on the individual’s needs and preferences. To that end, the AAN offers a set of recommendations to guide the development of the infrastructure, standards, content, and measures for electronically enabled care coordination and transitions in care as well as research needed to build the evidence base to assess outcomes of the associated interventions.

  12. Rehabilitating health services in Cambodia: the challenge of coordination in chronic political emergencies.

    Science.gov (United States)

    Lanjouw, S; Macrae, J; Zwi, A B

    1999-09-01

    The end of the Cold War brought with it opportunities to resolve a number of conflicts around the world, including those in Angola, Cambodia, El Salvador and Mozambique. International political efforts to negotiate peace in these countries were accompanied by significant aid programmes ostensibly designed to redress the worst effects of conflict and to contribute to the consolidation of peace. Such periods of political transition, and associated aid inflows, constitute an opportunity to improve health services in countries whose health indicators have been among the worst in the world and where access to basic health services is significantly diminished by war. This paper analyzes the particular constraints to effective coordination of health sector aid in situations of 'post'-conflict transition. These include: the uncertain legitimacy and competence of state structures; donor choice of implementing channels; and actions by national and international political actors which served to undermine coordination mechanisms in order to further their respective agendas. These obstacles hindered efforts by health professionals to establish an effective coordination regime, for example, through NGO mapping and the establishment of aid coordinating committees at national and provincial levels. These technical measures were unable to address the basic constitutional question of who had the authority to determine the distribution of scarce resources during a period of transition in political authority. The peculiar difficulties of establishing effective coordination mechanisms are important to address if the long-term effectiveness of rehabilitation aid is to be enhanced.

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

    Science.gov (United States)

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

    2014-01-01

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

  14. Assessment of the coordination of integrated health service delivery networks by the primary health care: COPAS questionnaire validation in the Brazilian context.

    Science.gov (United States)

    Rodrigues, Ludmila Barbosa Bandeira; Dos Santos, Claudia Benedita; Goyatá, Sueli Leiko Takamatsu; Popolin, Marcela Paschoal; Yamamura, Mellina; Deon, Keila Christiane; Lapão, Luis Miguel Veles; Santos Neto, Marcelino; Uchoa, Severina Alice da Costa; Arcêncio, Ricardo Alexandre

    2015-07-22

    Health systems organized as networks and coordinated by the Primary Health Care (PHC) may contribute to the improvement of clinical care, sanitary conditions, satisfaction of patients and reduction of local budget expenditures. The aim of this study was to adapt and validate a questionnaire - COPAS - to assess the coordination of Integrated Health Service Delivery Networks by the Primary Health Care. A cross sectional approach was used. The population was pooled from Family Health Strategy healthcare professionals, of the Alfenas region (Minas Gerais, Brazil). Data collection was performed from August to October 2013. The results were checked for the presence of floor and ceiling effects and the internal consistency measured through Cronbach alpha. Construct validity was verified through convergent and discriminant values following Multitrait-Multimethod (MTMM) analysis. Floor and ceiling effects were absent. The internal consistency of the instrument was satisfactory; as was the convergent validity, with a few correlations lower then 0.30. The discriminant validity values of the majority of items, with respect to their own dimension, were found to be higher or significantly higher than their correlations with the dimensions to which they did not belong. The results showed that the COPAS instrument has satisfactory initial psychometric properties and may be used by healthcare managers and workers to assess the PHC coordination performance within the Integrated Health Service Delivery Network.

  15. Coordination and health sector adaptation to climate change in the Vietnamese Mekong Delta

    Directory of Open Access Journals (Sweden)

    Daniel Gilfillan

    2017-09-01

    Full Text Available This research examines the impact of three coordination dimensions on health sector adaptation to climate change in the Vietnamese Mekong Delta: cross-scale, cross-sectoral, and cross-boundary. While tasks are divided up between government ministries and departments in Vietnam, there is little collaboration on issues that span mandates. Similarly, while water flows in the Vietnamese Mekong Delta take resource management and health concerns across provincial boundaries, formal mechanisms for interprovincial collaboration are lacking. While decentralization efforts have sought to devolve authority and decision making to lower levels, there is continued state-centered top-down policy making, and this limits collaborative coordination across scales. All three of these issues inhibit health sector adaptation to climate change in the Vietnamese Mekong Delta, and though these coordination issues are recognized by the Vietnamese government, to date there has been little success in addressing them. The authors hope to stimulate further debate and discussion of coordination problems, and conclude that despite some significant challenges, the South West Steering Committee could play a facilitating role coordinating climate change responses in health and other sectors across the Vietnamese Mekong Delta. As an analysis of governance, this research is applicable to other areas and sectors in Vietnam, as well as to other parts of South East Asia.

  16. Information needs of physicians, care coordinators, and families to support care coordination of children and youth with special health care needs (CYSHCN).

    Science.gov (United States)

    Ranade-Kharkar, Pallavi; Weir, Charlene; Norlin, Chuck; Collins, Sarah A; Scarton, Lou Ann; Baker, Gina B; Borbolla, Damian; Taliercio, Vanina; Del Fiol, Guilherme

    2017-09-01

    Identify and describe information needs and associated goals of physicians, care coordinators, and families related to coordinating care for medically complex children and youth with special health care needs (CYSHCN). We conducted 19 in-depth interviews with physicians, care coordinators, and parents of CYSHCN following the Critical Decision Method technique. We analyzed the interviews for information needs posed as questions using a systematic content analysis approach and categorized the questions into information need goal types and subtypes. The Critical Decision Method interviews resulted in an average of 80 information needs per interview. We categorized them into 6 information need goal types: (1) situation understanding, (2) care networking, (3) planning, (4) tracking/monitoring, (5) navigating the health care system, and (6) learning, and 32 subtypes. Caring for CYSHCN generates a large amount of information needs that require significant effort from physicians, care coordinators, parents, and various other individuals. CYSHCN are often chronically ill and face developmental challenges that translate into intense demands on time, effort, and resources. Care coordination for CYCHSN involves multiple information systems, specialized resources, and complex decision-making. Solutions currently offered by health information technology fall short in providing support to meet the information needs to perform the complex care coordination tasks. Our findings present significant opportunities to improve coordination of care through multifaceted and fully integrated informatics solutions. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  17. Management of water hyacinth: Final meeting and international conference. Working paper submitted by the Regional Coordinator

    International Nuclear Information System (INIS)

    1981-01-01

    Full text: Final Meeting. This meeting will essentially make a terminal review of the project and register final records of work done on the various aspects, such as: - biology of the plant; - biological control; - biogas; - wastewater treatment; - papers and boards; - integrated systems, etc. We should have at the meeting a complete account of the work done in the project under each of the above headings. For example, under 'biogas' we should prepare one consolidated account of work carried out in all the three participating countries rather than individual country reports. Likewise on 'papers and boards', and the other items. To enable preparation of reports in this form there should naturally be prior consultations and contacts among the concerned investigators by correspondence and, if necessary, personal visits. These reports will then be edited and compiled by the Regional Coordinator in the form of a book or monograph on the Management of Water Hyacinth project as a whole. Contributors to chapters will be cited. International Conference. Independent of the consolidated reports, national coordinators may prepare papers for presentation at the proposed international conference. These papers could be prepared m the usual form and style for publication in international scientific journals. Although several papers could be prepared out of work done by us, we may consider the desirability of limiting the number, in order to give adequate opportunities for the other invited participants to the conference. There would be no bar on publication of these scientific papers after the conference in appropriate journals irrespective of whether a separate volume on proceedings of the conference is brought out or not. India would be happy to host the terminal review meeting to be followed by the conference. The likely period would be last week of January to first week in February, 1983. (author)

  18. Measuring public health practice and outcomes in chronic disease: a call for coordination.

    Science.gov (United States)

    Porterfield, Deborah S; Rogers, Todd; Glasgow, LaShawn M; Beitsch, Leslie M

    2015-04-01

    A strategic opportunity exists to coordinate public health systems and services researchers' efforts to develop local health department service delivery measures and the efforts of divisions within the Centers for Disease Control and Prevention's National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) to establish outcome indicators for public health practice in chronic disease. Several sets of outcome indicators developed by divisions within NCCDPHP and intended for use by state programs can be tailored to assess outcomes of interventions within smaller geographic areas or intervention settings. Coordination of measurement efforts could potentially allow information to flow from the local to the state to the federal level, enhancing program planning, accountability, and even subsequent funding for public health practice.

  19. Animal Health Ireland: providing national leadership and coordination of non-regulatory animal health issues in Ireland.

    Science.gov (United States)

    More, S J; Doherty, M L; Downey, L; McKenzie, K; Devitt, C; O'Flaherty, J

    2011-12-01

    Livestock production plays an important role in the Irish economy. Regulatory animal health issues are the responsibility of government, but until recently there has been no national coordination of non-regulatory animal health issues. This gap has recently been filled with the establishment of Animal Health Ireland (AHI), a not-for-profit, partnership-based organisation providing national leadership and coordination of non-regulatory animal health issues in Ireland. Animal Health Ireland provides benefits to livestock producers and processors by providing the knowledge, education and coordination required to establish effective control strategies, both on-farm and nationally. This paper presents a brief overview of the context for AHI, and of its establishment and initial activities. Non-regulatory animal health issues have been prioritised. A series of work programmes (each focusing on a high-priority issue) have been established. Partnership is critical to success, both for AHI as an organisation and for effective farm-level transfer of knowledge. This model for national leadership and coordination of non-regulatory animal health issues may be of relevance elsewhere.

  20. A Real-World Community Health Worker Care Coordination Model for High-Risk Children.

    Science.gov (United States)

    Martin, Molly A; Perry-Bell, Kenita; Minier, Mark; Glassgow, Anne Elizabeth; Van Voorhees, Benjamin W

    2018-04-01

    Health care systems across the United States are considering community health worker (CHW) services for high-risk patients, despite limited data on how to build and sustain effective CHW programs. We describe the process of providing CHW services to 5,289 at-risk patients within a state-run health system. The program includes 30 CHWs, six care coordinators, the Director of Care Coordination, the Medical Director, a registered nurse, mental health specialists, and legal specialists. CHWs are organized into geographic and specialized teams. All CHWs receive basic training that includes oral and mental health; some receive additional disease-specific training. CHWs develop individualized care coordination plans with patients. The implementation of these plans involves delivery of a wide range of social service and coordination support. The number of CHW contacts is determined by patient risk. CHWs spend about 60% of their time in an office setting. To deliver the program optimally, we had to develop multiple CHW job categories that allow for CHW specialization. We created new technology systems to manage operations. Field issues resulted in program changes to improve service delivery and ensure safety. Our experience serves as a model for how to integrate CHWs into clinical and community systems.

  1. The role of health information technology in care coordination in the United States.

    Science.gov (United States)

    Hsiao, Chun-Ju; King, Jennifer; Hing, Esther; Simon, Alan E

    2015-02-01

    Examine the extent to which office-based physicians in the United States receive patient health information necessary to coordinate care across settings and determine whether receipt of information needed to coordinate care is associated with use of health information technology (HIT) (defined by presence or absence of electronic health record system and electronic sharing of information). Cross-sectional study using the 2012 National Electronic Health Records Survey (65% weighted response rate). Office-based physicians. Use of HIT and 3 types of patient health information needed to coordinate care. In 2012, 64% of physicians routinely received the results of a patient's consultation with a provider outside of their practice, whereas 46% routinely received a patient's history and reason for a referred consultation from a provider outside of their practice. About 54% of physicians reported routinely receiving a patient's hospital discharge information. In adjusted analysis, significant differences in receiving necessary information were observed by use of HIT. Compared with those not using HIT, a lower percentage of physicians who used an electronic health record system and shared patient health information electronically failed to receive the results of outside consultations or patient's history and reason for a referred consultation. No significant differences were observed for the receipt of hospital discharge information by use of HIT. Among physicians routinely receiving information needed for care coordination, at least 54% of them did not receive the information electronically. Although a higher percentage of physicians using HIT received patient information necessary for care coordination than those who did not use HIT, more than one third did not routinely receive the needed patient information at all.

  2. 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.

  3. 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.

  4. A Qualitative Analysis of Success Stories from Michiana Coordinated School Health Leadership Institute Participants

    Science.gov (United States)

    DeWitt, Natalie; Lohrmann, David K.; O'Neill, James; Clark, Jeffrey K.

    2011-01-01

    Background: The purpose of this study was to detect and document common themes among success stories, along with challenges, as related by participants in the Michiana Coordinated School Health Leadership Institute. Four-member teams from 18 Michigan and Indiana school districts participated in semiannual Institute workshops over a 3-year period…

  5. 76 FR 1432 - Office of the National Coordinator for Health Information Technology; HIT Standards Committee...

    Science.gov (United States)

    2011-01-10

    ... Technology; HIT Standards Committee Advisory Meeting; Notice of Meeting AGENCY: Office of the National Coordinator for Health Information Technology, HHS. ACTION: Notice of Meeting. This notice announces a... Information Technology (ONC). The meeting will be open to the public. Name of Committee: HIT Standards...

  6. 75 FR 8954 - Office of the National Coordinator for Health Information Technology; HIT Standards Committee...

    Science.gov (United States)

    2010-02-26

    ... Technology; HIT Standards Committee Advisory Meeting; Notice of Meeting AGENCY: Office of the National Coordinator for Health Information Technology, HHS ACTION: Notice of meeting. This notice announces a... Information Technology (ONC). The meeting will be open to the public. Name of Committee: HIT Standards...

  7. 75 FR 70923 - Office of the National Coordinator for Health Information Technology; HIT Policy Committee...

    Science.gov (United States)

    2010-11-19

    ... Technology; HIT Policy Committee Advisory Meeting; Notice of Meeting AGENCY: Office of the National Coordinator for Health Information Technology, HHS ACTION: Notice of meeting. This notice announces a... Information Technology (ONC). The meeting will be open to the public. Name of Committee: HIT Policy Committee...

  8. 75 FR 70923 - Office of the National Coordinator for Health Information Technology; HIT Standards Committee...

    Science.gov (United States)

    2010-11-19

    ... Technology; HIT Standards Committee Advisory Meeting; Notice of Meeting AGENCY: Office of the National Coordinator for Health Information Technology, HHS. ACTION: Notice of meeting. This notice announces a... Information Technology (ONC). The meeting will be open to the public. Name of Committee: HIT Standards...

  9. 75 FR 29761 - Office of the National Coordinator for Health Information Technology: HIT Standards Committee...

    Science.gov (United States)

    2010-05-27

    ... Technology: HIT Standards Committee Advisory Meeting; Notice of Meeting AGENCY: Office of the National Coordinator for Health Information Technology, HHS. ACTION: Notice of meeting. This notice announces a... Information Technology (ONC). The meeting will be open to the public. Name of Committee: HIT Standards...

  10. 76 FR 4354 - Office of the National Coordinator for Health Information Technology; HIT Standards Committee...

    Science.gov (United States)

    2011-01-25

    ... Technology; HIT Standards Committee Advisory Meeting; Notice of Meeting AGENCY: Office of the National Coordinator for Health Information Technology, HHS. ACTION: Notice of meeting. This notice announces a... Information Technology (ONC). The meeting will be open to the public. Name of Committee: HIT Standards...

  11. British Association for the Study of Community Dentistry (BASCD) guidance on sampling for surveys of child dental health. A BASCD coordinated dental epidemiology programme quality standard.

    Science.gov (United States)

    Pine, C M; Pitts, N B; Nugent, Z J

    1997-03-01

    The British Association for the Study of Community Dentistry (BASCD) is responsible for the coordination of locally based surveys of child dental health which permit local and national comparisons between health authorities and regions. These surveys began in 1985/86 in England and Wales, 1987/88 in Scotland and 1993/94 in Northern Ireland. BASCD has taken an increasing lead in setting quality standards in discussion with the NHS Epidemiology Coordinators of the Dental Epidemiology Programme. This paper comprises guidance on the sampling for these surveys.

  12. Towards successful coordination of electronic health record based-referrals: a qualitative analysis.

    Science.gov (United States)

    Hysong, Sylvia J; Esquivel, Adol; Sittig, Dean F; Paul, Lindsey A; Espadas, Donna; Singh, Simran; Singh, Hardeep

    2011-07-27

    Successful subspecialty referrals require considerable coordination and interactive communication among the primary care provider (PCP), the subspecialist, and the patient, which may be challenging in the outpatient setting. Even when referrals are facilitated by electronic health records (EHRs) (i.e., e-referrals), lapses in patient follow-up might occur. Although compelling reasons exist why referral coordination should be improved, little is known about which elements of the complex referral coordination process should be targeted for improvement. Using Okhuysen & Bechky's coordination framework, this paper aims to understand the barriers, facilitators, and suggestions for improving communication and coordination of EHR-based referrals in an integrated healthcare system. We conducted a qualitative study to understand coordination breakdowns related to e-referrals in an integrated healthcare system and examined work-system factors that affect the timely receipt of subspecialty care. We conducted interviews with seven subject matter experts and six focus groups with a total of 30 PCPs and subspecialists at two tertiary care Department of Veterans Affairs (VA) medical centers. Using techniques from grounded theory and content analysis, we identified organizational themes that affected the referral process. Four themes emerged: lack of an institutional referral policy, lack of standardization in certain referral procedures, ambiguity in roles and responsibilities, and inadequate resources to adapt and respond to referral requests effectively. Marked differences in PCPs' and subspecialists' communication styles and individual mental models of the referral processes likely precluded the development of a shared mental model to facilitate coordination and successful referral completion. Notably, very few barriers related to the EHR were reported. Despite facilitating information transfer between PCPs and subspecialists, e-referrals remain prone to coordination

  13. Towards successful coordination of electronic health record based-referrals: a qualitative analysis

    Directory of Open Access Journals (Sweden)

    Paul Lindsey A

    2011-07-01

    Full Text Available Abstract Background Successful subspecialty referrals require considerable coordination and interactive communication among the primary care provider (PCP, the subspecialist, and the patient, which may be challenging in the outpatient setting. Even when referrals are facilitated by electronic health records (EHRs (i.e., e-referrals, lapses in patient follow-up might occur. Although compelling reasons exist why referral coordination should be improved, little is known about which elements of the complex referral coordination process should be targeted for improvement. Using Okhuysen & Bechky's coordination framework, this paper aims to understand the barriers, facilitators, and suggestions for improving communication and coordination of EHR-based referrals in an integrated healthcare system. Methods We conducted a qualitative study to understand coordination breakdowns related to e-referrals in an integrated healthcare system and examined work-system factors that affect the timely receipt of subspecialty care. We conducted interviews with seven subject matter experts and six focus groups with a total of 30 PCPs and subspecialists at two tertiary care Department of Veterans Affairs (VA medical centers. Using techniques from grounded theory and content analysis, we identified organizational themes that affected the referral process. Results Four themes emerged: lack of an institutional referral policy, lack of standardization in certain referral procedures, ambiguity in roles and responsibilities, and inadequate resources to adapt and respond to referral requests effectively. Marked differences in PCPs' and subspecialists' communication styles and individual mental models of the referral processes likely precluded the development of a shared mental model to facilitate coordination and successful referral completion. Notably, very few barriers related to the EHR were reported. Conclusions Despite facilitating information transfer between PCPs and

  14. Regional simulations of the Faroe Bank Channel overflow using a σ-coordinate ocean model

    Science.gov (United States)

    Seim, Knut S.; Fer, Ilker; Berntsen, Jarle

    Gravity-driven overflow of cold, deep and intermediate water from the Norwegian Sea through the Faroe Bank Channel carries significant volume flux and contributes to the ventilation of the deep North Atlantic Ocean. Here we present results from regional simulations of the Faroe Bank Channel overflow using a terrain-following ( σ-coordinate) ocean model with fine resolution near the sea bed. The model results are compared with observations of hydrography, currents and turbulence conducted in 2008. Turbulent dissipation rate and eddy diffusivity profiles inferred from the observations are used in refining the parameters of the turbulence closure. The model reproduces the observed vertical structure of the enhanced dissipation and diffusivity in the bottommost 50-60 m exceptionally well. In this region, shear-induced mixing dominates and is found to be well-represented by the applied second order turbulence closure models. Farther away from the boundary, however, in the 100-m thick interfacial layer and above the plume-ambient interface, the model does not resolve the observed mixing. The contribution of turbulence from breaking internal waves is one of the processes not represented in the model with significant consequences for observed entrainment and mixing. Regular sub-inertial oscillations (eddies) at 4-4.5 day period develop downstream of the sill, consistent with the observations. When averaged over several eddy events, the evolution of section-averaged plume properties over the oscillation period shows that the eddies significantly affect mixing and the descent rate of the plume. At a section 60 km downstream of the sill, eddies lead to periodic and abrupt cross-isobath descent of the overflow plume and an increase in dissipation rate by one order of magnitude.

  15. [The coordination betwen health and social services in the care of people with severe mental disorders].

    Science.gov (United States)

    López Alvarez, Marcelino; Laviana Cuetos, Margarita

    2016-01-01

    Coordination between health and social services is a key point in caring for an increasing number of people affected by different types of health problems. The change in demographic and epidemiological patterns in our societies evidences the need of this coordination, usually not covered by our care systems. A sector in which the coordination is particularly important is the care of people with disabilities related to the suffering from severe mental disorders. This is a field that has been too long on the sidelines of the general health and social care systems as a result of the social stigma and traditional psychiatric institutions, setting in motion a vicious circle that must be broken in order to identify and to respond to the needs of such persons. In fact, the processes of change towards community care, with targets for recovery and not mere palliative or marginalizing care, necessarily incorporate this coordination as a cornerstone strategy for social inclusion and citizenship. Although there are still significant gaps in this regard, especially in Spain. However, there are experiences of change, such as that of Andalusia, which set the tone for the development of a strategy for integrated care, whose foundations and main elements we try to summarize in the present article. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  16. Co-ordinated research project on health impacts of mercury cycling in contaminated environments studied by nuclear techniques. Report on the second research co-ordination meeting

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2002-07-01

    The specific research objective of this coordinated research project is to study and assess the factors influencing the dynamics of Hg cycling and its impact on human health in mercury contaminated ecosystems, especially in tropical environments, using radioisotopes and enriched stable isotope tracers and/or complementary analytical techniques. Areas of research include: Evaluation of the relevant environmental factors influencing mercury transformations, transportation (mass balances), and partitioning in ecosystems; Development, validation and application of appropriate methodologies for the measurement of Hg methylation and de-methylation rates in various environmental compartments; Development, validation and application of appropriate methodologies for the measurement of Hg fluxes at natural interfaces such as sediment-water, water-air, land-air, plant-air, and saline-water-fresh-water, etc.; Determination and evaluation of the human exposure to Hg using bio-indicators such as hair, blood, and urine in light of epidemiological requirements; Preparation of an appropriate test sample of tropical sediment for comparability studies. Expected research outputs are: Recommended approaches for the determination of mercury methylation and de-methylation rates and flux measurements; A compilation of reliable data on mercury methylation and de-methylation rates and fluxes in contaminated tropical ecosystems for comparison with existing data from temperate regions; Generated knowledge on factors influencing mercury transformations, transport and partitioning in various ecosystems; Test sample of tropical sediment for comparability studies; Database of bio-indicator measurements (hair, blood, and urine, etc.) of human Hg exposure in contaminated tropical ecosystems; and Recommended countermeasures for the prevention and/or reduction of mercury contamination in polluted areas. This compilation contains country reports on the Second Research Coordination Meeting, Minamata

  17. Co-ordinated research project on health impacts of mercury cycling in contaminated environments studied by nuclear techniques. Report on the second research co-ordination meeting

    International Nuclear Information System (INIS)

    2002-01-01

    The specific research objective of this coordinated research project is to study and assess the factors influencing the dynamics of Hg cycling and its impact on human health in mercury contaminated ecosystems, especially in tropical environments, using radioisotopes and enriched stable isotope tracers and/or complementary analytical techniques. Areas of research include: Evaluation of the relevant environmental factors influencing mercury transformations, transportation (mass balances), and partitioning in ecosystems; Development, validation and application of appropriate methodologies for the measurement of Hg methylation and de-methylation rates in various environmental compartments; Development, validation and application of appropriate methodologies for the measurement of Hg fluxes at natural interfaces such as sediment-water, water-air, land-air, plant-air, and saline-water-fresh-water, etc.; Determination and evaluation of the human exposure to Hg using bio-indicators such as hair, blood, and urine in light of epidemiological requirements; Preparation of an appropriate test sample of tropical sediment for comparability studies. Expected research outputs are: Recommended approaches for the determination of mercury methylation and de-methylation rates and flux measurements; A compilation of reliable data on mercury methylation and de-methylation rates and fluxes in contaminated tropical ecosystems for comparison with existing data from temperate regions; Generated knowledge on factors influencing mercury transformations, transport and partitioning in various ecosystems; Test sample of tropical sediment for comparability studies; Database of bio-indicator measurements (hair, blood, and urine, etc.) of human Hg exposure in contaminated tropical ecosystems; and Recommended countermeasures for the prevention and/or reduction of mercury contamination in polluted areas. This compilation contains country reports on the Second Research Coordination Meeting, Minamata

  18. Barriers to healthcare coordination in market-based and decentralized public health systems: a qualitative study in healthcare networks of Colombia and Brazil.

    Science.gov (United States)

    Vargas, Ingrid; Mogollón-Pérez, Amparo Susana; De Paepe, Pierre; Ferreira da Silva, Maria Rejane; Unger, Jean-Pierre; Vázquez, María-Luisa

    2016-07-01

    Although integrated healthcare networks (IHNs) are promoted in Latin America in response to health system fragmentation, few analyses on the coordination of care across levels in these networks have been conducted in the region. The aim is to analyse the existence of healthcare coordination across levels of care and the factors influencing it from the health personnel' perspective in healthcare networks of two countries with different health systems: Colombia, with a social security system based on managed competition and Brazil, with a decentralized national health system. A qualitative, exploratory and descriptive-interpretative study was conducted, based on a case study of healthcare networks in four municipalities. Individual semi-structured interviews were conducted with a three stage theoretical sample of (a) health (112) and administrative (66) professionals of different care levels, and (b) managers of providers (42) and insurers (14). A thematic content analysis was conducted, segmented by cases, informant groups and themes. The results reveal poor clinical information transfer between healthcare levels in all networks analysed, with added deficiencies in Brazil in the coordination of access and clinical management. The obstacles to care coordination are related to the organization of both the health system and the healthcare networks. In the health system, there is the existence of economic incentives to compete (exacerbated in Brazil by partisan political interests), the fragmentation and instability of networks in Colombia and weak planning and evaluation in Brazil. In the healthcare networks, there are inadequate working conditions (temporary and/or part-time contracts) which hinder the use of coordination mechanisms, and inadequate professional training for implementing a healthcare model in which primary care should act as coordinator in patient care. Reforms are needed in these health systems and networks in order to modify incentives, strengthen

  19. The public communication of science in public health graduate programs in Brazil: From the coordinators' perspective

    Science.gov (United States)

    Teixeira, C. A.; Gallo, P. R.

    2014-12-01

    Introduction - The elaboration process of public policies for science and technology in knowledge societies should include not only experts, but all society members. There are studies on lay people's perception of science and technology. However, what is the scientists' perspective on public communication of science? Objectives - To describe and characterize the concepts that coordinators of Brazilian public health graduate programs have about public communication of science. Methods - This is an analytical and descriptive report of an exploratory research (doctoral study). The answers of fifty-one coordinators to two questionnaires were submitted for content analysis. The categories were transformed into variables that allowed the data processing by the Hiérarchique Classificatoire et Cohésitive (CHIC®) software. Results - Similarity analysis strongly suggested (0,99) that coordinators understand public communication as a communication directed to academic peers and students, also as a form of participation in scientific events and communication by scientific papers. Likewise, the implication analysis suggested a strong implication (0,98) between scientific communication understood as public communication. Conclusion - The notion of public communication of science as a social right and as a commitment and responsibility of researchers and research centers is not explicitly present in the narrative of the coordinators, although in general the coordinators conceive it as a relevant activity. This study thus contributes to a reflection on the role of scientists, researchers and research centers in public communication of science and technology.

  20. 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.

  1. ORIGINAL ARTICLE Oral Health in the African Region: Progress ...

    African Journals Online (AJOL)

    Ogunbodede

    and to reinforce partnerships in order to mobilize and coordinate the human, financial, material and institutional resources needed .... strengthened their health facilities ... management information systems; ... professional associations, business and ... facilitating the implementation process as ... of Dentistry, University of the.

  2. A needs assessment of health information technology for improving care coordination in three leading patient-centered medical homes.

    Science.gov (United States)

    Richardson, Joshua E; Vest, Joshua R; Green, Cori M; Kern, Lisa M; Kaushal, Rainu

    2015-07-01

    We investigated ways that patient-centered medical homes (PCMHs) are currently using health information technology (IT) for care coordination and what types of health IT are needed to improve care coordination. A multi-disciplinary team of researchers conducted semi-structured telephone interviews with 28 participants from 3 PCMHs in the United States. Participants included administrators and clinicians from PCMHs, electronic health record (EHR) and health information exchange (HIE) representatives, and policy makers. Participants identified multiple barriers to care coordination using current health IT tools. We identified five areas in which health IT can improve care coordination in PCMHs: 1) monitoring patient populations, 2) notifying clinicians and other staff when specific patients move across care settings, 3) collaborating around patients, 4) reporting activities, and 5) interoperability. To accomplish these tasks, many participants described using homegrown care coordination systems separate from EHRs. The participants in this study have resources, experience, and expertise with using health IT for care coordination, yet they still identified multiple areas for improvement. We hypothesize that focusing health IT development in the five areas we identified can enable more effective care coordination. Key findings from this work are that homegrown systems apart from EHRs are currently used to support care coordination and, also, that reporting tools are key components of care coordination. New health IT that enables monitoring, notifying, collaborating, reporting, and interoperability would enhance care coordination within PCMHs beyond what current health IT enables. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  3. "Walking in a maze": community providers' difficulties coordinating health care for homeless patients.

    Science.gov (United States)

    LaCoursiere Zucchero, Terri; McDannold, Sarah; McInnes, D Keith

    2016-09-07

    While dual usage of US Department of Veterans Affairs (VA) and non-VA health services increases access to care and choice for veterans, it is also associated with a number of negative consequences including increased morbidity and mortality. Veterans with multiple health conditions, such as the homeless, may be particularly susceptible to the adverse effects of dual use. Homeless veteran dual use is an understudied yet timely topic given the Patient Protection and Affordable Care Act and Veterans Choice Act of 2014, both of which may increase non-VA care for this population. The study purpose was to evaluate homeless veteran dual use of VA and non-VA health care by describing the experiences, perspectives, and recommendations of community providers who care for the population. Three semi-structured focus group interviews were conducted with medical, dental, and behavioral health providers at a large, urban Health Care for the Homeless (HCH) program. Qualitative content analysis procedures were used. HCH providers experienced challenges coordinating care with VA medical centers for their veteran patients. Participants lacked knowledge about the VA health care system and were unable to help their patients navigate it. The HCH and VA medical centers lacked clear lines of communication. Providers could not access the VA medical records of their patients and felt this hampered the quality and efficiency of care veterans received. Substantial challenges exist in coordinating care for homeless veteran dual users. Our findings suggest recommendations related to education, communication, access to electronic medical records, and collaborative partnerships. Without dedicated effort to improve coordination, dual use is likely to exacerbate the fragmented care that is the norm for many homeless persons.

  4. Integrating Behavioral Health and Primary Care: Consulting, Coordinating and Collaborating Among Professionals.

    Science.gov (United States)

    Cohen, Deborah J; Davis, Melinda; Balasubramanian, Bijal A; Gunn, Rose; Hall, Jennifer; deGruy, Frank V; Peek, C J; Green, Larry A; Stange, Kurt C; Pallares, Carla; Levy, Sheldon; Pollack, David; Miller, Benjamin F

    2015-01-01

    This paper sought to describe how clinicians from different backgrounds interact to deliver integrated behavioral and primary health care, and the contextual factors that shape such interactions. This was a comparative case study in which a multidisciplinary team used an immersion-crystallization approach to analyze data from observations of practice operations, interviews with practice members, and implementation diaries. The observed practices were drawn from 2 studies: Advancing Care Together, a demonstration project of 11 practices located in Colorado; and the Integration Workforce Study, consisting of 8 practices located across the United States. Primary care and behavioral health clinicians used 3 interpersonal strategies to work together in integrated settings: consulting, coordinating, and collaborating (3Cs). Consulting occurred when clinicians sought advice, validated care plans, or corroborated perceptions of a patient's needs with another professional. Coordinating involved 2 professionals working in a parallel or in a back-and-forth fashion to achieve a common patient care goal, while delivering care separately. Collaborating involved 2 or more professionals interacting in real time to discuss a patient's presenting symptoms, describe their views on treatment, and jointly develop a care plan. Collaborative behavior emerged when a patient's care or situation was complex or novel. We identified contextual factors shaping use of the 3Cs, including: time to plan patient care, staffing, employing brief therapeutic approaches, proximity of clinical team members, and electronic health record documenting behavior. Primary care and behavioral health clinicians, through their interactions, consult, coordinate, and collaborate with each other to solve patients' problems. Organizations can create integrated care environments that support these collaborations and health professions training programs should equip clinicians to execute all 3Cs routinely in practice

  5. Strengthening the Coordination of Pediatric Mental Health and Medical Care: Piloting a Collaborative Model for Freestanding Practices

    Science.gov (United States)

    Greene, Carolyn A.; Ford, Julian D.; Ward-Zimmerman, Barbara; Honigfeld, Lisa; Pidano, Anne E.

    2016-01-01

    Background: Collaborative pediatric mental health and primary care is increasingly recognized as optimal for meeting the needs of children with mental health problems. This paper describes the challenges faced by freestanding specialty mental health clinics and pediatric health practices to provide such coordinated mind-and-body treatment. It…

  6. Health policies and federative gaps in Brazil: an analysis of regional capacity of services delivery.

    Science.gov (United States)

    Ribeiro, José Mendes; Moreira, Marcelo Rasga; Ouverney, Assis Mafort; Silva, Cosme Marcelo Furtado Passos da

    2017-04-01

    This paper analyzes Brazilian health regions according to their service delivery capacity from the debate on the crisis of cooperative federalism in the SUS that resulted from decentralizing process established in the 1988 Constitution. Service delivery capacity tracer indicators were selected by regions and statistical analyses evidenced greater regional capacity in hospital care and large asymmetries with regard to the availability of physicians, high complexity equipment and private insurance coverage. In conclusion,we argue that further solutions are required to strengthen governmental capacity to reduce regional inequalities throughincreased central coordination.

  7. International cooperation and coordination of activities to rehabilitate the population, ecology and economic development of Semipalatinsk region

    International Nuclear Information System (INIS)

    Behrstock, H.

    1998-01-01

    It is in this context that international cooperation and coordination took important steps forward in 1997 and 1998. At the last session of the United Nations General Assembly in December 1997, a Resolution was submitted with nearly 50 co-sponsors and adopted unanimously which called for an assessment to be conducted of the humanitarian effects of the nuclear testing in the Semipalatinsk region. It requested the United nations Secretary General, U N organizations and agencies, with the support of the international community, to collaborate in carrying out this assessment and to report back to the General Assembly at its next regular session which shall begin later this month in New York. This was a remarkable turning point in the global awareness about Semipalatinsk. The resolution also implicitly drew attention to the fact that Kazakstan and its populations, as victims of an extraordinary chapter of the nuclear era, should have the knowledge and the benefits that might come from an appropriate assessment of the consequences and the needs resulting from 40 years of nuclear testing, as well as the rise and fall of the Polygon. The total package of priority needs includes some $43.2 million dollars of projects: $33.7 are deemed to be relatively highest priority, but many could be effectively implemented in phases or stages and would still make a most significant contribution and impact. The breakdown is - health diagnosis, treatment and rehabilitation - $24 million; - urgent humanitarian needs - $3.3 million; - ecological stabilization and environmental protection - $7.8 million; - economic rehabilitation - $6.6 million; - information dissemination - $1.3 million

  8. Network Performance and Coordination in the Health, Education, Telecommunications System. Satellite Technology Demonstration, Technical Report No. 0422.

    Science.gov (United States)

    Braunstein, Jean; Janky, James M.

    This paper describes the network coordination for the Health, Education, Telecommunications (HET) system. Specifically, it discusses HET network performance as a function of a specially-developed coordination system which was designed to link terrestrial equipment to satellite operations centers. Because all procedures and equipment developed for…

  9. 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.

  10. [Report of the third meeting of the coordinators of the regional MRP networks in Germany on 15 and 16 December 2011 at the Robert Koch Institute].

    Science.gov (United States)

    Mielke, M

    2012-11-01

    Since 2004 the Robert Koch-Institute has supported the formation of regional networks for prevention of the spread of methicillin-resistant Staphylococcus aureus and multiresistant pathogens (MRSA/MRP, EpiBull 5/2005)). The third meeting of the coordinators of the regional MRP networks in Germany took place on 15 and 16 December 2011. A total of 60 representatives of the Public Health Services from 12 states participated. It must be emphasized that in the meantime many successfully established networks are active and not all coordinators of existing networks could participate merely due to the organizational format. Interested parties can obtain a good overview via a link to the corresponding internet homepage of each state under http://www.rki.de → Infektionsschutz → Krankenhaushygiene → Regionale Netzwerke. In summary it was clear that the number and the activity of regional MRP networks in Germany have further increased. The networks can synergistically benefit from important experiences through the different individual focal points of each network and a corresponding exchange of ideas.

  11. Compact galaxies in the region with the center coordinates 07sup(h)59sup(m)+54 deg 44'

    International Nuclear Information System (INIS)

    Boerngen, F.; Kalloglyan, A.T.

    1980-01-01

    A list of 70 compact galaxies is presented, galaxies being found in the metagalactic field in the region with center coordinates αsub(1950)=07sup(h)59sup(m), deltasub(1950)54 deg 44'. The selection of objects have been carried out on negatives obtained in the Schmidt focus of the two-meter universal telescope of Tautenburg observatory in the colour B and V system. Galaxies of the highest surface brightness and of spherical configuration have been included. Only in some cases slightly elongated objects have been included due to their very high surface brightness. The coordinates, B and V stellar values of all objects have been measured. The maps of their identification are presented

  12. [Health projects managed by Nursing Coordinators: an analysis of contents and degree of success].

    Science.gov (United States)

    Palese, Alvisa; Bresciani, Federica; Brutti, Caterina; Chiari, Ileana; Fontana, Luciana; Fronza, Ornella; Gasperi, Giuseppina; Gheno, Oscar; Guarese, Olga; Leali, Anna; Mansueti, Nadia; Masieri, Enrico; Messina, Laura; Munaretto, Gabriella; Paoli, Claudia; Perusi, Chiara; Randon, Giulia; Rossi, Gloria; Solazzo, Pasquale; Telli, Debora; Trenti, Giuliano; Veronese, Elisabetta; Saiani, Luisa

    2012-01-01

    To describe the evolution and results of health projects run in hospitals and managed by Nursing Coordinators. A convenience sample of 13 north Italian hospital, and a sample of 56 Nursing Coordinators with a permanent position from at least 1 year, was contacted. The following information was collected with a structured interview: projects run in 2009, topic, if bottom up or top down, number of staff involved and state (ended, still running, stopped). In 2009 Nursing Coordinators started 114 projects (mean 1.8±1.2 each): 94 (82.5%) were improvement projects, 17 (14.9%) accreditation, and 3 (2.6%) research. The projects involved 2.732 staff members (73.7%; average commitment 84 hours); 55 (48.2%) projects were still running, 52 (45.6%) completed, for 5 (4.4%) there was no assessment and 2 (1.8%) had been stopped. Nurses are regularly involved in several projects. A systematic monitoring of the results obtained and stabilization strategies are scarce. Due to the large number of resources invested, a correct management and the choice of areas relevant for patients' problems and needs are pivotal.

  13. [Strengthening primary health care: a strategy to maximize coordination of care].

    Science.gov (United States)

    de Almeida, Patty Fidelis; Fausto, Márcia Cristina Rodrigues; Giovanella, Lígia

    2011-02-01

    To describe and analyze the actions developed in four large cities to strengthen the family health strategy (FHS) in Brazil. Case studies were carried out in Aracaju, Belo Horizonte, Florianópolis, and Vitória based on semi-structured interviews with health care managers. In addition, a cross-sectional study was conducted with questionnaires administered to a sample of FHS workers and services users. Actions needed to strengthen primary health care services were identified in all four cities. These include increasing the number of services offered at the primary health care level, removing barriers to access, restructuring primary services as the entry point to the health care system, enhancing problem-solving capacity (diagnostic and therapeutic support and networking between health units to organize the work process, training, and supervision), as well as improving articulation between surveillance and care actions. The cities studied have gained solid experience in the reorganization of the health care model based on a strengthening of health primary care and of the capacity to undertake the role of health care coordinator. However, to make the primary care level the customary entry point and first choice for users, additional actions are required to balance supplier-induced and consumer-driven demands. Consumer driven demand is the biggest challenge for the organization of teamwork processes. Support for and recognition of FHS as a basis for primary health care is still an issue. Initiatives to make FHS better known to the population, health care professionals at all levels, and civil society organizations are still needed.

  14. Co-ordinated research project on health impacts of mercury cycling in contaminated environments studied by nuclear techniques. Report on the first research co-ordination meeting

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2001-07-01

    The specific research objective of this coordinated research project is to study and assess the factors influencing the dynamics of Hg cycling and its impact on human health in mercury contaminated ecosystems, especially in tropical environments, using radioisotopes and enriched stable isotope tracers and/or complementary analytical techniques. Areas of research include: Evaluation of the relevant environmental factors influencing mercury transformations, transportation (mass balances), and partitioning in ecosystems; Development, validation and application of appropriate methodologies for the measurement of Hg methylation and de-methylation rates in various environmental compartments; Development, validation and application of appropriate methodologies for the measurement of Hg fluxes at natural interfaces such as sediment-water, water-air, land-air, plant-air, and saline-water-fresh-water, etc.; Determination and evaluation of the human exposure to Hg using bio-indicators such as hair, blood, and urine in light of epidemiological requirements; Preparation of an appropriate test sample of tropical sediment for comparability studies. Expected research outputs are: Recommended approaches for the determination of mercury methylation and de-methylation rates and flux measurements; A compilation of reliable data on mercury methylation and de-methylation rates and fluxes in contaminated tropical ecosystems for comparison with existing data from temperate regions; Generated knowledge on factors influencing mercury transformations, transport and partitioning in various ecosystems; Test sample of tropical sediment for comparability studies; Database of bio-indicator measurements (hair, blood, and urine, etc.) of human Hg exposure in contaminated tropical ecosystems; and Recommended countermeasures for the prevention and/or reduction of mercury contamination in polluted areas.

  15. Co-ordinated research project on health impacts of mercury cycling in contaminated environments studied by nuclear techniques. Report on the first research co-ordination meeting

    International Nuclear Information System (INIS)

    2001-01-01

    The specific research objective of this coordinated research project is to study and assess the factors influencing the dynamics of Hg cycling and its impact on human health in mercury contaminated ecosystems, especially in tropical environments, using radioisotopes and enriched stable isotope tracers and/or complementary analytical techniques. Areas of research include: Evaluation of the relevant environmental factors influencing mercury transformations, transportation (mass balances), and partitioning in ecosystems; Development, validation and application of appropriate methodologies for the measurement of Hg methylation and de-methylation rates in various environmental compartments; Development, validation and application of appropriate methodologies for the measurement of Hg fluxes at natural interfaces such as sediment-water, water-air, land-air, plant-air, and saline-water-fresh-water, etc.; Determination and evaluation of the human exposure to Hg using bio-indicators such as hair, blood, and urine in light of epidemiological requirements; Preparation of an appropriate test sample of tropical sediment for comparability studies. Expected research outputs are: Recommended approaches for the determination of mercury methylation and de-methylation rates and flux measurements; A compilation of reliable data on mercury methylation and de-methylation rates and fluxes in contaminated tropical ecosystems for comparison with existing data from temperate regions; Generated knowledge on factors influencing mercury transformations, transport and partitioning in various ecosystems; Test sample of tropical sediment for comparability studies; Database of bio-indicator measurements (hair, blood, and urine, etc.) of human Hg exposure in contaminated tropical ecosystems; and Recommended countermeasures for the prevention and/or reduction of mercury contamination in polluted areas

  16. [Clinical and managerial autonomy. Perception of the coordinators of the health centers in Mallorca, Spain].

    Science.gov (United States)

    Tamborero Cao, Gaspar; Gómez Nadal, Amalia; García Pineda, Atanasio; Miguélez Chamorro, Angélica; Canet Martorell, Rosa; Esteva Cantó, Magdalena

    2011-12-01

    The self-management has been linked with increased efficiency and job satisfaction. Before any changes aimed at a more autonomous management is important to know the position of professionals and managers. objective: To assess the importance attached by the coordinators of the health centers (HC) to the clinical and managerial autonomy, knowing their decision making capacity and their expectations about the feasibility of implementing a project of self-management. cross-sectional study, application questionnaire. Primary Care, 2009. All the coordinators of the HC of Mallorca (N = 47). 27 questions that explore the coordinator's opinion about the importance of the components of the self-management, its ability to present intervention, the propensity / aversion to risk, leadership, and the feasibility of a self-management. response rate: 42/47 (89,4%). 42 (100%) attaches the highest importance to the management of human resources, 41 (97,6%) to demand management and 40 (95,2%) to the management of waiting lists. 15 (35,7%) would take a financial risk, 14 (33,3%) were considered trained and 18 (42,9%) were willing to lead a process of self-management. 14 (33,3%) thought that the professionals in your team would not be interested in a process of self-management and 29 (69%) believed that others could develop HC of Mallorca. The respondents were coordinators have a limited ability to decide on the components of the self-management, being risk averse and make a little leadership ability and willingness to self-management projects.

  17. Sub-regional Workshop on Illicit Nuclear Trafficking Information Management and Coordination

    International Nuclear Information System (INIS)

    2010-01-01

    The workshop was organized to; have a comprehensive set of information which effectively supports implementation of the Nuclear Security Plan; understand nuclear security needs on a global scale to identify areas of cooperation between and among the Agency and Member States; determine illicit global trafficking trends and patterns, including theft and other malicious acts involving radioactive material; fully protect sensitive nuclear security information from disclosure; coordinate the nuclear security support programmes of Member States and international organizations with those of the Agency and have effective mechanisms of interaction with other international organizations

  18. [Occupational health administrative coordination a propos of a case: brake linings with asbestos in a company].

    Science.gov (United States)

    García Gómez, Montserrat; Alonso Urreta, Iciar; Antón Tomey, Carlos; Bosque Peralta, Isabel; García-Gutierrez, María Jesús; Luna Lacarta, Francisco José; Martínez Arguisuelas, Nieves; Mena Marín, María Luisa; Vázquez Cortizo, Margarita

    2018-04-10

    The current structure of the Spanish State of Autonomies is characterized by institutional pluralism and the autonomy of the different public administrations. In this context, the principle of coordination is fundamental for the cohesion of the system, but experience shows that its implementation is difficult. This paper examines the set of actions carried out by the administrations in relation to an occupational and public health problem raised in March 2016. The Public Health General Direction of Aragon's Government was informed of a possible use of brake linings with asbestos to manufacture axles for agricultural machinery by a Company from Zaragoza; the collaboration from Aragon's Institute of Occupational Safety and Health, the Industry Department and the Labour and Social Security Inspectorate were asked; the joint action of these administrations detected the use of several models of brake linings with a content of 2-5% of Chrysotile. The brake linings came from a Chinese company. The axles nated are sold in several Spanish Autonomous Communities. A national alert was activated by the SIRIPQ (System of Rapid Exchange of Information on Chemical Products) which is coordinated by the Ministry of Health, Social Services and Equality. Several measures were taken including: ceasing the work with the brake linings, the replacement of brake linings with asbestos, the immobilization of brake linings in the company by application of the REACH Reglament, etc. This case shows that the cooperation and co-responsibility of public administrations from different territorial, sectoral and competence areas allows improving the occupational risks prevention and the public health.

  19. The Accelerating And Constraining Factors Of The Coordinated And Balanced Development Of Regions

    Directory of Open Access Journals (Sweden)

    Vladimir Stepanovich Bochko

    2015-03-01

    Full Text Available In the article, the hypothesis that the modern industrial-technological process causes complication of socio-economic space and conducts to amplification its integrity, which, in turn, causes the need for the coordinated and balanced development, is proved. The process of complication of economic space is revealed as a result of number growth of communications caused by creation of the enterprises and organizations, by the change of structure of manufacture and increase of an educational level of the population. The characteristics of a new quality of economic space are given. The factors of the coordinated and balanced development of territories are allocated. The contents «a commercial combination» is shown. The necessity of transition to the system innovation thinking in conditions of becoming complicated economic space is proved. The idea of use «rebalancing of the economy « as a new vision of equation in conditions of crisis situations is offered. The conclusion is made that the result of theoretical and practical searches should become formation vital stability of development of territories, which is provided with intelligence — technological and moral — ethical level of the population, living on it

  20. Evaluation of the Coordination of Zonguldak-Bartın-Karabük Region Plans

    Directory of Open Access Journals (Sweden)

    Sevgi GÖRMÜŞ, Mustafa ARTAR

    2010-01-01

    Full Text Available It is observed that industry is dominant in the decisions regarding the development of Zonguldak-Bartın-KarabükRegion in the planned development process. However, the geographic structure of the region has not allowed thedevelopment of industry. The rate of poverty and migration has increased due to unrealized industry policies. Onthe other hand, unrealized industry policies have led to the conservation of the nature and natural formations.The region has been well-known in tourism in recent years with its natural beauties.If the ecotourism is developed in Zonguldak-Bartın-Karabük Part of Western Black Sea Region with its naturalbeauties, different altitudes, water sources and forests, this part can be a trademark in preserving the biodiversityof Turkey and application of ecotourism. This region keeps its attraction for industry as well with its naturalzones having international importance and ancient coastal cities but this case increases the existingenvironmental problems. Migration and unemployment are the most important problems for the region whererural population is dense. When planned carefully, ecotourism can be a significant initiative for the region and animportant source of income for the inhabitants of the region.

  1. Research on the Coordinative Development of Regional Higher Education and Economy

    Science.gov (United States)

    Hong, Yingjun

    2012-01-01

    In the current society, economic development in any region has to rely on higher education. Conversely, higher education cannot do without regional economic development in order to achieve greater progress in scale and level. Starting with the function of higher education in Wenzhou, this paper analyzes the reality and problems in Wenzhou's higher…

  2. 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.

  3. Development of a hospital-based care coordination program for children with special health care needs.

    Science.gov (United States)

    Petitgout, Janine M; Pelzer, Daniel E; McConkey, Stacy A; Hanrahan, Kirsten

    2013-01-01

    A hospital-based Continuity of Care program for children with special health care needs is described. A family-centered team approach provides care coordination and a medical home. The program has grown during the past 10 years to include inpatients and outpatients from multiple services and outreach clinics. Improved outcomes, including decreased length of stay, decreased cost, and high family satisfaction, are demonstrated by participants in the program. Pediatric nurse practitioners play an important role in the medical home, collaborating with primary care providers, hospital-based specialists, community services, and social workers to provide services to children with special health care needs. Copyright © 2013 National Association of Pediatric Nurse Practitioners. Published by Mosby, Inc. All rights reserved.

  4. Rate regions for coordination of Decode-and-Forward relays and direct users

    DEFF Research Database (Denmark)

    Thai, Chan; Popovski, Petar

    2012-01-01

    Recently, the ideas of wireless network coding (NC) has significantly enriched the area of wireless cooperation/relaying. They bring substantial gains in spectral efficiency mainly in scenarios with two–way relaying. Inspired by the ideas of wireless NC, recently we have proposed techniques...... for coordinated direct/relay (CDR) transmissions. Leveraging on the fact that the interference can be subsequently canceled, these techniques embrace the interference among the communication flows to/from direct and relayed users. Hence, by allowing simultaneous transmissions, spectral efficiency is increased....... In our prior work, we have proposed CDR with Decode–and–Forward (DF) relay in two scenarios. In this paper, we extend the two existing regenerative CDR schemes and proposed for the other two scenarios such that all schemes benefit from the aforementioned principle of containing the interference...

  5. Principal coordinate analysis of genotype × environment interaction for grain yield of bread wheat in the semi-arid regions

    Directory of Open Access Journals (Sweden)

    Sabaghnia Naser

    2013-01-01

    Full Text Available Multi-environmental trials have significant main effects and significant multiplicative genotype × environment (GE interaction effect. Principal coordinate analysis (PCOA offers a more appropriate statistical analysis to deal with such situations, compared to traditional statistical methods. Eighteen bread wheat genotypes were grown in four semi-arid regions over three year seasons to study the GE interaction and yield stability and obtained data on grain yield were analyzed using PCOA. Combined analysis of variance indicated that all of the studied effects including the main effects of genotype and environments as well as the GE interaction were highly significant. According to grand means and total mean yield, test environments were grouped to two main groups as high mean yield (H and low mean yield (L. There were five H test environments and six L test environments which analyzed in the sequential cycles. For each cycle, both scatter point diagram and minimum spanning tree plot were drawn. The identified most stable genotypes with dynamic stability concept and based on the minimum spanning tree plots and centroid distances were G1 (3310.2 kg ha-1 and G5 (3065.6 kg ha-1, and therefore could be recommended for unfavorable or poor conditions. Also, genotypes G7 (3047.2 kg ha-1 and G16 (3132.3 kg ha-1 were located several times in the vertex positions of high cycles according to the principal coordinates analysis. The principal coordinates analysis provided useful and interesting ways of investigating GE interaction of barley genotypes. Finally, the results of principal coordinates analysis in general confirmed the breeding value of the genotypes, obtained on the basis of the yield stability evaluation.

  6. Strengthening intergovernmental coordination in support of regional development: attempts, tools and reflections

    CSIR Research Space (South Africa)

    Goss, H

    2008-04-01

    Full Text Available This paper address the socio-economic objectives of government and the challenges around integrated planning and investment, government has identified district and metro areas to be the pivotal sites for regional development and government...

  7. The New Coordinates of Globalization and Regional Integration: Resizing the Euro-Mediterranean Partnership

    Directory of Open Access Journals (Sweden)

    Marcel Moldoveanu

    2017-04-01

    Full Text Available The increasingly strong process of interdependence between globalization and regionalization - in the context of the end of the bipolar power at world level - has engendered a new philosophy regarding the evolution of the world, a reconsideration of the strategy of political and diplomatic, economic and also cultural and human relationships. In my opinion, in a multipolar world, that will bring into the first line of international relations new big actors of regional and universal vocation (China, Rusia, Brasil, India, the European Union will play an extensive role in participating at the geostrategic, regional and global equilibrium, through promotion of an „open diplomacy” that will allow – by dialogue and cooperation – the resolving more rapidly and efficiently the great challenges of the beginning of the century and millenium: the reduction of the great development gaps, the regional and global security, in a very solid economic background. A new dimension of the EU enlargement policy at regional scale is represented by the cooperation relations and the attraction into the European circuit of material and spiritual values of the countries in the Central and Eastern Europe. In the context of deepening the interdependence and complementarities at regional and global level, more focus should be put on the viable ways and modalities to intensify the cooperation in the Danube-Black Sea and Euro-Mediterranean geo-economic and strategic areas. The two big geo-strategic regions of the world belong to the same civilization and are subject to similar changes as the other regions of the world, despite some specific features of history and culture. The intensification and diversification of the cooperation at the Central and South-Eastern European level, as well as the Euro-Mediterranean and Danube-Black Sea region, does not represent an alternative to the general objective process of integration into the Euro-Atlantic structures, but a

  8. First intercomparison exercise in the frame of the coordinated investigation program of the IAEA on regional intercomparison of personal dosimetry

    International Nuclear Information System (INIS)

    Massera, G.; Papadopulos, S.B.; Gregori, B.N.; DaSilva, T.; Griffith, R.; )

    1998-01-01

    During the days 7 and 11 of October of 1996 took place in Buenos Aires, Argentina, the first Meeting of the Coordinated Investigation program of the IAEA on Regional Intercomparison of Personal Dosimetry for Latin American. In this meeting participated nine representatives of reference laboratories and of personal dosimetry of the region. Fundamental aspect of personal dosimetry relates with the quantity personal dose equivalent Hp application and the implementation of intercomparison exercise in order to improve the quality of the dose estimation have been discussed. Also lectures carried out by the specialist on Hp and practical aspects of it implementation; answer and calibration according to the ISO 4037; intercomparison methods: procedures and organizations. It was carried out the first intercomparison exercise where the participants collaborated in the preparations and irradiations of personal dosemeters they have brought. (author)

  9. Coordination of Regional Structures’ Interests Concerning Investment Resources of Educational Services of Enterprises under High-Risk Conditions

    Directory of Open Access Journals (Sweden)

    Semchuk Zhanna V.

    2016-02-01

    Full Text Available The development of professional education in the context of interaction with the labor market has been analyzed and inconsistencies of professional and economic nature have been revealed. Reasons for the imbalance in the structure of the market for labor and education have been identified, and it was noted that they have a negative impact on the economic security of educational institutions and cause the accumulation of negative factors as well. Elements of foreign experience in forecasting economic development and associated with it changes in educational services with regard to high-risk conditions have been considered for the purpose of its application in Ukraine. A conceptual model of information technology for coordination of regional structures’ interests concerning investment resources of educational services of enterprises under high-risk conditions has been proposed. The information technology is based on the econometric model for optimizing enterprise Internet payment systems, criterion of hierarchical games theories, multiobjective optimization, active systems, the model for diagnosing internal and external threats to the economic security of the educational institution; means and methodology of the system-value approach; algorithms for recognition of crisis situations; the optimization model for forecasting crisis situations and managing risk as well as the decision-making system for coordination of regional structures’ interests concerning investment resources based on the model of a program-designtarget complex

  10. Antimicrobial Resistance Control Strategies: A Coordinated Research Initiative Experience in the Asia Pacific Region.

    Science.gov (United States)

    Lapierre, Lisette; Asenjo, Gabriela; Vergara, Constanza; Cornejo, Javiera

    2017-05-01

    The objective was to gather information on the status of antimicrobial surveillance in the Asia Pacific region and suggest control strategies. Twenty-one economies of the Asia Pacific region participated in this initiative. A survey was conducted on antimicrobial use and surveillance throughout the region. A workshop was carried out to create awareness about the issue and discuss the implementation of control strategies. Based on the survey results and workshop conclusions, it can be established that there is better understanding of the implications of antimicrobial resistance in the human medicine area. Only few economies take actions to control antimicrobial resistance on a veterinary/agricultural level. To confront antimicrobial resistance, it is critical to raise awareness; cooperation between all countries is needed to apply international standards, to be able to have harmonized public policies. Countries must align and improve their systems for surveillance and monitoring of antimicrobial resistance in human, animals, and the environment.

  11. AgMIP 1.5°C Assessment: Mitigation and Adaptation at Coordinated Global and Regional Scales

    Science.gov (United States)

    Rosenzweig, C.

    2016-12-01

    The AgMIP 1.5°C Coordinated Global and Regional Integrated Assessments of Climate Change and Food Security (AgMIP 1.5 CGRA) is linking site-based crop and livestock models with similar models run on global grids, and then links these biophysical components with economics models and nutrition metrics at regional and global scales. The AgMIP 1.5 CGRA assessment brings together experts in climate, crop, livestock, economics, nutrition, and food security to define the 1.5°C Protocols and guide the process throughout the assessment. Scenarios are designed to consistently combine elements of intertwined storylines of future society including socioeconomic development (Shared Socioeconomic Pathways), greenhouse gas concentrations (Representative Concentration Pathways), and specific pathways of agricultural sector development (Representative Agricultural Pathways). Shared Climate Policy Assumptions will be extended to provide additional agricultural detail on mitigation and adaptation strategies. The multi-model, multi-disciplinary, multi-scale integrated assessment framework is using scenarios of economic development, adaptation, mitigation, food policy, and food security. These coordinated assessments are grounded in the expertise of AgMIP partners around the world, leading to more consistent results and messages for stakeholders, policymakers, and the scientific community. The early inclusion of nutrition and food security experts has helped to ensure that assessment outputs include important metrics upon which investment and policy decisions may be based. The CGRA builds upon existing AgMIP research groups (e.g., the AgMIP Wheat Team and the AgMIP Global Gridded Crop Modeling Initiative; GGCMI) and regional programs (e.g., AgMIP Regional Teams in Sub-Saharan Africa and South Asia), with new protocols for cross-scale and cross-disciplinary linkages to ensure the propagation of expert judgment and consistent assumptions.

  12. 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.

  13. Proposal for coordinated health research in PFAS-contaminated communities in the United States.

    Science.gov (United States)

    Bruton, Thomas A; Blum, Arlene

    2017-11-14

    The drinking water of more than six million Americans in numerous communities has been found to contain highly fluorinated chemicals at concentrations of concern. Certain of these chemicals, including perfluorooctanoic acid and perfluorooctane sulfonic acid, are known to be persistent, bioaccumulative, and associated with adverse health outcomes in humans and animal models. The possible health impacts of exposure to highly fluorinated chemicals are of great concern to communities whose water has been impacted. Community members want information, and are asking for biomonitoring, exposure pathway analysis, and health studies. Governmental agencies are striving to deal with these multiple concerns in the face of information and resource constraints. We propose the development of a high-level research strategy to maximize what can be learned about health effects of highly fluorinated chemicals and methods to reduce or eliminate exposure. We suggest coordinating the research across multiple communities for greater statistical power. If implemented, such a strategy could help to generate information and evidence integration to enable regulatory decision making and contribute to reducing future exposures.

  14. Coordinating across scales: Building a regional marsh bird monitoring program from national and state Initiatives

    Science.gov (United States)

    Shriver, G.W.; Sauer, J.R.

    2008-01-01

    Salt marsh breeding bird populations (rails, bitterns, sparrows, etc.) in eastern North America are high conservation priorities in need of site specific and regional monitoring designed to detect population changes over time. The present status and trends of these species are unknown but anecdotal evidence of declines in many of the species has raised conservation concerns. Most of these species are listed as conservation priorities on comprehensive wildlife plans throughout the eastern U.S. National Wildlife Refuges, National Park Service units, and other wildlife conservation areas provide important salt marsh habitat. To meet management needs for these areas, and to assist regional conservation planning, survey designs are being developed to estimate abundance and population trends for these breeding bird species. The primary purpose of this project is to develop a hierarchical sampling frame for salt marsh birds in Bird Conservation Region (BCR) 30 that will provide the ability to estimate species population abundances on 1) specific sites (i.e. National Parks and National Wildlife Refuges), 2) within states or regions, and 3) within BCR 30. The entire breeding range of Saltmarsh Sharp-tailed and Coastal Plain Swamp sparrows are within BCR 30, providing an opportunity to detect population trends within the entire breeding ranges of two priority species.

  15. Care coordinator views and experiences of physical health monitoring in clients with severe mental illness: A qualitative study.

    Science.gov (United States)

    Gronholm, Petra C; Onagbesan, Oluwadamilola; Gardner-Sood, Poonam

    2017-11-01

    Excess mortality among people with severe mental illness (SMI) is largely attributed to co-morbid physical illness. Improving the physical health of this population is critically important; however, physical health monitoring among people with SMI is often inadequate. This study aimed to facilitate an enhanced understanding of barriers to successfully attend to clients' physical health in mental health settings, through exploring care coordinators' views and experiences regarding their ability to monitor physical health in clients with SMI (specifically, psychosis). Semi-structured interviews were conducted with seven care coordinators from a South East London (UK) community mental health team. Data were analysed using thematic analysis principles. Three themes were identified in these data, capturing (1) how care coordinators viewed the professional roles of other clinical staff and themselves, (2) views on barriers to the provision of physical healthcare and (3) factors that motivated care coordinators to attend to clients' physical health. Our findings can inform efforts to implement physical healthcare interventions within mental health settings. Such insights are timely, as academic literature and guidelines regarding clinical practice increasingly promote the value of integrated provision of mental and physical healthcare.

  16. Assessing needs and assets for building a regional network infrastructure to reduce cancer related health disparities.

    Science.gov (United States)

    Wells, Kristen J; Lima, Diana S; Meade, Cathy D; Muñoz-Antonia, Teresita; Scarinci, Isabel; McGuire, Allison; Gwede, Clement K; Pledger, W Jack; Partridge, Edward; Lipscomb, Joseph; Matthews, Roland; Matta, Jaime; Flores, Idhaliz; Weiner, Roy; Turner, Timothy; Miele, Lucio; Wiese, Thomas E; Fouad, Mona; Moreno, Carlos S; Lacey, Michelle; Christie, Debra W; Price-Haywood, Eboni G; Quinn, Gwendolyn P; Coppola, Domenico; Sodeke, Stephen O; Green, B Lee; Lichtveld, Maureen Y

    2014-06-01

    Significant cancer health disparities exist in the United States and Puerto Rico. While numerous initiatives have been implemented to reduce cancer disparities, regional coordination of these efforts between institutions is often limited. To address cancer health disparities nation-wide, a series of regional transdisciplinary networks through the Geographic Management Program (GMaP) and the Minority Biospecimen/Biobanking Geographic Management Program (BMaP) were established in six regions across the country. This paper describes the development of the Region 3 GMaP/BMaP network composed of over 100 investigators from nine institutions in five Southeastern states and Puerto Rico to develop a state-of-the-art network for cancer health disparities research and training. We describe a series of partnership activities that led to the formation of the infrastructure for this network, recount the participatory processes utilized to develop and implement a needs and assets assessment and implementation plan, and describe our approach to data collection. Completion, by all nine institutions, of the needs and assets assessment resulted in several beneficial outcomes for Region 3 GMaP/BMaP. This network entails ongoing commitment from the institutions and institutional leaders, continuous participatory and engagement activities, and effective coordination and communication centered on team science goals. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. Assessing Needs and Assets for Building a Regional Network Infrastructure to Reduce Cancer Related Health Disparities

    Science.gov (United States)

    Wells, Kristen J.; Lima, Diana S.; Meade, Cathy D.; Muñoz-Antonia, Teresita; Scarinci, Isabel; McGuire, Allison; Gwede, Clement K.; Pledger, W. Jack; Partridge, Edward; Lipscomb, Joseph; Matthews, Roland; Matta, Jaime; Flores, Idhaliz; Weiner, Roy; Turner, Timothy; Miele, Lucio; Wiese, Thomas E.; Fouad, Mona; Moreno, Carlos S.; Lacey, Michelle; Christie, Debra W.; Price-Haywood, Eboni G.; Quinn, Gwendolyn P.; Coppola, Domenico; Sodeke, Stephen O.; Green, B. Lee; Lichtveld, Maureen Y.

    2015-01-01

    Significant cancer health disparities exist in the United States and Puerto Rico. While numerous initiatives have been implemented to reduce cancer disparities, regional coordination of these efforts between institutions is often limited. To address cancer health disparities nationwide, a series of regional transdisciplinary networks through the Geographic Management Program (GMaP) and the Minority Biospecimen/Biobanking Geographic Management Program (BMaP) were established in six regions across the country. This paper describes the development of the Region 3 GMaP/BMaP network composed of over 100 investigators from nine institutions in five Southeastern states and Puerto Rico to develop a state-of-the-art network for cancer health disparities research and training. We describe a series of partnership activities that led to the formation of the infrastructure for this network, recount the participatory processes utilized to develop and implement a needs and assets assessment and implementation plan, and describe our approach to data collection. Completion, by all nine institutions, of the needs and assets assessment resulted in several beneficial outcomes for Region 3 GMaP/BMaP. This network entails ongoing commitment from the institutions and institutional leaders, continuous participatory and engagement activities, and effective coordination and communication centered on team science goals. PMID:24486917

  18. Coordination of Hepatitis C Virus Assembly by Distinct Regulatory Regions in Nonstructural Protein 5A.

    Directory of Open Access Journals (Sweden)

    Margarita Zayas

    2016-01-01

    Full Text Available Hepatitis C virus (HCV nonstructural protein (NS5A is a RNA-binding protein composed of a N-terminal membrane anchor, a structured domain I (DI and two intrinsically disordered domains (DII and DIII interacting with viral and cellular proteins. While DI and DII are essential for RNA replication, DIII is required for assembly. How these processes are orchestrated by NS5A is poorly understood. In this study, we identified a highly conserved basic cluster (BC at the N-terminus of DIII that is critical for particle assembly. We generated BC mutants and compared them with mutants that are blocked at different stages of the assembly process: a NS5A serine cluster (SC mutant blocked in NS5A-core interaction and a mutant lacking the envelope glycoproteins (ΔE1E2. We found that BC mutations did not affect core-NS5A interaction, but strongly impaired core-RNA association as well as virus particle envelopment. Moreover, BC mutations impaired RNA-NS5A interaction arguing that the BC might be required for loading of core protein with viral RNA. Interestingly, RNA-core interaction was also reduced with the ΔE1E2 mutant, suggesting that nucleocapsid formation and envelopment are coupled. These findings argue for two NS5A DIII determinants regulating assembly at distinct, but closely linked steps: (i SC-dependent recruitment of replication complexes to core protein and (ii BC-dependent RNA genome delivery to core protein, triggering encapsidation that is tightly coupled to particle envelopment. These results provide a striking example how a single viral protein exerts multiple functions to coordinate the steps from RNA replication to the assembly of infectious virus particles.

  19. Health Reform in Minnesota: An Analysis of Complementary Initiatives Implementing Electronic Health Record Technology and Care Coordination.

    Science.gov (United States)

    Soderberg, Karen; Rajamani, Sripriya; Wholey, Douglas; LaVenture, Martin

    2016-01-01

    Minnesota enacted legislation in 2007 that requires all health care providers in the state to implement an interoperable electronic health record (EHR) system by 2015. 100% of hospitals and 98% of clinics had adopted EHR systems by end of 2015. Minnesota's 2008 health reform included a health care home (HCH) program, Minnesota's patient centered medical home. By end of 2014, 43% of HCH eligible clinics were certified with 335 certified HCHs and 430 eligible but not certified clinics. To study the association between adoption and use of EHRs in primary care clinics and HCH certification, including use of clinical decision support tools, patient registries, electronic exchange of patient information, and availability of patient portals. Study utilized data from the 2015 Minnesota Health Information Technology Clinic Survey conducted annually by the Minnesota Department of Health. The response rate was 80% with 1,181 of 1,473 Minnesota clinics, including 662 HCH eligible primary care clinics. The comparative analysis focused on certified HCHs (311) and eligible but not certified clinics (351). HCH clinics utilized the various tools of EHR technology at a higher rate than non-HCH clinics. This greater utilization was noted across a range of functionalities: clinical decision support, patient disease registries, EHR to support quality improvement, electronic exchange of summary care records and availability of patient portals. HCH certification was significant for clinical decision support tools, registries and quality improvement. HCH requirements of care management, care coordination and quality improvement can be better supported with EHR technology, which underscores the higher rate of utilization of EHR tools by HCH clinics. Optimizing electronic exchange of health information remains a challenge for all clinics, including HCH certified clinics. This research presents the synergy between complementary initiatives supporting EHR adoption and HCH certification

  20. First mesospheric turbulence study using coordinated rocket and MST radar measurements over Indian low latitude region

    Directory of Open Access Journals (Sweden)

    H. Chandra

    2008-09-01

    Full Text Available A campaign to study turbulence in the mesosphere, over low latitudes in India, using rocket-borne measurements and Indian MST radar, was conducted during July 2004. A rocket-borne Langmuir probe detected a spectrum of electron density irregularities, with scale sizes in the range of about 1 m to 1 km, in 67.5–78.0 km and 84–89 km altitude regions over a low latitude station Sriharikota (13.6° N, 80.2° E. A rocket-borne chaff experiment measured zonal and meridional winds about 30 min after the Langmuir probe flight. The MST radar located at Gadanki (13.5° N, 79.2° E, which is about 100 km west of Sriharikota, also detected the presence of a strong scattering layer in 73.5–77.5 km region from which radar echoes corresponding to 3 m irregularities were received. Based on the region of occurrence of irregularities, which was highly collisional, presence of significant shears in zonal and meridional components of wind measured by the chaff experiment, 10 min periodicity in zonal and meridional winds obtained by the MST radar and the nature of wave number spectra of the irregularities, it is suggested that the observed irregularities were produced through the neutral turbulence mechanism. The percentage amplitude of fluctuations across the entire scale size range showed that the strength of turbulence was stronger in the lower altitude regions and decreased with increasing altitude. It was also found that the amplitude of fluctuations was large in regions of steeper electron density gradients. MST radar observations showed that at smaller scales of turbulence such as 3 m, (a the thickness of the turbulent layer was between 2 and 3 km and (b and fine structures, with layer thicknesses of about a km or less were also embedded in these layers. Rocket also detected 3-m fluctuations, which were very strong (a few percent in lower altitudes (67.5 to 71.0 km and small but clearly well above the noise floor at higher altitudes. Rocket and radar

  1. First mesospheric turbulence study using coordinated rocket and MST radar measurements over Indian low latitude region

    Energy Technology Data Exchange (ETDEWEB)

    Chandra, H.; Sinha, H.S.S.; Das, U.; Misra, R.N.; Das, S.R. [Physical Research Lab., Ahmedabad (India); Datta, J.; Chakravarty, S.C. [ISRO Headquarters, Bangalore (India); Patra, A.K.; Vekateswara Rao, N.; Narayana Rao, D. [National Atmospheric Research Lab., Tirupati (India)

    2008-07-01

    A campaign to study turbulence in the mesosphere, over low latitudes in India, using rocket-borne measurements and Indian MST radar, was conducted during July 2004. A rocket-borne Langmuir probe detected a spectrum of electron density irregularities, with scale sizes in the range of about 1 m to 1 km, in 67.5-78.0 km and 84-89 km altitude regions over a low latitude station Sriharikota (13.6 N, 80.2 E). A rocket-borne chaff experiment measured zonal and meridional winds about 30 min after the Langmuir probe flight. The MST radar located at Gadanki (13.5 N, 79.2 E), which is about 100 km west of Sriharikota, also detected the presence of a strong scattering layer in 73.5-77.5 km region from which radar echoes corresponding to 3 m irregularities were received. Based on the region of occurrence of irregularities, which was highly collisional, presence of significant shears in zonal and meridional components of wind measured by the chaff experiment, 10 min periodicity in zonal and meridional winds obtained by the MST radar and the nature of wave number spectra of the irregularities, it is suggested that the observed irregularities were produced through the neutral turbulence mechanism. The percentage amplitude of fluctuations across the entire scale size range showed that the strength of turbulence was stronger in the lower altitude regions and decreased with increasing altitude. It was also found that the amplitude of fluctuations was large in regions of steeper electron density gradients. MST radar observations showed that at smaller scales of turbulence such as 3 m, (a) the thickness of the turbulent layer was between 2 and 3 km and (b) and fine structures, with layer thicknesses of about a km or less were also embedded in these layers. Rocket also detected 3-m fluctuations, which were very strong (a few percent) in lower altitudes (67.5 to 71.0 km) and small but clearly well above the noise floor at higher altitudes. Rocket and radar results also point to the

  2. A Network Analysis Perspective to Implementation: The Example of Health Links to Promote Coordinated Care.

    Science.gov (United States)

    Yousefi Nooraie, Reza; Khan, Sobia; Gutberg, Jennifer; Baker, G Ross

    2018-01-01

    Although implementation models broadly recognize the importance of social relationships, our knowledge about applying social network analysis (SNA) to formative, process, and outcome evaluations of health system interventions is limited. We explored applications of adopting an SNA lens to inform implementation planning, engagement and execution, and evaluation. We used Health Links, a province-wide program in Canada aiming to improve care coordination among multiple providers of high-needs patients, as an example of a health system intervention. At the planning phase, an SNA can depict the structure, network influencers, and composition of clusters at various levels. It can inform the engagement and execution by identifying potential targets (e.g., opinion leaders) and by revealing structural gaps and clusters. It can also be used to assess the outcomes of the intervention, such as its success in increasing network connectivity; changing the position of certain actors; and bridging across specialties, organizations, and sectors. We provided an overview of how an SNA lens can shed light on the complexity of implementation along the entire implementation pathway, by revealing the relational barriers and facilitators, the application of network-informed and network-altering interventions, and testing hypotheses on network consequences of the implementation.

  3. Care coordination, the family-centered medical home, and functional disability among children with special health care needs.

    Science.gov (United States)

    Litt, Jonathan S; McCormick, Marie C

    2015-01-01

    Children with special health care needs (CSHCN) are at increased risk for functional disabilities. Care coordination has been shown to decrease unmet health service use but has yet been shown to improve functional status. We hypothesize that care coordination services lower the odds of functional disability for CSHCN and that this effect is greater within the context of a family-centered medical home. A secondary objective was to test the mediating effect of unmet care needs on functional disability. Our sample included children ages 0 to 17 years participating the 2009-2010 National Survey of Children with Special Health Care Needs. Care coordination, unmet needs, and disability were measured by parent report. We used logistic regression models with covariate adjustment for confounding and a mediation analysis approach for binary outcomes to assess the effect of unmet needs. There were 34,459 children in our sample. Care coordination was associated with lower odds of having a functional disability (adjusted odds ratio 0.82, 95% confidence interval 0.77, 0.88). This effect was greater for care coordination in the context of a medical home (adjusted odds ratio 0.71, 95% confidence interval 0.66, 0.76). The relationship between care coordination and functional disability was mediated by reducing unmet services. Care coordination is associated with lower odds of functional disability among CSHCN, especially when delivered in the setting of a family-centered medical home. Reducing unmet service needs mediates this effect. Our findings support a central role for coordination services in improving outcomes for vulnerable children. Copyright © 2015 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  4. National and subnational HIV/AIDS coordination: are global health initiatives closing the gap between intent and practice?

    Directory of Open Access Journals (Sweden)

    Rukhadze Natia

    2010-03-01

    Full Text Available Abstract Background A coordinated response to HIV/AIDS remains one of the 'grand challenges' facing policymakers today. Global health initiatives (GHIs have the potential both to facilitate and exacerbate coordination at the national and subnational level. Evidence of the effects of GHIs on coordination is beginning to emerge but has hitherto been limited to single-country studies and broad-brush reviews. To date, no study has provided a focused synthesis of the effects of GHIs on national and subnational health systems across multiple countries. To address this deficit, we review primary data from seven country studies on the effects of three GHIs on coordination of HIV/AIDS programmes: the Global Fund to Fight AIDS, Tuberculosis and Malaria, the President's Emergency Plan for AIDS Relief (PEPFAR, and the World Bank's HIV/AIDS programmes including the Multi-country AIDS Programme (MAP. Methods In-depth interviews were conducted at national and subnational levels (179 and 218 respectively in seven countries in Europe, Asia, Africa and South America, between 2006 and 2008. Studies explored the development and functioning of national and subnational HIV coordination structures, and the extent to which coordination efforts around HIV/AIDS are aligned with and strengthen country health systems. Results Positive effects of GHIs included the creation of opportunities for multisectoral participation, greater political commitment and increased transparency among most partners. However, the quality of participation was often limited, and some GHIs bypassed coordination mechanisms, especially at the subnational level, weakening their effectiveness. Conclusions The paper identifies residual national and subnational obstacles to effective coordination and optimal use of funds by focal GHIs, which these GHIs, other donors and country partners need to collectively address.

  5. Uma história de conceitos na saúde pública: integralidade, coordenação, descentralização, regionalização e universalidade A history of public health concepts: integrity, coordination, decentralization, regionalization, and universality

    Directory of Open Access Journals (Sweden)

    Guilherme Arantes Mello

    2012-12-01

    Full Text Available O Sistema Único de Saúde conferiu visibilidade a uma série de conceitos próprios da organização de sistemas de saúde. Entre eles a integralidade, que delimita fronteiras comuns com quase todos os demais princípios do Sistema, tem sido objeto de ampla literatura no Brasil. Com base em extensa revisão de fontes primárias e secundárias, este artigo apresenta uma recuperação histórica dos conceitos de integralidade, descentralização, regionalização e universalidade - ideias e conceitos que em grande parte se conformam e se interligam no ideário da organização dos serviços sanitários pelo modelo dos Centros de Saúde distritais.Brazil's Unified Health System (Sistema Único de Saúde has highlighted a series of concepts specific to the organization of healthcare systems. Among these, integrity - which shares boundaries with almost all other System principles - has been the object of much academic production in Brazil. Based on an extensive review of primary and secondary sources, the article offers a historical recovery of the concepts of integrity, decentralization, regionalization, and universality - ideas and concepts that in good measure are shaped by and interlinked with the set of ideals of the organization of sanitary services according to the district health centers model.

  6. ARCAD3-SAFARI coordinated study of auroral and polar F-region ionospheric irregularities

    International Nuclear Information System (INIS)

    Villain, J.P.; Hanuise, C.

    1986-01-01

    Simultaneous observations of F-region ionospheric irregularities have been performed with the SAFARI ground-based HF radars and the ISOPROBE experiment on board the AUREOL-3 satellite. Among seven orbits during which the satellite trajectory was directly in the radar beam or in the vicinity, four of them have been analyzed in detail. The spectral power of the electron density variations ΔNsub(e)/Nsub(e) has been calculated for wavelengths between 20 m and 1 km from the isoprobe high time resolution thermal plasma measurements. One spectrum is obtained every 1.2 s, a time which corresponds to about 10 km along the satellite trajectory. The presence of echoes observed in the F-region with the SAFARI radars is compared with the spectral power of the electron density variations deduced from the ISOPROBE ''in situ'' measurements. A good agreement is found between the two sets of observations and a numerical value of the spectral power corresponding to detection of echoes by the radar is given. A synoptical view of the event is given and interpreted according to the existing theories of plasma irregularities

  7. ARCAD3-SAFARI coordinated study of auroral and polar F-region ionospheric irregularities

    International Nuclear Information System (INIS)

    Villain, J.P.; Hanuise, C.; Beghin, C.

    1985-01-01

    Simultaneous observations of F-region ionospheric irregularities have been performed with the SAFARI ground based HF radars and the ISOPROBE experiment on board the AUREOL-3 satellite. Among seven orbits during which the satellite trajectory was directly in the radar beam or in the vicinity, four of them have been analysed in detail. The spectral power of the electron density variations ΔNe/Ne has been calculated for wavelengths between 20 m and 1 km from the ISOPROBE high time resolution thermal plasma measurements. One spectrum is obtained every 1.2 sec., which corresponds to about 10 km along the satellite trajectory. The SAFARI experiment is a set of two HF coherent radars located at Lycksele (Sweden) and Oulu (Finland). These radars are sensitive to F-region ionospheric irregularities of 10 m wavelength in the polar and auroral ionosphere. The phase velocity of the irregularities obtained from the Doppler spectrum is related to the ambient plasma drift. The presence of echoes observed with the SAFARI radars is compared with the spectral power of the electron density variations deduced from the ISOPROBE in-situ measurements. A good agreement is found between the two sets of observations and a numerical value of the spectral power corresponding to detection of echoes by the radar is given. A synoptical view of the event is given and interpreted according to the existing theories on plasma irregularities

  8. The AgMIP Coordinated Global and Regional Assessments (CGRA) of Climate Change Impacts on Agriculture and Food Security

    Science.gov (United States)

    Ruane, Alex; Rosenzweig, Cynthia; Elliott, Joshua; Antle, John

    2015-01-01

    The Agricultural Model Intercomparison and Improvement Project (AgMIP) has been working since 2010 to construct a protocol-based framework enabling regional assessments (led by regional experts and modelers) that can provide consistent inputs to global economic and integrated assessment models. These global models can then relay important global-level information that drive regional decision-making and outcomes throughout an interconnected agricultural system. AgMIPs community of nearly 800 climate, crop, livestock, economics, and IT experts has improved the state-of-the-art through model intercomparisons, validation exercises, regional integrated assessments, and the launch of AgMIP programs on all six arable continents. AgMIP is now launching Coordinated Global and Regional Assessments (CGRA) of climate change impacts on agriculture and food security to link global and regional crop and economic models using a protocol-based framework. The CGRA protocols are being developed to utilize historical observations, climate projections, and RCPsSSPs from CMIP5 (and potentially CMIP6), and will examine stakeholder-driven agricultural development and adaptation scenarios to provide cutting-edge assessments of climate changes impact on agriculture and food security. These protocols will build on the foundation of established protocols from AgMIPs 30+ activities, and will emphasize the use of multiple models, scenarios, and scales to enable an accurate assessment of related uncertainties. The CGRA is also designed to provide the outputs necessary to feed into integrated assessment models (IAMs), nutrition and food security assessments, nitrogen and carbon cycle models, and additional impact-sector assessments (e.g., water resources, land-use, biomes, urban areas). This presentation will describe the current status of CGRA planning and initial prototype experiments to demonstrate key aspects of the protocols before wider implementation ahead of the IPCC Sixth Assessment

  9. The AgMIP Coordinated Global and Regional Assessments (CGRA) of Climate Change Impacts on Agriculture and Food Security

    Science.gov (United States)

    Ruane, A. C.; Rosenzweig, C.; Antle, J. M.; Elliott, J. W.

    2015-12-01

    The Agricultural Model Intercomparison and Improvement Project (AgMIP) has been working since 2010 to construct a protocol-based framework enabling regional assessments (led by regional experts and modelers) that can provide consistent inputs to global economic and integrated assessment models. These global models can then relay important global-level information that drive regional decision-making and outcomes throughout an interconnected agricultural system. AgMIP's community of nearly 800 climate, crop, livestock, economics, and IT experts has improved the state-of-the-art through model intercomparisons, validation exercises, regional integrated assessments, and the launch of AgMIP programs on all six arable continents. AgMIP is now launching Coordinated Global and Regional Assessments (CGRA) of climate change impacts on agriculture and food security to link global and regional crop and economic models using a protocol-based framework. The CGRA protocols are being developed to utilize historical observations, climate projections, and RCPs/SSPs from CMIP5 (and potentially CMIP6), and will examine stakeholder-driven agricultural development and adaptation scenarios to provide cutting-edge assessments of climate change's impact on agriculture and food security. These protocols will build on the foundation of established protocols from AgMIP's 30+ activities, and will emphasize the use of multiple models, scenarios, and scales to enable an accurate assessment of related uncertainties. The CGRA is also designed to provide the outputs necessary to feed into integrated assessment models (IAMs), nutrition and food security assessments, nitrogen and carbon cycle models, and additional impact-sector assessments (e.g., water resources, land-use, biomes, urban areas). This presentation will describe the current status of CGRA planning and initial prototype experiments to demonstrate key aspects of the protocols before wider implementation ahead of the IPCC Sixth Assessment

  10. Status of national health research systems in ten countries of the WHO African Region

    Directory of Open Access Journals (Sweden)

    Kirigia Joses M

    2006-10-01

    Full Text Available Abstract Background The World Health Organization (WHO Regional Committee for Africa, in 1998, passed a resolution (AFR/RC48/R4 which urged its Member States in the Region to develop national research policies and strategies and to build national health research capacities, particularly through resource allocation, training of senior officials, strengthening of research institutions and establishment of coordination mechanisms. The purpose of this study was to take stock of some aspects of national resources for health research in the countries of the Region; identify current constraints facing national health research systems; and propose the way forward. Methods A questionnaire was prepared and sent by pouch to all the 46 Member States in the WHO African Region through the WHO Country Representatives for facilitation and follow up. The health research focal person in each of the countries Ministry of Health (in consultation with other relevant health research bodies in the country bore the responsibility for completing the questionnaire. The data were entered and analysed in Excel spreadsheet. Results The key findings were as follows: the response rate was 21.7% (10/46; three countries had a health research policy; one country reported that it had a law relating to health research; two countries had a strategic health research plan; three countries reported that they had a functional national health research system (NHRS; two countries confirmed the existence of a functional national health research management forum (NHRMF; six countries had a functional ethical review committee (ERC; five countries had a scientific review committee (SRC; five countries reported the existence of health institutions with institutional review committees (IRC; two countries had a health research programme; and three countries had a national health research institute (NHRI and a faculty of health sciences in the national university that conducted health research

  11. 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

  12. Coordination of care in the Chinese health care systems: a gap analysis of service delivery from a provider perspective.

    Science.gov (United States)

    Wang, Xin; Birch, Stephen; Zhu, Weiming; Ma, Huifen; Embrett, Mark; Meng, Qingyue

    2016-10-12

    Increases in health care utilization and costs, resulting from the rising prevalence of chronic conditions related to the aging population, is exacerbated by a high level of fragmentation that characterizes health care systems in China. There have been several pilot studies in China, aimed at system-level care coordination and its impact on the full integration of health care system, but little is known about their practical effects. Huangzhong County is one of the pilot study sites that introduced organizational integration (a dimension of integrated care) among health care institutions as a means to improve system-level care coordination. The purposes of this study are to examine the effect of organizational integration on system-level care coordination and to identify factors influencing care coordination and hence full integration of county health care systems in rural China. We chose Huangzhong and Hualong counties in Qinghai province as study sites, with only Huangzhong having implemented organizational integration. A mixed methods approach was used based on (1) document analysis and expert consultation to develop Best Practice intervention packages; (2) doctor questionnaires, identifying care coordination from the perspective of service provision. We measured service provision with gap index, overlap index and over-provision index, by comparing observed performance with Best Practice; (3) semi-structured interviews with Chiefs of Medicine in each institution to identify barriers to system-level care coordination. Twenty-nine institutions (11 at county-level, 6 at township-level and 12 at village-level) were selected producing surveys with a total of 19 schizophrenia doctors, 23 diabetes doctors and 29 Chiefs of Medicine. There were more care discontinuities for both diabetes and schizophrenia in Huangzhong than in Hualong. Overall, all three index scores (measuring service gaps, overlaps and over-provision) showed similar tendencies for the two conditions

  13. [Network Analyses in Regional Health Care Research: Example of Dermatological Care in the Metropolitan Region of Hamburg].

    Science.gov (United States)

    Augustin, J; Austermann, J; Erasmi, S

    2016-10-18

    Background: One of the overall objectives of the legislator is to ensure an overall "homogeneous", and easily accessible medical care for the population. The physician-patient ratio can be used to describe the regional health care situation. But this method does not provide information concerning the availability of, for instance, the nearest doctor. Therefore, further parameters such as accessibility must be taken into consideration. For this purpose, network analyses are an appropriate method. The objective of this study is to present methodological tools to evaluate the healthcare situation in the metropolitan region of Hamburg, primarily focusing on accessibility using dermatologists as an example. Methods: Analyzing data of 20 counties, the geographical distribution of N=357 dermatologists and the physician-patient ratio were calculated. In a second step, a network analysis regarding accessibility was performed. In order to calculate accessibility, address data (physicians) were transformed into coordinates, consisting of defined places (N=303) and restrictions (e. g. speed, turn restrictions) of the network. The calculation of population-based accessibility is based on grid cells for the population density. Results: Despite adequacy of the overall medical situation, differences in the availability of the nearest dermatologists in the metropolitan region are remarkable, particularly when use of public transport is taken into consideration. In some counties, over 60% of the population require at least one hour to get to the nearest dermatologist using public transportation. In rural regions within the metropolitan area are particularly affected. Conclusion: The network analysis has shown that the choice and availability of transportation in combination with the location (rural/urban) is essential for health care access. Especially elderly people in rural areas with restricted mobility are at a disadvantage. Therefore, modern health care approaches (e

  14. MANAGEMENT OF INNOVATION IN HEALTH CARE AT THE REGIONAL LEVEL

    Directory of Open Access Journals (Sweden)

    Ye. G. Totskaya

    2014-01-01

    , provides a systematic approach to management, and ensures efficient operation of medical institutions and public access to innovative medical diagnostic technologies. The advantage of innovative products and technologies using within the doctrine of innovative management is that they provide a comprehensive approach to the diagnosis and treatment of patients. The introducted managing innovation technologies allow to improve organizational performance of healthcare institutions and to achieve significant medical and social effects: high level of diagnosis and treatment, improved access and quality of care what promotes the public health.Conclusion. Formation of regional innovation medical environment with advanced innovation infrastructure, interaction of its elements through an effective system of coordination and control is a prerequisite and basis for more mature and system-level structure – an industry innovative cluster. Active development of innovation in health care based on cooperation among the different actors of innovation and interagency collaboration provides a professional staff to the sphere of research commercialization, accomplishes innovative technology transfer to a real economy, and enables the integration in the worldwide innovation environment through the implementation of technological and scientific research projects.

  15. Co-ordinated Interdisciplinary Efforts on Research in Animal Production and Health

    Directory of Open Access Journals (Sweden)

    Houe Hans

    2003-03-01

    Full Text Available The objectives are to review results and experiences from interdisciplinary research projects in Research Centre for the Management of Animal Production and Health (CEPROS concerning scientific content, organisation, and collaboration. The Centre has been founded as a result of an agreement between four institutions: the Danish Institute of Agricultural Sciences (DIAS, the Danish Veterinary Laboratory (DVL, the Danish Veterinary Institute for Virus Research (DVIV and The Royal Veterinary and Agricultural University (KVL. CEPROS is a "research centre without walls" and is physically located as an integrated part of the four institutions named above. The Centre has close collaboration with the industry. The superior goals of the Centre are to co-ordinate fundamental and applied research and simultaneously integrate the veterinary and the production oriented livestock research within animal health and welfare, taking into consideration the production economics and reduced use of medication. The assignment of the Centre is to initiate and carry out research, aiming to investigate the influence of breeding and production systems on animal health and welfare as well as on production and product quality. The Centre has since 1997 established 16 interdisciplinary research projects dealing with cattle, pigs, poultry, or mink. The scientific content can be divided into three research clusters: A. Management of animal production and health in production systems, B: Pathogenesis of production diseases, and C. Animal health economics. In Cluster A, the physical environments of production systems have been investigated, broader definitions of the concept health have been established and used in identification of risk factors. Cluster B has investigated physiological, immunological and genetic mechanisms behind development of production diseases and how to apply this knowledge in disease prevention. The cluster in animal health economics has developed decision

  16. 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

  17. The emergence of Ebola as a global health security threat: From ′lessons learned′ to coordinated multilateral containment efforts

    Directory of Open Access Journals (Sweden)

    Sarathi Kalra

    2014-01-01

    Full Text Available First reported in remote villages of Africa in the 1970s, the Ebolavirus was originally believed to be transmitted to people from wild animals. Ebolavirus (EBOV causes a severe, frequently fatal hemorrhagic syndrome in humans. Each outbreak of the Ebolavirus over the last three decades has perpetuated fear and economic turmoil among the local and regional populations in Africa. Until now it has been considered a tragic malady confined largely to the isolated regions of the African continent, but it is no longer so. The frequency of outbreaks has increased since the 1970s. The 2014 Ebola outbreak in Western Africa has been the most severe in history and was declared a public health emergency by the World Health Organization. Given the widespread use of modern transportation and global travel, the EBOV is now a risk to the entire Global Village, with intercontinental transmission only an airplane flight away. Clinically, symptoms typically appear after an incubation period of approximately 11 days. A flu-like syndrome can progress to full hemorrhagic fever with multiorgan failure, and frequently, death. Diagnosis is confirmed by detection of viral antigens or Ribonucleic acid (RNA in the blood or other body fluids. Although historically the mortality of this infection exceeded 80%, modern medicine and public health measures have been able to lower this figure and reduce the impact of EBOV on individuals and communities. The treatment involves early, aggressive supportive care with rehydration. Core interventions, including contact tracing, preventive initiatives, active surveillance, effective isolation and quarantine procedures, and timely response to patients, are essential for a successful outbreak control. These measures, combined with public health education, point-of-care diagnostics, promising new vaccine and pharmaceutical efforts, and coordinated efforts of the international community, give new hope to the Global effort to eliminate Ebola

  18. The Emergence of Ebola as a Global Health Security Threat: From ‘Lessons Learned’ to Coordinated Multilateral Containment Efforts

    Science.gov (United States)

    Kalra, Sarathi; Kelkar, Dhanashree; Galwankar, Sagar C.; Papadimos, Thomas J.; Stawicki, Stanislaw P.; Arquilla, Bonnie; Hoey, Brian A.; Sharpe, Richard P.; Sabol, Donna; Jahre, Jeffrey A.

    2014-01-01

    First reported in remote villages of Africa in the 1970s, the Ebolavirus was originally believed to be transmitted to people from wild animals. Ebolavirus (EBOV) causes a severe, frequently fatal hemorrhagic syndrome in humans. Each outbreak of the Ebolavirus over the last three decades has perpetuated fear and economic turmoil among the local and regional populations in Africa. Until now it has been considered a tragic malady confined largely to the isolated regions of the African continent, but it is no longer so. The frequency of outbreaks has increased since the 1970s. The 2014 Ebola outbreak in Western Africa has been the most severe in history and was declared a public health emergency by the World Health Organization. Given the widespread use of modern transportation and global travel, the EBOV is now a risk to the entire Global Village, with intercontinental transmission only an airplane flight away. Clinically, symptoms typically appear after an incubation period of approximately 11 days. A flu-like syndrome can progress to full hemorrhagic fever with multiorgan failure, and frequently, death. Diagnosis is confirmed by detection of viral antigens or Ribonucleic acid (RNA) in the blood or other body fluids. Although historically the mortality of this infection exceeded 80%, modern medicine and public health measures have been able to lower this figure and reduce the impact of EBOV on individuals and communities. The treatment involves early, aggressive supportive care with rehydration. Core interventions, including contact tracing, preventive initiatives, active surveillance, effective isolation and quarantine procedures, and timely response to patients, are essential for a successful outbreak control. These measures, combined with public health education, point-of-care diagnostics, promising new vaccine and pharmaceutical efforts, and coordinated efforts of the international community, give new hope to the Global effort to eliminate Ebola as a public

  19. Development of a Florida Coastal Mapping Program Through Local and Regional Coordination

    Science.gov (United States)

    Hapke, C. J.; Kramer, P. A.; Fetherston-Resch, E.; Baumstark, R.

    2017-12-01

    The State of Florida has the longest coastline in the contiguous United States (2,170 km). The coastal zone is heavily populated and contains 1,900 km of sandy beaches that support economically important recreation and tourism. Florida's waters also host important marine mineral resources, unique ecosystems, and the largest number of recreational boats and saltwater fishermen in the country. There is increasing need and demand for high resolution data of the coast and adjacent seafloor for resource and habitat mapping, understanding coastal vulnerability, evaluating performance of restoration projects, and many other coastal and marine spatial planning efforts. The Florida Coastal Mapping Program (FCMP), initiated in 2017 as a regional collaboration between four federal and three state agencies, has goals of establishing the priorities for high resolution seafloor mapping of Florida's coastal environment, and developing a strategy for leveraging funds to support mapping priorities set by stakeholders. We began by creating a comprehensive digital inventory of existing data (collected by government, the private sector, and academia) from 1 kilometer inland to the 200 meter isobath for a statewide geospatial database and gap analysis. Data types include coastal topography, bathymetry, and acoustic data such as sidescan sonar and subbottom profiles. Next, we will develop appropriate proposals and legislative budget requests in response to opportunities to collect priority data in high priority areas. Data collection will be undertaken by a combination of state and federal agencies. The FCMP effort will provide the critical baseline information that is required for characterizing changes to fragile ecosystems, assessing marine resources, and forecasting the impacts on coastal infrastructure and recreational beaches from future storms and sea-level rise.

  20. 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.

  1. [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.

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

    Science.gov (United States)

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

    2014-01-01

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

  3. Light element atom, molecule and radical behaviour in the divertor and edge plasma regions. Summary report of the 1. research coordination meeting

    International Nuclear Information System (INIS)

    Braams, B.J.

    2010-01-01

    The first research coordination meeting of the Coordinated Research Project (CRP) on Light Element Atom, Molecule and Radical Behaviour in the Divertor and Edge Plasma Regions was held 18-20 November 2009 at IAEA headquarters, bringing together experts representing 14 institutions. Participants summarized their recent and ongoing work pertinent to the research project. The specific objectives of the CRP and a detailed work plan were formulated. The discussions, conclusions and recommendations of the meeting are summarized in this report. (author)

  4. [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.

  5. 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.

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

    Science.gov (United States)

    Carlton, Erik L; Singh, Simone Rauscher

    2018-05-01

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

  7. Therapeutic itineraries for patients with cerebrovascular accident: fragmentation of care in a regionalized health network

    Directory of Open Access Journals (Sweden)

    Márcia Cristina Rodrigues Fausto

    Full Text Available Abstract Objectives: to analyze the itineraries of patients with cerebrovascular accident (CVA in the Interstate health region in San Francisco Valley. Methods: this study uses the qualitative approach through the construction of Therapeutic Itineraries (IT. In the IT mapping the observation was prioritized on the different points and forms to access health service in search of care. Results: sixteen semi-structured interviews with healthcare users were conducted. There were diverse forms to access and provide services at the Rede Interestadual de Atenção à Saúde do Vale do Médio São Francisco-PEBA (Interstate Healthcare Network Region in the San Francisco Valley, which could be characterized by disorganized and uncoordinated care in the analyzed cases, despite the guarantee of hospital care. The Primary Health Care (APS teams are present at a care point with most of the patients' itineraries, however, little integration to the regionalized network and they were unable to perform their functions and coordinate the care. It is observed pilgrimage assistance, fragmented care and difficulties in receiving care after post hospitalization which is essential for the patients’ rehabilitation. Conclusions: traces of fragments of the regional health system are important warning signs that points out fragility in PEBA and demonstrate persistent gaps in the public health system to fulfil the responsibility and guarantee individuals’ right for health.

  8. 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...

  9. [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.

  10. British Association for the Study of Community Dentistry (BASCD) guidance on the statistical aspects of training and calibration of examiners for surveys of child dental health. A BASCD coordinated dental epidemiology programme quality standard.

    Science.gov (United States)

    Pine, C M; Pitts, N B; Nugent, Z J

    1997-03-01

    The British Association for the Study of Community Dentistry (BASCD) is responsible for the coordination of locally based surveys of child dental health which permit local and national comparisons between health authorities and regions. These surveys began in 1985/86 in England and Wales, 1987/88 in Scotland and 1993/94 in Northern Ireland. BASCD has taken an increasing lead in setting quality standards in discussion with the NHS Epidemiology Coordinators of the Dental Epidemiology Programme. This paper comprises guidance on the statistical aspects of training and calibration of examiners for these surveys.

  11. 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

  12. 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 ...

  13. 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

  14. 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.

  15. Co-ordinated research project on isotopic evaluations of maternal and child health nutrition to help prevent stunting. Report on the 1. research co-ordination meeting

    International Nuclear Information System (INIS)

    1999-01-01

    The concept for the Co-ordinated Research Programme on isotopic evaluations of maternal and child nutrition to help prevent stunting was a consequence of discussions held between IAEA staff and participants in a regional training course on 'Isotope Techniques in Human Nutrition' held in Lima, Peru in June 1996. The intention then was to develop research on factors influencing the success of lactation and the consequent effects on the breast-fed child. The project would have Latin American participants to promote regional exchange of expertise and ideas. Initial participation was from Argentina, Chile, Mexico, Peru and Venezuela. Brazil and Pakistan have now been added to these. There are three Specific Research Objectives: (1) To develop stable isotope methods for measuring breast-milk intake using regionally available equipment. (2) To apply the methodology in the assessment of milk intake in infants in relation to maternal nutrition, socio-economic status and education, and infant nutrition and intake of macro- and micro-nutrients. (3) To use information gathered at 2) to determine the need for supplementation programmes for mothers and/or infants, and educational programmes for the mothers

  16. Co-ordinated research project on isotopic evaluations of maternal and child health nutrition to help prevent stunting. Report on the 1. research co-ordination meeting

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-09-01

    The concept for the Co-ordinated Research Programme on isotopic evaluations of maternal and child nutrition to help prevent stunting was a consequence of discussions held between IAEA staff and participants in a regional training course on `Isotope Techniques in Human Nutrition` held in Lima, Peru in June 1996. The intention then was to develop research on factors influencing the success of lactation and the consequent effects on the breast-fed child. The project would have Latin American participants to promote regional exchange of expertise and ideas. Initial participation was from Argentina, Chile, Mexico, Peru and Venezuela. Brazil and Pakistan have now been added to these. There are three Specific Research Objectives: (1) To develop stable isotope methods for measuring breast-milk intake using regionally available equipment. (2) To apply the methodology in the assessment of milk intake in infants in relation to maternal nutrition, socio-economic status and education, and infant nutrition and intake of macro- and micro-nutrients. (3) To use information gathered at 2) to determine the need for supplementation programmes for mothers and/or infants, and educational programmes for the mothers Refs, figs, tabs, graphs

  17. 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.

  18. Care coordination, medical complexity, and unmet need for prescription medications among children with special health care needs.

    Science.gov (United States)

    Aboneh, Ephrem A; Chui, Michelle A

    Children with special health care needs (CSHCN) have multiple unmet health care needs including that of prescription medications. The objectives of this study were twofold: 1) to quantify and compare unmet needs for prescription medications for subgroups of CSHCN without and with medical complexity (CMC)-those who have multiple, chronic, and complex medical conditions associated with severe functional limitations and high utilization of health care resources, and 2) to describe its association with receipt of effective care coordination services and level of medical complexity. A secondary data analysis of the 2009/2010 National Survey of CSHCN, a nationally representative telephone survey of parents of CSHCN, was conducted. Logistic regression models were constructed to determine associations between unmet need for prescription medications and medical complexity and care coordination for families of CSHCN, while controlling for demographic variables such as race, insurance, education level, and household income. Analyses accounted for the complex survey design and sampling weights. CMC represented about 3% of CSHCN. CMC parents reported significantly more unmet need for prescription medications and care coordination (4%, 68%), compared to Non-CMC parents (2%, 40%). Greater unmet need for prescription medications was associated with unmet care coordination (adjusted OR 3.81; 95% CI: 2.70-5.40) and greater medical complexity (adjusted OR 2.01; 95% CI: 1.00-4.03). Traditional care coordination is primarily facilitated by nurses and nurse practitioners with little formal training in medication management. However, pharmacists are rarely part of the CSHCN care coordination model. As care delivery models for these children evolve, and given the complexity of and numerous transitions of care for these patients, pharmacists can play an integral role to improve unmet needs for prescription medications. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Collaborative survey of perinatal loss in planned and unplanned home births. Northern Region Perinatal Mortality Survey Coordinating Group.

    OpenAIRE

    1996-01-01

    OBJECTIVE: To document the outcome of planned and unplanned births outside hospital. DESIGN: Confidential review of every pregnancy ending in stillbirth or neonatal death in which plans had been made for home delivery, irrespective of where delivery eventually occurred. The review was part of a sustained collaborative survey of all perinatal deaths. SETTING: Northern Regional Health Authority area. SUBJECTS: All 558,691 registered births to women normally resident in the former Northern Regio...

  20. Health Services Utilization in Older Adults with Dementia Receiving Care Coordination: The MIND at Home Trial.

    Science.gov (United States)

    Amjad, Halima; Wong, Stephanie K; Roth, David L; Huang, Jin; Willink, Amber; Black, Betty S; Johnston, Deirdre; Rabins, Peter V; Gitlin, Laura N; Lyketsos, Constantine G; Samus, Quincy M

    2018-02-01

    To investigate effects of a novel dementia care coordination program on health services utilization. A total of 303 community-dwelling adults aged ≥70 with a cognitive disorder in Baltimore, Maryland (2008-2011). Single-blind RCT evaluating efficacy of an 18-month care coordination intervention delivered through community-based nonclinical care coordinators, supported by an interdisciplinary clinical team. Study partners reported acute care/inpatient, outpatient, and home- and community-based service utilization at baseline, 9, and 18 months. From baseline to 18 months, there were no significant group differences in acute care/inpatient or total outpatient services use, although intervention participants had significantly increased outpatient dementia/mental health visits from 9 to 18 months (p = .04) relative to controls. Home and community-based support service use significantly increased from baseline to 18 months in the intervention compared to control (p = .005). While this dementia care coordination program did not impact acute care/inpatient services utilization, it increased use of dementia-related outpatient medical care and nonmedical supportive community services, a combination that may have helped participants remain at home longer. Future care model modifications that emphasize delirium, falls prevention, and behavior management may be needed to influence inpatient service use. © Health Research and Educational Trust.

  1. Care coordination in bone health screening between individual behaviors and health care services among Korean-American women across three age groups

    OpenAIRE

    Young-Shin Lee

    2017-01-01

    Integrated continuous care is important to prevent and treat brittle bone status in the aging process; however, minority groups often have limited access to health services. The purpose of this study was to identify the care coordination among women’s perceptions about their bone health, information from health care providers, and the results of Bone Mineral Density (BMD) tests across three age groups. The study was a cross-sectional comparative design. A total of 63 Korean American women com...

  2. BORC Functions Upstream of Kinesins 1 and 3 to Coordinate Regional Movement of Lysosomes along Different Microtubule Tracks.

    Science.gov (United States)

    Guardia, Carlos M; Farías, Ginny G; Jia, Rui; Pu, Jing; Bonifacino, Juan S

    2016-11-15

    The multiple functions of lysosomes are critically dependent on their ability to undergo bidirectional movement along microtubules between the center and the periphery of the cell. Centrifugal and centripetal movement of lysosomes is mediated by kinesin and dynein motors, respectively. We recently described a multi-subunit complex named BORC that recruits the small GTPase Arl8 to lysosomes to promote their kinesin-dependent movement toward the cell periphery. Here, we show that BORC and Arl8 function upstream of two structurally distinct kinesin types: kinesin-1 (KIF5B) and kinesin-3 (KIF1Bβ and KIF1A). Remarkably, KIF5B preferentially moves lysosomes on perinuclear tracks enriched in acetylated α-tubulin, whereas KIF1Bβ and KIF1A drive lysosome movement on more rectilinear, peripheral tracks enriched in tyrosinated α-tubulin. These findings establish BORC as a master regulator of lysosome positioning through coupling to different kinesins and microtubule tracks. Common regulation by BORC enables coordinate control of lysosome movement in different regions of the cell. Published by Elsevier Inc.

  3. Microbiological and ecological responses to global environmental changes in polar regions (MERGE): An IPY core coordinating project

    Science.gov (United States)

    Naganuma, Takeshi; Wilmotte, Annick

    2009-11-01

    An integrated program, “Microbiological and ecological responses to global environmental changes in polar regions” (MERGE), was proposed in the International Polar Year (IPY) 2007-2008 and endorsed by the IPY committee as a coordinating proposal. MERGE hosts original proposals to the IPY and facilitates their funding. MERGE selected three key questions to produce scientific achievements. Prokaryotic and eukaryotic organisms in terrestrial, lacustrine, and supraglacial habitats were targeted according to diversity and biogeography; food webs and ecosystem evolution; and linkages between biological, chemical, and physical processes in the supraglacial biome. MERGE hosted 13 original and seven additional proposals, with two full proposals. It respected the priorities and achievements of the individual proposals and aimed to unify their significant results. Ideas and projects followed a bottom-up rather than a top-down approach. We intend to inform the MERGE community of the initial results and encourage ongoing collaboration. Scientists from non-polar regions have also participated and are encouraged to remain involved in MERGE. MERGE is formed by scientists from Argentina, Australia, Austria, Belgium, Brazil, Bulgaria, Canada, Egypt, Finland, France, Germany, Italy, Japan, Korea, Malaysia, New Zealand, Philippines, Poland, Russia, Spain, UK, Uruguay, USA, and Vietnam, and associates from Chile, Denmark, Netherlands, and Norway.

  4. Collaborative survey of perinatal loss in planned and unplanned home births. Northern Region Perinatal Mortality Survey Coordinating Group.

    Science.gov (United States)

    1996-11-23

    To document the outcome of planned and unplanned births outside hospital. Confidential review of every pregnancy ending in stillbirth or neonatal death in which plans had been made for home delivery, irrespective of where delivery eventually occurred. The review was part of a sustained collaborative survey of all perinatal deaths. Northern Regional Health Authority area. All 558,691 registered births to women normally resident in the former Northern Regional Health Authority area during 1981-94. Perinatal death. The estimated perinatal mortality during 1981-94 among women booked for a home birth was 14 deaths in 2888 births. This was less than half that among all women in the region. Only three of the 14 women delivered outside hospital. Independent review suggested that two of the 14 deaths might have been averted by different management. Both births occurred in hospital, and in only one was management before admission of the mother judged inappropriate. Perinatal loss to the 64 women who booked for hospital delivery but delivered outside and to the 67 women who delivered outside hospital without ever making arrangements to receive professional care during labour accounted for the high perinatal mortality (134 deaths in 3466 deliveries) among all births outside hospital. The perinatal hazard associated with planned home birth in the few women who exercised this option (unplanned delivery outside hospital.

  5. 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

  6. Case of cholera preparedness, response and prevention in the SADC region: A need for proactive and multi-level communication and co-ordination

    CSIR Research Space (South Africa)

    Said, MD

    2011-10-01

    Full Text Available In this paper the authors seek to identify the most appropriate model for a regional co-ordination mechanism for cholera preparedness, response and prevention. The qualitative mixed-method data collection approach that was followed revealed the need...

  7. 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

  8. Data Management Coordinators (DMC)

    Science.gov (United States)

    The Regional Data Management Coordinators (DMCs) were identified to serve as the primary contact for each region for all Water Quality Framework activities. They will facilitate and communicate information to the necessary individuals at the region and tra

  9. 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.

  10. [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

  11. Acceptability of a mobile health intervention to enhance HIV care coordination for patients with substance use disorders

    OpenAIRE

    Westergaard, Ryan P.; Genz, Andrew; Panico, Kristen; Surkan, Pamela J.; Keruly, Jeanne; Hutton, Heidi E.; Chang, Larry W.; Kirk, Gregory D.

    2017-01-01

    Background Persons living with HIV and substance use disorders face barriers to sustained engagement in medical care, leading to suboptimal antiretroviral treatment outcomes. Innovative mobile technology tools such as customizable smartphone applications have the potential to enhance existing care coordination programs, but have not been rigorously studied. Methods We developed and implemented a two-component intervention consisting of peer health navigation supported by a smartphone applicat...

  12. [Characteristics of the leadership of health center coordinators in the autonomous community of Murcia].

    Science.gov (United States)

    Menárguez Puche, J F; Saturno Hernández, P J

    1998-12-01

    To describe the style and effectiveness (adaptability) of the leadership of coordinators of an autonomous community according to the model of leadership on the ground, analysing its relationship with the work environment. Observational crossover study. All the functioning teams in this community. Medical and nursing coordinators. Hersey and Blanchard's questionnaire on leadership on the ground was employed. This identifies 1) the predominant style (scoring for style 0-12). On the approach of the coordinator to personal relationships and/or task development, it identifies 4 points: direction, persuasion, participation, delegation. 2) Adaptability of the manager (ranging from +24 to -24), based on that the best choice between different options depends on the maturity of the group. To contrast work environment and leadership, a validated questionnaire, adapted to our milieu, was used. Overall reply rate (51 coordinators) was 89.4%. Analysis of styles was: persuasive 5.05 points (SD = 1.25), participatory 4.74 (SD 1.76), directive 1.2 (SD 1.11) and delegating 0.34 (SD 0.68). Adaptability scored 8.38 points (SD = 4.67), and was greater for the nursing coordinators (p Leadership adaptability was quite high and greater in nursing. The most prevalent styles were the persuasive and the participatory, more efficacious in teams of average maturity. Theoretical effectiveness was positively related to a better work environment.

  13. Algorithm to find high density EEG scalp coordinates and analysis of their correspondence to structural and functional regions of the brain.

    Science.gov (United States)

    Giacometti, Paolo; Perdue, Katherine L; Diamond, Solomon G

    2014-05-30

    Interpretation and analysis of electroencephalography (EEG) measurements relies on the correspondence of electrode scalp coordinates to structural and functional regions of the brain. An algorithm is introduced for automatic calculation of the International 10-20, 10-10, and 10-5 scalp coordinates of EEG electrodes on a boundary element mesh of a human head. The EEG electrode positions are then used to generate parcellation regions of the cerebral cortex based on proximity to the EEG electrodes. The scalp electrode calculation method presented in this study effectively and efficiently identifies EEG locations without prior digitization of coordinates. The average of electrode proximity parcellations of the cortex were tabulated with respect to structural and functional regions of the brain in a population of 20 adult subjects. Parcellations based on electrode proximity and EEG sensitivity were compared. The parcellation regions based on sensitivity and proximity were found to have 44.0 ± 11.3% agreement when demarcated by the International 10-20, 32.4 ± 12.6% by the 10-10, and 24.7 ± 16.3% by the 10-5 electrode positioning system. The EEG positioning algorithm is a fast and easy method of locating EEG scalp coordinates without the need for digitized electrode positions. The parcellation method presented summarizes the EEG scalp locations with respect to brain regions without computation of a full EEG forward model solution. The reference table of electrode proximity versus cortical regions may be used by experimenters to select electrodes that correspond to anatomical and functional regions of interest. Copyright © 2014 Elsevier B.V. All rights reserved.

  14. Front-office staff can improve clinical tobacco intervention: health coordinator pilot project.

    Science.gov (United States)

    Bass, Frederic; Naish, Brigham; Buwembo, Isaac

    2013-11-01

    To learn whether front-line personnel in primary care practices can increase delivery of clinical tobacco interventions and also help smokers address physical inactivity, at-risk alcohol use, and depression. Uncontrolled before-and-after design. Vancouver, BC, area (4 practices); northern British Columbia (2 practices). Six practices, with 1 staff person per practice serving as a "health coordinator" who tracked and, after the baseline period, delivered preventive interventions to all patients who smoked. To assess delivery of preventive interventions, each practice was to sample 300 consecutive patient records, both at baseline and at follow-up 15 months later. Front-office staff were recruited, trained, paid, and given ongoing support to provide preventive care. Clinicians supplemented this care with advice and guided the use of medication. Effectiveness of the intervention was based on comparison, at baseline and at follow-up, of the proportion of patients with any of the following 6 proven intervention components documented in their medical records: chart reminder, advice received, self-management plan, target quit date, referral, and follow-up date (as they applied to tobacco, physical inactivity, at-risk alcohol use, and depression). A Tobacco Intervention Flow Sheet cued preventive care, and its data were entered into a spreadsheet (which served as a smokers' registry). Qualitative appraisal data were noted. For tobacco, substantial increases occurred after the intervention period in the proportion of patients with each of the intervention components noted in their charts: chart reminder (20% vs 94%); provision of advice (34% vs 79%); self-management plan (14% vs 57%); target quit date (5% vs 11%); referral (6% vs 11%); and follow-up date (7% vs 42%). Interventions for physical inactivity and depression showed some gains, but there were no gains for at-risk alcohol use. Front-line staff, patients, and clinicians were enthusiastic about the services offered

  15. Health care networks implementation and regional governance challenges in the Legal Amazon Region: an analysis of the QualiSUS-Rede Project.

    Science.gov (United States)

    Casanova, Angela Oliveira; Cruz, Marly Marques; Giovanella, Ligia; Alves, Glaydes Dos Reis; Cardoso, Gisela Cordeiro Pereira

    2017-04-01

    This paper aims to analyze the potential, limits and challenges of regional governance in the implementation process of health care networks in three Brazilian regions: Alto Solimões (Amazonas), Belém (Pará) and an interstate region comprising Tocantins, Pará and Maranhão states (Topama). The study is based on the evaluation study on the implementation of the Quality Health Care Network Development and Improvement Project (QualiSUS-Rede). This is a qualitative multiple case study with the analysis of official documents and use of semi-structured interviews with key stakeholders conducted from July to December 2014. Governance review encompassed three components: stakeholders involved, especially local steering groups and their regional coordination capacity; strategies used for strengthening regional governance, anchored on the intervention's modeling; and implementation of local health care networks. Results point that the regional managing commissions were the main governance strategy and that the QualiSUS-Rede Project strengthened regional governance and integration differently in every case, depending on stakeholders' administration and consensus capacity on regional and political priorities.

  16. [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.

  17. 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.

  18. Care Coordination with Schools: The Role of Family-Centered Care for Children with Special Health Care Needs.

    Science.gov (United States)

    Barnard-Brak, Lucy; Stevens, Tara; Carpenter, Julianna

    2017-05-01

    Objectives Family-centered care has been associated with positive outcomes for children with special health care needs. The purpose of the current study was to examine the relationship of family-centered care as associated with care coordination with schools and school absences (e.g., missed days) as reported by parents of children with special health care needs. Methods The current study utilized data from the National Survey of Children with Special Health Care Needs 2009-201 (N = 40,242) to achieve this purpose. The National Survey of Children with Special Health Care Needs may be considered a nationally-representative and community-based sample of parent responses for children with special health care needs across the United States. Results Results from the current study indicate that family-centered care is associated with fewer absences and improved care coordination with schools when applicable. The variables of functional difficulties, poverty level, and the number of conditions were statistically controlled. Conclusions We suggest that the positive influence of family-centered care when practiced extends beyond the family and interacts with educational outcomes. We also suggest that the role of schools appears to be under-studied given the role that schools can play in family-centered care.

  19. 42 CFR 457.80 - Current State child health insurance coverage and coordination.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Current State child health insurance coverage and... HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES Introduction; State Plans for Child Health Insurance Programs and Outreach Strategies...

  20. 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

  1. 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.

  2. 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

  3. 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.

  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. [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.

  6. 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

  7. Setting the Stage: Coordinated Approaches to School Health and Physical Education

    Science.gov (United States)

    Kelder, Steven H.; Karp, Grace Goc; Scruggs, Philip W.; Brown, Helen

    2014-01-01

    Is there anything more important than the health, well-being and education of a nation's children? This paper takes the position that school is the most important place to educate children about health and to develop lifelong health promoting skills. We believe that health promotion programs and activities are integral to the school's…

  8. 75 FR 57276 - Office of the National Coordinator for Health Information Technology; HIT Policy Committee...

    Science.gov (United States)

    2010-09-20

    ...: Health IT Policy Committee's Governance Workgroup. General Function of the Health IT Policy Committee: To... use of health information as is consistent with the Federal Health IT Strategic Plan and that includes... needed. Purpose of the Governance Workgroup: To draft a set of recommendations on the scope and process...

  9. 76 FR 10598 - Office of the National Coordinator for Health Information Technology; Recommendations Received...

    Science.gov (United States)

    2011-02-25

    ... Information Technology to publish in the Federal Register and post on the internet all policy recommendations... for Health Information Technology (ONC), Department of Health and Human Services (HHS). ACTION: Notice. SUMMARY: Section 3002(e) of the Public Health Service Act, as amended by the Health Information Technology...

  10. 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.

  11. Study protocol: cross-national comparative case study of recovery-focused mental health care planning and coordination (COCAPP).

    Science.gov (United States)

    Simpson, Alan; Hannigan, Ben; Coffey, Michael; Jones, Aled; Barlow, Sally; Cohen, Rachel; Všetečková, Jitka; Faulkner, Alison; Haddad, Mark

    2015-07-03

    The collaborative care planning study (COCAPP) is a cross-national comparative study of care planning and coordination in community mental healthcare settings. The context and delivery of mental health care is diverging between the countries of England and Wales whilst retaining points of common interest, hence providing a rich geographical comparison for research. Across England the key vehicle for the provision of recovery-focused, personalised, collaborative mental health care is the care programme approach (CPA). The CPA is a form of case management introduced in England in 1991, then revised in 2008. In Wales the CPA was introduced in 2003 but has now been superseded by The Mental Health (Care Co-ordination and Care and Treatment Planning) (CTP) Regulations (Mental Health Measure), a new statutory framework. In both countries, the CPA/CTP requires providers to: comprehensively assess health/social care needs and risks; develop a written care plan (which may incorporate risk assessments, crisis and contingency plans, advanced directives, relapse prevention plans, etc.) in collaboration with the service user and carer(s); allocate a care coordinator; and regularly review care. The overarching aim of this study is to identify and describe the factors that ensure CPA/CTP care planning and coordination is personalised, recovery-focused and conducted collaboratively. COCAPP will employ a concurrent transformative mixed methods approach with embedded case studies. Phase 1 (Macro-level) will consider the national context through a meta-narrative mapping (MNM) review of national policies and the relevant research literature. Phase 2 (Meso-level and Micro-level) will include in-depth micro-level case studies of everyday 'frontline' practice and experience with detailed qualitative data from interviews and reviews of individual care plans. This will be nested within larger meso-level survey datasets, senior-level interviews and policy reviews in order to provide

  12. ”How do the patients and their close relatives experience The Coordinated Investigation Model of Dementia in the North Denmark Region?”

    DEFF Research Database (Denmark)

    Hulgaard, Hanne; Ottesen, Aase Marie

    How do the patients and their close relatives experience The Coordinated Investigation Model of Dementia in the North Denmark Region? The aim of the project was to investigate how the patients and their close relatives experienced the investigation and the subsequent social medicine intervention,...... with lowest effective cost. A formal agreement regarding follow-up should be implemented. The relatives should be more involved during both investigation period and in the socio-medical follow-up....

  13. 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.

  14. 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

  15. [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.

  16. 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.

  17. 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.

  18. 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.

  19. 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.

  20. Report of the results of the second phase of Research Coordinated Program of IAEA ''Regional Intercomparison of Personnel Dosimetry''

    International Nuclear Information System (INIS)

    Morales, J.; Diaz, E.; Hernandez, E.; Capote, E.

    1998-01-01

    In this report the results of an intercomparison program within a research coordinated program are presented. This is a second phase of the study that consisted in to evaluate the implementation of the new ICRU quantities for individual monitoring by the dosimetry laboratories. In this report the organization aspects, quality control of the irradiations performed by the reference laboratory (SSDL of the Centro de Proteccion e Higiene de las radiaciones) as well the results of the participant laboratories are included

  1. [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.

  2. Community Based Research Network: Opportunities for Coordination of Care, Public Health Surveillance, and Farmworker Research

    OpenAIRE

    Cooper, Sharon P.; Heyer, Nicholas; Shipp, Eva M.; Ryder, E. Roberta; Hendrikson, Edward; Socias, Christina M; del Junco, Deborah J.; Valerio, Melissa; Partida, Sylvia

    2014-01-01

    Introduction: The lack of aggregated longitudinal health data on farmworkers has severely limited opportunities to conduct research to improve their health status. To correct this problem, we have created the infrastructure necessary to develop and maintain a national Research Data Repository of migrant and seasonal farmworker patients and other community members receiving medical care from Community and Migrant Health Centers (C/MHCs). Project specific research databases can be easily extrac...

  3. 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.

  4. The role of veterinary services in animal health and food safety surveillance, and coordination with other services.

    Science.gov (United States)

    Bellemain, V

    2013-08-01

    The control of animal health and food safety has undergone profound changes and is now seen in terms of a global approach, 'from the stable to the table'. The risks themselves have also evolved, principally due to changing practices, and this, coupled with increased knowledge and changes in consumer demands, has led to a more global conception of production chains. In terms of official controls, targeted control of the final food product has gradually been replaced by control of the production processes and an integrated approach to hazards throughout the production chain. This, in turn, has resulted in a new division of responsibilities among the producers (farmers), the manufacturers and the administration; namely, Veterinary Services. The areas in which veterinarians are involved have gradually been extended from animal production to all levels of the food production chain. Animal health interventions on farms are comparable to interventions in agri-food companies. Both are, or should be, included in veterinary training and education. To meet new challenges, the current trend is for Veterinary Services to be responsible for, or coordinate, sanitary interventions from the stable to the table. Coordination between Veterinary Services and other relevant authorities is a key component of good public governance, especially for effective action and optimal management of the resources available.

  5. Navy-NGO Coordination for Health-Related HCA Missions: A Suggested Planning Framework

    Science.gov (United States)

    2008-11-01

    COCOMs have plans for several more de- ployments in the coming years. In 2006, USNS Mercy, a hospital ship with a white-painted hull bear - ing a large...facilities and health care equipment, medicines and vaccines, such health aides as eyeglasses and walking sticks, large-scale water purifi- cation systems

  6. Coordinating Systems of Care Using Health Information Technology: Development of the ADHD Care Assistant

    Science.gov (United States)

    Power, Thomas J.; Michel, Jeremy; Mayne, Stephanie; Miller, Jeffrey; Blum, Nathan J.; Grundmeier, Robert W.; Guevara, James P.; Fiks, Alexander G.

    2016-01-01

    Perhaps the two principal venues for the delivery of mental health services are schools and primary care practices. Unfortunately, these systems of care are poorly connected, which may result in care that is fragmented and suboptimal. This article describes the development and implementation of an electronic health record portal, known as the ADHD…

  7. 75 FR 51819 - Office of the National Coordinator for Health Information Technology; HIT Policy Committee's...

    Science.gov (United States)

    2010-08-23

    ... Team, Enrollment, Governance, Adoption/ Certification, and Information Exchange workgroups. General... the electronic exchange and use of health information as is consistent with the Federal Health IT... hold the following public meetings during September 2010: September 3rd Governance Workgroup, 1 p.m. to...

  8. 75 FR 65485 - Office of the National Coordinator for Health Information Technology; HIT Policy Committee's...

    Science.gov (United States)

    2010-10-25

    ... Team, Enrollment, Governance, Adoption/ Certification, and Information Exchange workgroups. General... the electronic exchange and use of health information as is consistent with the Federal Health IT...; November 3rd Information Exchange Workgroup, 10 a.m. to 11:30 a.m./ET; November 5th Governance Workgroup, 1...

  9. 75 FR 57026 - Office of the National Coordinator for Health Information Technology; HIT Policy Committee's...

    Science.gov (United States)

    2010-09-17

    ... Team, Enrollment, Governance, Adoption/ Certification, and Information Exchange workgroups. General... the electronic exchange and use of health information as is consistent with the Federal Health IT... hold the following public meetings during October 2010: October 4th Governance Workgroup, 9 a.m. to 4 p...

  10. 77 FR 48157 - Office of the National Coordinator for Health Information Technology; Announcement of...

    Science.gov (United States)

    2012-08-13

    ... Information Technology (ONC) announces the launch of the Managing Meds Video Challenge. This challenge is an... or pharmacist, you can also participate by demonstrating how you use health information technology... Health Information Technology. (7) Federal grantees may not use Federal funds to develop COMPETES Act...

  11. [Food and beverages available in automatic food dispensers in health care facilities of the Portugal North Health Region].

    Science.gov (United States)

    Rodrigues, Filipa Gomes; Ramos, Elisabete; Freitas, Mário; Neto, Maria

    2010-01-01

    Patients and health staff frequently need to stay in health care facilities for quite a long time. Therefore, it's necessary to create the conditions that allow the ingestion of food during those periods, namely through the existence of automatic food dispensers. However, the available food and beverages might not always be compatible with a healthy diet. The aim of this work was to evaluate if the food and beverages available in automatic food dispensers in public Ambulatory Care Facilities (ACF) and Hospitals of the Portugal North Health Region were contributing to a healthy diet, during the year of 2007. A questionnaire was elaborated and sent to the Coordinators of the Health Sub-Regions and to the Hospital Administrators. The questionnaire requested information about the existence of automatic food dispensers in the several departments of each health care facility, as well as which food and beverages were available and most sold. Afterwards, the pre-processing of the results involved the classification of the food and beverages in three categories: recommended, sometimes recommended and not recommended. The questionnaire reply ratio was 71% in ACF and 83% in Hospitals. Automatic food dispensers were available in all the Hospitals and 86.5% of ACF. It wasn't possible to acquire food in 37% of the health facility departments. These departments were all located in ACF. The more frequently available beverages in departments with automatic food dispensers were coffee, still water, tea, juices and nectars and soft drinks. Still water, coffee, yogurt, juices and nectars and soft drinks were reported as the most sold. The more frequently avaliable food items were chocolate, recommended cookies, not recommended cakes, recommended sandwiches and sometimes recommended croissants. The food items reported as being the most sold were recommended sandwiches, chocolate, recommended cookies, sometimes recommended croissants and not recommended cookies. The beverages in the

  12. Care Coordination for Children with Complex Special Health Care Needs: The Value of the Advanced Practice Nurse’s Enhanced Scope of Knowledge and Practice

    Science.gov (United States)

    Looman, Wendy S.; Presler, Elizabeth; Erickson, Mary M.; Garwick, Ann E.; Cady, Rhonda G.; Kelly, Anne M.; Finkelstein, Stanley M.

    2012-01-01

    Efficiency and effectiveness of care coordination depends on a match between the needs of the population and the skills, scope of practice, and intensity of services provided by the care coordinator. There is limited existing literature that addresses the relevance of the APN role as a fit for coordination of care for children with SHCN. The objective of this paper is to describe the value of the advanced practice nurse’s (APN’s) enhanced scope of knowledge and practice for relationship-based care coordination in healthcare homes that serve children with complex special health care needs (SHCN). The TeleFamilies project is provided as an example of the integration of an APN care coordinator in a healthcare home for children with SHCN. PMID:22560803

  13. Leadership by example: coordinating government roles in improving health care quality

    National Research Council Canada - National Science Library

    Smith, Barbara M; Corrigan, Janet M; Eden, Jill

    ... but also throughout the nation’s health care system. The book describes the federal programs and the populations they serve: Medicare (elderly), Medicaid (low income), SCHIP (children), VHA (veterans), TRICARE...

  14. 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.

  15. Care coordination in bone health screening between individual behaviors and health care services among Korean-American women across three age groups

    Directory of Open Access Journals (Sweden)

    Young-Shin Lee

    2017-01-01

    Full Text Available Integrated continuous care is important to prevent and treat brittle bone status in the aging process; however, minority groups often have limited access to health services. The purpose of this study was to identify the care coordination among women’s perceptions about their bone health, information from health care providers, and the results of Bone Mineral Density (BMD tests across three age groups. The study was a cross-sectional comparative design. A total of 63 Korean American women completed both the assessment of BMD of the femoral neck and an interview survey. One’s own risks of osteoporosis, screening behaviors, and health care providers’ advice were analyzed according to three age (pre-, peri-, and post-menopausal groups, BMD levels, and health insurance coverage. Overall, health insurance coverage and having a primary health care provider of Korean American women were 59.0% and 32.0%, respectively; 61.9% had lower than normal BMD levels, which were significantly increased by advanced age. Individual awareness of risks of osteoporosis and screening behaviors were significantly higher in peri-menopausal than in pre- and post-menopausal groups, but no differences were found in health care providers’ information. The awareness and care providers’ information by BMD level or health insurance did not differ. The findings show a discrepancy between individual perceptions and behaviors and health care providers’ recommendations regard to bone health. Health behaviors should be guided by professional health care providers. The women in the post-menopausal stage need to be educated about the high risk of osteoporosis and its management.

  16. 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)

  17. 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.

  18. [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.

  19. Lessons learned about coordinating academic partnerships from an international network for health education.

    Science.gov (United States)

    Luo, Airong; Omollo, Kathleen Ludewig

    2013-11-01

    There is a growing trend of academic partnerships between U.S., Canadian, and European health science institutions and academic health centers in low- and middle-income countries. These partnerships often encounter challenges such as resource disparities and power differentials, which affect the motivations, expectations, balance of benefits, and results of the joint projects. Little has been discussed in previous literature regarding the communication and project management processes that affect the success of such partnerships. To fill the gap in the literature, the authors present lessons learned from the African Health Open Educational Resources Network, a multicountry, multiorganizational partnership established in May 2008. The authors introduce the history of the network, then discuss actively engaging stakeholders throughout the project's life cycle (design, planning, execution, and closure) through professional development, relationship building, and assessment activities. They focus on communication and management practices used to identify mutually beneficial project goals, ensure timely completion of deliverables, and develop sustainable sociotechnical infrastructure for future collaborative projects. These activities yielded an interactive process of action, assessment, and reflection to ensure that project goals and values were aligned with implementation. The authors conclude with a discussion of lessons learned and how the partnership project may serve as a model for other universities and academic health centers in high-income countries and low- and middle-income countries that are interested in or currently pursuing international academic partnerships.

  20. Data integration and warehousing: coordination between newborn screening and related public health programs.

    Science.gov (United States)

    Therrell, Bradford L

    2003-01-01

    At birth, patient demographic and health information begin to accumulate in varied databases. There are often multiple sources of the same or similar data. New public health programs are often created without considering data linkages. Recently, newborn hearing screening (NHS) programs and immunization programs have virtually ignored the existence of newborn dried blood spot (DBS) newborn screening databases containing similar demographic data, creating data duplication in their 'new' systems. Some progressive public health departments are developing data warehouses of basic, recurrent patient information, and linking these databases to other health program databases where programs and services can benefit from such linkages. Demographic data warehousing saves time (and money) by eliminating duplicative data entry and reducing the chances of data errors. While newborn screening data are usually the first data available, they should not be the only data source considered for early data linkage or for populating a data warehouse. Birth certificate information should also be considered along with other data sources for infants that may not have received newborn screening or who may have been born outside of the jurisdiction and not have birth certificate information locally available. This newborn screening serial number provides a convenient identification number for use in the DBS program and for linking with other systems. As a minimum, data linkages should exist between newborn dried blood spot screening, newborn hearing screening, immunizations, birth certificates and birth defect registries.

  1. Regional transportation operations collaboration and coordination : a primer for working together to improve transportation safety, reliability, and security

    Science.gov (United States)

    2002-01-01

    This primer was written for transportation professionals and public safety officials from cities, counties, and States who are responsible for day-to-day management and operations within a metropolitan region. It is intended to help agencies and orga...

  2. A coordinated school health approach to obesity prevention among Appalachian youth: the Winning with Wellness Pilot Project.

    Science.gov (United States)

    Schetzina, Karen E; Dalton, William T; Lowe, Elizabeth F; Azzazy, Nora; VonWerssowetz, Katrina M; Givens, Connie; Pfortmiller, Deborah T; Stern, H Patrick

    2009-01-01

    Childhood obesity has been an increasing problem in the United States, especially in rural areas. Effective prevention approaches are needed. This article describes the development, implementation, effectiveness, feasibility, and sustainability of a school-based obesity prevention pilot project, Winning with Wellness. The program was based on the coordinated school health model and included a community-based participatory research approach aimed at promoting healthy eating and physical activity in a rural Appalachian elementary school. Findings from this preliminary project revealed improvements in nutrition offerings and increased physical activity during the school day. In addition, the program was found to be acceptable to teachers, successfully implemented utilizing both existing and newly developed resources, and sustainable as evidenced in continued practice and expansion to other area schools.

  3. The Application of Theories of Conflict and Interest Coordination to the Special Aspects of the Regional-Level Budget Policy

    Directory of Open Access Journals (Sweden)

    Михаил Николаевич Грачев

    2011-09-01

    Full Text Available In the given article there is shown that the process of the regional-level budget policy implementation is not free from contradictions arising in the course of the resource allocation and expenditure responsibilities between the levels of the government, and often acquires the conflict nature. Taking into consideration the basic theories, the authors proposed the typology of conflicts between the regional government and municipalities, which can be used in the inter-budget relationships.

  4. 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

  5. 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.

  6. 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.

  7. Dynamic clustering scheme based on the coordination of management and control in multi-layer and multi-region intelligent optical network

    Science.gov (United States)

    Niu, Xiaoliang; Yuan, Fen; Huang, Shanguo; Guo, Bingli; Gu, Wanyi

    2011-12-01

    A Dynamic clustering scheme based on coordination of management and control is proposed to reduce network congestion rate and improve the blocking performance of hierarchical routing in Multi-layer and Multi-region intelligent optical network. Its implement relies on mobile agent (MA) technology, which has the advantages of efficiency, flexibility, functional and scalability. The paper's major contribution is to adjust dynamically domain when the performance of working network isn't in ideal status. And the incorporation of centralized NMS and distributed MA control technology migrate computing process to control plane node which releases the burden of NMS and improves process efficiently. Experiments are conducted on Multi-layer and multi-region Simulation Platform for Optical Network (MSPON) to assess the performance of the scheme.

  8. 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.

  9. Regional Coordination and Analysis of OCRWM Transportation Program: Fourth Quarter and Final Report, January 15, 1998 - April 14, 1998

    International Nuclear Information System (INIS)

    Western Interstate Energy Board

    1998-01-01

    This is the fourth quarter report on the activities of the High-Level Radioactive Waste Committee of the Western Interstate Energy Board. Together with the first three quarterly reports, this constitutes a final report. Over the course of the year, work under this contract has focused on: 1. Efforts to improved the Department's proposal to implement Section 180(c) of the Nuclear Waste Policy Act. (DOE has since suspended its efforts to implement this provision of the law.); 2. Advice to DOB on ways to conduct effective analysis of mode and routing options for spent fuel and high-level waste shipments under the Nuclear Waste Policy Act. (DOE has since suspended efforts to develop an effective mode and route selection process); 3. Advice to DOE on needed improvements in OCRWM's privatization initiative.; 4. Monitoring spent fuel and HLW developments that affect western state interests.; 5. Participating in DOE forums such as the Transportation External Coordination Working Group.; 6. Offering comments on documents related to NWPA transportation (e.g., the Navy's DELS for a container system for the management of spent nuclear fuel, DOE's Transportation Cask Quick Facts, DOE's report to Congress on the Price-Anderson Act)

  10. Isotope based assessment of groundwater renewal in water scarce regions. Proceedings of a final research co-ordination meeting

    International Nuclear Information System (INIS)

    2001-10-01

    The isotopic composition and chemical constituents of water infiltrating through the soil zone (unsaturated zone, or zone of aeration) into groundwater can be employed to determine the moisture transport in the unsaturated zone, thus enabling estimation of the water infiltration rate to the underlying aquifer. This was the basis on which this CRP was initiated in 1996. The overall results obtained from three years of applied field research related to study of moisture transport dynamics and estimation of natural recharge through use of isotope/hydrochemical depth profiles of the soil moisture in the unsaturated zone were presented and discussed at the final Research Co-ordination Meeting held in Vienna from 18 to 21 October 1999. A total of 44 sites were involved in the project on which detailed information on physiography, lithology, rainfall, unsaturated moisture content and a variety of chemical and isotopic determinants is now available. This publication contains 11 individual reports presented by CRP participants at the Meeting. Each of the reports have been indexed separately

  11. 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.

  12. 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

  13. Harnessing genomics to improve health in the Eastern Mediterranean Region – an executive course in genomics policy

    Directory of Open Access Journals (Sweden)

    Singer Peter A

    2005-01-01

    Full Text Available Abstract Background While innovations in medicine, science and technology have resulted in improved health and quality of life for many people, the benefits of modern medicine continue to elude millions of people in many parts of the world. To assess the potential of genomics to address health needs in EMR, the World Health Organization's Eastern Mediterranean Regional Office and the University of Toronto Joint Centre for Bioethics jointly organized a Genomics and Public Health Policy Executive Course, held September 20th–23rd, 2003, in Muscat, Oman. The 4-day course was sponsored by WHO-EMRO with additional support from the Canadian Program in Genomics and Global Health. The overall objective of the course was to collectively explore how to best harness genomics to improve health in the region. This article presents the course findings and recommendations for genomics policy in EMR. Methods The course brought together senior representatives from academia, biotechnology companies, regulatory bodies, media, voluntary, and legal organizations to engage in discussion. Topics covered included scientific advances in genomics, followed by innovations in business models, public sector perspectives, ethics, legal issues and national innovation systems. Results A set of recommendations, summarized below, was formulated for the Regional Office, the Member States and for individuals. • Advocacy for genomics and biotechnology for political leadership; • Networking between member states to share information, expertise, training, and regional cooperation in biotechnology; coordination of national surveys for assessment of health biotechnology innovation systems, science capacity, government policies, legislation and regulations, intellectual property policies, private sector activity; • Creation in each member country of an effective National Body on genomics, biotechnology and health to: - formulate national biotechnology strategies - raise

  14. Hypothyroidism coordinately and transiently affects myelin protein gene expression in most rat brain regions during postnatal development.

    Science.gov (United States)

    Ibarrola, N; Rodríguez-Peña, A

    1997-03-28

    To assess the role of thyroid hormone on myelin gene expression, we have studied the effect of hypothyroidism on the mRNA steady state levels for the major myelin protein genes: myelin basic protein (MBP), proteolipid protein (PLP), myelin-associated glycoprotein (MAG) and 2':3'-cyclic nucleotide 3'-phosphodiesterase (CNP) in different rat brain regions, during the first postnatal month. We found that hypothyroidism reduces the levels of every myelin protein transcript, with striking differences between the different brain regions. Thus, in the more caudal regions, the effect of hypothyroidism was extremely modest, being only evident at the earlier stages of myelination. In contrast, in the striatum and the cerebral cortex the important decrease in the myelin protein transcripts is maintained beyond the first postnatal month. Therefore, thyroid hormone modulates in a synchronous fashion the expression of the myelin genes and the length of its effect depends on the brain region. On the other hand, hyperthyroidism leads to an increase of the major myelin protein transcripts above control values. Finally, lack of thyroid hormone does not change the expression of the oligodendrocyte progenitor-specific gene, the platelet derived growth factor receptor alpha.

  15. Possibility of extending space-time coordinates

    International Nuclear Information System (INIS)

    Wang Yongcheng.

    1993-11-01

    It has been shown that one coordinate system can describe a whole space-time region except some supersurfaces on which there are coordinate singularities. The conditions of extending a coordinate from real field to complex field are studied. It has been shown that many-valued coordinate transformations may help us to extend space-time regions and many-valued metric functions may make one coordinate region to describe more than one space-time regions. (author). 11 refs

  16. 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

  17. 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.

  18. 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

  19. Ocean forecasting in terrain-following coordinates: Formulation and skill assessment of the Regional Ocean Modeling System

    Science.gov (United States)

    Haidvogel, D.B.; Arango, H.; Budgell, W.P.; Cornuelle, B.D.; Curchitser, E.; Di, Lorenzo E.; Fennel, K.; Geyer, W.R.; Hermann, A.J.; Lanerolle, L.; Levin, J.; McWilliams, J.C.; Miller, A.J.; Moore, A.M.; Powell, T.M.; Shchepetkin, A.F.; Sherwood, C.R.; Signell, R.P.; Warner, J.C.; Wilkin, J.

    2008-01-01

    Systematic improvements in algorithmic design of regional ocean circulation models have led to significant enhancement in simulation ability across a wide range of space/time scales and marine system types. As an example, we briefly review the Regional Ocean Modeling System, a member of a general class of three-dimensional, free-surface, terrain-following numerical models. Noteworthy characteristics of the ROMS computational kernel include: consistent temporal averaging of the barotropic mode to guarantee both exact conservation and constancy preservation properties for tracers; redefined barotropic pressure-gradient terms to account for local variations in the density field; vertical interpolation performed using conservative parabolic splines; and higher-order, quasi-monotone advection algorithms. Examples of quantitative skill assessment are shown for a tidally driven estuary, an ice-covered high-latitude sea, a wind- and buoyancy-forced continental shelf, and a mid-latitude ocean basin. The combination of moderate-order spatial approximations, enhanced conservation properties, and quasi-monotone advection produces both more robust and accurate, and less diffusive, solutions than those produced in earlier terrain-following ocean models. Together with advanced methods of data assimilation and novel observing system technologies, these capabilities constitute the necessary ingredients for multi-purpose regional ocean prediction systems. 

  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. 100% of the World Ocean Floor Mapped by 2030 - Contribution of the South and West Pacific Regional Data Assembly and Coordination Centre to the Seabed 2030 Initiative

    Science.gov (United States)

    Lamarche, G.; Neil, H.; Stagpoole, V. M.; Greenland, A.; Mackay, K.; Black, J.; Griffin, E.

    2017-12-01

    The Seabed 2030 SaWPac Centre (South and West Pacific Ocean Regional Data Assembly and Coordination Centre) has been formed to generate new high resolution ocean floor maps of the western and southern Pacific Ocean. The centre is part of the joint Nippon Foundation and the General Bathymetric Chart of the Oceans (GEBCO) initiative to produce a definitive map of the World Ocean floor by 2030, empowering the world to make policy decisions, use the ocean sustainability and undertake scientific research based on detailed bathymetric information of the Earth's seabed. The SaWPac Centre is based at NIWA Wellington (New Zealand) and includes a collaborative partnership with GNS Science and Land Information New Zealand. It is responsible for the region from South America to Australia, north of latitude 50°S to 10° north of the Equator and the western part of the Northern Pacific Ocean to Russia. The region includes the world's deepest trenches and also covers some of the remotest oceans where bathymetric data form existing ship tracks is spaced up to 100 km apart. The challenge for the SaWPac Centre is to collate and combine all the available bathymetric data from the numerous nations that have surveyed in the region. The centre will also promote efforts to collect new data and contribute to map products generated by the Seabed 2030 global mapping project.

  2. 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.

  3. 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

  4. Health Information Infrastructure for People with Intellectual and Developmental Disabilities (I/DD) Living in Supported Accommodation: Communication, Co-Ordination and Integration of Health Information.

    Science.gov (United States)

    Dahm, Maria R; Georgiou, Andrew; Balandin, Susan; Hill, Sophie; Hemsley, Bronwyn

    2017-10-25

    People with intellectual and/or developmental disability (I/DD) commonly have complex health care needs, but little is known about how their health information is managed in supported accommodation, and across health services providers. This study aimed to describe the current health information infrastructure (i.e., how data and information are collected, stored, communicated, and used) for people with I/DD living in supported accommodation in Australia. It involved a scoping review and synthesis of research, policies, and health documents relevant in this setting. Iterative database and hand searches were conducted across peer-reviewed articles internationally in English and grey literature in Australia (New South Wales) up to September 2015. Data were extracted from the selected relevant literature and analyzed for content themes. Expert stakeholders were consulted to verify the authors' interpretations of the information and content categories. The included 286 sources (peer-reviewed n = 27; grey literature n = 259) reflect that the health information for people with I/DD in supported accommodation is poorly communicated, coordinated and integrated across isolated systems. 'Work-as-imagined' as outlined in policies, does not align with 'work-as-done' in reality. This gap threatens the quality of care and safety of people with I/DD in these settings. The effectiveness of the health information infrastructure and services for people with I/DD can be improved by integrating the information sources and placing people with I/DD and their supporters at the centre of the information exchange process.

  5. Prevalence of mental illness within families in a regional child-focussed mental health service.

    Science.gov (United States)

    Naughton, Michael F A; Maybery, Darryl J; Goodyear, Melinda

    2018-04-01

    Nearly 50% of all mental illnesses begin in childhood before the age of 14 years, and over 20% of parents have a mental illness. Few studies have examined the co-occurrence of mental illnesses in parents and children. In the present study, we examined the extent of mental illness within families of 152 clients attending an Australian regional child and adolescent mental health service (CAMHS). A cross-sectional study design was employed involving a case record review and clinician-completed questionnaire of the children and youth attending a CAMHS. It was found that 79% of these children were living with a parent with mental illness. The predominant diagnosis of both child and parent was an anxiety or mood disorder, and many families had co-occurring risk factors of domestic violence and limited social supports. The findings in this Australian cohort are similar to those of other international research. While novel in nature, the present study has highlighted the extent of both mental illness and scarce supports for both children and parents in the same family. The findings indicate the need for a coordinated multiservice delivery of appropriate and consistent family-focussed interventions, responding to both mental illness and social supports for children and parents. Further research should examine specific components of family need and support, as seen through the eyes of the child and their parent. © 2017 Australian College of Mental Health Nurses Inc.

  6. Demonstrating managed aquifer recharge as a solution for climate change adaptation: results from Gabardine project and asemwaterNet coordination action in the Algarve region (Portugal

    Directory of Open Access Journals (Sweden)

    João Paulo Lobo Ferreira

    2014-09-01

    Full Text Available In the Algarve southern Portugal region, Managed Aquifer Recharge (MAR research activities have been developed to provide not only water surplus storage in aquifers during wet years, focusing in the Querença-Silves aquifer (FP6 ASEMWATERNet Coordination Action, but also groundwater quality rehabilitation in the Campina de Faro aquifer (FP6 Gabardine Project. Following MAR research potentialities in southern Portugal, this paper describes the objectives, conceptual demonstration, background and capabilities of one of the selected Circum-Mediterranean pilot sites (in Portugal that will be researched in the new FP7-ENV-2013-WATER-INNO-DEMO MARSOL project, which started Dec. 1st, 2013. In the Algarve pilot site, several case-study areas will be located in the Querença-Silves aquifer and in the Campina de Faro aquifer.

  7. 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

  8. 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.

  9. Explicitly computing geodetic coordinates from Cartesian coordinates

    Science.gov (United States)

    Zeng, Huaien

    2013-04-01

    This paper presents a new form of quartic equation based on Lagrange's extremum law and a Groebner basis under the constraint that the geodetic height is the shortest distance between a given point and the reference ellipsoid. A very explicit and concise formulae of the quartic equation by Ferrari's line is found, which avoids the need of a good starting guess for iterative methods. A new explicit algorithm is then proposed to compute geodetic coordinates from Cartesian coordinates. The convergence region of the algorithm is investigated and the corresponding correct solution is given. Lastly, the algorithm is validated with numerical experiments.

  10. A narrative synthesis of the impact of primary health care delivery models for refugees in resettlement countries on access, quality and coordination.

    Science.gov (United States)

    Joshi, Chandni; Russell, Grant; Cheng, I-Hao; Kay, Margaret; Pottie, Kevin; Alston, Margaret; Smith, Mitchell; Chan, Bibiana; Vasi, Shiva; Lo, Winston; Wahidi, Sayed Shukrullah; Harris, Mark F

    2013-11-07

    Refugees have many complex health care needs which should be addressed by the primary health care services, both on their arrival in resettlement countries and in their transition to long-term care. The aim of this narrative synthesis is to identify the components of primary health care service delivery models for such populations which have been effective in improving access, quality and coordination of care. A systematic review of the literature, including published systematic reviews, was undertaken. Studies between 1990 and 2011 were identified by searching Medline, CINAHL, EMBASE, Cochrane Library, Scopus, Australian Public Affairs Information Service - Health, Health and Society Database, Multicultural Australian and Immigration Studies and Google Scholar. A limited snowballing search of the reference lists of all included studies was also undertaken. A stakeholder advisory committee and international advisers provided papers from grey literature. Only English language studies of evaluated primary health care models of care for refugees in developed countries of resettlement were included. Twenty-five studies met the inclusion criteria for this review of which 15 were Australian and 10 overseas models. These could be categorised into six themes: service context, clinical model, workforce capacity, cost to clients, health and non-health services. Access was improved by multidisciplinary staff, use of interpreters and bilingual staff, no-cost or low-cost services, outreach services, free transport to and from appointments, longer clinic opening hours, patient advocacy, and use of gender-concordant providers. These services were affordable, appropriate and acceptable to the target groups. Coordination between the different health care services and services responding to the social needs of clients was improved through case management by specialist workers. Quality of care was improved by training in cultural sensitivity and appropriate use of interpreters. The

  11. Forecasting drug utilization and expenditure in a metropolitan health region

    Directory of Open Access Journals (Sweden)

    Korkmaz Seher

    2010-05-01

    Full Text Available Abstract Background New pharmacological therapies are challenging the healthcare systems, and there is an increasing need to assess their therapeutic value in relation to existing alternatives as well as their potential budget impact. Consequently, new models to introduce drugs in healthcare are urgently needed. In the metropolitan health region of Stockholm, Sweden, a model has been developed including early warning (horizon scanning, forecasting of drug utilization and expenditure, critical drug evaluation as well as structured programs for the introduction and follow-up of new drugs. The aim of this paper is to present the forecasting model and the predicted growth in all therapeutic areas in 2010 and 2011. Methods Linear regression analysis was applied to aggregate sales data on hospital sales and dispensed drugs in ambulatory care, including both reimbursed expenditure and patient co-payment. The linear regression was applied on each pharmacological group based on four observations 2006-2009, and the crude predictions estimated for the coming two years 2010-2011. The crude predictions were then adjusted for factors likely to increase or decrease future utilization and expenditure, such as patent expiries, new drugs to be launched or new guidelines from national bodies or the regional Drug and Therapeutics Committee. The assessment included a close collaboration with clinical, clinical pharmacological and pharmaceutical experts from the regional Drug and Therapeutics Committee. Results The annual increase in total expenditure for prescription and hospital drugs was predicted to be 2.0% in 2010 and 4.0% in 2011. Expenditures will increase in most therapeutic areas, but most predominantly for antineoplastic and immune modulating agents as well as drugs for the nervous system, infectious diseases, and blood and blood-forming organs. Conclusions The utilisation and expenditure of drugs is difficult to forecast due to uncertainties about the rate

  12. Gravity wave life cycle (GW-LCYCLE): Initial results from a coordinated field program to trace gravity waves from the troposphere to the MLT-region

    Science.gov (United States)

    Rapp, Markus

    Gravity waves (GW) play an important role in the coupling between the troposphere and the middle atmosphere (˜10 - 120 km). GWs couple different atmospheric regions both in the vertical as well as in the horizontal directions by means of momentum and energy transport. Notably, this coupling is effective both from the troposphere upwards, and also in the opposite direction by indirect effects on circulation patterns. While the importance of GW for understanding atmospheric structure, dynamics and climate is now widely recognized, surprisingly little is still known about the details of the GW life cycle, i.e., the processes of GW excitation, propagation and dissipation. To address this issue a coordinated field program - named GW-LCYCLE - has been established in which ground based observations with radars, lidars and airglow imagers are combined with airborne observations, balloon soundings, and modelling to trace GWs from their source in the troposphere to their area of dissipation in the middle atmosphere. Within GW-LCYCLE an initial field campaign was conducted in December 2013 in Northern Scandinavia. The research aircraft DLR-FALCON was deployed to Kiruna, Sweden, from where several flights (with a total of 25 flight hours) were conducted to study mountain wave generation by flow over the Scandinavian mountain ridge. The FALCON was equipped with a downward looking wind lidar operating at a wavelength of 2 mum as well as with an in-flight system to measure winds, temperatures and pressures and with several in-situ instruments to detect wave signatures in trace gases like H _{2}O, CO _{2}, CO, CH _{4}, N _{2}O, HNO _{3} and SO _{2}. Ground based observations of winds and temperatures from the troposphere to the mesosphere/lower thermosphere (MLT-) region were conducted from Kiruna as well as from Andenes, Norway. These measurements were augmented by balloon soundings from the same places as well as from Sodankylä in Finland. Coordinated observations were

  13. Reliability of functioning and reserves of system, controlling movements with different coordination structure of special health group girl students in physical education process

    Directory of Open Access Journals (Sweden)

    A.A. Pryimakov

    2017-04-01

    Full Text Available Purpose: to study reliability of functioning and reserves of system, controlling movements with different coordination structure of special health group girl students (low health level in physical education process. Material: in the research special health group girl students (n=136, age 17-19 participated. They were divided into 2 groups - control and experimental. The program, directed to increase reliability and reserves of system controlling movements, was realized. It was based on physical exercises of complicated coordination with novelty elements, which were fulfilled under musical accompaniment. The research continued one academic year. Results: in girl students with health problems we registered higher differential thresholds, when reproducing local movements in complicated conditions. They used visual and hearing feedback channels for informing brain’s programming areas about made mistakes. They were worse teachable in training accurate movements. These girl students have less expressed compensation reserves under impact of hindering factors and interferences. It can be interpreted as non-specific crisscross negative response to motor functional system in case of health problems. All these determine reduction of reserve potentials of motor control system. Conclusions: The main reserve potentials’ criteria of control over different coordination structure movements are: quickness of passing to program mechanism of fine movements’ regulation in stable conditions of functioning; power and effectiveness of compensatory reactions, ensuring interference immunity of system, controlling movements under interfering factors; reliability of maintaining movements’ qualitative parameters in optimal range under interfering factors; reduction of sensor interconnections in stable functioning conditions.

  14. Poisson Coordinates.

    Science.gov (United States)

    Li, Xian-Ying; Hu, Shi-Min

    2013-02-01

    Harmonic functions are the critical points of a Dirichlet energy functional, the linear projections of conformal maps. They play an important role in computer graphics, particularly for gradient-domain image processing and shape-preserving geometric computation. We propose Poisson coordinates, a novel transfinite interpolation scheme based on the Poisson integral formula, as a rapid way to estimate a harmonic function on a certain domain with desired boundary values. Poisson coordinates are an extension of the Mean Value coordinates (MVCs) which inherit their linear precision, smoothness, and kernel positivity. We give explicit formulas for Poisson coordinates in both continuous and 2D discrete forms. Superior to MVCs, Poisson coordinates are proved to be pseudoharmonic (i.e., they reproduce harmonic functions on n-dimensional balls). Our experimental results show that Poisson coordinates have lower Dirichlet energies than MVCs on a number of typical 2D domains (particularly convex domains). As well as presenting a formula, our approach provides useful insights for further studies on coordinates-based interpolation and fast estimation of harmonic functions.

  15. Control options for communal energy turnaround by energy coordination centres. Investigation based on the Erzgebirge energy region; Steuerungsmoeglichkeiten der kommunalen Energiewende durch Energieleitstellen. Untersuchung anhand der Energieregion-Erzgebirge

    Energy Technology Data Exchange (ETDEWEB)

    Zuk, David

    2012-11-01

    The book investigates the role of energy coordination centres for communal energy turnaround. The investigations were carried out in the Erzgebirge energy region, which comprises 13 member communities. It was found that the influence of an energy coordination centre on a community is parallel to the community's awareness of the necessity of local energy turnaround measures. Energy control centres can sharpen this awareness of communities by outlining individual advantages of engagement with these issues and by making concrete suggestions for projects. Here, it becomes clear that communities will be more interested especially in bigger investment projects of an (external)financially strong investor. Most of the communities under investigation were in the range of 1,000 to 7,000 inhabitants; it must be assumed that in this case the opinions of the highest-ranked person of communal authority. This consideration should influence the scope of action of energy coordination centres. The example of a 'pioneering community' in the energy region showed that the consulting services of the energy coordination centre not only led to lower energy consumption (and, in consequence, lower energy expenses) on a medium-term basis but also helped to coordinate the activities of initiatives, e.g. initiatives promoting citizens-owned solar power stations. As the book shows, energy coordination centres take care of communities in general but are also actively supporting initiatives within the community and have a coordinating function when it comes to intercommunity projects. While energy coordination centres are not a 'heal-all' for implementation of the energy turnaround at community level or regional level, they must be viewed as a powerful instrument to achieve it. (orig.)

  16. AgMIP Coordinated Global and Regional Assessments for 1.5°C and 2.0°C

    Science.gov (United States)

    Rosenzweig, C.

    2017-12-01

    The Agricultural Model Intercomparison and Improvement Project (AgMIP) has developed novel methods for Coordinated Global and Regional Assessments (CGRA) of agriculture and food security in a changing world. The present study performs a proof-of-concept of the CGRA to demonstrate advantages and challenges of the framework. This effort responds to the request by UNFCCC for the implications of limiting global temperature increases to 1.5°C and 2.0°C above pre-industrial conditions. The protocols for the 1.5°C/2.0°C assessment establish explicit and testable linkages across disciplines and scales, connecting outputs and inputs from the Shared Socio-economic Pathways (SSPs), Representative Agricultural Pathways (RAPs), HAPPI and CMIP5 ensemble scenarios, global gridded crop models, global agricultural economic models, site-based crop models, and within-country regional economic models. CGRA results show that at the global scale, mixed areas of positive and negative simulated yield changes, with declines in some breadbasket regions led to overall declines in productivity at both 1.5°C and 2.0°C. These projected global yield changes resulted in increases in prices of major commodities in a global economic model. Simulations for 1.5°C and 2.0°C using site-based crop models had mixed results depending on region and crop, but with more negative effects on productivity at 2.0°C than at 1.5°C for the most part. In conjunction with price changes from the global economics models, these productivity declines resulted generally in small positive effects on regional farm livelihoods, showing that farming systems should continue to be viable under high mitigation scenarios. CGRA protocols focus on how mitigation actions and effects differ across scales, with main mechanisms studied in the integrated assessment models being policies and technologies that reduce direct non-CO2 emissions from agriculture, reduce CO2 emissions from land use change and forest sink enhancement

  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. Mitigating the health impacts of a natural disaster--the June 2007 long-weekend storm in the Hunter region of New South Wales.

    Science.gov (United States)

    Cretikos, Michelle A; Merritt, Tony D; Main, Kelly; Eastwood, Keith; Winn, Linda; Moran, Lucille; Durrheim, David N

    A severe storm that began on Thursday, 7 June 2007 brought heavy rains and gale-force winds to Newcastle, Gosford, Wyong, Sydney, and the Hunter Valley region of New South Wales. The storm caused widespread flooding and damage to houses, businesses, schools and health care facilities, and damaged critical infrastructure. Ten people died as a result of the storm, and approximately 6000 residents were evacuated. A natural disaster was declared in 19 local government areas, with damage expected to reach $1.5 billion. Additional demands were made on clinical health services, and interruption of the electricity supply to over 200,000 homes and businesses, interruption of water and gas supplies, and sewerage system pump failures presented substantial public health threats. A public health emergency operations centre was established by the Hunter New England Area Health Service to coordinate surveillance activities, respond to acute public health issues and prevent disease outbreaks. Public health activities focused on providing advice, cooperating with emergency service agencies, monitoring water quality and availability, preventing illness from sewage-contaminated flood water, assessing environmental health risks, coordinating the local government public health response, and surveillance for storm-related illness and disease outbreaks, including gastroenteritis. The local ABC (Australian Broadcasting Corporation) radio station played a key role in disseminating public health advice. A household survey conducted within a fortnight of the storm established that household preparedness and storm warning systems could be improved.

  19. The first coordinated observations of mid-latitude E-region quasi-periodic radar echoes and lower thermospheric 557.7-nm airglow

    Directory of Open Access Journals (Sweden)

    T. Ogawa

    2005-10-01

    Full Text Available We present the first coordinated observations of quasi-periodic (QP radar echoes from sporadic-E (Es field-aligned irregularities (FAIs, OI 557.7-nm airglow, and neutral winds in a common volume over Shigaraki, Japan (34.9° N, 136.1° E on the night of 5 August 2002 during the SEEK-2 campaign. QP echo altitudes of 90-110 km were lower than usual by 10 km, enabling us to make a detailed comparison among QP echoes, airglow intensity, and neutral wind at around 96 km altitude. Eastward movement of the QP echo regions is consistent with the motions of neutral winds, airglow structures, and FAIs, suggesting that the electrodynamics of Es-layers is fundamentally controlled by the neutral atmospheric dynamics. During the QP echo event, the echo altitudes clearly went up (down in harmony with an airglow enhancement (subsidence that also moved to the east. This fact suggests that the eastward-moving enhanced airglow region included an upward (downward component of neutral winds to raise (lower the altitude of the wind-shear node responsible for the Es formation. The airglow intensity, echo intensity, and Doppler velocity of FAIs at around 96 km altitude fluctuated with periods from 10 min to 1h, indicating that these parameters were modulated with short-period atmospheric disturbances. Some QP echo regions below 100km altitude contained small-scale QP structures in which very strong neutral winds exceeding 100 m/s existed. The results are compared with recent observations, theories, and simulations of QP echoes. Keywords. Ionosphere (Ionosphere-atmosphere interactions; Ionospheric irregularities; Mid-latitude ionosphere

  20. Co-ordinated research project on health impact of mercury cycling in contaminated environments studied by nuclear techniques. Report on the final research co-ordination meeting

    International Nuclear Information System (INIS)

    2004-01-01

    Mercury is a global pollutant because of its ability to undergo long distance transport into the atmosphere. In view of these global concerns the IAEA has organised a CRP to elucidate the biological, chemical, and physical factors, which influence the transformations of Hg and its compounds in the ecosystem and the dynamics of the mercury recycling. Under the title 'Health impacts of mercury cycling in contaminated environments studied by nuclear techniques' the CRP was started in October 1999 and concluded in February 2004. This report provides an overview of the various activities performed under the CRP by the various participants. The overall achievements are summarized and those aspects that require a further deeper look are also pointed out. The individual country reports are also given which detail on the progress made by the respective participants, during the CRP period. It is hoped that the results would encourage further research activities on these and related issues in the respective countries with the CRP participant as a catalyst to further these studies

  1. Family-centred service coordination in childhood health and disability services: the search for meaningful service outcome measures.

    Science.gov (United States)

    Trute, B; Hiebert-Murphy, D; Wright, A

    2008-05-01

    Potential service outcome measures were tested for their utility in the assessment of the quality of 'family centred' service coordination in the provincial network of children's disability services in Manitoba, Canada. This study is based on in-home survey data provided by 103 mothers at 6 and 18 months following assignment of a 'dedicated' service coordinator. Service outcome indicators included measures of parent self-esteem, parenting stress, family functioning and the need for family support resources. Hierarchical regression analyses showed no relationship between level of quality of family-centred service coordination and standardized psychosocial measures of parent and family functioning. However, family centredness of service coordination was found to predict significant reduction in level of family need for psychosocial support resources after 18 months of contact with a service coordinator. Outcome measures that are focused on specific and tangible results of service coordination appear to be of higher utility in service quality assessment than are more global, standardized measures of parent and family functioning.

  2. Food and Health in Europe: a new basis for action. WHO Regional Office for Europe. 2004

    DEFF Research Database (Denmark)

    Robertson, Aileen

    sector to include sectors ranging from agriculture and food processing, manufacturing and trade to transport, retailing, catering and advertising. Food and nutrition policies should be coordinated so that public health is given due priority in the making of food policies by non-health sectors......, multisectoral food and nutrition policies to encourage the sustainable production of food, its safety and the provision of food of high nutritional quality for all....

  3. Coordinating AgMIP data and models across global and regional scales for 1.5°C and 2.0°C assessments.

    Science.gov (United States)

    Rosenzweig, Cynthia; Ruane, Alex C; Antle, John; Elliott, Joshua; Ashfaq, Muhammad; Chatta, Ashfaq Ahmad; Ewert, Frank; Folberth, Christian; Hathie, Ibrahima; Havlik, Petr; Hoogenboom, Gerrit; Lotze-Campen, Hermann; MacCarthy, Dilys S; Mason-D'Croz, Daniel; Contreras, Erik Mencos; Müller, Christoph; Perez-Dominguez, Ignacio; Phillips, Meridel; Porter, Cheryl; Raymundo, Rubi M; Sands, Ronald D; Schleussner, Carl-Friedrich; Valdivia, Roberto O; Valin, Hugo; Wiebe, Keith

    2018-05-13

    The Agricultural Model Intercomparison and Improvement Project (AgMIP) has developed novel methods for Coordinated Global and Regional Assessments (CGRA) of agriculture and food security in a changing world. The present study aims to perform a proof of concept of the CGRA to demonstrate advantages and challenges of the proposed framework. This effort responds to the request by the UN Framework Convention on Climate Change (UNFCCC) for the implications of limiting global temperature increases to 1.5°C and 2.0°C above pre-industrial conditions. The protocols for the 1.5°C/2.0°C assessment establish explicit and testable linkages across disciplines and scales, connecting outputs and inputs from the Shared Socio-economic Pathways (SSPs), Representative Agricultural Pathways (RAPs), Half a degree Additional warming, Prognosis and Projected Impacts (HAPPI) and Coupled Model Intercomparison Project Phase 5 (CMIP5) ensemble scenarios, global gridded crop models, global agricultural economics models, site-based crop models and within-country regional economics models. The CGRA consistently links disciplines, models and scales in order to track the complex chain of climate impacts and identify key vulnerabilities, feedbacks and uncertainties in managing future risk. CGRA proof-of-concept results show that, at the global scale, there are mixed areas of positive and negative simulated wheat and maize yield changes, with declines in some breadbasket regions, at both 1.5°C and 2.0°C. Declines are especially evident in simulations that do not take into account direct CO 2 effects on crops. These projected global yield changes mostly resulted in increases in prices and areas of wheat and maize in two global economics models. Regional simulations for 1.5°C and 2.0°C using site-based crop models had mixed results depending on the region and the crop. In conjunction with price changes from the global economics models, productivity declines in the Punjab, Pakistan, resulted in

  4. Coordinating AgMIP data and models across global and regional scales for 1.5°C and 2.0°C assessments

    Science.gov (United States)

    Rosenzweig, Cynthia; Ruane, Alex C.; Antle, John; Elliott, Joshua; Ashfaq, Muhammad; Chatta, Ashfaq Ahmad; Ewert, Frank; Folberth, Christian; Hathie, Ibrahima; Havlik, Petr; Hoogenboom, Gerrit; Lotze-Campen, Hermann; MacCarthy, Dilys S.; Mason-D'Croz, Daniel; Contreras, Erik Mencos; Müller, Christoph; Perez-Dominguez, Ignacio; Phillips, Meridel; Porter, Cheryl; Raymundo, Rubi M.; Sands, Ronald D.; Schleussner, Carl-Friedrich; Valdivia, Roberto O.; Valin, Hugo; Wiebe, Keith

    2018-05-01

    The Agricultural Model Intercomparison and Improvement Project (AgMIP) has developed novel methods for Coordinated Global and Regional Assessments (CGRA) of agriculture and food security in a changing world. The present study aims to perform a proof of concept of the CGRA to demonstrate advantages and challenges of the proposed framework. This effort responds to the request by the UN Framework Convention on Climate Change (UNFCCC) for the implications of limiting global temperature increases to 1.5°C and 2.0°C above pre-industrial conditions. The protocols for the 1.5°C/2.0°C assessment establish explicit and testable linkages across disciplines and scales, connecting outputs and inputs from the Shared Socio-economic Pathways (SSPs), Representative Agricultural Pathways (RAPs), Half a degree Additional warming, Prognosis and Projected Impacts (HAPPI) and Coupled Model Intercomparison Project Phase 5 (CMIP5) ensemble scenarios, global gridded crop models, global agricultural economics models, site-based crop models and within-country regional economics models. The CGRA consistently links disciplines, models and scales in order to track the complex chain of climate impacts and identify key vulnerabilities, feedbacks and uncertainties in managing future risk. CGRA proof-of-concept results show that, at the global scale, there are mixed areas of positive and negative simulated wheat and maize yield changes, with declines in some breadbasket regions, at both 1.5°C and 2.0°C. Declines are especially evident in simulations that do not take into account direct CO2 effects on crops. These projected global yield changes mostly resulted in increases in prices and areas of wheat and maize in two global economics models. Regional simulations for 1.5°C and 2.0°C using site-based crop models had mixed results depending on the region and the crop. In conjunction with price changes from the global economics models, productivity declines in the Punjab, Pakistan, resulted in

  5. Integrating views on support for mid-level health worker performance: a concept mapping study with regional health system actors in rural Guatemala.

    Science.gov (United States)

    Hernández, Alison R; Hurtig, Anna-Karin; Dahlblom, Kjerstin; San Sebastián, Miguel

    2015-10-08

    Mid-level health workers are on the front-lines in underserved areas in many LMICs, and their performance is critical for improving the health of vulnerable populations. However, improving performance in low-resource settings is complex and highly dependent on the organizational context of local health systems. This study aims to examine the views of actors from different levels of a regional health system in Guatemala on actions to support the performance of auxiliary nurses, a cadre of mid-level health workers with a prominent role in public sector service delivery. A concept mapping study was carried out to develop an integrated view on organizational support and identify locally relevant strategies for strengthening performance. A total of 93 regional and district managers, and primary and secondary care health workers participated in generating ideas on actions needed to support auxiliary nurses' performance. Ideas were consolidated into 30 action items, which were structured through sorting and rating exercises, involving a total of 135 of managers and health workers. Maps depicting participants' integrated views on domains of action and dynamics in sub-groups' interests were generated using a sequence of multivariate statistical analyses, and interpreted by regional managers. The combined input of health system actors provided a multi-faceted view of actions needed to support performance, which were organized in six domains, including: Communication and coordination, Tools to orient work, Organizational climate of support, Motivation through recognition, Professional development and Skills development. The nature of relationships across hierarchical levels was identified as a cross-cutting theme. Pattern matching and go-zone maps indicated directions for action based on areas of consensus and difference across sub-groups of actors. This study indicates that auxiliary nurses' performance is interconnected with the performance of other health system actors who

  6. Regionalization Lessons from Denmark

    DEFF Research Database (Denmark)

    Vrangbæk, Karsten

    2016-01-01

    and coordination. Regions and municipalities in Denmark are governed by directly elected democratic councils. The Danish case is thus an example of democratic decentralization, but within a framework of national coordination and fiscal control. In spite of the difference in size and historical traditions...... there are also many similarities between Canada and Denmark, particularly in terms of health and social policy goals and aspirations, and in terms of the commitment to a comprehensive, universal healthcare system. These similarities provide interesting opportunities for comparison....

  7. 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)

  8. Assessing coastal wetland vulnerability to sea-level rise along the northern Gulf of Mexico coast: Gaps and opportunities for developing a coordinated regional sampling network.

    Science.gov (United States)

    Osland, Michael J; Griffith, Kereen T; Larriviere, Jack C; Feher, Laura C; Cahoon, Donald R; Enwright, Nicholas M; Oster, David A; Tirpak, John M; Woodrey, Mark S; Collini, Renee C; Baustian, Joseph J; Breithaupt, Joshua L; Cherry, Julia A; Conrad, Jeremy R; Cormier, Nicole; Coronado-Molina, Carlos A; Donoghue, Joseph F; Graham, Sean A; Harper, Jennifer W; Hester, Mark W; Howard, Rebecca J; Krauss, Ken W; Kroes, Daniel E; Lane, Robert R; McKee, Karen L; Mendelssohn, Irving A; Middleton, Beth A; Moon, Jena A; Piazza, Sarai C; Rankin, Nicole M; Sklar, Fred H; Steyer, Greg D; Swanson, Kathleen M; Swarzenski, Christopher M; Vervaeke, William C; Willis, Jonathan M; Wilson, K Van

    2017-01-01

    to transform a broadly disseminated and unplanned collection of SET-MH stations into a coordinated and strategic regional network. This regional network would provide data for predicting and preparing for the responses of coastal wetlands to accelerated sea-level rise and other aspects of global change.

  9. Assessing coastal wetland vulnerability to sea-level rise along the northern Gulf of Mexico coast: Gaps and opportunities for developing a coordinated regional sampling network.

    Directory of Open Access Journals (Sweden)

    Michael J Osland

    analyses can be used to transform a broadly disseminated and unplanned collection of SET-MH stations into a coordinated and strategic regional network. This regional network would provide data for predicting and preparing for the responses of coastal wetlands to accelerated sea-level rise and other aspects of global change.

  10. Dialectical behaviour therapy for treating adults and adolescents with emotional and behavioural dysregulation: study protocol of a coordinated implementation in a publicly funded health service.

    LENUS (Irish Health Repository)

    Flynn, Daniel

    2018-02-26

    In the Republic of Ireland, borderline personality disorder (BPD) is a feature of approximately 11-20% of clinical presentations to outpatient clinics within mental health services. These estimates are similar to other countries including the UK and USA. Dialectical behaviour therapy (DBT) is an intervention with a growing body of evidence that demonstrates its efficacy in treating individuals diagnosed with BPD. While a number of randomised controlled trials (RCTs) have demonstrated the efficacy of DBT, there is limited research which evaluates the effectiveness of this model when applied to real world settings. Funding was secured to co-ordinate DBT training in public community-based mental health services across Ireland. As no other study has evaluated a co-ordinated national implementation of DBT, the current study proposes to investigate the effectiveness of DBT in both adult and child\\/adolescent community mental health services across Ireland, evaluate the coordinated implementation of DBT at a national level, and complete a comprehensive economic evaluation comparing DBT versus treatment-as-usual.

  11. 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

  12. Health care and patients' migration across Spanish regions.

    Science.gov (United States)

    Cantarero, David

    2006-06-01

    This paper analyses patient mobility across Spanish regions. A model of patient migration is specified and estimated using panel observations covering mobility and other main regional quality indicators over the period 1996-1999. Empirical results show that in Spain income and supply variables determines the quality of the service offered,, and that there is quality-driven mobility.

  13. Regionalizing the Recruitment of Health Personnel in Burkina Faso ...

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

    Human resources are essential to attaining the objectives of the Millennium development goals with respect to national health systems. In low-income countries, human health resources are characterized by a deficit of qualified personnel and an unequal distribution of existing personnel. To address these problems, the ...

  14. Correlates of maternal health care utilization in Rohilkhand region ...

    African Journals Online (AJOL)

    Maternal health care service utilization from health personnel was significantly associated with age at marriage ≥18 years, family size ≤3, birth order ≤2, nuclear family and higher socio‑economic status. Most of the pregnancy related complications were found among women aged >30 years, with birth order ≥3, having ...

  15. Coordination cycles

    Czech Academy of Sciences Publication Activity Database

    Steiner, Jakub

    -, č. 274 (2005), s. 1-26 ISSN 1211-3298 Institutional research plan: CEZ:AV0Z70850503 Keywords : coordination * crises * cycles and fluctuations Subject RIV: AH - Economics http://www.cerge-ei.cz/pdf/wp/Wp274.pdf

  16. Coordination cycles

    Czech Academy of Sciences Publication Activity Database

    Steiner, Jakub

    2008-01-01

    Roč. 63, č. 1 (2008), s. 308-327 ISSN 0899-8256 Institutional research plan: CEZ:AV0Z70850503 Keywords : global games * coordination * crises * cycles and fluctuations Subject RIV: AH - Economics Impact factor: 1.333, year: 2008

  17. Magnetic Coordinate Systems

    Science.gov (United States)

    Laundal, K. M.; Richmond, A. D.

    2017-03-01

    Geospace phenomena such as the aurora, plasma motion, ionospheric currents and associated magnetic field disturbances are highly organized by Earth's main magnetic field. This is due to the fact that the charged particles that comprise space plasma can move almost freely along magnetic field lines, but not across them. For this reason it is sensible to present such phenomena relative to Earth's magnetic field. A large variety of magnetic coordinate systems exist, designed for different purposes and regions, ranging from the magnetopause to the ionosphere. In this paper we review the most common magnetic coordinate systems and describe how they are defined, where they are used, and how to convert between them. The definitions are presented based on the spherical harmonic expansion coefficients of the International Geomagnetic Reference Field (IGRF) and, in some of the coordinate systems, the position of the Sun which we show how to calculate from the time and date. The most detailed coordinate systems take the full IGRF into account and define magnetic latitude and longitude such that they are constant along field lines. These coordinate systems, which are useful at ionospheric altitudes, are non-orthogonal. We show how to handle vectors and vector calculus in such coordinates, and discuss how systematic errors may appear if this is not done correctly.

  18. Geometric situation of points of division of regions of direct and return currency in channels with the presence of heating zone limited on the longitudinal coordinate

    Science.gov (United States)

    Gerasimov, A.; Kirpichnikov, A.; Sabirova, F.

    2018-03-01

    The analysis of energy balance equation for viscous laminar flow of fluid or gas in the cylindrical channel in the area (zone) of warm up bounded along the longitudinal coordinate is made. It was found that at laminar flow of fluid or gas in a round pipe, in each warm up area bounded along the longitudinal coordinate there are the areas of direct and reverse flows separated by a plane that is a locus of points where temperature is maximal for each fixed value of radial coordinate r.

  19. [Duration of work absence attributable to non work-related diseases by health regions in catalonia].

    Science.gov (United States)

    Torá Rocamora, Isabel; Martínez Martínez, José Miguel; Delclos Clanchet, Jordi; Jardí Lliberia, Josefina; Alberti Casas, Constança; Serra Pujadas, Consol; Manzanera López, Rafael; Benavides, Fernando G

    2010-01-01

    This study analyze the duration of episodes of work absence due to non work-related diseases in Catalonia by health regions, assuming a homogeneous distribution of durations between health regions. A retrospective cohort study of 811.790 episodes in 2005 and followed to episode closure through July 2007 provided by the Institut Català d'Avaluacions Mèdiques, describing their median duration (MD) in days for each of the seven health regions of Catalonia. The probability of returning to work was plotted according to Wang_Chang survival curves and median durations were then compared using the Barcelona health region as the referent group. Results were extended through stratification by sex. The Camp de Tarragona health region had the shortest MD (5 days), while the episodes in the Alt Pirineu i Aran region had the longest (MD, 13 days). The Barcelona health region had a MD of 7 days as was the case for Cataluña Central. MD in Girona was 8 days, and in Lleida and Terres de l'Ebre it was 9 days. This latter region also had the highest median duration 13 days. The are significant differences in the duration of work absence between the health regions of Catalonia. These differences persisted after adjusting for age, management of episodes and social security system status, in both men and women.

  20. Exploring Ecosystems and Health by Shifting to a Regional Focus: Perspectives from the Oceania EcoHealth Chapter

    Directory of Open Access Journals (Sweden)

    Jonathan Kingsley

    2015-10-01

    Full Text Available This article highlights contributions that can be made to the public health field by incorporating “ecosystem approaches to health” to tackle future environmental and health challenges at a regional level. This qualitative research reviews attitudes and understandings of the relationship between public health and the environment and the priorities, aspirations and challenges of a newly established group (the Oceania EcoHealth Chapter who are attempting to promote these principles. Ten semi-structured interviews with Oceania EcoHealth Chapter members highlighted the important role such groups can play in informing organisations working in the Oceania region to improve both public health and environmental outcomes simultaneously. Participants of this study emphasise the need to elevate Indigenous knowledge in Oceania and the role regional groups play in this regard. They also emphasis that regional advocacy and ecosystem approaches to health could bypass silos in knowledge and disciplinary divides, with groups like the Oceania EcoHealth Chapter acting as a mechanism for knowledge exchange, engagement, and action at a regional level with its ability to bridge the gap between environmental stewardship and public health.

  1. Exploring Ecosystems and Health by Shifting to a Regional Focus: Perspectives from the Oceania EcoHealth Chapter

    Science.gov (United States)

    Kingsley, Jonathan; Patrick, Rebecca; Horwitz, Pierre; Parkes, Margot; Jenkins, Aaron; Massy, Charles; Henderson-Wilson, Claire; Arabena, Kerry

    2015-01-01

    This article highlights contributions that can be made to the public health field by incorporating “ecosystem approaches to health” to tackle future environmental and health challenges at a regional level. This qualitative research reviews attitudes and understandings of the relationship between public health and the environment and the priorities, aspirations and challenges of a newly established group (the Oceania EcoHealth Chapter) who are attempting to promote these principles. Ten semi-structured interviews with Oceania EcoHealth Chapter members highlighted the important role such groups can play in informing organisations working in the Oceania region to improve both public health and environmental outcomes simultaneously. Participants of this study emphasise the need to elevate Indigenous knowledge in Oceania and the role regional groups play in this regard. They also emphasis that regional advocacy and ecosystem approaches to health could bypass silos in knowledge and disciplinary divides, with groups like the Oceania EcoHealth Chapter acting as a mechanism for knowledge exchange, engagement, and action at a regional level with its ability to bridge the gap between environmental stewardship and public health. PMID:26473903

  2. Health effects in residents of regions with high background radiation

    International Nuclear Information System (INIS)

    Hanson, G.P.

    1984-01-01

    Possible health problems created by high natural levels of background radiation are hard to detect, partly because the health problems involved would exist to some degree irrespective of radiation exposure, partly because other factors affect the incidence of such problems, and partly because the differences between normal background radiation levels and radiation levels found in most high-radiation areas are not extreme. Nevertheless, the need to know about such health effects is evident, and so various studies conducted over the past 30 years have sought to determine whether those effects exist and what they are. Overall, however, the fragmentary and uncertain nature of many of these findings makes it hard to draw firm conclusions about the health risks involved or the desirability of countermeasures. So despite considerable efforts and some progress over the past three decades, the need for a clear quantitative assessment of the consequences is as great as ever

  3. Correlates of Maternal Health Care Utilization in Rohilkhand Region ...

    African Journals Online (AJOL)

    Bareilly district, Uttar Pradesh to cover maximum number of women. All currently ... inequalities in the utilization of maternal health care services have been ..... With regard to work status, one study made in four Indian states supports our ...

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

    Science.gov (United States)

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

    2012-06-01

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

  5. Regional differences in antihyperglycemic medication are not explained by individual socioeconomic status, regional deprivation, and regional health care services. Observational results from the German DIAB-CORE consortium.

    Directory of Open Access Journals (Sweden)

    Christina Bächle

    Full Text Available This population-based study sought to extend knowledge on factors explaining regional differences in type 2 diabetes mellitus medication patterns in Germany.Individual baseline and follow-up data from four regional population-based German cohort studies (SHIP [northeast], CARLA [east], HNR [west], KORA [south] conducted between 1997 and 2010 were pooled and merged with both data on regional deprivation and regional health care services. To analyze regional differences in any or newer anti-hyperglycemic medication, medication prevalence ratios (PRs were estimated using multivariable Poisson regression models with a robust error variance adjusted gradually for individual and regional variables.The study population consisted of 1,437 people aged 45 to 74 years at baseline, (corresponding to 49 to 83 years at follow-up with self-reported type 2 diabetes. The prevalence of receiving any anti-hyperglycemic medication was 16% higher in KORA (PR 1.16 [1.08-1.25], 10% higher in CARLA (1.10 [1.01-1.18], and 7% higher in SHIP (PR 1.07 [1.00-1.15] than in HNR. The prevalence of receiving newer anti-hyperglycemic medication was 49% higher in KORA (1.49 [1.09-2.05], 41% higher in CARLA (1.41 [1.02-1.96] and 1% higher in SHIP (1.01 [0.72-1.41] than in HNR, respectively. After gradual adjustment for individual variables, regional deprivation and health care services, the effects only changed slightly.Neither comprehensive individual factors including socioeconomic status nor regional deprivation or indicators of regional health care services were able to sufficiently explain regional differences in anti-hyperglycemic treatment in Germany. To understand the underlying causes, further research is needed.

  6. Regional variation in the predictive validity of self-rated health for mortality

    Directory of Open Access Journals (Sweden)

    Edward R. Berchick

    2017-12-01

    Full Text Available Self-rated health (SRH is a commonly used measure for assessing general health in surveys in the United States. However, individuals from different parts of the United States may vary in how they assess their health. Geographic differences in health care access and in the prevalence of illnesses may make it difficult to discern true regional differences in health when using SRH as a health measure. In this article, we use data from the 1986 and 1989–2006 National Health Interview Survey Linked Mortality Files and estimate Cox regression models to examine whether the relationship between SRH and five-year all-cause mortality differs by Census region. Contrary to hypotheses, there is no evidence of regional variation in the predictive validity of SRH for mortality. At all levels of SRH, and for both non-Hispanic white and non-Hispanic black respondents, SRH is equally and strongly associated with five-year mortality across regions. Our results suggest that differences in SRH across regions are not solely due to differences in how respondents assess their health across regions, but reflect true differences in health. Future research can, therefore, employ this common measure to investigate the geographic patterning of health in the United States.

  7. Environmental Health assessment 200 Days after Earthquake-Affected Region in East Azerbaijan Earthquake, North-Western of Iran, 2012

    Directory of Open Access Journals (Sweden)

    Alihossein Zeinalzadeh

    2017-04-01

    assessment and pre-crisis coordination among various organizations led to negative effects of environmental factors on health status in villages. Providing intra-sector coordination for waste management with a sanitary disposal of sewage and detection hazardous materials aftermath as well as immediate measurements in the water supply system are necessary for health promotion of the affected population  in the disaster region.DOI: 10.20518/tjph.326814

  8. Coordinated Traffic Incident and Congestion Management (TIM-CM) : Mitigating Regional Impacts of Major Traffic Incidents in the Seattle I-5 Corridor

    Science.gov (United States)

    2018-02-02

    Within the Seattle metropolitan area, traffic incident management (TIM) operations provide a multi-jurisdictional and coordinated strategy to detect, respond to, and clear traffic incidents so that traffic flow can be restored quickly and safely. The...

  9. [Challenges to decentralization and local participation within the health rights protection framework: Experience of the SUSALUD Northern Macro-regional Intendance].

    Science.gov (United States)

    Rebaza-Iparraguirre, Henry; Vela-López, Miguel; Villegas-Ortega, José; Lozada-Urbano, Michelle; Munares-García, Oscar

    2016-01-01

    In Peru, health protection rights and the National Health Authority (SUSALUD) coexist with the aim to ensure that every Peruvian may exercise his/her rights. According to the L.D. (Spanish: Decreto legislativo) N° 1158, strategies must be deployed to ensure effective decentralization and ensure compliance with user rights. As a result, the Northern Macro-regional Intendance (IMRN) was created, with headquarters in the city of Chiclayo, and a coverage area including Lambayeque, Tumbes, Piura, Cajamarca, La Libertad, and Amazonas. The northern macro-region promotes information dissemination, coordination, and local participation in health activities, with an emphasis on handling complaints and claims as well as implementation and operation support of user boards (JUS). After 6 months, implementation of the IMRN experience is undergoing consolidation.

  10. Child health in Peru: importance of regional variation and community effects on children's height and weight.

    Science.gov (United States)

    Shin, Heeju

    2007-12-01

    In developing countries, height and weight are good indicators of children's health and nutritional status. Maternal education has been accepted as one of the most important influences on child health. Using the 2000 Demographic and Health Survey of Peru, however, I find that the effect of maternal education varies as a function of region. In the most prosperous urban region, maternal education is less important for child health than in poor rural areas, and a higher level of education has a greater effect in rural areas. Multilevel analysis shows that a significant part of the observed correlation between maternal education and child health is moderated by regional differences and community characteristics. The finding suggests that Peruvian public policy should emphasize resource redistribution as well as women's education, and that investment in maternal education should be considered within regional contexts to enhance child health in rural areas.

  11. [Mobile Health Units: An Analysis of Concepts and Implementation Requirements in Rural Regions.

    Science.gov (United States)

    Hämel, K; Kutzner, J; Vorderwülbecke, J

    2017-12-01

    Access to health services in rural regions represents a challenge. The development of care models that respond to health service shortages and pay particular attention to the increasing health care needs of the elderly is an important concern. A model that has been implemented in other countries is that of mobile health units. But until now, there is no overview of their possible objectives, functions and implementation requirements. This paper is based on a literature analysis and an internet research on mobile health units in rural regions. Mobile health units aim to avoid regional undersupply and address particularly vulnerable population groups. In the literature, mobile health units are described with a focus on specific illnesses, as well as those that provide comprehensive, partly multi-professional primary care that is close to patients' homes. The implementation of mobile health units is demanding; the key challenges are (a) alignment to the needs of the regional population, (b) user-oriented access and promotion of awareness and acceptance of mobile health units by the local population, and (c) network building within existing care structures to ensure continuity of care for patients. To fulfill these requirements, a community-oriented program development and implementation is important. Mobile health units could represent an interesting model for the provision of health care in rural regions in Germany. International experiences are an important starting point and should be taken into account for the further development of models in Germany. © Georg Thieme Verlag KG Stuttgart · New York.

  12. Opposite poles: A comparison between two Spanish regions in health-related quality of life, with implications for health policy

    Directory of Open Access Journals (Sweden)

    López-Valcárcel Beatriz G

    2010-09-01

    Full Text Available Abstract Background Although health is one of the main determinants of the welfare of societies, few studies have evaluated health related quality of life in representative samples of the population of a region or a country. Our aim is to describe the health-related quality of life of the inhabitants of two quite different Spanish regions (Canary Islands and Catalonia and to compare the prevalence of health problems between age-sex groups. Methods We use data obtained from the 2006 Health Survey of Catalonia and the 2004 Canary Islands Health Survey. With an ordinal composite variable measuring HRQOL we identify the association of characteristics of individuals with self-reported quality of life and test for differences between the regions. Results The prevalence of problems in the five EQ-5 D dimensions increases with age and is generally higher for women than for men. The dimension with the highest prevalence of problems is "anxiety/depression", and there is noteworthy the extent of discomfort and pain among Canary Island women. Education, especially among the elderly, has an important effect on health-related quality of life. Conclusions There are substantial structural and compositional differences between the two regions. Regional context is a significant factor, independent of the compositional differences, and the effects of context are manifest above all in women. The findings show the importance of disease prevention and the need for improving the educational level of the population in order to reduce health inequalities.

  13. Health effects in residents of high background radiation regions

    International Nuclear Information System (INIS)

    Hanson, G.P.

    1984-01-01

    Although the health effects of radiation doses in occupationally exposed persons had received attention, it was not until the 1950s, when the atmospheric atom bomb tests of the United States and the Soviet Union had raised the level of environmental radioactivity, that the long-term effects of low-level radiation dosage became a matter of popular concern throughout the world. The United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) was created, and the World Health Organization (WHO) appointed an expert committee to provide advice concerning radiation and human health. In its first report, the WHO expert committee identified several areas of high natural radiation where studies of the exposed population might possibly provide information concerning the effects of chromic low-level radiation dosage

  14. TECHNICAL COORDINATION

    CERN Multimedia

    A. Ball

    Overview From a technical perspective, CMS has been in “beam operation” state since 6th November. The detector is fully closed with all components operational and the magnetic field is normally at the nominal 3.8T. The UXC cavern is normally closed with the radiation veto set. Access to UXC is now only possible during downtimes of LHC. Such accesses must be carefully planned, documented and carried out in agreement with CMS Technical Coordination, Experimental Area Management, LHC programme coordination and the CCC. Material flow in and out of UXC is now strictly controlled. Access to USC remains possible at any time, although, for safety reasons, it is necessary to register with the shift crew in the control room before going down.It is obligatory for all material leaving UXC to pass through the underground buffer zone for RP scanning, database entry and appropriate labeling for traceability. Technical coordination (notably Stephane Bally and Christoph Schaefer), the shift crew and run ...

  15. The Health Effects of Climate Change in the WHO European Region

    Directory of Open Access Journals (Sweden)

    Tanja Wolf

    2015-11-01

    Full Text Available The evidence of observed health effects as well as projections of future health risks from climate variability and climate change is growing. This article summarizes new knowledge on these health risks generated since the IPCC fourth assessment report (AR4 was published in 2007, with a specific focus on the 53 countries comprising the WHO European Region. Many studies on the effects of weather, climate variability, and climate change on health in the European Region have been published since 2007, increasing the level of certainty with regard to already known health threats. Exposures to temperature extremes, floods, storms, and wildfires have effects on cardiovascular and respiratory health. Climate- and weather-related health risks from worsening food and water safety and security, poor air quality, and ultraviolet radiation exposure as well as increasing allergic diseases, vector- and rodent-borne diseases, and other climate-sensitive health outcomes also warrant attention and policy action to protect human health.

  16. Constraints to applying systems thinking concepts in health systems: A regional perspective from surveying stakeholders in Eastern Mediterranean countries.

    Science.gov (United States)

    El-Jardali, Fadi; Adam, Taghreed; Ataya, Nour; Jamal, Diana; Jaafar, Maha

    2014-12-01

    Systems Thinking (ST) has recently been promoted as an important approach to health systems strengthening. However, ST is not common practice, particularly in Low- and Middle-Income Countries (LMICs). This paper seeks to explore the barriers that may hinder its application in the Eastern Mediterranean Region (EMR) and possible strategies to mitigate them. A survey consisting of open-ended questions was conducted with a purposive sample of health policy-makers such as senior officials from the Ministry of Health (MoH), researchers, and other stakeholders such as civil society groups and professional associations from ten countries in the region. A total of 62 respondents participated in the study. Thematic analysis was conducted. There was strong recognition of the relevance and usefulness of ST to health systems policy-making and research, although misconceptions about what ST means were also identified. Experience with applying ST was very limited. Approaches to designing health policies in the EMR were perceived as reactive and fragmented (66%). Commonly perceived constraints to application of ST were: a perceived notion of its costliness combined with lack of the necessary funding to operationalize it (53%), competing political interests and lack of government accountability (50%), lack of awareness about relevance and value (47%), limited capacity to apply it (45%), and difficulty in coordinating and managing stakeholders (39%). While several strategies have been proposed to mitigate most of these constraints, they emphasized the importance of political endorsement and adoption of ST at the leadership level, together with building the necessary capacity to apply it and apply the learning in research and practice.

  17. Empowering Health Care Decision-makers to Achieve Regional ...

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

    This project builds on earlier work on the development and validation of an economic model to estimate the social, economic, and health burden of tobacco, together with the expected impact of tax increases in Argentina, Bolivia, Brazil, Chile, Colombia, Mexico, and Peru. Researchers will develop and evaluate the ...

  18. Space and place for WHO health development dialogues in the African Region.

    Science.gov (United States)

    Kirigia, Joses Muthuri; Nabyonga-Orem, Juliet; Dovlo, Delanyo Yao Tsidi

    2016-07-18

    Majority of the countries in the World Health Organization (WHO) African Region are not on track to achieve the health-related Millennium Development Goals, yet even more ambitious Sustainable Development Goals (SDGs), including SDG 3 on heath, have been adopted. This paper highlights the challenges - amplified by the recent Ebola virus disease (EVD) outbreak in West Africa - that require WHO and other partners' dialogue in support of the countries, and debate on how WHO can leverage the existing space and place to foster health development dialogues in the Region. To realise SDG 3 on ensuring healthy lives and promoting well-being for all at all ages, the African Region needs to tackle the persistent weaknesses in its health systems, systems that address the social determinants of health and national health research systems. The performance of the third item is crucial for the development and innovation of systems, products and tools for promoting, maintaining and restoring health in an equitable manner. Under its new leadership, the WHO Regional Office for Africa is transforming itself to galvanise existing partnerships, as well as forging new ones, with a view to accelerating the provision of timely and quality support to the countries in pursuit of SDG 3. WHO in the African Region engages in dialogues with various stakeholders in the process of health development. The EVD outbreak in West Africa accentuated the necessity for optimally exploiting currently available space and place for health development discourse. There is urgent need for the WHO Regional Office for Africa to fully leverage the space and place arenas of the World Health Assembly, WHO Regional Committee for Africa, African Union, Regional economic communities, Harmonization for Health in Africa, United Nations Economic Commission for Africa, African Development Bank, professional associations, and WHO African Health Forum, when it is created, for dialogues to mobilise the required resources to

  19. Health effects of the Chernobyl disaster: illness or illness behavior? A comparative general health survey in two former Soviet regions

    NARCIS (Netherlands)

    Havenaar, J.; Rumyantzeva, G.; Kasyanenko, A.; Kaasjager, K.; Westermann, Anneke; van den Brink, W.; van den Bout, J.; Savelkoul, J.

    1997-01-01

    Results are described of a general health survey (n = 3044) that was conducted 6.5 years after the Chernobyl accident in 1986 in a seriously contaminated region in Belarus and a socioeconomically comparable, but unaffected, region in the Russian Federation. The purpose of the study was to

  20. Eastern Health Board Regional Orthodontic Service: an initial audit.

    LENUS (Irish Health Repository)

    Dowling, P A

    1997-01-01

    This initial audit of 600 recently assessed Eastern Health Board orthodontic patients suggests that a large number of them (47 per cent) requires referral for routine restorative and preventive dental care. Closer links are needed with general dental practitioners and community dental surgeons to resolve these needs. The trend for a high referral of females and Class 11 Division 1 malocclusion type correlated well with studies in other countries.

  1. 5-4-3-2-1 go! Coordinating pediatric resident education and community health promotion to address the obesity epidemic in children and youth.

    Science.gov (United States)

    Stahl, Christiane Ellen; Necheles, Jonathan Wolf; Mayefsky, Jay Hirsh; Wright, Lydia Katherine; Rankin, Kristin Michele

    2011-03-01

    This study investigated the feasibility and effectiveness of training pediatric residents to conduct a brief clinic-based behavioral intervention in coordination with community dissemination of a health promotion message developed by the Consortium for Lowering Obesity in Chicago Children. A total of 113 residents completed a short (obesity rates: increased intake of fruits and vegetables (28% vs 16%, P < .01), increased intake of water (30% vs 19%, P < .01), increased physical activity (40% vs 29%, P < .03), and decreased television time (36% vs 24%, P < .01). Brief training using the 5-4-3-2-1-Go! message seems to be feasible and effective.

  2. The health regionalization process from the perspective of the transation cost theory.

    Science.gov (United States)

    Sancho, Leyla Gomes; Geremia, Daniela Savi; Dain, Sulamis; Geremia, Fabiano; Leão, Cláudio José Silva

    2017-04-01

    This study analyzes the incidence of transaction costs in the regionalization process of health policies in the Brazilian federal system. In this work, regionalized health actions contracted and agreed between federal agencies have assumed a transactional nature. A conceptual theoretical essay of reflective nature was prepared with the purpose of questioning and proposing new approaches to improve the health regionalization process. The main considerations suggest that institutional management tools proposed by the standards and regulations of the Unified Health System have a low potential to reduce transaction costs, especially due to hardships in reconciling common goals among the entities, environment surrounded by uncertainty, asymmetries and incomplete information, bounded rationality and conflict of interest. However, regionalization can reduce the incidence of social and/or operational costs, through improved access to health and the construction of more efficient governance models.

  3. Homologous regions of Fen1 and p21Cip1 compete for binding to the same site on PCNA: a potential mechanism to co-ordinate DNA replication and repair.

    Science.gov (United States)

    Warbrick, E; Lane, D P; Glover, D M; Cox, L S

    1997-05-15

    Following genomic damage, the cessation of DNA replication is co-ordinated with onset of DNA repair; this co-ordination is essential to avoid mutation and genomic instability. To investigate these phenomena, we have analysed proteins that interact with PCNA, which is required for both DNA replication and repair. One such protein is p21Cip1, which inhibits DNA replication through its interaction with PCNA, while allowing repair to continue. We have identified an interaction between PCNA and the structure specific nuclease, Fen1, which is involved in DNA replication. Deletion analysis suggests that p21Cip1 and Fen1 bind to the same region of PCNA. Within Fen1 and its homologues a small region (10 amino acids) is sufficient for PCNA binding, which contains an 8 amino acid conserved PCNA-binding motif. This motif shares critical residues with the PCNA-binding region of p21Cip1. A PCNA binding peptide from p21Cip1 competes with Fen1 peptides for binding to PCNA, disrupts the Fen1-PCNA complex in replicating cell extracts, and concomitantly inhibits DNA synthesis. Competition between homologous regions of Fen1 and p21Cip1 for binding to the same site on PCNA may provide a mechanism to co-ordinate the functions of PCNA in DNA replication and repair.

  4. Regional health workforce planning through action research: lessons for commissioning health services from a case study in Far North Queensland.

    Science.gov (United States)

    Panzera, Annette June; Murray, Richard; Stewart, Ruth; Mills, Jane; Beaton, Neil; Larkins, Sarah

    2016-01-01

    Creating a stable and sustainable health workforce in regional, rural and remote Australia has long been a challenge to health workforce planners, policy makers and researchers alike. Traditional health workforce planning is often reactive and assumes continuation of current patterns of healthcare utilisation. This demonstration project in Far North Queensland exemplifies how participatory regional health workforce planning processes can accurately model current and projected local workforce requirements. The recent establishment of Primary Health Networks (PHNs) with the intent to commission health services tailored to individual healthcare needs underlines the relevance of such an approach. This study used action research methodology informed by World Health Organization (WHO) systems thinking. Four cyclical stages of health workforce planning were followed: needs assessment; health service model redesign; skills-set assessment and workforce redesign; and development of a workforce and training plan. This study demonstrated that needs-based loco-regional health workforce planning can be achieved successfully through participatory processes with stakeholders. Stronger health systems and workforce training solutions were delivered by facilitating linkages and planning processes based on community need involving healthcare professionals across all disciplines and sectors. By focusing upon extending competencies and skills sets, local health professionals form a stable and sustainable local workforce. Concrete examples of initiatives generated from this process include developing a chronic disease inter-professional teaching clinic in a rural town and renal dialysis being delivered locally to an Aboriginal community. The growing trend of policy makers decentralising health funding, planning and accountability and rising health system costs increase the future utility of this approach. This type of planning can also assist the new PHNs to commission health services

  5. Impact of the role of senior dual disability coordinator on the perceived self-efficacy and job satisfaction of mental health clinicians.

    Science.gov (United States)

    Hendren, Amanda Jayne; Kendall, Melissa Bianca

    2015-01-01

    This study aimed to evaluate a new service role in mental health services, namely, the senior dual disability coordinator role (SDDC) for its impact on the perceived self-efficacy of mental health clinicians in managing clients with dual disability (mental illness and acquired brain injury and/or intellectual disability) and their job satisfaction. Mental health clinicians from a health service district in Queensland, Australia who contacted the SDDC for clinical consultation and liaison between July 2011 and July 2013 were asked to complete a questionnaire assessing perceived self-efficacy in working with clients with dual disability as well as their job satisfaction, prior to (T1) and following (T2) their contact with the SDDC. Twenty-five clinicians completed and returned pre- and post-measure questionnaires. Self-reported knowledge of dual disability, clinical skills in dual disability, service knowledge in dual disability as well as perceived self-efficacy, and job satisfaction increased significantly from T1 to T2. There were no significant differences across professional discipline or years of service. The delivery of a clinical consultation liaison service as part of the role of SDDC may assist mental health clinicians with self-efficacy and job satisfaction, regardless of the number of years they have worked in the service or their professional discipline. Mental health clinicians with improved self-efficacy for working with clients with dual disability may be more likely to consider the client suitable for services through mental health and follow-up with treatment and linking the client with other identified suitable services. Implications for Rehabilitation Dual disability (mental illness and acquired brain injury and/or intellectual disability) presents specific challenges for mental health services Specific strategies are needed to build capacity among mental health practitioners in order to meet the needs of people with dual disability and provide

  6. [Primary and secondary data on dementia care as an example of regional health planning].

    Science.gov (United States)

    Ulrich, Lisa-R; Schatz, Tanja R; Lappe, Veronika; Ihle, Peter; Barthen, Linda; Gerlach, Ferdinand M; Erler, Antje

    2017-12-01

    Health service planning that takes into account as far as possible the regional needs and regional discrepancies is a controversial health issue in Germany. In a pilot scheme, we tested a planning process for regional healthcare services, based on the example of dementia care. The aim of this article is to present the strengths and limitations of this planning process. We developed an indicator set for dementia care based on routine regional data obtained from two German statutory health insurance companies. Additionally, primary data based on a questionnaire sent to all GPs in the area were evaluated. These data were expanded through the addition of official socio-demographic population data. Procedures and evaluation strategies, discussion of the results and the derivation of planning measures followed, in close agreement with a group of local experts. Few epidemiological data on regional variations in health care planning are publicly available. Secondary data from statutory health insurance companies can be assessed to support the estimation of regional health care needs, but interpretation is difficult. The use of surveys to collect primary data, and the assessment of results by the local health board may facilitate interpretation and may contribute towards more valid statements regarding regional health planning. Despite the limited availability of data and the considerable efforts involved in data analysis, the project demonstrates how needs-based health service planning can be carried out in a small region, taking into account the increasing demands of the local health care providers and the special local features.

  7. Modeling the Impacts of Global Climate and Regional Land Use Change on Regional Climate, Air Quality and Public Health in the New York Metropolitan Region

    Science.gov (United States)

    Rosenthal, J. E.; Knowlton, K. M.; Kinney, P. L.

    2002-12-01

    There is an imminent need to downscale the global climate models used by international consortiums like the IPCC (Intergovernmental Panel on Climate Change) to predict the future regional impacts of climate change. To meet this need, a "place-based" climate model that makes specific regional projections about future environmental conditions local inhabitants could face is being created by the Mailman School of Public Health at Columbia University, in collaboration with other researchers and universities, for New York City and the 31 surrounding counties. This presentation describes the design and initial results of this modeling study, aimed at simulating the effects of global climate change and regional land use change on climate and air quality over the northeastern United States in order to project the associated public health impacts in the region. Heat waves and elevated concentrations of ozone and fine particles are significant current public health stressors in the New York metropolitan area. The New York Climate and Health Project is linking human dimension and natural sciences models to assess the potential for future public health impacts from heat stress and air quality, and yield improved tools for assessing climate change impacts. The model will be applied to the NY metropolitan east coast region. The following questions will be addressed: 1. What changes in the frequency and severity of extreme heat events are likely to occur over the next 80 years due to a range of possible scenarios of land use and land cover (LU/LC) and climate change in the region? 2. How might the frequency and severity of episodic concentrations of ozone (O3) and airborne particulate matter smaller than 2.5 æm in diameter (PM2.5) change over the next 80 years due to a range of possible scenarios of land use and climate change in the metropolitan region? 3. What is the range of possible human health impacts of these changes in the region? 4. How might projected future human

  8. Coordinating controls

    Energy Technology Data Exchange (ETDEWEB)

    Anon.

    1986-07-15

    While physics Laboratories are having to absorb cuts in resources, the machines they rely on are becoming more and more complex, requiring increasingly sophisticated systems. Rather than being a resourceful engineer or physicist able to timber together solutions in his 'backyard', the modern controls specialist has become a professional in his own right. Because of possible conflicts between increasing sophistication on one hand and scarcer resources on the other, there was felt a need for more contacts among controls specialists to exchange experiences, coordinate development and discuss 'family problems', away from meetings where the main interest is on experimental physics.

  9. Coordinated unbundling

    DEFF Research Database (Denmark)

    Timmermans, Bram; Zabala-Iturriagagoitia, Jon Mikel

    2013-01-01

    Public procurement for innovation is a matter of using public demand to trigger innovation. Empirical studies have demonstrated that demand-based policy instruments can be considered to be a powerful tool in stimulating innovative processes among existing firms; however, the existing literature has...... not focused on the role this policy instrument can play in the promotion of (knowledge-intensive) entrepreneurship. This paper investigates this link in more detail and introduces the concept of coordinated unbundling as a strategy that can facilitate this purpose. We also present a framework on how...

  10. Coordinating controls

    International Nuclear Information System (INIS)

    Anon.

    1986-01-01

    While physics Laboratories are having to absorb cuts in resources, the machines they rely on are becoming more and more complex, requiring increasingly sophisticated systems. Rather than being a resourceful engineer or physicist able to timber together solutions in his 'backyard', the modern controls specialist has become a professional in his own right. Because of possible conflicts between increasing sophistication on one hand and scarcer resources on the other, there was felt a need for more contacts among controls specialists to exchange experiences, coordinate development and discuss 'family problems', away from meetings where the main interest is on experimental physics

  11. Towards an e-Health Cloud Solution for Remote Regions at Bahia-Brazil.

    Science.gov (United States)

    Sarinho, V T; Mota, A O; Silva, E P

    2017-12-19

    This paper presents CloudMedic, an e-Health Cloud solution that manages health care services in remote regions of Bahia-Brazil. For that, six main modules: Clinic, Hospital, Supply, Administrative, Billing and Health Business Intelligence, were developed to control the health flow among health actors at health institutions. They provided database model and procedures for health business rules, a standard gateway for data maintenance between web views and database layer, and a multi-front-end framework based on web views and web commands configurations. These resources were used by 2042 health actors in 261 health posts covering health demands from 118 municipalities at Bahia state. They also managed approximately 2.4 million health service 'orders and approximately 13.5 million health exams for more than 1.3 million registered patients. As a result, a collection of health functionalities available in a cloud infrastructure was successfully developed, deployed and validated in more than 28% of Bahia municipalities. A viable e-Health Cloud solution that, despite municipality limitations in remote regions, decentralized and improved the access to health care services at Bahia state.

  12. Bismarck meets Beveridge on the Silk Road: coordinating funding sources to create a universal health financing system in Kyrgyzstan.

    Science.gov (United States)

    Kutzin, Joseph; Ibraimova, Ainura; Jakab, Melitta; O'Dougherty, Sheila

    2009-07-01

    Options for health financing reform are often portrayed as a choice between general taxation (known as the Beveridge model) and social health insurance (known as the Bismarck model). Ten years of health financing reform in Kyrgyzstan, since the introduction of its compulsory health insurance fund in 1997, provide an excellent example of why it is wrong to reduce health financing policy to a choice between the Beveridge and Bismarck models. Rather than fragment the system according to the insurance status of the population, as many other low- and middle-income countries have done, the Kyrgyz reforms were guided by the objective of having a single system for the entire population. Key features include the role and gradual development of the compulsory health insurance fund as the single purchaser of health-care services for the entire population using output-based payment methods, the complete restructuring of pooling arrangements from the former decentralized budgetary structure to a single national pool, and the establishment of an explicit benefit package. Central to the process was the transformation of the role of general budget revenues - the main source of public funding for health - from directly subsidizing the supply of services to subsidizing the purchase of services on behalf of the entire population by redirecting them into the health insurance fund. Through their approach to health financing policy, and pooling in particular, the Kyrgyz health reformers demonstrated that different sources of funds can be used in an explicitly complementary manner to enable the creation of a unified, universal system.

  13. Mental health problems in a regional population of Australian adolescents: association with socio-demographic characteristics

    OpenAIRE

    Dray, Julia; Bowman, Jenny; Freund, Megan; Campbell, Elizabeth; Hodder, Rebecca K.; Lecathelinais, Christophe; Wiggers, John

    2016-01-01

    Background Population level data regarding the general mental health status, and the socio-demographic factors associated with the mental health status of adolescents in Australia aged 12?16?years is limited. This study assessed prevalence of mental health problems in a regional population of Australian students in Grades 7?10, and investigated associations between mental health problems and socio-demographic factors. Methods A web-based survey was conducted in 21 secondary schools located in...

  14. An Exponential Increase in Regional Health Information Exchange With Collaborative Policies and Technologies.

    Science.gov (United States)

    Downing, N Lance; Lane, Steven; Eisenberg, Mathew; Sharp, Christopher; Palma, Jonathan; Longhurst, Christopher

    2015-01-01

    In the United States, the ability to securely exchange health information between organization has been limited by technical interoperability, patient identity matching, and variable institutional policies. Here, we examine the regional experience in a national health information exchange network by examining clinical data sharing between eleven Northern California organizations using the same health information exchange (HIE) platform between 2013-2014. We identify key policies and technologies that have led to a dramatic increase in health information exchange.

  15. [Cooperation according to French Law "hospital, patients, health and territories": Pharmacists' involvement in Aquitaine region].

    Science.gov (United States)

    d'Elbée, M; Baumevieille, M; Dumartin, C

    2017-06-01

    In 2009, the French Act "Hospital, Patients, Health and Territories" (loi "Hôpital, Patients, Santé et Territoires") reorganized the outpatient care pathway and defined missions aimed at improving cooperation between pharmaceutical and medical professionals. Five years later, we conducted a survey among community pharmacists in order to assess the appropriation of these missions and the way cooperation was implemented. We also aimed to investigate factors that could hamper or ease the development of these activities in order to identify actions needed to improve pharmacists' involvement. In partnership with the local health authorities "Agence régionale de santé", we conducted a survey via an online questionnaire sent to pharmacy holders in July 2014 in Aquitaine region. Information was collected about the pharmacies, involvement in collaborative activities, and barriers to cooperation. Overall, 20% (249) of pharmacists responded to the survey. They owned predominantly rural pharmacies (46%) or neighborhood pharmacies (41%), with two pharmacists per pharmacy (48%). Regarding collaborative activities, the majority of pharmacists (78%) had conducted interviews with their patients taking vitamin K antagonist therapy and they were willing to continue (87%). The implication was less common concerning other actions such as referent pharmacist for nursing homes (19%) or activities relating to therapeutic educational programs for patients with chronic conditions (34%). The vast majority of respondents (85%) were not aware of opportunities to become a correspondent pharmacist. The main obstacles for engaging in these activities were the lack of time, lack of knowledge about these missions and the lack of remuneration. We identified differences in pharmacists' involvement in collaborative activities depending on selected characteristics of the pharmacies. The findings of this survey underlined pharmacists' acceptance of these missions and suggest that better information

  16. Health effects in residents of high background radiation regions

    International Nuclear Information System (INIS)

    Hanson, G.P.; Komarov, E.

    1983-01-01

    Studies carried out in various countries and by the World Health Organization on health effects of exposure of populations to high levels of natural background radiation result in observations of different significance. There are indications of changes in chromosome aberration rate; Down's syndrome has been observed to be possibly related to radiation exposure; malignant neoplasms in bone apparently correspond to high concentrations of 226 Ra in drinking water. Although various researchers have looked for them, effects have not been demonstrated regarding cancer mortality (other than malignant neoplasms involving bone), gross congenital abnormalities, fertility index, growth and development, hereditary disease (other than the possibility of Down's syndrome), infant mortality, longevity, multiple births, sex ratio, or spontaneous abortion rate. On the basis of reported data clear quantitative conception of the risk of low-level radiation from natural sources could not be developed and feasibility studies of further epidemiological programmes should be organized. The possibility of reducing the collective population dose from natural sources could be further explored and a basis for necessary legal action on establishment of standards for possible sources of natural radiation, such as building materials, fertilizers, natural gas and water, might be developed. (author)

  17. TECHNICAL COORDINATION

    CERN Multimedia

    A. Ball

    2010-01-01

    Operational Experience At the end of the first full-year running period of LHC, CMS is established as a reliable, robust and mature experiment. In particular common systems and infrastructure faults accounted for <0.6 % CMS downtime during LHC pp physics. Technical operation throughout the entire year was rather smooth, the main faults requiring UXC access being sub-detector power systems and rack-cooling turbines. All such problems were corrected during scheduled technical stops, in the shadow of tunnel access needed by the LHC, or in negotiated accesses or access extensions. Nevertheless, the number of necessary accesses to the UXC averaged more than one per week and the technical stops were inevitably packed with work packages, typically 30 being executed within a few days, placing a high load on the coordination and area management teams. It is an appropriate moment for CMS Technical Coordination to thank all those in many CERN departments and in the Collaboration, who were involved in CMS techni...

  18. The crisis of health in a crisis ridden region.

    Science.gov (United States)

    Maziak, Wasim

    2009-01-01

    The overall picture of the Arab world today is dire; no Arab country is free from political strife, foreign intervention, or the threat of terrorism. Continuing instability and the failure of national governments to uphold the rule of law and deliver on development are tearing apart the fabric of Arab societies. Internally, Arab regimes' agendas are shaped by security and their makeup by kinship and loyalty, pushing people to seek refuge within their primordial loyalties. From the outside, foreign meddling in the name of "democracy" is deepening the Arab world's instability, therefore providing justification for opponents of change to discredit the values of human rights and power sharing. In such an environment, the voiceless majority becomes the main victims, with detrimental effects on their physical and mental wellbeing. A domino-like breakdown of the Arab region, with serious consequences for world's stability, is becoming an increasingly likely scenario.

  19. Research within the coordinated programme on practices for the radiation sterilization of medical supplies in countries of Asia and the Pacific Region

    International Nuclear Information System (INIS)

    Hilmy, N.

    1982-01-01

    The results are presented of a four year coordinated research programme related to: effects of gamma radiation on chloramphenicol and hydrocortisone acetate mixture eye ointment, methodology of biological dosimetry, radiation sterilization dose setting using fraction positive and most resistant microbes, effects of gamma radiation on neomycin sulphate and procaine penicillin G in solid state, and calibration of panoramic batch irradiation using Ceric dosemeter

  20. The impact of regional and neighbourhood deprivation on physical health in Germany: a multilevel study

    Directory of Open Access Journals (Sweden)

    Razum Oliver

    2010-07-01

    Full Text Available Abstract Background There is increasing evidence that individual health is at least partly determined by neighbourhood and regional factors. Mechanisms, however, remain poorly understood, and evidence from Germany is scant. This study explores whether regional as well as neighbourhood deprivation are associated with physical health and to what extent this association can be explained by specific neighbourhood exposures. Methods Using 2004 data from the German Socio-Economic Panel Study (SOEP merged with regional and neighbourhood characteristics, we fitted multilevel linear regression models with subjective physical health, as measured by the SF-12, as the dependent variable. The models include regional and neighbourhood proxies of deprivation (i.e. regional unemployment quota, average purchasing power of the street section as well as specific neighbourhood exposures (i.e. perceived air pollution. Individual characteristics including socioeconomic status and health behaviour have been controlled for. Results This study finds a significant association between area deprivation and physical health which is independent of compositional factors and consistent across different spatial scales. Furthermore the association between neighbourhood deprivation and physical health can be partly explained by specific features of the neighbourhood environment. Among these perceived air pollution shows the strongest association with physical health (-2.4 points for very strong and -1.5 points for strong disturbance by air pollution, standard error (SE = 0.8 and 0.4, respectively. Beta coefficients for perceived air pollution, perceived noise and the perceived distance to recreational resources do not diminish when including individual health behaviour in the models. Conclusions This study highlights the difference regional and in particular neighbourhood deprivation make to the physical health of individuals in Germany. The results support the argument that

  1. Situational analysis: preliminary regional review of the Mental Health Atlas 2014.

    Science.gov (United States)

    Gater, R; Chew, Z; Saeed, K

    2015-09-28

    The WHO comprehensive Mental Health Action Plan 2013-2020 established goals and objectives that Member States have agreed to meet by 2020. To update the Atlas of Mental Health 2011, specific indicators from the Mental Health Action Plan and additional indicators on service coverage were incorporated into the questionnaire for the Atlas 2014. The data will help facilitate improvement in information gathering and focus efforts towards implementation of the Mental Health Action Plan. The questionnaire was completed by the national mental health focal point of each country. This preliminary review seeks to consolidate data from the initial response to the Atlas 2014 questionnaire by Member States in the Eastern Mediterranean Region. Data for this review were analysed for the whole Region, by health systems groupings and by individual countries. Where possible, data are compared with the Mental Health Atlas 2011 to give a longitudinal perspective.

  2. Pacific island health inequities forecast to grow unless profound changes are made to health systems in the region.

    Science.gov (United States)

    Matheson, Don; Park, Kunhee; Soakai, Taniela Sunia

    2017-10-01

    Objective Twenty years ago the Pacific's health ministers developed a 'Healthy Islands' vision to lead health development in the subregion. This paper reports on a review of health development over this period and discusses the implications for the attainment of the health related Sustainable Development Goals. Methods The review used qualitative and quantitative methods. The qualitative review included conducting semi-structured interviews with Pacific Island Government Ministers and officials, regional agencies, health workers and community members. A document review was also conducted. The quantitative review consisted of examining secondary data from regional and global data collections. Results The review found improvement in health indicators, but increasing health inequality between the Pacific and the rest of the world. Many of the larger island populations were unable to reach the health Millennium Development Goals. The 'Healthy Islands' vision remained an inspiration to health ministers and senior officials in the region. However, implementation of the 'Healthy Islands' approach was patchy, under-resourced and un-sustained. Communicable and Maternal and Child Health challenges persist alongside unprecedented levels of non-communicable diseases, inadequate levels of health finance and few skilled health workers as the major impediments to health development for many of the Pacific's countries. Conclusions The current trajectory for health in the Pacific will lead to increasing health inequity with the rest of the world. The challenges to health in the region include persisting communicable disease and maternal and child health threats, unprecedented levels of NCDs, climate change and instability, as well as low economic growth. In order to change the fortunes of this region in the age of the SDGs, a substantial investment in health is required, including in the health workforce, by countries and donors alike. That investment requires a nuanced response

  3. 42 CFR 422.106 - Coordination of benefits with employer or union group health plans and Medicaid.

    Science.gov (United States)

    2010-10-01

    ... group health plans and Medicaid. 422.106 Section 422.106 Public Health CENTERS FOR MEDICARE & MEDICAID... plans and Medicaid. (a) General rule. If an MA organization contracts with an employer, labor... enrollees in an MA plan, or contracts with a State Medicaid agency to provide Medicaid benefits to...

  4. Drivers Motivating Community Health Improvement Plan Completion by Local Public Health Agencies and Community Partners in the Rocky Mountain Region and Western Plains.

    Science.gov (United States)

    Hill, Anne; Wolf, Holly J; Scallan, Elaine; Case, Jenny; Kellar-Guenther, Yvonne

    There are numerous drivers that motivate completion of community health improvement plans (CHIPs). Some are more obvious and include voluntary public health accreditation, state requirements, federal and state funding, and nonprofit hospital requirements through IRS regulations. Less is known about other drivers, including involvement of diverse partners and belief in best practices, that may motivate CHIP completion. This research investigated the drivers that motivated CHIP completion based on experiences of 51 local public health agencies (LPHAs). An explanatory mixed-methods design, including closed- and open-ended survey questions and key informant interviews, was used to understand the drivers that motivated CHIP completion. Analysis of survey data involved descriptive statistics. Classical content analysis was used for qualitative data to clarify survey findings. The surveys and key informant interviews were conducted in the Rocky Mountain Region and Western Plains among 51 medium and large LPHAs in Colorado, Kansas, Montana, Nebraska, North Dakota, South Dakota, Utah, and Wyoming. More than 50% of respondents were public health directors; the balance of the respondents were division/program directors, accreditation coordinators, and public health planners. CHIP completion. Most LPHAs in the Rocky Mountains and Western Plains have embraced developing and publishing a CHIP, with 80% having completed their plan and another 13% working on it. CHIP completion is motivated by a belief in best practices, with LPHAs and partners seeing the benefit of quality improvement activities linked to the CHIP and the investment of nonprofit hospitals in the process. Completing a CHIP is strengthened through engagement of diverse partners and a well-functioning partnership. The future of CHIP creation depends on LPHAs and partners investing in the CHIP as a best practice, dedicating personnel to CHIP activities, and enhancing leadership skills to contribute to a synergistic

  5. Family, money, and health: Regional differences in the determinants of life satisfaction over the life course

    Science.gov (United States)

    Margolis, Rachel; Myrskylä, Mikko

    2013-01-01

    We examine how family, money, and health explain variation in life satisfaction over the life cycle across seven global regions using data from the World Values Survey. With a life domain approach, we study whether the importance of the life domains varies by region and age groups and whether the variation explained by each factor is due to the magnitude or prevalence of each factor. Globally, family, money, and health explain a substantial fraction of life satisfaction, increasing from 12 percent in young adulthood to 15 percent in mature adulthood. Health is the most important factor, and its importance increases with age. Income is unimportant above age 50. Remarkably, the contribution of family is small across ages. Across regions health is most important in the wealthier, and income in the poorer regions of the world. Family explains a substantial fraction of life satisfaction only in Western Europe and Anglophone countries. Findings highlight that the population-level importance of family, money, and health in explaining variation in life satisfaction across regions is mainly attributable to the individual-level life satisfaction differences between people of different statuses rather than differences in the distribution of various states such as poor health across regions. PMID:24796263

  6. Investigating the Perceptions of Care Coordinators on Using Behavior Theory-Based Mobile Health Technology With Medicaid Populations: A Grounded Theory Study.

    Science.gov (United States)

    Sigler, Brittany Erika

    2017-03-21

    Medicaid populations are less engaged in their health care than the rest of the population, translating to worse health outcomes and increased health care costs. Since theory-based mobile health (mHealth) interventions have been shown to increase patient engagement, mobile phones may be an optimal strategy to reach this population. With increased development of theory-based mHealth technology, these interventions must now be evaluated with these medically underserved populations in a real-world setting. The aim of our study was to investigate care coordinators' perceived value of using a health behavior theory-based mHealth platform with Medicaid clients. In particular, attention was paid to the perceived impact on patient engagement. This research was conducted using the patient-provider text messaging (short message service, SMS) platform, Sense Health (now Wellpass), which integrates the transtheoretical model (TTM), also called the stages of change model; social cognitive theory (SCT); supportive accountability; and motivational interviewing (MI). Interviews based in grounded theory methodology were conducted with 10 care managers to understand perceptions of the relationship between mHealth and patient engagement. The interviews with care managers yielded a foundation for a grounded theory model, presenting themes that suggested 4 intertwined correlative relationships revolving around patient engagement: (1) A text messaging (short message service, SMS) platform supplements the client-care manager dynamic, which is grounded in high quality, reciprocal-communication to increase patient engagement; (2) Texting enhances the relationship between literacy and access to care for Medicaid patients, increasing low-literacy patients' agency to access services; (3) Texting enhances communication, providing care managers with a new means to support their clients; and (4) Reminders augment client accountability, leading to both increased motivation and readiness to change

  7. Audit of a diabetic health education program at a large Primary Health Care Center in Asir region.

    Science.gov (United States)

    Al-Khaldi, Y M; Khan, M Y

    2000-09-01

    To evaluate the health education program in a large Primary Health Care Center, to find out the problems faced by the staff and to suggest the practical and relevant solutions. This study was carried out at Wasat Abha Primary Health Care Center, Asir region during 1997. The files of diabetics who attended the center were evaluated for health education topics by using a checklist. The essential structure of diabetic health education program was assessed by using another check list designed by the investigators. Data entry and analysis was carried out through SPSS package. Chi-square test was applied wherever necessary. The total number of diabetics who attended Wasat Abha Primary Health Care Center was 198. The duration of diabetes mellitus was 7.7+5.8 years. Ninety percent of these were married, 50.5% were educated and 79% were employed. Compliance to appointment was good in 60% and poor in 30% of diabetics. About 73% of the diabetics received at least one health education topic while 27% did not receive any health education at all. Only 33% of diabetic patients had adequate health education. Ninety one percent were provided with diabetic identification cards, 80% were explained about diabetes and 77% were educated about the role of diet. Essential structure for diabetes education program was found to be unsatisfactory. Effective diabetic health education program needs the availability of all essential structures, community participation and integration of the government and private sectors. The deficiencies in the structures and the process of health education programs in our practice are almost universal to other Primary Health Care Centers in the Asir region. Providing the Primary Health Care Centers with all essential structures and annual auditing are complimentary to a successful diabetic health education program.

  8. Inequalities in healthy life expectancy by Brazilian geographic regions: findings from the National Health Survey, 2013.

    Science.gov (United States)

    Szwarcwald, Célia Landmann; Souza Júnior, Paulo Roberto Borges de; Marques, Aline Pinto; Almeida, Wanessa da Silva de; Montilla, Dalia Elena Romero

    2016-11-17

    The demographic shift and epidemiologic transition in Brazil have drawn attention to ways of measuring population health that complement studies of mortality. In this paper, we investigate regional differences in healthy life expectancy based on information from the National Health Survey (PNS), 2013. In the survey, a three-stage cluster sampling (census tracts, households and individuals) with stratification of the primary sampling units and random selection in all stages was used to select 60,202 Brazilian adults (18 years and over). Healthy life expectancies (HLE) were estimated by Sullivan's method according to sex, age and geographic region, using poor self-rated health for defining unhealthy status. Logistic regression models were used to investigate socioeconomic and regional inequalities in poor self-rated health, after controlling by sex and age. Wide disparities by geographic region were found with the worst indicators in the North and Northeast regions, whether considering educational attainment, material deprivation, or health care utilization. Life expectancy at birth for women and men living in the richest regions was 5 years longer than for those living in the less wealthy regions. Modeling the variation across regions for poor self-rated health, statistically significant effects (p < 0.001) were found for the North and Northeast when compared to the Southeast, even after controlling for age, sex, diagnosis of at least one non-communicable chronic disease, and schooling or socioeconomic class. Marked regional inequalities in HLE were found, with the loss of healthy life much higher among residents of the poorest regions, especially among the elderly. By combining data on self-rated health status and mortality in a single indicator, Healthy Life Expectancy, this study demonstrated the excess burden of poor health experienced by populations in the less wealthy regions of Brazil. To mitigate the effects of social exclusion, the development of strategies

  9. Health needs of regional Australian children in out-of-home care.

    Science.gov (United States)

    Arora, Nitin; Kaltner, Melissa; Williams, Judy

    2014-10-01

    This study aims to identify the health needs of children placed in out-of-home care in regional Queensland and to compare them with the needs of similar children in metropolitan Queensland. Retrospective chart review and subsequent analysis of data from the first assessments of the children placed in care from January 2005 to April 2011. Health needs based on assessment recommendations were then compared with needs and recommendations from a similar clinic in metropolitan Brisbane. Two hundred thirty-nine first assessments were reviewed. The average number of health referrals arising out of each assessment was 2. 72% children were between 2 and 12 years of age and accounted for 76% of the health referrals made. The 10-13% of the children needed referrals for medical and surgical specialties, audiology, speech pathology, dental, and ophthalmology/optometry, each. A percentage of 30 needed ongoing paediatric care. The 15% needed immunisation catch up, 35% counselling and behaviour management, and 15% formal mental health referrals. These were comparable to the health needs identified in out-of-home care children residing in metropolitan Queensland. Children in care who live in a regional setting have similar health-care needs compared with urban children. Given restricted health services in regional settings, there is difficulty in accessing services to meet these needs. © 2014 The Authors. Journal of Paediatrics and Child Health © 2014 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  10. [Model for the regional allocation of the National Health Care Fund].

    Science.gov (United States)

    Loreti, P; Muzzi, A; Bruni, G

    1989-01-01

    In 1978 a National Health Service (Servizio Sanitario Nazionale = SSN) was constituted in Italy which exercises jurisdiction in the sector of health care and is duty bound to assist all citizens. Basically speaking, the NHS is organized on three levels (national, regional and local) with the management of direct operations assigned to the (about 700) Local Health Boards (Unità Sanitaria Locale = USL) each of which covers a well determined territorial area. The Authors indicate that rarely discussed or evaluated are the procedures for the regional allocation of health care funding which is determined by Parliament within the ambit of the National Budget (The National Health Care Fund). The current allocation model distributes the available capital resources for each expense item (e.g. hospitalization, pharmaceutical assistance, etc.) on a per capita basis with respect to the regional populations modified in order to allow for differing degrees of health care requirements. The regional populations are subdivided into broad age groups (e.g. children, intermediary, the elderly) with specific weighting factors expressing the different level of health care requirements. The application of these weighting factors alters the regional populations (with no change in the total population of the country) in order to express them in equivalent units with respect to the health care need. Moreover, standardized death rates are introduced into the model as indicators of the different health risk, and their application leads to a further modification in the level of the regional populations so as to express them in equivalent units with respect to the health risk as well. Once the available financial resources have been subdivided in this "theoretical" way, the following corrective factors are applied: a) hospital mobility correction factor: the regions with a credit admissions balance are assigned an additional cost which is borne by the regions with a debit admissions balance; b

  11. Analysis of environment state in technogenic region and its threat to public health

    OpenAIRE

    Grishenko S.V.; Grishenko I.I.; Ohotnikova M.V.; Mustafina A.O.; Kudimov P.V.; Mustafin T.A.

    2014-01-01

    The purpose of the research is to give a complex hygienic evaluation of environment state in Donetsk region and to determine the degree of their potential danger to population health. It includes air pollution, water contamination, state of soil. Nearly 43000 samples of air, 32000 drinking water samples and 4500 soil samples were analyzed. Regions with the highest rate of environmental pollution were defined. It was found that the main sources of environment pollution in Donetsk region are fe...

  12. 77 FR 44107 - Information From Foreign Regions Applying for Recognition of Animal Health Status

    Science.gov (United States)

    2012-07-27

    ...We are amending the regulations that govern the importation of animals and animal products by consolidating the list of factors APHIS considers when evaluating the animal health status of a foreign region and by setting out new factors APHIS will consider when evaluating a region as historically free of a specific disease. These changes will make clearer the types of information APHIS needs from a requesting region in order to conduct an evaluation.

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

    Science.gov (United States)

    Gupta, Indrani; Mondal, Swadhin

    2014-01-01

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

  14. Regional Standards for Rangeland Health and Guidelines for Livestock Grazing Management ... A Progress Report

    OpenAIRE

    1996-01-01

    In August 1995, new BLM regulations for rangeland administration went into effect. The new regulations require BLM to establish regional standards for rangeland health and guidelines for grazing management. This publication is a report on the alternatives being considered for the Montana/Dakotas Rangeland Health Standards and Guidelines process.

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

    NARCIS (Netherlands)

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

    2015-01-01

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

  16. The health status of population in the regions boarding to Semipalatinsk nuclear test site

    International Nuclear Information System (INIS)

    Balmukhanov, S.B.; Raisova, G.K.; Balmukhanov, T.S.; Voronin, A.M.; Sandybaev, M.N.

    2002-01-01

    It is performed the detailed investigation the health status of Semipalatinsk region population affected by constant radioactive irradiation during 40 years. The special attention attached to such pathologies as cancer, congenial defects of development and pathologies of cardio-vascular and nervous systems. It is also characterized the children health status. (author)

  17. Readying Health Services for Climate Change: A Policy Framework for Regional Development

    Science.gov (United States)

    2011-01-01

    Climate change presents the biggest threat to human health in the 21st century. However, many public health leaders feel ill equipped to face the challenges of climate change and have been unable to make climate change a priority in service development. I explore how to achieve a regionally responsive whole-of-systems approach to climate change in the key operational areas of a health service: service governance and culture, service delivery, workforce development, asset management, and financing. The relative neglect of implementation science means that policymakers need to be proactive about sourcing and developing models and processes to make health services ready for climate change. Health research funding agencies should urgently prioritize applied, regionally responsive health services research for a future of climate change. PMID:21421953

  18. Readying health services for climate change: a policy framework for regional development.

    Science.gov (United States)

    Bell, Erica

    2011-05-01

    Climate change presents the biggest threat to human health in the 21st century. However, many public health leaders feel ill equipped to face the challenges of climate change and have been unable to make climate change a priority in service development. I explore how to achieve a regionally responsive whole-of-systems approach to climate change in the key operational areas of a health service: service governance and culture, service delivery, workforce development, asset management, and financing. The relative neglect of implementation science means that policymakers need to be proactive about sourcing and developing models and processes to make health services ready for climate change. Health research funding agencies should urgently prioritize applied, regionally responsive health services research for a future of climate change.

  19. Oral Health Inequalities between Rural and Urban Populations of the African and Middle East Region.

    Science.gov (United States)

    Ogunbodede, E O; Kida, I A; Madjapa, H S; Amedari, M; Ehizele, A; Mutave, R; Sodipo, B; Temilola, S; Okoye, L

    2015-07-01

    Although there have been major improvements in oral health, with remarkable advances in the prevention and management of oral diseases, globally, inequalities persist between urban and rural communities. These inequalities exist in the distribution of oral health services, accessibility, utilization, treatment outcomes, oral health knowledge and practices, health insurance coverage, oral health-related quality of life, and prevalence of oral diseases, among others. People living in rural areas are likely to be poorer, be less health literate, have more caries, have fewer teeth, have no health insurance coverage, and have less money to spend on dental care than persons living in urban areas. Rural areas are often associated with lower education levels, which in turn have been found to be related to lower levels of health literacy and poor use of health care services. These factors have an impact on oral health care, service delivery, and research. Hence, unmet dental care remains one of the most urgent health care needs in these communities. We highlight some of the conceptual issues relating to urban-rural inequalities in oral health, especially in the African and Middle East Region (AMER). Actions to reduce oral health inequalities and ameliorate rural-urban disparity are necessary both within the health sector and the wider policy environment. Recommended actions include population-specific oral health promotion programs, measures aimed at increasing access to oral health services in rural areas, integration of oral health into existing primary health care services, and support for research aimed at informing policy on the social determinants of health. Concerted efforts must be made by all stakeholders (governments, health care workforce, organizations, and communities) to reduce disparities and improve oral health outcomes in underserved populations. © International & American Associations for Dental Research 2015.

  20. Annual report on activities of Regional Public Health Offices in the Slovak Republic in 2009

    International Nuclear Information System (INIS)

    2010-01-01

    A brief account of activities carried out by the Regional Public Health Offices in the Slovak Republic in 2009 is presented. These activities are reported under the headings: (1) Environment; (2) Preventive occupational medicine; (3) Hygiene, nutrition, food safety and cosmetic products; (4) Hygiene of children and youth; (5) Epidemiology; (6) Objectification of environmental factors and working environment; (7) Medical microbiology; (8) Health promotion; (9) Health protection against radiation; (10) Complaints and petitions; (11) Control of tobacco and alcohol.

  1. Annual report on activities of Regional Public Health Offices in the Slovak Republic in 2010

    International Nuclear Information System (INIS)

    2011-01-01

    A brief account of activities carried out by the Regional Public Health Offices in the Slovak Republic in 2010 is presented. These activities are reported under the headings: (1) Environment; (2) Preventive occupational medicine; (3) Hygiene, nutrition, food safety and cosmetic products; (4) Hygiene of children and youth; (5) Epidemiology; (6) Objectification of environmental factors and working environment; (7) Medical microbiology; (8) Health promotion; (9) Health protection against radiation; (10) Complaints and petitions; (11) Control of tobacco and alcohol.

  2. Rationale, design and methods for a randomised and controlled trial of the impact of virtual reality games on motor competence, physical activity, and mental health in children with developmental coordination disorder

    Directory of Open Access Journals (Sweden)

    Straker Leon M

    2011-08-01

    Full Text Available Abstract Background A healthy start to life requires adequate motor development and physical activity participation. Currently 5-15% of children have impaired motor development without any obvious disorder. These children are at greater risk of obesity, musculoskeletal disorders, low social confidence and poor mental health. Traditional electronic game use may impact on motor development and physical activity creating a vicious cycle. However new virtual reality (VR game interfaces may provide motor experiences that enhance motor development and lead to an increase in motor coordination and better physical activity and mental health outcomes. VR games are beginning to be used for rehabilitation, however there is no reported trial of the impact of these games on motor coordination in children with developmental coordination disorder. Methods This cross-over randomised and controlled trial will examine whether motor coordination is enhanced by access to active electronic games and whether daily activity, attitudes to physical activity and mental health are also enhanced. Thirty children aged 10-12 years with poor motor coordination (≤ 15th percentile will be recruited and randomised to a balanced ordering of 'no active electronic games' and 'active electronic games'. Each child will participate in both conditions for 16 weeks, and be assessed prior to participation and at the end of each condition. The primary outcome is motor coordination, assessed by kinematic and kinetic motion analysis laboratory measures. Physical activity and sedentary behaviour will be assessed by accelerometry, coordination in daily life by parent report questionnaire and attitudes to physical activity, self-confidence, anxiety and depressed mood will be assessed by self report questionnaire. A sample of 30 will provide a power of > 0.9 for detecting a 5 point difference in motor coordination on the MABC-2 TIS scale (mean 17, sd = 5. Discussion This is the first trial to

  3. Rationale, design and methods for a randomised and controlled trial of the impact of virtual reality games on motor competence, physical activity, and mental health in children with developmental coordination disorder.

    Science.gov (United States)

    Straker, Leon M; Campbell, Amity C; Jensen, Lyn M; Metcalf, Deborah R; Smith, Anne J; Abbott, Rebecca A; Pollock, Clare M; Piek, Jan P

    2011-08-18

    A healthy start to life requires adequate motor development and physical activity participation. Currently 5-15% of children have impaired motor development without any obvious disorder. These children are at greater risk of obesity, musculoskeletal disorders, low social confidence and poor mental health. Traditional electronic game use may impact on motor development and physical activity creating a vicious cycle. However new virtual reality (VR) game interfaces may provide motor experiences that enhance motor development and lead to an increase in motor coordination and better physical activity and mental health outcomes. VR games are beginning to be used for rehabilitation, however there is no reported trial of the impact of these games on motor coordination in children with developmental coordination disorder. This cross-over randomised and controlled trial will examine whether motor coordination is enhanced by access to active electronic games and whether daily activity, attitudes to physical activity and mental health are also enhanced. Thirty children aged 10-12 years with poor motor coordination (≤ 15th percentile) will be recruited and randomised to a balanced ordering of 'no active electronic games' and 'active electronic games'. Each child will participate in both conditions for 16 weeks, and be assessed prior to participation and at the end of each condition. The primary outcome is motor coordination, assessed by kinematic and kinetic motion analysis laboratory measures. Physical activity and sedentary behaviour will be assessed by accelerometry, coordination in daily life by parent report questionnaire and attitudes to physical activity, self-confidence, anxiety and depressed mood will be assessed by self report questionnaire. A sample of 30 will provide a power of > 0.9 for detecting a 5 point difference in motor coordination on the MABC-2 TIS scale (mean 17, sd = 5). This is the first trial to examine the impact of new virtual reality games on

  4. Health-related quality of life and peer relationships in adolescents with developmental coordination disorder and attention-deficit-hyperactivity disorder.

    Science.gov (United States)

    Dewey, Deborah; Volkovinskaia, Anna

    2018-07-01

    Health-related quality of life (HRQoL) and peer relationships were investigated in adolescents with developmental coordination disorder (DCD) and attention-deficit-hyperactivity disorder (ADHD). Adolescents with DCD (n=9), ADHD (n=9), DCD and ADHD (n=10), and typically developing adolescents (n=16) completed the following questionnaires: KIDSCREEN-52 Health-Related Quality of Life Questionnaire and Peer Relations Questionnaire for Children. Twenty-five participants took part in semi-structured interviews. Adolescents with DCD and ADHD had lower HRQoL on the mood and emotions, school environment, and financial resources scales of the KIDSCREEN-52 than adolescents in the DCD and typically developing groups (all p<0.05). On the Peer Relations Questionnaire for Children, the DCD and ADHD group reported significantly higher victimization compared with those in the typically developing (p=0.030) and DCD (p=0.010) groups. Qualitative interviews among young people with DCD and ADHD revealed feelings of marginalization and victimization. Descriptors such as 'misfits', 'oddballs', 'weird', and 'the rejects' were used to describe themselves. HRQoL and peer relationships are negatively affected in adolescents with DCD and ADHD. WHAT THIS PAPER ADDS?: Children with developmental coordination disorder (DCD) do not display poorer overall health-related quality of life (HRQoL) versus typically developing controls. Having DCD and attention-deficit-hyperactivity disorder (ADHD) was associated with poorer HRQoL. Adolescents with DCD and ADHD experience significantly higher levels of peer victimization than typically developing adolescents. HRQoL and peer relationships are significantly associated in adolescent respondents. © 2018 Mac Keith Press.

  5. 40 CFR 109.6 - Coordination.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 21 2010-07-01 2010-07-01 false Coordination. 109.6 Section 109.6 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS CRITERIA FOR STATE, LOCAL AND REGIONAL OIL REMOVAL CONTINGENCY PLANS § 109.6 Coordination. For the purposes of coordination...

  6. 76 FR 13209 - United States and State of Texas v. United Regional Health Care System; Proposed Final Judgment...

    Science.gov (United States)

    2011-03-10

    ... of Texas v. United Regional Health Care System, Civil Action No. 7:11-cv- 00030-O. On February 25..., ambulatory surgery center or radiology center in [a] 15 mile radius of United Regional Health Care System... 95% of billed charges for all inpatient and outpatient services at United Regional Health Care System...

  7. Regional variations in health care intensity and physician perceptions of quality of care.

    Science.gov (United States)

    Sirovich, Brenda E; Gottlieb, Daniel J; Welch, H Gilbert; Fisher, Elliott S

    2006-05-02

    Research has documented dramatic differences in health care utilization and spending across U.S. regions with similar levels of patient illness. Although patient outcomes and quality of care have been found to be no better in regions of high health care intensity, it is unknown whether physicians in these regions feel more capable of providing good patient care than those in low-intensity regions. To determine whether physicians in high-intensity regions feel better able to care for patients than physicians in low-intensity regions. Physician telephone survey. 51 metropolitan and 9 nonmetropolitan areas of the United States and a supplemental national sample. 10,577 physicians who provided care to adults in 1998 or 1999 were surveyed for the Community Tracking Study (response rate, 61%). The End-of-Life Expenditure Index, a measure of spending that reflects differences in the overall quantity of medical services provided rather than differences in illness or price, was used to determine health care intensity in the physicians' community. Outcomes included physicians' perceived availability of clinical services, ability to provide high-quality care to patients, and career satisfaction. Although the highest-intensity regions have substantially more hospital beds and specialists per capita, physicians in these regions reported more difficulty obtaining needed services for their patients. The proportion of physicians who felt able to obtain elective hospital admissions ranged from 50% in high-intensity regions to 64% in the lowest-intensity region (P market factors (for example, managed care penetration); the difference in perceived ability to provide high-quality care was no longer statistically significant (P = 0.099). The cross-sectional design prevented demonstration of a causal relationship between intensity and physician perceptions of quality. Despite more resources, physicians in regions of high health care intensity did not report greater ease in obtaining

  8. Co-ordinated research project on use of nuclear and related analytical techniques in studying human health impacts of toxic elements consumed through foodstuffs contaminated by industrial activities. Report on the first research co-ordination meeting

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2003-07-01

    The overall objective of the Co-ordinated research project is to provide a scientific basis for better assessment of selected pollutants in the food chain with a view to elucidating their impacts on human health and nutrition. Results of this study will enhance the existing body of knowledge and can be used to develop preventive strategies. Specific objectve: To determine the extent to which toxic element levels in food are affected by surrounding industrial activities and to assess potential human exposure from the consumption of such foodstuffs. EXPECTED RESEARCH OUTPUTS (RESULTS): Harmonized protocols and procedures for sampling and analyses; ? Compiled results for toxic element levels and their average daily dietary intake (ADDI) / dietary intake; Evaluated toxic element exposure levels based on biological indicators (where applicable); Publications of the study results in an IAEA TECDOC, and in peer-reviewed journals by participants. ACTION PLAN (ACTIVITIES) a. Core research activities: 1 Identification of the study areas and population groups. 2 Collection of information on food consumption patterns of the population groups under study (e.g. through questionnaires). 3 Development of harmonized protocols and validation of analytical methodologies in compliance with ISO/IEC 17025. 4 Collection and analysis of food samples, and estimation of the dietary intake. 5 Collection and analysis of biological indicators where applicable. 6 Evaluation of possible relationships between human exposures and biological indicators for the pollutants studied. 4b. Supplementary activities: ? Speciation studies of pollutants. ? Comparison of present and previous data on relevant parameters. ? Possible production and distribution of laboratory intercomparison samples. 7. Recommendations for nuclear analytical techniques ? Nuclear analytical technique (NAT) such as INAA, PIXE, PIGE, XRF should be the primary technique of analysis; Instrumental neutron activation analysis (INAA

  9. Farmers' perceptions of health in the Riverland region of South Australia: 'If it's broke, fix it'.

    Science.gov (United States)

    Rawolle, Tessa A; Sadauskas, David; van Kessel, Gisela; Dollman, James

    2016-10-01

    To explore perceptions of health among South Australian farmers. Descriptive qualitative study, using semi-structured interviews. Two rural towns in the Riverland region of South Australia. Fifteen adults involved in farming within the Riverland region of South Australia, from a variety of farming industries; age range 23-70 years old; 53% male, 47% female. Perceptions and definitions of health. Participants described an ecological understanding of health across individual, farm, and community domains. Participants perceived health as being able to function and complete farm work. Participants reported that farm work helped to maintain fitness, but the multiple stress and hazards associated with farming had a significant influence on health. Participants described how health was influenced by community activities and social support from friends and families. Women were reported to take a lead role in health. Health providers can frame interventions to resonate with the perceptions of health held by people, shaped and formed by the context of farming. Further research is needed to explore farmers' perceptions of health in different locations, from different industries and from a range of age groups. © 2016 National Rural Health Alliance Inc.

  10. 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.

  11. RUN COORDINATION

    CERN Multimedia

    Christophe Delaere

    2013-01-01

    The focus of Run Coordination during LS1 is to monitor closely the advance of maintenance and upgrade activities, to smooth interactions between subsystems and to ensure that all are ready in time to resume operations in 2015 with a fully calibrated and understood detector. After electricity and cooling were restored to all equipment, at about the time of the last CMS week, recommissioning activities were resumed for all subsystems. On 7 October, DCS shifts began 24/7 to allow subsystems to remain on to facilitate operations. That culminated with the Global Run in November (GriN), which   took place as scheduled during the week of 4 November. The GriN has been the first centrally managed operation since the beginning of LS1, and involved all subdetectors but the Pixel Tracker presently in a lab upstairs. All nights were therefore dedicated to long stable runs with as many subdetectors as possible. Among the many achievements in that week, three items may be highlighted. First, the Strip...

  12. RUN COORDINATION

    CERN Multimedia

    C. Delaere

    2013-01-01

    Since the LHC ceased operations in February, a lot has been going on at Point 5, and Run Coordination continues to monitor closely the advance of maintenance and upgrade activities. In the last months, the Pixel detector was extracted and is now stored in the pixel lab in SX5; the beam pipe has been removed and ME1/1 removal has started. We regained access to the vactank and some work on the RBX of HB has started. Since mid-June, electricity and cooling are back in S1 and S2, allowing us to turn equipment back on, at least during the day. 24/7 shifts are not foreseen in the next weeks, and safety tours are mandatory to keep equipment on overnight, but re-commissioning activities are slowly being resumed. Given the (slight) delays accumulated in LS1, it was decided to merge the two global runs initially foreseen into a single exercise during the week of 4 November 2013. The aim of the global run is to check that we can run (parts of) CMS after several months switched off, with the new VME PCs installed, th...

  13. Protocole of a controlled before-after evaluation of a national health information technology-based program to improve healthcare coordination and access to information.

    Science.gov (United States)

    Saillour-Glénisson, Florence; Duhamel, Sylvie; Fourneyron, Emmanuelle; Huiart, Laetitia; Joseph, Jean Philippe; Langlois, Emmanuel; Pincemail, Stephane; Ramel, Viviane; Renaud, Thomas; Roberts, Tamara; Sibé, Matthieu; Thiessard, Frantz; Wittwer, Jerome; Salmi, Louis Rachid

    2017-04-21

    Improvement of coordination of all health and social care actors in the patient pathways is an important issue in many countries. Health Information (HI) technology has been considered as a potentially effective answer to this issue. The French Health Ministry first funded the development of five TSN ("Territoire de Soins Numérique"/Digital health territories) projects, aiming at improving healthcare coordination and access to information for healthcare providers, patients and the population, and at improving healthcare professionals work organization. The French Health Ministry then launched a call for grant to fund one research project consisting in evaluating the TSN projects implementation and impact and in developing a model for HI technology evaluation. EvaTSN is mainly based on a controlled before-after study design. Data collection covers three periods: before TSN program implementation, during early TSN program implementation and at late TSN program implementation, in the five TSN projects' territories and in five comparison territories. Three populations will be considered: "TSN-targeted people" (healthcare system users and people having characteristics targeted by the TSN projects), "TSN patient users" (people included in TSN experimentations or using particular services) and "TSN professional users" (healthcare professionals involved in TSN projects). Several samples will be made in each population depending on the objective, axis and stage of the study. Four types of data sources are considered: 1) extractions from the French National Heath Insurance Database (SNIIRAM) and the French Autonomy Personalized Allowance database, 2) Ad hoc surveys collecting information on knowledge of TSN projects, TSN program use, ease of use, satisfaction and understanding, TSN pathway experience and appropriateness of hospital admissions, 3) qualitative analyses using semi-directive interviews and focus groups and document analyses and 4) extractions of TSN

  14. Ebola Preparedness in the Netherlands: The Need for Coordination Between the Public Health and the Curative Sector.

    NARCIS (Netherlands)

    Swaan, Corien M; Öry, Alexander V; Schol, Lianne G C; Jacobi, André; Richardus, Jan Hendrik; Timen, Aura

    2018-01-01

    During the Ebola outbreak in West Africa in 2014-2015, close cooperation between the curative sector and the public health sector in the Netherlands was necessary for timely identification, referral, and investigation of patients with suspected Ebola virus disease (EVD).

  15. Ebola Preparedness in the Netherlands: The Need for Coordination Between the Public Health and the Curative Sector

    NARCIS (Netherlands)

    C. Swaan (Corien); Öry, A.V. (Alexander V.); Schol, L.G.C. (Lianne G. C.); A. Jacobi (Andre); J.H. Richardus (Jan Hendrik); A. Timen (Aura)

    2017-01-01

    markdownabstractContext: During the Ebola outbreak in West Africa in 2014-2015, close cooperation between the curative sector and the public health sector in the Netherlands was necessary for timely identification, referral, and investigation of patients with suspected Ebola virus disease (EVD).

  16. The Relationship between School-Level Characteristics and Implementation Fidelity of a Coordinated School Health Childhood Obesity Prevention Intervention

    Science.gov (United States)

    Lederer, Alyssa M.; King, Mindy H.; Sovinski, Danielle; Seo, Dong-Chul; Kim, Nayoung

    2015-01-01

    Background: Curtailing childhood obesity is a public health imperative. Although multicomponent school-based programs reduce obesity among children, less is known about the implementation fidelity of these interventions. This study examines process evaluation findings for the Healthy, Energetic Ready, Outstanding, Enthusiastic, Schools (HEROES)…

  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. An Approach to Coordinate Efforts to Reduce the Public Health Burden of Stroke: The Delta States Stroke Consortium

    OpenAIRE

    Virginia J. Howard; Joe Acker; Camilo R. Gomez; Ada H. Griffies; Wanda Magers; Max Michael III; Sean R. Orr; Martha Phillips; James M. Raczynski; John E. Searcy; Richard M. Zweifler; George Howard

    2004-01-01

    Stroke is the third leading cause of death and a leading cause of disability in the United States, with a particularly high burden on the residents of the southeastern states, a region dubbed the Stroke Belt. These five states Alabama, Arkansas, Louisiana, Mississippi, and Tennessee have formed the Delta States Stroke Consortium to direct efforts to reduce this burden. The consortium is proposing an approach to identify domains where interventions may be instituted and an array of activitie...

  19. Determinants of life expectancy in eastern mediterranean region: a health production function.

    Science.gov (United States)

    Bayati, Mohsen; Akbarian, Reza; Kavosi, Zahra

    2013-06-01

    Determinants of health or health production function in health economics literature constitute noticeable issues in health promotion. This study aimed at estimating a health production function for East Mediterranean Region (EMR) based on the Grossman theoretical model. This ecological study was performed using the econometric methods. The panel data model was used in order to determine the relationship between life expectancy and socioeconomic factors. The data for 21 EMR countries between 1995 and 2007 were used. Fixed-effect-model was employed to estimate the parameters based on Hausman test. In estimating the health production function, factors such as income per capita (β=0.05, Pdeterminants of health status, proxied by life expectancy at birth. A notable result was the elasticity of life expectancy with respect to the employment rate and its significance level was different between males (β=0.13, P0.001). In order to improve the health status in EMR countries, health policymakers should focus on the factors which lie outside the healthcare system. These factors are mainly associated with economic growth and development level. Thus, the economic stabilisation policies with the aim of increasing the productivity, economic growth, and reducing unemployment play significant roles in the health status of the people of the region.

  20. A 'mystery client' evaluation of adolescent sexual and reproductive health services in health facilities from two regions in Tanzania.

    Directory of Open Access Journals (Sweden)

    Zaina Mchome

    Full Text Available Unwelcoming behaviours and judgemental attitudes have long been recognised as a barrier to young people's access to reproductive health services. Over the last decade youth friendly reproductive health services have been promoted and implemented world-wide. However, long term evidence of the impact of these programmes is lacking. We report the results of a large mystery client evaluation of adolescent sexual and reproductive health services in Tanzania, a country that has had a long established youth friendly policy. Forty-eight visits made to thirty-three health facilities were conducted by twelve young people (six in each region trained to perform three different scripted scenarios (i.e., condom request, information on sexually transmitted infections and family planning. The study revealed barriers in relation to poor signage and reception for services. In addition health workers demonstrated paternalistic attitudes as well as lack of knowledge about adolescent sexual and reproductive health services. In some cases, health workers discouraged young people from using services such as condoms and family planning methods. Lack of confidentiality and privacy were also noted to be common challenges for the young people involved. Intervention strategies that focus on changing health workers' mind-set in relation to adolescent sexual and reproductive health are crucial for ensuring quality provision of sexual and reproductive health services to young people. The study identified the importance of reception or signs at the health units, as this can facilitate young people's efforts in seeking sexual and reproductive health services. Likewise, improvement of health workers knowledge of existing policy and practice on sexual and reproductive health services and youth friendly services is much needed.

  1. 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

  2. Development of Community Mental Health Services: The Case of Emilia‐Romagna Italian Region

    Directory of Open Access Journals (Sweden)

    Angelo Fioritti

    2014-06-01

    Full Text Available Italian psychiatry has gained International attention after its radical reform of 1978, which established the progressive closure of mental hospitals and the establishment of community services throughout the country. However it is technically inappropriate to talk about Italian psychiatry as the devolution process has transferred to the regions all competences about policy, planning and evaluating health services. This explains the variety of “community psychiatries” that can be found along the peninsula and the reasons of interest that can arise from their comparison. The development of community psychiatry in Emilia‐Romagna, a region of 4 million inhabitants in Northern Italy, has proceeded through two partially overlapping phases of deinstitutionalization (1978‐1997 and development of integrated mental health departments (1990‐2008. The analysis of raw data about allocation of resources and professional capital development give way to tentative comparisons with the current Portuguese situation of implementation of a similar reform. In 2006 the regional Council launched a three year project aimed at rethinking the welfare system and the integration of social and health services, considering the dramatic social and demographic changes occurring in the region. This project has implied also a three year process of redrafting mental health policy finalised in the Emilia‐Romagna Mental Health Action Plan 2009‐2011 approved by the council in March 2009. It basically follows two strategies: integration of health and social services and further qualification of health services. The former is pursued through a reshaping of the planning and commissioning bodies of both health and social services, previously separated and now merging. They are taking responsibility on many issues related to mental health care, such as prevention, mental health promotion, supported employment, supported housing, subsidies, self‐help. The improvement of

  3. The Influence of Regional Social Inequality and Labour Market Characteristics on Health

    Directory of Open Access Journals (Sweden)

    Christiane Gross

    2013-09-01

    Full Text Available The influence of contextual factors on individual health status has been demonstrated by a number of studies even when controlling for the individual socio-economic situation (and other relevant factors. The article examines whether and to what extent variables of the place of residence have an effect on individual health status. We do not only refer to income levels and inequality, but also to effects of the educational level and inequality and the regional unemployment rate. As data basis for the individual level, we use the 2006 wave of the German Socio-Economic Panel Study (SOEP and add regional information on the aggregate level based on the regional units (Raumordnungsregionen of the Microcensus of 2005. These data will be analysed using multilevel models. The results reveal that regional educational inequality intensifies the individual educational effect, whereby members of less-educated groups in educationally disparate regions exhibit particularly low health chances. In addition, a high regional unemployment rate intensifies the negative effect of individual unemployment on men’s health.

  4. Stability of return to work after a coordinated and tailored intervention for sickness absence compensation beneficiaries with mental health problems

    DEFF Research Database (Denmark)

    Martin, Marie H. T.; D. Nielsen, Maj Britt; Pedersen, Jacob

    2015-01-01

    PURPOSE: Mental health problems (MHPs) are increasingly common as reasons for long-term sickness absence. However, the knowledge of how to promote a stable return to work (RTW) after sickness absence due to MHPs is limited. The purpose of this study was to assess the effects of a multidisciplinary...... showed no benefits in terms of improved stability of RTW, reduced sickness absence or improved labour market status after 2 years when compared to conventional case management. IMPLICATIONS FOR REHABILITATION: Evidence for effective return-to-work (RTW) interventions for people with mental health...... compared to conventional case management of sickness absence beneficiaries in Denmark. A stronger focus on cooperation with social insurance officers and employers may produce better results....

  5. Annual report of the regional public health authorities in the Slovak Republic. Year 2012

    International Nuclear Information System (INIS)

    2013-02-01

    A brief account of activities carried out by the regional public health authorities of the Public Health Authority of the Slovak Republic (UVZ SR) in 2012 is presented. These activities are reported under the headings: (1) The environment; (2) Preventive occupational medicine; (3) Hygiene of nutrition, food safety and cosmetic products; (4) Hygiene of children and youth; (5) Epidemiology; (6) Objectivization of factors of living conditions; (7) Medical microbiology; (8) Health promotion; (9) Health protection against radiation; (10) Complaints and petitions; (11) Medical informatics and biostatistics; (12) Lectures and publications.

  6. Annual report of the regional public health authorities in the Slovak Republic. Year 2011

    International Nuclear Information System (INIS)

    2011-07-01

    A brief account of activities carried out by the regional public health authorities of the Public Health Authority of the Slovak Republic (UVZ SR) in 2011 is presented. These activities are reported under the headings: (1) The environment; (2) Preventive occupational medicine; (3)Hygiene of nutrition, food safety and cosmetic products; (4) Hygiene of children and youth; (5) Epidemiology; (6) Objectivization of factors of living conditions; (7) Medical microbiology; (8) Health promotion; (9) Health protection against radiation; (10) Complaints and petitions; (11) Medical informatics and biostatistics; (12) Lectures and publications.

  7. Annual report of the regional public health authorities in the Slovak Republic. Year 2010

    International Nuclear Information System (INIS)

    2011-04-01

    A brief account of activities carried out by the regional public health authorities of the Public Health Authority of the Slovak Republic (UVZ SR) in 2010 is presented. These activities are reported under the headings: (1) The environment; (2) Preventive occupational medicine; (3)Hygiene of nutrition, food safety and cosmetic products; (4) Hygiene of children and youth; (5) Epidemiology; (6) Objectivization of factors of living conditions; (7) Medical microbiology; (8) Health promotion; (9) Health protection against radiation; (10) Complaints and petitions; (11) Medical informatics and biostatistics.

  8. The Veteran-Initiated Electronic Care Coordination: A Multisite Initiative to Promote and Evaluate Consumer-Mediated Health Information Exchange.

    Science.gov (United States)

    Klein, Dawn M; Pham, Kassi; Samy, Leila; Bluth, Adam; Nazi, Kim M; Witry, Matthew; Klutts, J Stacey; Grant, Kathleen M; Gundlapalli, Adi V; Kochersberger, Gary; Pfeiffer, Laurie; Romero, Sergio; Vetter, Brian; Turvey, Carolyn L

    2017-04-01

    Information continuity is critical to person-centered care when patients receive care from multiple healthcare systems. Patients can access their electronic health record data through patient portals to facilitate information exchange. This pilot was developed to improve care continuity for rural Veterans by (1) promoting the use of the Department of Veterans Affairs (VA) patient portal to share health information with non-VA providers, and (2) evaluating the impact of health information sharing at a community appointment. Veterans from nine VA healthcare systems were trained to access and share their VA Continuity of Care Document (CCD) with their non-VA providers. Patients and non-VA providers completed surveys on their experiences. Participants (n = 620) were primarily older, white, and Vietnam era Veterans. After training, 78% reported the CCD would help them be more involved in their healthcare and 86% planned to share it regularly with non-VA providers. Veterans (n = 256) then attended 277 community appointments. Provider responses from these appointments (n = 133) indicated they were confident in the accuracy of the information (97%) and wanted to continue to receive the CCD (96%). Ninety percent of providers reported the CCD improved their ability to have an accurate medication list and helped them make medication treatment decisions. Fifty percent reported they did not order a laboratory test or another procedure because of information available in the CCD. This pilot demonstrates feasibility and value of patient access to a CCD to facilitate information sharing between VA and non-VA providers. Outreach and targeted education are needed to promote consumer-mediated health information exchange.

  9. Path integrals in curvilinear coordinates

    International Nuclear Information System (INIS)

    Prokhorov, L.V.

    1984-01-01

    Integration limits are studied for presenting the path integral curvilinear coordinates. For spherical (and topoloqically equivalent) coordinates it is shown that in formulas involving classical action in the exponent integration over all variables should be carried out within infinite limits. Another peculiarity is associated with appearance of the operator q which provides a complete definition of the wave functions out of the physical region. arguments are given upporting the validity of the cited statament in the general case

  10. Appraisal of the coordinator-based transplant organizational model.

    Science.gov (United States)

    Filipponi, F; De Simone, P; Mosca, F

    2005-01-01

    In 1999, the Italian Parliament passed a law aimed at setting the standards of practice and quality in organ, tissue and cell donation, and transplantation. For the first time in the history of Italian transplantation, a coordinator-based model reproducing some of the basic principles of the Spanish system was officially enacted by the Parliament, bringing to an end years of lacking regulation. What differentiates those coordinator-based systems adopted in Southern Europe from Northern European national and multinational transplant organizations is the functional integration of donor and transplant care activities enacted by national governments. The Italian model of transplant health care consists of four levels of transplant coordination: local, regional, interregional, and national. The latter is represented by Centro Nazionale Trapianti (CNT; the Italian National Center for Transplantation). CNT objectives consist of ensuring equitable access to donation and transplant care for all citizens according to the principles of the Italian National Health System. In achieving these goals, CNT acts in cooperation with three interregional transplant agencies: the Nord Italia Transplant program, the Associazione InterRegionale Trapianti, and the Organizzazione Centro Sud Trapianti. Whereas local and interregional coordinators are at the front line of all donation and transplant activities, regional and national coordinators function to monitor, direct, and plan donation and transplant health care activities. Based on the increase in donation and transplant activities recently achieved in those countries that have adopted a governmental coordinator-based transplant care model, we believe that such a system is appropriate to serve patients' interests according to the principles of subsidiary and equity. However, it should further be improved by expansion of the governance model throughout Europe, through implementation of current standards of care, and by adopting the

  11. Veterans Health Administration Office of Nursing Services exploration of positive patient care synergies fueled by consumer demand: care coordination, advanced clinic access, and patient self-management.

    Science.gov (United States)

    Wertenberger, Sydney; Yerardi, Ruth; Drake, Audrey C; Parlier, Renee

    2006-01-01

    The consumers who utilize the Veterans Health Administration healthcare system are older, and most are learning to live with chronic diseases. Their desires and needs have driven changes within the Veterans Health Administration. Through patient satisfaction initiatives and other feedback sources, consumers have made it clear that they do not want to wait for their care, they want a say in what care is provided to them, and they want to remain as independent as possible. Two interdisciplinary processes/models of healthcare are being implemented on the national level to address these issues: advanced clinic access and care coordination. These programs have a synergistic relationship and are integrated with patient self-management initiatives. Positive outcomes of these programs also meet the needs of our staff. As these new processes and programs are implemented nationwide, skills of both patients and nursing staff who provide their care need to be enhanced to meet the challenges of providing nursing care now and into the 21st century. Veterans Health Administration Office of Nursing Services Strategic Planning Work Group is defining and implementing processes/programs to ensure nurses have the knowledge, information, and skills to meet these patient care demands at all levels within the organization.

  12. Explaining regional variations in health care utilization between Swiss cantons using panel econometric models.

    Science.gov (United States)

    Camenzind, Paul A

    2012-03-13

    In spite of a detailed and nation-wide legislation frame, there exist large cantonal disparities in consumed quantities of health care services in Switzerland. In this study, the most important factors of influence causing these regional disparities are determined. The findings can also be productive for discussing the containment of health care consumption in other countries. Based on the literature, relevant factors that cause geographic disparities of quantities and costs in western health care systems are identified. Using a selected set of these factors, individual panel econometric models are calculated to explain the variation of the utilization in each of the six largest health care service groups (general practitioners, specialist doctors, hospital inpatient, hospital outpatient, medication, and nursing homes) in Swiss mandatory health insurance (MHI). The main data source is 'Datenpool santésuisse', a database of Swiss health insurers. For all six health care service groups, significant factors influencing the utilization frequency over time and across cantons are found. A greater supply of service providers tends to have strong interrelations with per capita consumption of MHI services. On the demand side, older populations and higher population densities represent the clearest driving factors. Strategies to contain consumption and costs in health care should include several elements. In the federalist Swiss system, the structure of regional health care supply seems to generate significant effects. However, the extent of driving factors on the demand side (e.g., social deprivation) or financing instruments (e.g., high deductibles) should also be considered.

  13. SALTRA: a regional program for workers' health and sustainable development in Central America.

    Science.gov (United States)

    Wesseling, Catharina; Aragón, Aurora; Elgstrand, Kaj; Flores, Reinaldo; Hogstedt, Christer; Partanen, Timo

    2011-01-01

    In 2003, the university-based Program on Work and Health in Central America, SALTRA, was launched to build national and regional capacities in occupational safety and health with the goal of preventing and reducing poverty in Central America. SALTRA has implemented 20 projects including action projects in priority sectors (e.g., construction, sugarcane, hospitals, migrant coffee workers); strengthening of surveillance (occupational health profiles, carcinogenic exposures, fatal injuries and pesticides); a participatory model for training and risk monitoring by workers; building occupational health capacity for professionals, employers, and workers, with collaborating networks between the countries; strengthening of universities in work, environment, and health; studies of serious occupational and environmental situations; communication channels; and continued efforts to raise political awareness. SALTRA has placed issues of workers' health on political, business, and academic agendas throughout the region and has laid the foundations for achieving substantial future improvements in health conditions of all workers in the region. External evaluators envisioned SALTRA as an innovative development model.

  14. Co-ordinated research project on isotopic evaluations of maternal and child health nutrition to help prevent stunting

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2000-07-01

    Nearly 200 million young children in developing countries around the world are stunted due to in great extent to malnutrition during infancy. Even though breast feeding is the best nourishment a mother can provide to her baby, after about six months of age, complementary foods, also called as weaning foods, are needed to meet the infant's nutritional recommendations. On the other hand, complementary feeding sometimes reduces breast milk intake and can introduce a potential source of contamination leading to a number of gastrointestinal infections, which can substantially impair growth. Thus, it is very important to accurately measure the amount of breast milk consumed and also to assessthe amount and quality of complementary foods introduced to the infant's diet. An isotopic method for measuring breast milk intake based on deuterium dilution and kinetics has been validated using isotope ratio mass spectrometry (IRMS). Recently, a more economical infrared spectroscopy (IS) method has also been used and validated against IRMS. The objectives of this CRP were i) to develop stable isotope methods for measuring breast milk intake using regionally available equipment, ii) use isotopic methods to evaluate nutrient reserves, namely vitamin A, iron and zinc, and energy expenditure in mothers to determine the relative needs for nutritional supplements of mothers in the region, and iii) to use isotopic techniques to compare the nutrient density of milk with nutrient levels in the mother to learn for which nutrients breast milk is a reliable indicator of maternal nutrient reserves in marginally nourished women.

  15. Co-ordinated research project on isotopic evaluations of maternal and child health nutrition to help prevent stunting

    International Nuclear Information System (INIS)

    2000-01-01

    Nearly 200 million young children in developing countries around the world are stunted due to in great extent to malnutrition during infancy. Even though breast feeding is the best nourishment a mother can provide to her baby, after about six months of age, complementary foods, also called as weaning foods, are needed to meet the infant's nutritional recommendations. On the other hand, complementary feeding sometimes reduces breast milk intake and can introduce a potential source of contamination leading to a number of gastrointestinal infections, which can substantially impair growth. Thus, it is very important to accurately measure the amount of breast milk consumed and also to assess the amount and quality of complementary foods introduced to the infant's diet. An isotopic method for measuring breast milk intake based on deuterium dilution and kinetics has been validated using isotope ratio mass spectrometry (IRMS). Recently, a more economical infrared spectroscopy (IS) method has also been used and validated against IRMS. The objectives of this CRP were i) to develop stable isotope methods for measuring breast milk intake using regionally available equipment, ii) use isotopic methods to evaluate nutrient reserves, namely vitamin A, iron and zinc, and energy expenditure in mothers to determine the relative needs for nutritional supplements of mothers in the region, and iii) to use isotopic techniques to compare the nutrient density of milk with nutrient levels in the mother to learn for which nutrients breast milk is a reliable indicator of maternal nutrient reserves in marginally nourished women

  16. 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.

  17. 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.

  18. Respiratory health issues in the Asia-Pacific region: an overview.

    Science.gov (United States)

    Jamrozik, Euzebiusz; Musk, Arthur William

    2011-01-01

    The Asia-Pacific region is home to a large heterogeneous population whose respiratory health is influenced by diverse social, economic and environmental factors. Despite this variability, the most prevalent causes of respiratory morbidity and mortality are tobacco smoking, infection, and air pollution. This review aims to summarize current respiratory health issues in the region including smoking-related diseases especially COPD, lung cancer and infectious problems such as pandemic influenza, the severe acute respiratory syndrome coronavirus, bacterial pneumonia and tuberculosis, as well as the contribution of air pollution to respiratory disease. Published data on trends in the epidemiology and management of respiratory diseases and are summarized; finally, the limitations of available data and projections for the future of respiratory health in the region are discussed. © 2010 Commonwealth of Australia. Respirology © 2010 Asian Pacific Society of Respirology.

  19. [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.

  20. Comparison of a Commonwealth-initiated regional radiation oncology facility in Toowoomba with a Queensland Health facility

    International Nuclear Information System (INIS)

    Poulsen, M.; Ramsay, R.; Gogna, K.; Middleton, M.; Martin, J.; Khoo, E.; Wong, W.; McQuitty, S.; Walpole, E.; Fairweather, R.

    2010-01-01

    The aim was to compare a private Commonwealth-initiated regional radiation oncology facility in Toowoomba with a Queensland Health facility (QHF) in Brisbane. The comparison concentrated on staffing, case mix and operational budgets, but was not able to look at changes in access to services. Data were collected from the two facilities from January 2008 to June 2008 inclusive. A number of factors were compared, including case mix, staffing levels, delay times for treatment, research, training and treatment costs. The case mix between the two areas was similar with curative treatments making up just over half the work load in both centres and two-thirds the work being made up of cancers of breast and prostate. Staffing levels were leaner in Toowoomba, especially in the areas of nursing, administration and trial coordinators. Research activity was slightly higher in Toowoomba. The average medicare cost per treatment course was similar in both centres ($5000 per course). Total costs of an average treatment including patient, State and Commonwealth costs, showed a 30% difference in costing favouring Toowoomba. This regional radiation oncology centre has provided state-of-the-art cancer care that is close to home for patients living in the Darling Downs region. Both public and private patients have been treated with modest costs to the patient and significant savings to QH. The case mix is similar to the QHF, and there has been significant activity in clinical research. A paperless working environment is one factor that has allowed staffing levels to be reduced. Ongoing support from Governments are required if private facilities are to participate in important ongoing staff training.

  1. Determining the source region of auroral emissions in the prenoon oval using coordinated Polar BEAR UV-imaging and DMSP particle measurements

    Science.gov (United States)

    Newell, Patrick T.; Meng, CHING-I.; Huffman, Robert E.

    1992-01-01

    The Polar Beacon Experiment and Auroral Research (Polar BEAR) satellite included the capability for imaging the dayside auroral oval in full sunlight at several wavelengths. Particle observations from the DMSP F7 satellite during dayside auroral oval crossings are compared with approximately simultaneous Polar BEAR 1356-A images to determine the magnetospheric source region of the dayside auroral oval. The source region is determined from the DMSP particle data, according to recent work concerning the classification and identification of precipitation source regions. The close DMSP/Polar BEAR coincidences all occur when the former satellite is located between 0945 and 1000 MLT. Instances of auroral arcs mapping to each of several different regions, including the boundary plasma sheet, the low-latitude boundary layer, and the plasma mantle were found. It was determined that about half the time the most prominent auroral arcs are located at the interfaces between distinct plasma regions, at least at the local time studied here.

  2. Level of infertility in regions according to Ministry of Public Health data.

    OpenAIRE

    Tymchenko, O. I.; Mykytenko, D. O.; Koba, O. P.; Lynchak, O. V.

    2014-01-01

    The aim of the research: estimation of morbidity and prevalence, risks of female and male infertility among the different regions of Ukraine. Materials and methods. The Morbidity and prevalence of female and male infertility were calculated according to Ministry of Public Health official statistics (2002-2012) per 1 000 of population of reproductive age (15-44). Relative risk including 95% confidence interval was calculated for each region in comparison with whole Ukraine. Results. In Ukrain...

  3. Home Monitoring and Personal Health Management Services in a Regional Health Telematics Network

    National Research Council Canada - National Science Library

    Traganitis, A

    2001-01-01

    ...), the R&D issues involved in the design, development and implementation of a modular and configurable Home Care Platform that supports different health and social care domains, and the results of the clinical...

  4. Health insurance subsidies and deductible choice: Evidence from regional variation in subsidy schemes.

    Science.gov (United States)

    Kaufmann, Cornel; Schmid, Christian; Boes, Stefan

    2017-09-01

    The extent to which premium subsidies can influence health insurance choices is an open question. In this paper, we explore the regional variation in subsidy schemes in Switzerland, designed as either in-kind or cash transfers, to study their impact on the choice of health insurance deductibles. Using health survey data and a difference-in-differences methodology, we find that in-kind transfers increase the likelihood of choosing a low deductible plan by approximately 4 percentage points (or 7%). Our results indicate that the response to in-kind transfers is strongest among women, middle-aged and unmarried individuals, which we explain by differences in risk-taking behavior, health status, financial constraints, health insurance and financial literacy. We discuss our results in the light of potential extra-marginal effects on the demand for health care services, which are however not supported by our data. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Regional health inequalities: changes observed in Brazil from 2000-2016.

    Science.gov (United States)

    Albuquerque, Mariana Vercesi de; Viana, Ana Luiza d'Ávila; Lima, Luciana Dias de; Ferreira, Maria Paula; Fusaro, Edgard Rodrigues; Iozzi, Fabíola Lana

    2017-04-01

    Advances in reducing poverty and inequalities in the 2000s had a paradoxical effect in Brazil. This article examines how socioeconomic transformations, and the complexity of health services, are expressed in the regions established for planning purposes and the inter-governmental management of the Brazilian Unified Health System. An effort was made to identify and explain differences in the compositions of the 438 existing health regions and their spatial distribution by comparing situations observed in 2016 with those in 2000. Factor analysis and grouping techniques were used to construct a typology in the two years of the series, which was based on a diverse set of secondary data sources. It was found that there was an evolution in terms of income levels and service provision within the health regions, with a significant improvement in the socioeconomic conditions of the population. These results suggest that there was a positive impact from the combination of strategies related to social, economic and regional policies for the promotion of development, which generated more widespread well-being within the affected areas. However, limitations remain regarding the policies implemented for the universalization of the health system.

  6. Regional economic development programs related to the registration systems for the health records of radiation workers

    International Nuclear Information System (INIS)

    Nakagawa, Haruo; Kanda, Keiji

    2000-01-01

    The two policies, 'Promotion of Health Care for Elderly Person' and Completion of Health Care System' are important for regional economic development. If we apply the Health Records Registration Systems for Radiation Workers to the Regional Health Care System, we can get a more effective plan for regional economic development. In Japan, most of the electric power companies depend on radiation works to the external labor. As the chance of employment usually depends on the time and the period of outage of nuclear power stations, the employment of radiation works lacks its stability. From the analysis on the mobility of radiation workers, we can see the stability of employment increases in proportion to the number of reactors. This paper proposes the need for such a registration system to be granted under three laws governing special accounts for power supply municipalities and to set up the system within regional medical information systems. It also proposes the founding of an Overall Health Insurance Cooperative, managed by contractors safety union in the municipalities as soon as the condition of founding, 3, 000 people, is satisfied. (author)

  7. [The eradication of the poliomyelitis in the European Region of the World Health Organization].

    Science.gov (United States)

    Limia Sánchez, Aurora

    2013-01-01

    Poliomyelitis was considered an important event for the public health since the end of XIX century when this disease became epidemic. As soon as vaccines were available member states of the World Health Organization (WHO) in the European Region started to implement vaccination programmes against polio with an important impact in the incidence in this disease. In May 1988, the World Health Assembly resolution for the global eradication of poliomyelitis was adopted and the mechanisms to oversee the progress in the different WHO Regions were established. This article briefly reviews the history of polio in the WHO European Region, the process for certification and maintenance, the strategies for eradication and the current situation in the European Region and globally. The European Region was certified polio-free in 2002. Nevertheless, there are still three endemic countries in the world, some others use live attenuated vaccines as well as countries in the Horn of Africa are recently suffering the reintroduction of wild poliovirus. Considering these circumstances, the risk of reintroduction of poliovirus and the generation of outbreaks in the European Region exists, therefore high vaccination coverage against polio and good quality surveillance systems are needed to be guaranteed in every member state.

  8. Highways and outposts: economic development and health threats in the central Brazilian Amazon region

    OpenAIRE

    Barcellos, Christovam; Feitosa, Patrícia; Damacena, Giseli N; Andreazzi, Marco A

    2010-01-01

    Abstract Background Economic development is often evoked as a driving force that has the capacity to improve the social and health conditions of remote areas. However, development projects produce uneven impacts on local communities, according to their different positions within society. This study examines the spatial distribution of three major health threats in the Brazilian Amazon region that may undergo changes through highway construction. Homicide mortality, AIDS incidence and malaria ...

  9. Training in reproductive health and sexuality: the case of a regional program in Latin America.

    Science.gov (United States)

    Ramos, S; Gogna, M

    1997-01-01

    Beginning in July 1993, a 5-year program has sought to provide social research, training, and technical assistance in reproductive health and sexuality in Argentina, Chile, Peru, and Colombia by 1) building research capacity and promoting an interdisciplinary approach to reproductive health and sexuality and 2) promoting a gender perspective to these issues. The target groups are women's nongovernmental organizations (NGOs); family planning, reproductive health, and women's health providers; and social scientists conducting health-related research. Training activities include regional workshops, a Regional Resident Fellowship Program to support graduate-level education, and provision of technical assistance. The first 3 years of the program have revealed that the basic training needs in these areas include 1) helping women's NGOs improve their record-keeping capacity, evaluation processes, theoretical and methodological background, and institutional-building ability; 2) sensitizing women's health providers to sociocultural dimension of health-illness issues and to a gender and human rights perspective; and 3) training social scientist researchers to apply their skills in applied research, develop their theoretical background, and improve research quality control procedures. The main challenges for training activities in the field of reproductive health and sexuality are posed by the complexity of the issues and their interdisciplinary nature.

  10. Inequities in visual health and health services use in a rural region in Spain.

    Science.gov (United States)

    Latorre-Arteaga, Sergio; Fernández-Sáez, José; Gil-González, Diana

    2017-06-06

    To analyse perceived visual health and health services use in a rural population in relation to socioeconomic characteristics and compared with the general population in Spain. Cross-sectional study in a rural population using a structured questionnaire including questions comparable to the Spanish National Health Survey (2012). A descriptive analysis was carried out through the calculation of frequencies and prevalence, the χ 2 test for independent variables, contrasts of proportions and logistic regression to obtain associations between the rural and general populations and socioeconomic variables. For the rural population studied, the prevalence of poor perceptions of visual health is 40.8% in men and 39.4% in women, and is strongly associated with age, employment situation, income and presence of chronic diseases (p ˂0.001). Compared with the general population, the rural population has a higher risk of presenting with serious difficulties related to farsightedness (OR: 2.56; 95% CI: 1.32-4.95) and make less use of optical correction (OR: 0.57; 95%CI: 0.44-0.74). The use of health services is not sufficient for adequate prevention, particularly in diabetics. For those affected by poor vision, the distance to travel to receive an eye exam, the belief that eyesight problems come with age and the cost of glasses are the principal reasons used to explain why eyesight problems are not resolved. The rural population presents worse visual health that is influenced by social and economic factors. Improving accessibility and reducing barriers is essential to tackle avoidable visual disability and reduce health inequities. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  11. Job satisfaction and associated factors among health professionals working at Western Amhara Region, Ethiopia.

    Science.gov (United States)

    Temesgen, Kalkidan; Aycheh, Moges Wubie; Leshargie, Cheru Tesema

    2018-04-17

    In Ethiopia assuring the satisfaction of health care provider with their job is a major challenging problem. Job satisfaction is a worker's emotional response to different job related factors resulting in finding pleasure, comfort, confidence, rewards, personal growth and various positive opportunities, including upward mobility, recognition, and appraisal done on a merit pattern with monetary value as compensation. Professionals, whose needs and expectations are satisfied, tend to be more productive compared to their colleagues. Thus, study is aimed at assessing job satisfaction and associated factors among health professionals working at Western Amhara region, Ethiopia. An institution-based cross sectional study was conducted on March 2016 at Western Amhara region among 575 health professionals selected using simple random sampling. Logistic regression analysis was used to identify factors related to job satisfaction. Variables which have p-value less than or equal to 0.05 with corresponding AOR at 95 confidence interval was considered to declare the significance association. This study revealed that job satisfaction of health professional working at Western Amhara region was 31.7%. The mean age of respondent was 27.13 years. Majority of them, 79.3% and 95.3% were less than 30 years in age and orthodox Christian religion followers respectively. The presence of health professionals' reference manual/guide, alcohol drinking, workload, experience, educational status and profession types were identified as significant factors associated with health care professionals' job satisfaction level. Professional being laboratory technicians, pharmacists and Environmental health workers were 4.86 times more likely to satisfy themselves than nurses, midwives and Public health officers. Similarly, in their educational status, degree and above holders were 5.64 times more likely to satisfy themselves than below degree holders. Health professionals whose experience with > 3

  12. Status of blood transfusion in World Health Organization-Eastern Mediterranean Region (WHO-EMR): Successes and challenges.

    Science.gov (United States)

    Darbandi, Arezoo; Mashati, Pargol; Yami, Amir; Gharehbaghian, Arshia; Namini, Mehdi Tabrizi; Gharehbaghian, Ahmad

    2017-06-01

    Blood products are used for patient treatment and survival in the cases of major surgery, hematological disorders or cancer therapy. Presently the main blood components are not yet replaceable by artificial products and all activities related to blood transfusion is highly dependent on the healthcare development of each country. The World Health Organization Eastern Mediterranean Region (WHO-EMR) comprises of 21 member states with variable socio-economic status effective on blood transfusion activities. The fundamental motivation behind this research was to accumulate some data of blood practices in this region and to have an appropriate image of the WHO-EMR region. The data were collected through the published papers or data, blood transfusion services websites, and the other health official websites like WHO. Among WHO-EMR countries there are some with a nationally organized blood transfusion establishment such as Egypt, Iran, Iraq, Kuwait, Morocco, Oman, Pakistan, and Syria. In a few, blood transfusion administrations are hospital-based like Saudi Arabia. The others are run by Red Crescent such as Bahrain, Tunisia and UEA or by Red Cross like Lebanon. Only Iran and UAE succeed to have 100% voluntary non-remunerated blood donors; however, most of them are still under the weight of family/replacement blood donation such as Afghanistan, Egypt, Iraq, Lebanon, Morocco, Saudi Arabia and Sudan or even paid donors like Pakistan and Yemen. The haemovigilance and training programs have been implemented in some countries including Bahrain, Iran, Jordan, Kuwait, Oman, Qatar, Saudi Arabia, Tunisia and UAE. Unfortunately, there are rare and inaccessible information about some EMR states like Djibouti, Palestine and Somalia so that little data can be independently discovered. In these countries different measures ought to be additionally designated to ensure blood products adequacy and safety such as the development of well-coordinated national blood transfusion centers with

  13. Iraqi health system in kurdistan region: medical professionals' perspectives on challenges and priorities for improvement.

    Science.gov (United States)

    Shabila, Nazar P; Al-Tawil, Namir G; Tahir, Rebaz; Shwani, Falah H; Saleh, Abubakir M; Al-Hadithi, Tariq S

    2010-11-30

    The views of medical professionals on efficiency of health system and needs for any changes are very critical and constitute a cornerstone for any health system improvement. This is particularly relevant to Iraqi Kurdistan case as the events of the last few decades have significantly devastated the national Iraqi health system while the necessity for adopting a new health care system is increasingly recognized since 2004. This study aims to examine the regional health system in Iraqi Kurdistan from medical professionals' perspectives and try to define its problems and priorities for improvement. A survey questionnaire was developed and administered to a convenience sample of 250 medical professionals in Erbil governorate. The questionnaire included four items; rating of the quality of services and availability of resources in the health institutions, view on different aspects of the health system, the perceived priority needs for health system improvement and gender and professional characteristics of the respondents. The response rate to the survey was 83.6%. A high proportion of respondents rated the different aspects of services and resources in the health institutions as weak or very weak including the availability of the required quantity and quality of medicines (68.7%), the availability of sufficient medical equipment and investigation tools (68.7%), and the quality of offered services (65.3%). Around 72% of respondents had a rather negative view on the overall health system. The weak role of medical research, the weak role of professional associations in controlling the system and the inefficient health education were identified as important problems in the current health system (87.9%, 87.1% and 84.9%, respectively). The priority needs of health system improvement included adoption of social insurance for medical care of the poor (82%), enhancing the role of family medicine (77.2%), adopting health insurance system (76.1%) and periodic scientific

  14. TECHNICAL COORDINATION

    CERN Multimedia

    Austin Ball

    2013-01-01

      Since the last report, much visible progress has been made, as the LS1 programme approaches the halfway point. From early October, technical and safety shift-crew have been present around the clock, allowing detectors to stay switched on overnight, ensuring that safety systems are operational and instructions for non-expert shift-crew are clear. LS1 progress Throughout the summer, whilst the solenoid vacuum tank and YB0 surfaces were accessible, an extensive installation programme took place to prepare for Tracker colder operation and the PLT installation, in 2014, the Phase 1 Pixel Tracker installation, in 2016–’17, and the HCAL Phase 1 upgrade completion, ending in LS2. This included pipework for N2 or dry air to flush the Tracker bulkhead region, many sensors to monitor temperature and dew point in the Tracker and its service channels, heating wires outside the Tracker cooling bundles, supports for the new vacuum-jacketed, concentric, CO2 Pixel cooling lines, the PLT cool...

  15. TECHNICAL COORDINATION

    CERN Multimedia

    A. Ball and W. Zeuner

    2012-01-01

      UXC + detectors As explained in detail in the November 2011 bulletin, the bellows unit at −18.5 m from the CMS interaction point was identified as a prime candidate for the regularly occurring pressure spikes which occasionally led to sustained severe background conditions in 2011, affecting dead time and data quality. Similar regions in LHC with vacuum instabilities were observed to be close to bellows, which radiography showed to have distorted RF-fingers — on removal, they proved to have been severely overheated. The plans for the Year-End Technical Stop were adapted to prioritise radiography of the bellows at 16 m to 18 m either end of CMS. Excellent work by the beam pipe, survey and heavy mechanical teams allowed the X-rays to be taken as planned on 20th December, showing that the bellow at −18.5m had an obvious non-conformity. The RF-fingers were found inside the end of the opposing flared pipe instead of outside. In addition, the overlap between fingers and...

  16. Annual report on activities of Regional Public Health Offices in the Slovak Republic in 2008

    International Nuclear Information System (INIS)

    2009-01-01

    A brief account of activities carried out by the Regional Public Health Offices in the Slovak Republic in 2008 is presented. These activities are reported under the headings: (1) Environment; (2) Preventive occupational medicine; (3) Hygiene, nutrition, food safety and cosmetic products; (4) Hygiene of children and youth; (5) Epidemiology; (6) Objectification of environmental factors and working environment; (7) Medical microbiology; (8) Health promotion; (9) Health protection against radiation; (10) Complaints and petitions; (11) Control of tobacco and alcohol; (12) Evaluation of punitive measures for 2008.

  17. Med-CORDEX: a first coordinated inter-comparison of high-resolution and fully coupled regional climate models for the Mediterranean

    Science.gov (United States)

    Somot, Samuel

    2015-04-01

    Due to its geographical, meteorological and oceanographic features, the Mediterranean region can be considered as one of the best place to test and use regional climate modelling tools. It has been chosen as one of the CORDEX sub-domain (MED) leading to the Med-CORDEX initiative. This open and voluntary initiative, financially supported by MISTRALS/HyMeX, has been proposed by the Mediterranean climate modelling research community as a follow-up of previous initiatives. In addition to the CORDEX-like simulations (Atmosphere-RCM, 50 km, ERA-Interim and GCM driven runs), Med-CORDEX includes additional simulations to experiment some of the regional climate modelling current challenges. We present here the status and results of these additional simulations dedicated to the use of (1) very high-resolution Regional Climate Models (RCM, up to 10 km) and (2) fully coupled Regional Climate System Models (RCSM), coupling the various components of the regional climate (atmosphere, land surface and hydrology, river and ocean). Today, Med-CORDEX gathers 23 different modelling groups from 9 different countries (France, Italy, Spain, Serbia, Turkey, Greece, Tunisia, Germany, Hungary) in Europe, Middle-East and North-Africa. They use 12 different atmosphere RCMs including land-surface representation, 4 river models, 10 regional ocean models and 12 different Regional Climate System Models. Almost all the simulations planned (Evaluation, Historical and Scenarios modes) have been completed by the modelling teams. More than half of the runs are archived and freely available for non-commercial use through a dedicated database hosted at ENEA at www.medcordex.eu in common and standardized netcdf format (265,000 files and 3.6 Tb uploaded). This includes atmosphere-only, ocean-only and fully coupled regional climate models. In particular multi-model regional ocean simulations have been archived in a common and standardized format for the first time in the history of the Mediterranean Sea

  18. A case study of population health improvement at a Midwest regional hospital employer.

    Science.gov (United States)

    Long, D Adam; Sheehan, Paula

    2010-06-01

    This article reviews the population health improvement initiative of a Midwest regional hospital employer. Services included health risk assessments, health education, and motivational health coaching conducted telephonically. Outcomes categories for this program evaluation comprised participation rates, participant satisfaction, health status and behavior change, productivity change, health care claims savings, and return on investment. Participation rates varied widely with incentive structure, although retention of participants in coaching programs averaged 89%. The participant satisfaction rate for the last 14 months of interventions was 96%. Four years of population health status and behavior trending showed significant improvements in smoking status, dietary fat and fiber intake, exercise, mental health (ie, stress, effects depressive symptoms in the past year, life satisfaction), readiness to change (ie, diet, exercise, stress, smoking, body weight), perceptions of overall health, an index of good health habits, sum of lifestyle health risks, and sum of risks and chronic conditions. Body mass index showed nonsignificant improvements during the years of greatest participation (years 2 to 4). Indicators of productivity demonstrated improvements as well. These gains were noted for employees across all health risk statuses, which suggests population health improvement strategies can influence productivity even for healthy employees. Program year 3 was evaluated for health care claims savings using a 2-stage multivariate regression approach. Stage 1 was a computation of propensity-to-participate scores. Stage 2 was an estimation of per member per month (PMPM) claims savings for participant cohorts using a propensity score-weighted linear regression analysis. Participants averaged $40.65 PMPM savings over the control population. Program return on investment, including incentive costs and vendor fees, was 2.87:1.

  19. Variations between world regions in individual health: a multilevel analysis of the role of socio-economic factors

    NARCIS (Netherlands)

    Witvliet, Margot I.; Kunst, Anton E.; Stronks, Karien; Arah, Onyebuchi A.

    2012-01-01

    Background: Living in a particular region might affect health. We aimed to assess variations between regions in individual health. The role of socio-economic factors in the associations was also investigated. Methods: World Health Survey data were analysed on 220 487 individuals. Main outcomes

  20. Productivity losses associated with tuberculosis deaths in the World Health Organization African region.

    Science.gov (United States)

    Kirigia, Joses Muthuri; Muthuri, Rosenabi Deborah Karimi

    2016-06-01

    In 2014, almost half of the global tuberculosis deaths occurred in the World Health Organization (WHO) African Region. Approximately 21.5 % of the 6 060 742 TB cases (new and relapse) reported to the WHO in 2014 were in the African Region. The specific objective of this study was to estimate future gross domestic product (GDP) losses associated with TB deaths in the African Region for use in advocating for better strategies to prevent and control tuberculosis. The cost-of-illness method was used to estimate non-health GDP losses associated with TB deaths. Future non-health GDP losses were discounted at 3 %. The analysis was conducted for three income groups of countries. One-way sensitivity analysis at 5 and 10 % discount rates was undertaken to assess the impact on the expected non-health GDP loss. The 0.753 million tuberculosis deaths that occurred in the African Region in 2014 would be expected to decrease the future non-health GDP by International Dollars (Int$) 50.4 billion. Nearly 40.8, 46.7 and 12.5 % of that loss would come from high and upper-middle- countries or lower-middle- and low-income countries, respectively. The average total non-health GDP loss would be Int$66 872 per tuberculosis death. The average non-health GDP loss per TB death was Int$167 592 for Group 1, Int$69 808 for Group 2 and Int$21 513 for Group 3. Tuberculosis exerts a sizeable economic burden on the economies of the WHO AFR countries. This implies the need to strongly advocate for better strategies to prevent and control tuberculosis and to help countries end the epidemic of tuberculosis by 2030, as envisioned in the United Nations General Assembly resolution on Sustainable Development Goals (SDGs).

  1. Risk of Performance and Behavioral Health Decrements Due to Inadequate Cooperation, Coordination, Communication, and Psychosocial Adaptation within a Team

    Science.gov (United States)

    Landon, Lauren Blackwell; Vessey, William B.; Barrett, Jamie D.

    2015-01-01

    A team is defined as: "two or more individuals who interact socially and adaptively, have shared or common goals, and hold meaningful task interdependences; it is hierarchically structured and has a limited life span; in it expertise and roles are distributed; and it is embedded within an organization/environmental context that influences and is influenced by ongoing processes and performance outcomes" (Salas, Stagl, Burke, & Goodwin, 2007, p. 189). From the NASA perspective, a team is commonly understood to be a collection of individuals that is assigned to support and achieve a particular mission. Thus, depending on context, this definition can encompass both the spaceflight crew and the individuals and teams in the larger multi-team system who are assigned to support that crew during a mission. The Team Risk outcomes of interest are predominantly performance related, with a secondary emphasis on long-term health; this is somewhat unique in the NASA HRP in that most Risk areas are medically related and primarily focused on long-term health consequences. In many operational environments (e.g., aviation), performance is assessed as the avoidance of errors. However, the research on performance errors is ambiguous. It implies that actions may be dichotomized into "correct" or "incorrect" responses, where incorrect responses or errors are always undesirable. Researchers have argued that this dichotomy is a harmful oversimplification, and it would be more productive to focus on the variability of human performance and how organizations can manage that variability (Hollnagel, Woods, & Leveson, 2006) (Category III1). Two problems occur when focusing on performance errors: 1) the errors are infrequent and, therefore, difficult to observe and record; and 2) the errors do not directly correspond to failure. Research reveals that humans are fairly adept at correcting or compensating for performance errors before such errors result in recognizable or recordable failures

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

    Science.gov (United States)

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

    2017-07-01

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

  3. Determining the source region of auroral emissions in the prenoon oval using coordinated Polar BEAR UV-imaging and DMSP particle measurements

    International Nuclear Information System (INIS)

    Newell, P.T.; Meng, C.I.; Huffman, R.E.

    1992-01-01

    The Polar Beacon Experiment and Auroral Research (Polar BEAR) satellite included the capability for imaging the dayside auroral oval in full sunlight at several wavelengths. The authors compare particle observations from the DMSP F7 satellite during dayside auroral oval crossings with approximately simultaneous Polar BEAR 1,356-angstrom images to determine the magnetospheric source region of the dayside auroral oval. The source region is determined from the Defense Meteorological Satellite Program (DMSP) particle data, according to recent work concerning the classification and identification of precipitation source regions. The close DMSP/Polar BEAR coincidences all occur when the former satellite is located between 0945 and 1,000 MLT. The authors found instances of auroral arcs mapping to each of several different regions, including the boundary plasma sheet, the low-latitude boundary layer, and the plasma mantle. However, the results indicate that about half the time the most prominent auroral arcs are located at the interfaces between distinct plasma regions, at least at the local time studied here

  4. Co-ordinate control of synthesis of mitochondrial and non-mitochondrial hemoproteins: a binding site for the HAP1 (CYP1) protein in the UAS region of the yeast catalase T gene (CTT1).

    Science.gov (United States)

    Winkler, H; Adam, G; Mattes, E; Schanz, M; Hartig, A; Ruis, H

    1988-01-01

    Control of expression of the Saccharomyces cerevisiae CTT1 (catalase T) gene by the HAP1 (CYP1) gene, a mediator of heme control of mitochondrial cytochromes, was studied. Expression of a CTT1-lacZ fusion in a hap1 mutant showed that the CTT1 promoter is under HAP1 control. As demonstrated by a gel retardation assay, the HAP1 protein binds to a heme control region of the CTT1 gene. This binding in vitro is stimulated by hemin. The HAP1-binding sequence was localized by using DNA fragments spanning different regions, by DNase I footprinting and by methylation interference of DNA-protein binding. The binding site was compared to the HAP1-binding sequences previously characterized in detail (UAS1CYC1, UASCYC7). There is strikingly little similarity between the three sequences, which have only four of those 23 bp in common which are protected from DNase I digestion. However, the pattern of major and minor groove contacts in the complex is quite similar in all three cases. The results obtained show that there is true co-ordinate control of expression of mitochondrial cytochromes and at least some extra-mitochondrial hemoproteins. Heme acts as a metabolic signal in this coordination, which is mediated by the HAP1 protein. Images PMID:2844525

  5. Analysis of environment state in technogenic region and its threat to public health

    Directory of Open Access Journals (Sweden)

    Grishenko S.V.

    2014-03-01

    Full Text Available The purpose of the research is to give a complex hygienic evaluation of environment state in Donetsk region and to determine the degree of their potential danger to population health. It includes air pollution, water contamination, state of soil. Nearly 43000 samples of air, 32000 drinking water samples and 4500 soil samples were analyzed. Regions with the highest rate of environmental pollution were defined. It was found that the main sources of environment pollution in Donetsk region are ferrous and nonferrous metallurgy enterprises, power, coal, building industry and transport. All other sources ac¬count for only 5-10% of total emissions. Level of harmful technogenic pressing on population’s health was determined.

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

    DEFF Research Database (Denmark)

    Havelaar, Arie H.; Kirk, Martyn D.; Torgerson, Paul R.

    2015-01-01

    parasitic helminths, were highly localised. Thus, the burden of FBD is borne particularly by children under five years old-although they represent only 9% of the global population-and people living in low-income regions of the world. These estimates are conservative, i.e., underestimates rather than......Illness and death from diseases caused by contaminated food are a constant threat to public health and a significant impediment to socio-economic development worldwide. To measure the global and regional burden of foodborne disease (FBD), the World Health Organization (WHO) established...... different burdens of FBD, with the greatest falling on the subregions in Africa, followed by the subregions in South-East Asia and the Eastern Mediterranean D subregion. Some hazards, such as non-typhoidal S. enterica, were important causes of FBD in all regions of the world, whereas others, such as certain...

  7. 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.

  8. The tuberculosis program of Catalonia's Central Health Region (1986-1993).

    Science.gov (United States)

    Miret-Cuadras, P; Gonzalez-Fernandez, P; Lopez-Sanmartin, J L; Martin-Ramos, A; Pina Gutierrez, J M

    1997-04-01

    Catalonia's Central Health Region antituberculosis program, which began in 1985. To evaluate the cooperation of health staff and the program's effectiveness after 8 years. The following data from the nominal notifications and the expanded case reports were processed: epidemiological, clinical and treatment data, each patient's end results and the outcome of the contact investigation. The implementation of the program was evaluated by means of the number of notifications and contact investigations received, and its effectiveness was assessed by the percentage of sputum smear positive cases having completed treatment. There was an increase in the number of patients with an expanded case report (from 74% to 100%), with a final notification (from 61% to 99%) and with contact investigation (from 29% to 79%). The sputum smear positive cases who completed the treatment after 1990 exceeded 85%. The implementation of the program in the Region's health system is good and is improving in parallel with the control of the disease.

  9. Participatory evaluation of delivery of animal health care services by community animal health workers in Karamoja region of Uganda.

    Directory of Open Access Journals (Sweden)

    James Bugeza

    Full Text Available An evaluation exercise was carried out to assess the performance of Community Animal Health Workers (CAHWs in the delivery of animal health care services in Karamoja region, identify capacity gaps and recommend remedial measures.Participatory methods were used to design data collection tools. Questionnaires were administered to 204 CAHWs, 215 farmers and 7 District Veterinary Officers (DVOs to collect quantitative data. Seven DVOs and 1 Non Government Organization (NGO representative were interviewed as key informants and one focus group discussion was conducted with a farmer group in Nakapiripirit to collect qualitative data. Questionnaire data was analyzed using SPSS version 19. Key messages from interviews and the focus group discussion were recorded in a notebook and reported verbatim.70% of the farmers revealed that CAHWs are the most readily available animal health care service providers in their respective villages. CAHWs were instrumental in treatment of sick animals, disease surveillance, control of external parasites, animal production, vaccination, reporting, animal identification, and performing minor surgeries. Regarding their overall performance 88.8%(191/215 of the farmers said they were impressed. The main challenges faced by the CAHWs were inadequate facilitation, lack of tools and equipments, unwillingness of government to integrate them into the formal extension system, poor information flow, limited technical capacity to diagnose diseases, unwillingness of farmers to pay for services and sustainability issues.CAHWs remain the main source of animal health care services in Karamoja region and their services are largely satisfactory. The technical deficits identified require continuous capacity building programs, close supervision and technical backstopping. For sustainability of animal health care services in the region continuous training and strategic deployment of paraprofessionals that are formally recognised by the

  10. Participatory evaluation of delivery of animal health care services by community animal health workers in Karamoja region of Uganda.

    Science.gov (United States)

    Bugeza, James; Kankya, Clovice; Muleme, James; Akandinda, Ann; Sserugga, Joseph; Nantima, Noelina; Okori, Edward; Odoch, Terence

    2017-01-01

    An evaluation exercise was carried out to assess the performance of Community Animal Health Workers (CAHWs) in the delivery of animal health care services in Karamoja region, identify capacity gaps and recommend remedial measures. Participatory methods were used to design data collection tools. Questionnaires were administered to 204 CAHWs, 215 farmers and 7 District Veterinary Officers (DVOs) to collect quantitative data. Seven DVOs and 1 Non Government Organization (NGO) representative were interviewed as key informants and one focus group discussion was conducted with a farmer group in Nakapiripirit to collect qualitative data. Questionnaire data was analyzed using SPSS version 19. Key messages from interviews and the focus group discussion were recorded in a notebook and reported verbatim. 70% of the farmers revealed that CAHWs are the most readily available animal health care service providers in their respective villages. CAHWs were instrumental in treatment of sick animals, disease surveillance, control of external parasites, animal production, vaccination, reporting, animal identification, and performing minor surgeries. Regarding their overall performance 88.8%(191/215) of the farmers said they were impressed. The main challenges faced by the CAHWs were inadequate facilitation, lack of tools and equipments, unwillingness of government to integrate them into the formal extension system, poor information flow, limited technical capacity to diagnose diseases, unwillingness of farmers to pay for services and sustainability issues. CAHWs remain the main source of animal health care services in Karamoja region and their services are largely satisfactory. The technical deficits identified require continuous capacity building programs, close supervision and technical backstopping. For sustainability of animal health care services in the region continuous training and strategic deployment of paraprofessionals that are formally recognised by the traditional civil

  11. 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.

  12. Initial experiences and innovations in supervising community health workers for maternal, newborn, and child health in Morogoro region, Tanzania.

    Science.gov (United States)

    Roberton, Timothy; Applegate, Jennifer; Lefevre, Amnesty E; Mosha, Idda; Cooper, Chelsea M; Silverman, Marissa; Feldhaus, Isabelle; Chebet, Joy J; Mpembeni, Rose; Semu, Helen; Killewo, Japhet; Winch, Peter; Baqui, Abdullah H; George, Asha S

    2015-04-09

    Supervision is meant to improve the performance and motivation of community health workers (CHWs). However, most evidence on supervision relates to facility health workers. The Integrated Maternal, Newborn, and Child Health (MNCH) Program in Morogoro region, Tanzania, implemented a CHW pilot with a cascade supervision model where facility health workers were trained in supportive supervision for volunteer CHWs, supported by regional and district staff, and with village leaders to further support CHWs. We examine the initial experiences of CHWs, their supervisors, and village leaders to understand the strengths and challenges of such a supervision model for CHWs. Quantitative and qualitative data were collected concurrently from CHWs, supervisors, and village leaders. A survey was administered to 228 (96%) of the CHWs in the Integrated MNCH Program and semi-structured interviews were conducted with 15 CHWs, 8 supervisors, and 15 village leaders purposefully sampled to represent different actor perspectives from health centre catchment villages in Morogoro region. Descriptive statistics analysed the frequency and content of CHW supervision, while thematic content analysis explored CHW, supervisor, and village leader experiences with CHW supervision. CHWs meet with their facility-based supervisors an average of 1.2 times per month. CHWs value supervision and appreciate the sense of legitimacy that arises when supervisors visit them in their village. Village leaders and district staff are engaged and committed to supporting CHWs. Despite these successes, facility-based supervisors visit CHWs in their village an average of only once every 2.8 months, CHWs and supervisors still see supervision primarily as an opportunity to check reports, and meetings with district staff are infrequent and not well scheduled. Supervision of CHWs could be strengthened by streamlining supervision protocols to focus less on report checking and more on problem solving and skills development

  13. Evidence based practice in population health: a regional survey to inform workforce development and organisational change.

    Science.gov (United States)

    Adily, A; Ward, J

    2004-06-01

    To assess current capacity to implement evidence based practice (EBP) in population health. Postal survey of a regional population health workforce in Sydney, Australia. Division of Population Health, South Western Sydney Area Health Service. 104 population health staff (response rate: 73%). In the sample of regional population health practitioners, views about the current promotion of EBP were positive. Non-medical respondents with less that Masters degree were more likely to report "high self assessed need" to increase their capacity in EBP (p = 0.022). Confidence in understanding of EBP terminology was not associated with seniority but with highest level of education reached (pskills" or "need to increase their capacity in EBP" in their current position. The proportion of participants "strongly" supporting implementation of a colorectal cancer screening programme whose benefit was expressed as relative risk reduction was greater than that so supporting a programme whose benefit was expressed as number needed to screen (p = 0.008). Most respondents referred to their immediate managers when seeking support for EBP. The findings provide a quantitative baseline for capacity building through workplace programmes. Managerial commitment has been increased and performance development is now underway.

  14. 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.

  15. Readiness of ethics review systems for a changing public health landscape in the WHO African Region.

    Science.gov (United States)

    Motari, Marion; Ota, Martin Okechukwu; Kirigia, Joses Muthuri

    2015-12-02

    The increasing emphasis on research, development and innovation for health in providing solutions to the high burden of diseases in the African Region has warranted a proliferation of studies including clinical trials. This changing public health landscape requires that countries develop adequate ethics review capacities to protect and minimize risks to study participants. Therefore, this study assessed the readiness of national ethics committees to respond to challenges posed by a globalized biomedical research system which is constantly challenged by new public health threats, rapid scientific and technological advancements affecting biomedical research and development, delivery and manufacture of vaccines and therapies, and health technology transfer. This is a descriptive study, which used a questionnaire structured to elicit information on the existence of relevant national legal frameworks, mechanisms for ethical review; as well as capacity requirements for national ethics committees. The questionnaire was available in English and French and was sent to 41 of the then 46 Member States of the WHO African Region, excluding the five Lusophone Member States. Information was gathered from senior officials in ministries of health, who by virtue of their offices were considered to have expert knowledge of research ethics review systems in their respective countries. Thirty three of the 41 countries (80.5 %) responded. Thirty (90.9 %) of respondent countries had a national ethics review committee (NEC); 79 % of which were established by law. Twenty-five (83.3 %) NECs had secretarial and administrative support. Over 50 % of countries with NECs indicated a need for capacity strengthening through periodic training on international guidelines for health research (including clinical trials) ethics; and allocation of funds for administrative and secretariat support. Despite the existing training initiatives, the Region still experiences a shortage of professionals

  16. Correlations of indoor second-hand smoking, household smoking rules, regional deprivation and children mental health: Scottish Health Survey, 2013.

    Science.gov (United States)

    Shiue, Ivy

    2015-07-01

    It has been known that second-hand smoking and deprivation could cluster together affecting child health. However, little is known on the role of household smoking rules. Therefore, it was aimed to study the relationships among indoor second-hand smoking, household smoking rules, deprivation level and children mental health in a country-wide and population-based setting. Data was retrieved from and analysed in Scottish Health Survey, 2013. Information on demographics, indoor second-hand smoking status, household smoking rules, deprivation level and child mental health by Strengths and Difficulties Questionnaire was obtained by household interview through parents. Statistical analysis included chi-square test and survey-weighted logistic regression modelling. Of 1019 children aged 4-12, 17.9% (n = 182) lived in the 15% most deprivation areas. Deprived areas tended to be where indoor smoking occurred (p Scottish children are greater Glasgow, Ayrshire & Arran and Forth Valley while the top three sub-regions of exposure to the indoor second-hand smoking are Fife, Forth Valley and Ayrshire & Arran. The top three sub-regions with indoor smoking allowed are greater Glasgow, Western Isles and Borders. Children emotional and behavioural problems were reduced when the strict household smoking rules (not allowed or outdoor areas) applied. One in six Scottish children lived in the 15% most deprivation areas and exposed to indoor second-hand smoking that could have led to emotional and behavioural problems. Public health programs promoting strict household smoking rules should be encouraged in order to optimise children mental health.

  17. Implementation of a guideline for local health policy making by regional health services : Exploring determinants of use by a web survey

    NARCIS (Netherlands)

    Kuunders, T.J.M.; Jacobs, M.A.M.; Paulussen, T.G.W.M.; van de Goor, L.A.M.; van Bon, M.J.H.; van Oers, J.A.M.

    Background Previous evaluation showed insufficient use of a national guideline for integrated local health policy by Regional Health Services (RHS) in the Netherlands. The guideline focuses on five health topics and includes five checklists to support integrated municipal health policies. This study

  18. Implementation of a guideline for local health policy making by regional health services: exploring determinants of use by a web survey

    NARCIS (Netherlands)

    Kuunders, T.J.M.; Jacobs, M.A.M.; Goor, I.A.M. van de; Bon-Martens, M.J.H. van; Oers, H.A.M. van; Paulussen, T.G.W.M.

    2017-01-01

    Background. Previous evaluation showed insufficient use of a national guideline for integrated local health policy by Regional Health Services (RHS) in the Netherlands. The guideline focuses on five health topics and includes five checklists to support integrated municipal health policies. This

  19. Soil health in the Mediterranean region: Development and consolidation of a multifactor index to characterize the health of agricultural lands

    Science.gov (United States)

    Gil, Eshel; Guy, Levy; Oshri, Rinot; Michael, Borisover; Uri, Yermiyahu; Leah, Tsror; Hanan, Eizenberg; Tal, Svoray; Alex, Furman; Yael, Mishael; Yosef, Steinberger

    2017-04-01

    The link among between soil health, soil conservation, and food security, resilience, and function under a wide range of agricultural uses and different environmental systems, is at the heart of many ecofriendly research studies worldwide. We consider the health of soil as a function of its ability to provide ecosystem services, including agricultural production (provisional services); regulating natural cycles (regulation services) and as a habitat for plants (support services). Soil health is affected by a wide range of soil properties (biotic and abiotic) that maintain complex interactions among themselves. The decline in soil health includes degradation in its physical properties (e.g., deterioration of soil structure, compaction and sealing, water-repellency, soil erosion by water and wind), chemical properties (e.g., salinization, depletion of nutrients and organic matter content, accumulation of pollutants and reduction of the soils' ion exchange capacity) and biological properties (e.g., vulnerable populations of microflora, microfauna, and mesofauna, leading to a breach of ecological balance and biodiversity and, as a result, destruction of beneficial populations and pathogen outbreaks). Numerous studies show that agricultural practices have a major impact on soil functioning. Substituting longstanding tillage with no-till cropping and the amalgamation of cover crops in crop rotations were found to improve soil properties. Such changes contributed to the enhancement of the agronomical performance of the soil. On the other hand, these practices may result in lessened effectiveness of controlling perennial weeds. The evaluation of soil-health status in the Mediterranean region is very limited. Moreover, existing approaches for evaluation that have been used (such as the Cornell and Hany tests) do not give sufficient weight to important agronomic processes, such as soil erosion, salinization, sodification, spread of weeds in the fields (in particular, weeds

  20. Health transition in Brazil: regional</