WorldWideScience

Sample records for health support assessment

  1. Risk assessment in support of plant health

    DEFF Research Database (Denmark)

    Jeger, Michael; Schans, Jan; Lövei, Gabor L.

    2012-01-01

    With the establishment of the Plant Health Panel in 2006, EFSA became the body responsible for risk assessment in the plant health area for the European Union (EU). Since then more than 70 outputs have been produced dealing with the full range of organisms harmful to plant health across all crop...... environmental risk assessment and the evaluation of risk reducing options. Quantitative approaches have become increasingly important during this time. The Panel has developed such methods in climatic mapping (in association with the Joint Research Councils), application of spatial spread models, re......-evaluation of quantitative pathway analyses, and in statistical modelling of experimental data. A Plant Health Network has been established to facilitate interaction with EU Member States, especially in relation to data collection and co-ordination of risk assessment activities. At the current time a revision of the EU...

  2. Software Tools to Support the Assessment of System Health

    Science.gov (United States)

    Melcher, Kevin J.

    2013-01-01

    This presentation provides an overview of three software tools that were developed by the NASA Glenn Research Center to support the assessment of system health: the Propulsion Diagnostic Method Evaluation Strategy (ProDIMES), the Systematic Sensor Selection Strategy (S4), and the Extended Testability Analysis (ETA) tool. Originally developed to support specific NASA projects in aeronautics and space, these software tools are currently available to U.S. citizens through the NASA Glenn Software Catalog. The ProDiMES software tool was developed to support a uniform comparison of propulsion gas path diagnostic methods. Methods published in the open literature are typically applied to dissimilar platforms with different levels of complexity. They often address different diagnostic problems and use inconsistent metrics for evaluating performance. As a result, it is difficult to perform a one ]to ]one comparison of the various diagnostic methods. ProDIMES solves this problem by serving as a theme problem to aid in propulsion gas path diagnostic technology development and evaluation. The overall goal is to provide a tool that will serve as an industry standard, and will truly facilitate the development and evaluation of significant Engine Health Management (EHM) capabilities. ProDiMES has been developed under a collaborative project of The Technical Cooperation Program (TTCP) based on feedback provided by individuals within the aircraft engine health management community. The S4 software tool provides a framework that supports the optimal selection of sensors for health management assessments. S4 is structured to accommodate user ]defined applications, diagnostic systems, search techniques, and system requirements/constraints. One or more sensor suites that maximize this performance while meeting other user ]defined system requirements that are presumed to exist. S4 provides a systematic approach for evaluating combinations of sensors to determine the set or sets of

  3. Assessing Age Differences in the Relationship Between Emotional Support and Health Among Older Mexican Americans.

    Science.gov (United States)

    Krause, Neal

    2016-02-01

    Research reveals that people tend to place greater value on emotional support as they move through the life course. Older people are likely to do so because emotional support benefits them in some way. The purpose of this study was to see whether there are age differences in the relationship between emotional support and the number of chronic health conditions. In the process, an effort is made to contribute to the literature in three ways. First, an emphasis placed on assessing the relationship between emotional support and health within late life. Second, variations in the source of support are taken into account by contrasting support within religious institutions with support that is received outside church. Third, these issues are examined with data provided by a nationally representative sample of older Mexican Americans (N = 663). The findings suggest that age differences in the relationship between emotional support and health are present within late life. Moreover, the data indicate that this relationship holds for church-based social support but not support that is received outside the church.

  4. Application of Bayesian networks for hazard ranking of nanomaterials to support human health risk assessment

    NARCIS (Netherlands)

    Marvin, Hans J.P.; Bouzembrak, Yamine; Janssen, Esmée M.; Zande, van der Meike; Murphy, Finbarr; Sheehan, Barry; Mullins, Martin; Bouwmeester, Hans

    2017-01-01

    In this study, a Bayesian Network (BN) was developed for the prediction of the hazard potential and biological effects with the focus on metal- and metal-oxide nanomaterials to support human health risk assessment. The developed BN captures the (inter) relationships between the exposure route, the

  5. Assessing management support for worksite health promotion: psychometric analysis of the leading by example (LBE) instrument.

    Science.gov (United States)

    Della, Lindsay J; DeJoy, David M; Goetzel, Ron Z; Ozminkowski, Ronald J; Wilson, Mark G

    2008-01-01

    Describe the development of the leading by example (LBE) instrument. A total of 135 responses from employees of a private corporation working at 11 different worksites were factor analyzed in 2005. Exploratory factor analysis was used to obtain an initial factor structure. Factor validity was evaluated using confirmatory factor analysis methods. A second sample was collected in 2006 from the same population (N = 178) and was used to confirm the factor structure via confirmatory factor analysis. Cronbach's alpha and item-total correlations provided information on the reliability of the factor subscales. Four subscales were identified: business alignment with health promotion objectives, awareness of the health-productivity link, worksite support for health promotion, and leadership support for health promotion. Factor by group comparisons revealed that the initial factor structure was effective in detecting differences in organizational support for health promotion across different employee groups. Management support for health promotion can be assessed using the LBE, a brief self-report questionnaire. Researchers can use the LBE to diagnose, track, and evaluate worksite health promotion programs.

  6. Family functioning, health and social support assessed by aged home care clients and their family members.

    Science.gov (United States)

    Hautsalo, Katja; Rantanen, Anja; Astedt-Kurki, Päivi

    2013-10-01

    The aim of this study was to describe aged home care clients' and their family members' experiences of their family functioning, family health and social support received. An additional purpose was to determine which factors are connected with social support. Increasing life expectancy and ageing of the population require consideration of the adequacy of home care services and the role of family members as care providers. The older population is a very heterogeneous group because of their variable needs and several disabilities. To ensure the quality of home care, experimental information is needed from clients and their family members. A survey design with convenience sampling. The home care client and a family member of his/her answered a questionnaire together, including background questions, the Family Functioning, Health and Social Support instrument and an open question about support received from home care. Statistical methods were used to describe quantitative data, and content analysis was used in analysing the replies to the open question. Family health was noted as good, and family functioning and overall social support fairly good. An older person's higher basic education, higher age of the family member, better family health and male gender were connected with better social support received. The relationship of the older person and the family member as well as the duration of home care service use had an effect on social support received. The content analysis raised expectations related to time, planning of service, organisational factors and caring practise. Home care clients' and families' needs for support vary, and therefore, the assessment of needs, care planning and updating are important. The variable support needs of older people and their family members require flexible and adaptable home services. Cooperation between all participants involved in care would promote the well-being of the older person and the entire family. © 2012 Blackwell

  7. Subgroup analyses in cost-effectiveness analyses to support health technology assessments.

    Science.gov (United States)

    Fletcher, Christine; Chuang-Stein, Christy; Paget, Marie-Ange; Reid, Carol; Hawkins, Neil

    2014-01-01

    'Success' in drug development is bringing to patients a new medicine that has an acceptable benefit-risk profile and that is also cost-effective. Cost-effectiveness means that the incremental clinical benefit is deemed worth paying for by a healthcare system, and it has an important role in enabling manufacturers to obtain new medicines to patients as soon as possible following regulatory approval. Subgroup analyses are increasingly being utilised by decision-makers in the determination of the cost-effectiveness of new medicines when making recommendations. This paper highlights the statistical considerations when using subgroup analyses to support cost-effectiveness for a health technology assessment. The key principles recommended for subgroup analyses supporting clinical effectiveness published by Paget et al. are evaluated with respect to subgroup analyses supporting cost-effectiveness. A health technology assessment case study is included to highlight the importance of subgroup analyses when incorporated into cost-effectiveness analyses. In summary, we recommend planning subgroup analyses for cost-effectiveness analyses early in the drug development process and adhering to good statistical principles when using subgroup analyses in this context. In particular, we consider it important to provide transparency in how subgroups are defined, be able to demonstrate the robustness of the subgroup results and be able to quantify the uncertainty in the subgroup analyses of cost-effectiveness. Copyright © 2014 John Wiley & Sons, Ltd.

  8. Evaluation of SOVAT: An OLAP-GIS decision support system for community health assessment data analysis

    Directory of Open Access Journals (Sweden)

    Parmanto Bambang

    2008-06-01

    Full Text Available Abstract Background Data analysis in community health assessment (CHA involves the collection, integration, and analysis of large numerical and spatial data sets in order to identify health priorities. Geographic Information Systems (GIS enable for management and analysis using spatial data, but have limitations in performing analysis of numerical data because of its traditional database architecture. On-Line Analytical Processing (OLAP is a multidimensional datawarehouse designed to facilitate querying of large numerical data. Coupling the spatial capabilities of GIS with the numerical analysis of OLAP, might enhance CHA data analysis. OLAP-GIS systems have been developed by university researchers and corporations, yet their potential for CHA data analysis is not well understood. To evaluate the potential of an OLAP-GIS decision support system for CHA problem solving, we compared OLAP-GIS to the standard information technology (IT currently used by many public health professionals. Methods SOVAT, an OLAP-GIS decision support system developed at the University of Pittsburgh, was compared against current IT for data analysis for CHA. For this study, current IT was considered the combined use of SPSS and GIS ("SPSS-GIS". Graduate students, researchers, and faculty in the health sciences at the University of Pittsburgh were recruited. Each round consisted of: an instructional video of the system being evaluated, two practice tasks, five assessment tasks, and one post-study questionnaire. Objective and subjective measurement included: task completion time, success in answering the tasks, and system satisfaction. Results Thirteen individuals participated. Inferential statistics were analyzed using linear mixed model analysis. SOVAT was statistically significant (α = .01 from SPSS-GIS for satisfaction and time (p Conclusion Using SOVAT, tasks were completed more efficiently, with a higher rate of success, and with greater satisfaction, than the

  9. A Decision Support System for Drinking Water Production Integrating Health Risks Assessment

    Directory of Open Access Journals (Sweden)

    Ianis Delpla

    2014-07-01

    Full Text Available The issue of drinking water quality compliance in small and medium scale water services is of paramount importance in relation to the 98/83/CE European Drinking Water Directive (DWD. Additionally, concerns are being expressed over the implementation of the DWD with respect to possible impacts on water quality from forecast changes in European climate with global warming and further anticipated reductions in north European acid emissions. Consequently, we have developed a decision support system (DSS named ARTEM-WQ (AwaReness Tool for the Evaluation and Mitigation of drinking Water Quality issues resulting from environmental changes to support decision making by small and medium plant operators and other water stakeholders. ARTEM-WQ is based on a sequential risk analysis approach that includes consideration of catchment characteristics, climatic conditions and treatment operations. It provides a holistic evaluation of the water system, while also assessing human health risks of organic contaminants potentially present in treated waters (steroids, pharmaceuticals, pesticides, bisphenol-a, polychlorobiphenyls, polycyclic aromatic hydrocarbons, petrochemical hydrocarbons and disinfection by-products; n = 109. Moreover, the system provides recommendations for improvement while supporting decision making in its widest context. The tool has been tested on various European catchments and shows a promising potential to inform water managers of risks and appropriate mitigative actions. Further improvements should include toxicological knowledge advancement, environmental background pollutant concentrations and the assessment of the impact of distribution systems on water quality variation.

  10. Estimating active transportation behaviors to support health impact assessment in the United States

    Directory of Open Access Journals (Sweden)

    Theodore J Mansfield

    2016-05-01

    Full Text Available Health impact assessment (HIA has been promoted as a means to encourage transportation and city planners to incorporate health considerations into their decision-making. Ideally, HIAs would include quantitative estimates of the population health effects of alternative planning scenarios, such as scenarios with and without infrastructure to support walking and cycling. However, the lack of baseline estimates of time spent walking or biking for transportation (together known as active transportation, which are critically related to health, often prevents planners from developing such quantitative estimates. To address this gap, we use data from the 2009 US National Household Travel Survey to develop a statistical model that estimates baseline time spent walking and biking as a function of the type of transportation used to commute to work along with demographic and built environment variables. We validate the model using survey data from the Raleigh-Durham-Chapel Hill, NC, metropolitan area. We illustrate how the validated model could be used to support transportation-related HIAs by estimating the potential health benefits of built environment modifications that support walking and cycling. Our statistical model estimates that on average, individuals who commute on foot spend an additional 19.8 (95% CI 16.9–23.2 minutes per day walking compared to automobile commuters. Public transit riders walk an additional 5.0 (95% CI 3.5–6.4 minutes per day compared to automobile commuters. Bicycle commuters cycle for an additional 28.0 (95% CI 17.5–38.1 minutes per day compared to automobile commuters. The statistical model was able to predict observed transportation physical activity in the Raleigh-Durham-Chapel Hill region to within 0.5 MET-hours per day (equivalent to about 9 minutes of daily walking time for 83% of observations. Across the Raleigh-Durham-Chapel Hill region, an estimated 38 (95% CI 15–59 premature deaths potentially could be

  11. Estimating Active Transportation Behaviors to Support Health Impact Assessment in the United States.

    Science.gov (United States)

    Mansfield, Theodore J; Gibson, Jacqueline MacDonald

    2016-01-01

    Health impact assessment (HIA) has been promoted as a means to encourage transportation and city planners to incorporate health considerations into their decision-making. Ideally, HIAs would include quantitative estimates of the population health effects of alternative planning scenarios, such as scenarios with and without infrastructure to support walking and cycling. However, the lack of baseline estimates of time spent walking or biking for transportation (together known as "active transportation"), which are critically related to health, often prevents planners from developing such quantitative estimates. To address this gap, we use data from the 2009 US National Household Travel Survey to develop a statistical model that estimates baseline time spent walking and biking as a function of the type of transportation used to commute to work along with demographic and built environment variables. We validate the model using survey data from the Raleigh-Durham-Chapel Hill, NC, USA, metropolitan area. We illustrate how the validated model could be used to support transportation-related HIAs by estimating the potential health benefits of built environment modifications that support walking and cycling. Our statistical model estimates that on average, individuals who commute on foot spend an additional 19.8 (95% CI 16.9-23.2) minutes per day walking compared to automobile commuters. Public transit riders walk an additional 5.0 (95% CI 3.5-6.4) minutes per day compared to automobile commuters. Bicycle commuters cycle for an additional 28.0 (95% CI 17.5-38.1) minutes per day compared to automobile commuters. The statistical model was able to predict observed transportation physical activity in the Raleigh-Durham-Chapel Hill region to within 0.5 MET-hours per day (equivalent to about 9 min of daily walking time) for 83% of observations. Across the Raleigh-Durham-Chapel Hill region, an estimated 38 (95% CI 15-59) premature deaths potentially could be avoided if the entire

  12. Supporting decision making in cross-border regions: a health technology assessment tool for hospitals.

    Science.gov (United States)

    Knies, Saskia; Lombardi, Gloria; Commers, Matt; Dauben, Hans-Peter; Evers, Silvia; Michelsen, Kai; Oortwijn, Wija; Opara, Chibuzo; Brand, Helmut

    2013-01-01

    The aim of this study was to develop an health technology assessment (HTA) decision tool to support the decision-making process on health technologies for hospital decision makers in cross-border regions. Several methods were used to collect information necessary to develop the cross-border mini-HTA decision tool. The literature was inventoried on HTA in border regions and local settings and the use of HTA by local decision makers. Semi-structured interviews with hospital decision makers in cross-border regions were also performed. Based on group discussion of the resulting information, it was decided to use the Danish mini-HTA guideline as a starting point for development of the decision tool. After finishing the first version of the decision tool it was tested in two pilot studies. Some questions in the Danish mini-HTA guideline were not relevant. Other questions needed rephrasing and questions about cross-border situations were added. The pilots showed several missing topics, including legal questions and reimbursement issues. The final decision tool consists of three sections: a general section, a section for hospitals not cooperating cross-border and a section for hospitals that are cooperating with hospitals across a national or regional border. Based on our literature search, this may be the first cross-border mini-HTA decision tool. The decision tool will be of help for healthcare professionals and decision makers in border settings who would like to use HTA evidence to support their decision-making process.

  13. Assessing and Strengthening the Impact of Social Support on Mental Health.

    Science.gov (United States)

    Gottlieb, Benjamin H.

    1985-01-01

    Guidelines are given to assess the sources and types of social support people use as first and direct lines of defense in coping with life events and chronic hardships and to highlight how these ties mediate access to other supportive peer relationships. Suggests social workers organize groups and workshops to assess and strengthen network…

  14. Application of Bayesian networks for hazard ranking of nanomaterials to support human health risk assessment.

    Science.gov (United States)

    Marvin, Hans J P; Bouzembrak, Yamine; Janssen, Esmée M; van der Zande, Meike; Murphy, Finbarr; Sheehan, Barry; Mullins, Martin; Bouwmeester, Hans

    2017-02-01

    In this study, a Bayesian Network (BN) was developed for the prediction of the hazard potential and biological effects with the focus on metal- and metal-oxide nanomaterials to support human health risk assessment. The developed BN captures the (inter) relationships between the exposure route, the nanomaterials physicochemical properties and the ultimate biological effects in a holistic manner and was based on international expert consultation and the scientific literature (e.g., in vitro/in vivo data). The BN was validated with independent data extracted from published studies and the accuracy of the prediction of the nanomaterials hazard potential was 72% and for the biological effect 71%, respectively. The application of the BN is shown with scenario studies for TiO2, SiO2, Ag, CeO2, ZnO nanomaterials. It is demonstrated that the BN may be used by different stakeholders at several stages in the risk assessment to predict certain properties of a nanomaterials of which little information is available or to prioritize nanomaterials for further screening.

  15. mDurance: A Novel Mobile Health System to Support Trunk Endurance Assessment

    Directory of Open Access Journals (Sweden)

    Oresti Banos

    2015-06-01

    Full Text Available Low back pain is the most prevalent musculoskeletal condition. This disorder constitutes one of the most common causes of disability worldwide, and as a result, it has a severe socioeconomic impact. Endurance tests are normally considered in low back pain rehabilitation practice to assess the muscle status. However, traditional procedures to evaluate these tests suffer from practical limitations, which potentially lead to inaccurate diagnoses. The use of digital technologies is considered here to facilitate the task of the expert and to increase the reliability and interpretability of the endurance tests. This work presents mDurance, a novel mobile health system aimed at supporting specialists in the functional assessment of trunk endurance by using wearable and mobile devices. The system employs a wearable inertial sensor to track the patient trunk posture, while portable electromyography sensors are used to seamlessly measure the electrical activity produced by the trunk muscles. The information registered by the sensors is processed and managed by a mobile application that facilitates the expert’s normal routine, while reducing the impact of human errors and expediting the analysis of the test results. In order to show the potential of the mDurance system, a case study has been conducted. The results of this study prove the reliability of mDurance and further demonstrate that practitioners are certainly interested in the regular use of a system of this nature.

  16. Developing a decision support system to link health technology assessment (HTA) reports to the health system policies in Iran.

    Science.gov (United States)

    Yazdani, Shahram; Jadidfard, Mohammad-Pooyan

    2017-05-01

    The recent increase of 'Health Technology Assessment' (HTA)-related activities in Iran has necessitated the clarification of policy-making process based on the HTA reports. This study aimed to develop a Decision Support System (DSS) in order to adopt evidence-informed policies regarding health technologies in Iran. The study can be classified as Health Policy and Systems Research. A core panel of seven experts conducted two separate reviews of relevant literature for: 1- Determining the potential technology-related policies. 2- Listing the criteria influencing those policy decisions. The policies and criteria were separately discussed and subsequently rated for appropriateness and necessity during two expert meetings in 2013. In the next step, The 'Discrete Choice Experiment' (DCE) method was employed to develop the DSS for the final technology-related policies. Accordingly, the core panel members independently rated the appropriateness of each policy for 30 virtual technologies based on the random values assigned to all the criteria for each technology. The obtained data for each policy were separately analysed using stepwise regression model, resulting in a minimal set of independent and statistically significant criteria contributing in the experts' judgments about the appropriateness of that policy. The obtained regression coefficients were used as the relative weights of the different levels of the final criteria of any policy statement, shaping the decision support scoring tool for each policy. The study has outlined 64 policy decisions under 7 macro policy areas concerning a health technology. Also, 34 criteria used for making those policy decisions have been organized within a portfolio. DCE, using stepwise regression, resulted in 64 scoring tools shaping the DSS for all HTA-related policies. Both the results and methodology of the study may serve as a guide for policy makers (researchers), particularly in low and middle income countries, in developing

  17. CATCH/IT: a data warehouse to support comprehensive assessment for tracking community health.

    Science.gov (United States)

    Berndt, D. J.; Hevner, A. R.; Studnicki, J.

    1998-01-01

    A systematic methodology, Comprehensive Assessment for Tracking Community Health (CATCH), for analyzing the health status of communities has been under development at the University of South Florida since the early 1990s. CATCH draws 226 health status indicators from multiple data sources and uses an innovative comparative framework and weighted evaluation criteria to produce a rank-ordered list of community health problems. CATCH has been applied successfully in many Florida counties; focusing attention on high priority health issues and measuring the impact of health expenditures on community health status outcomes. Previously performed manually, we are using information technology (IT) to automate the CATCH methodology with a full-scale data warehouse, user-friendly forms and reports, and extended analysis and data mining capabilities. The automated system, CATCH/IT, will reduce the time to prepare community health status reports from months to days. In this paper, we present the current status of the project, along with the principal research and development issues and future directions of the project. PMID:9929220

  18. CATCH/IT: a data warehouse to support comprehensive assessment for tracking community health.

    Science.gov (United States)

    Berndt, D J; Hevner, A R; Studnicki, J

    1998-01-01

    A systematic methodology, Comprehensive Assessment for Tracking Community Health (CATCH), for analyzing the health status of communities has been under development at the University of South Florida since the early 1990s. CATCH draws 226 health status indicators from multiple data sources and uses an innovative comparative framework and weighted evaluation criteria to produce a rank-ordered list of community health problems. CATCH has been applied successfully in many Florida counties; focusing attention on high priority health issues and measuring the impact of health expenditures on community health status outcomes. Previously performed manually, we are using information technology (IT) to automate the CATCH methodology with a full-scale data warehouse, user-friendly forms and reports, and extended analysis and data mining capabilities. The automated system, CATCH/IT, will reduce the time to prepare community health status reports from months to days. In this paper, we present the current status of the project, along with the principal research and development issues and future directions of the project.

  19. Development of a Survey to Assess Local Health Department Organizational Processes and Infrastructure for Supporting Obesity Prevention.

    Science.gov (United States)

    Xiao, Ting; Stamatakis, Katherine A; McVay, Allese B

    2017-12-07

    Local health departments (LHDs) have an important function in controlling the growing epidemic of obesity in the United States. Data are needed to gain insight into the existence of routine functions and structures of LHDs that support and sustain obesity prevention efforts. The purpose of this study was to develop and examine the reliability of measures to assess foundational LHD organizational processes and functions specific to obesity prevention. Survey measures were developed using a stratified, random sample of US LHDs to assess supportive organizational processes and infrastructure for obesity prevention representing different domains. Data were analyzed using weighted κ and intraclass correlation coefficient for assessing test-retest reliability. Most items and summary indices in the majority of survey domains had moderate/substantial or almost perfect reliability. The overall findings support this survey instrument to be a reliable measurement tool for a large number of processes and functions that comprise obesity prevention-related capacity in LHDs.

  20. Trialing the Community-Based Collaborative Action Research Framework: Supporting Rural Health Through a Community Health Needs Assessment.

    Science.gov (United States)

    Van Gelderen, Stacey A; Krumwiede, Kelly A; Krumwiede, Norma K; Fenske, Candace

    2018-01-01

    To describe the application of the Community-Based Collaborative Action Research (CBCAR) framework to uplift rural community voices while conducting a community health needs assessment (CHNA) by formulating a partnership between a critical access hospital, public health agency, school of nursing, and community members to improve societal health of this rural community. This prospective explorative study used the CBCAR framework in the design, collection, and analysis of the data. The framework phases include: Partnership, dialogue, pattern recognition, dialogue on meaning of pattern, insight into action, and reflecting on evolving pattern. Hospital and public health agency leaders learned how to use the CBCAR framework when conducting a CHNA to meet Affordable Care Act federal requirements. Closing the community engagement gap helped ensure all voices were heard, maximized intellectual capital, synergized efforts, improved communication by establishing trust, aligned resources with initiatives, and diminished power struggles regarding rural health. The CBCAR framework facilitated community engagement and promoted critical dialogue where community voices were heard. A sustainable community-based collaborative was formed. The project increased the critical access hospital's capacity to conduct a CHNA. The collaborative's decision-making capacity was challenged and ultimately strengthened as efforts continue to be made to address rural health.

  1. Mental health and psychosocial support for South Sudanese refugees in northern Uganda: a needs and resource assessment.

    Science.gov (United States)

    Adaku, Alex; Okello, James; Lowry, Blakeley; Kane, Jeremy C; Alderman, Stephen; Musisi, Seggane; Tol, Wietse A

    2016-01-01

    Since December 2013, an armed conflict in South Sudan has resulted in the displacement of over 2.2 million people, more than 270,000 of whom are presently in refugee settlements located throughout Uganda. Existing literature suggests that refugees are at increased risk for a range of mental health and psychosocial problems. There is international consensus on the importance of needs and resource assessments to inform potential mental health and psychosocial support (MHPSS) interventions. We conducted a MHPSS needs and resource assessment in Rhino Camp refugee settlement in northern Uganda, between June and August 2014. We followed World Health Organization (WHO) and United Nations High Commissioner for Refugees (UNHCR) guidelines for MHPSS needs assessments in humanitarian settings. The assessment used a range of methodologies including: 1) a desk (literature) review to understand the context for mental health service provision; 2) an analysis of data from existing health information systems (HIS); 3) an assessment of the current infrastructure for service provision using a shortened version of a Who does What Where until When (4Ws); and 4) semi-structured individual and group interviews (total n = 86) with key informants (n = 13) and general community members (individual interviews n = 28, four focus groups with n = 45). Data from the HIS indicated that visits to health centers in refugee settlements attributable to psychotic disorders, severe emotional disorders, and other psychological complaints increased following the refugee influx between 2013 and 2014, but overall help-seeking from health centers was low compared to estimates from epidemiological studies. In semi-structured interviews the three highest ranked mental health and psychosocial problems included "overthinking", ethnic conflict, and child abuse. Other concerns included family separation, drug abuse, poverty, and unaccompanied minors. The 4Ws assessment revealed that there were

  2. Decision-Oriented Health Technology Assessment: One Step Forward in Supporting the Decision-Making Process in Hospitals.

    Science.gov (United States)

    Ritrovato, Matteo; Faggiano, Francesco C; Tedesco, Giorgia; Derrico, Pietro

    2015-06-01

    This article outlines the Decision-Oriented Health Technology Assessment: a new implementation of the European network for Health Technology Assessment Core Model, integrating the multicriteria decision-making analysis by using the analytic hierarchy process to introduce a standardized methodological approach as a valued and shared tool to support health care decision making within a hospital. Following the Core Model as guidance (European network for Health Technology Assessment. HTA core model for medical and surgical interventions. Available from: http://www.eunethta.eu/outputs/hta-core-model-medical-and-surgical-interventions-10r. [Accessed May 27, 2014]), it is possible to apply the analytic hierarchy process to break down a problem into its constituent parts and identify priorities (i.e., assigning a weight to each part) in a hierarchical structure. Thus, it quantitatively compares the importance of multiple criteria in assessing health technologies and how the alternative technologies perform in satisfying these criteria. The verbal ratings are translated into a quantitative form by using the Saaty scale (Saaty TL. Decision making with the analytic hierarchy process. Int J Serv Sci 2008;1:83-98). An eigenvectors analysis is used for deriving the weights' systems (i.e., local and global weights' system) that reflect the importance assigned to the criteria and the priorities related to the performance of the alternative technologies. Compared with the Core Model, this methodological approach supplies a more timely as well as contextualized evidence for a specific technology, making it possible to obtain data that are more relevant and easier to interpret, and therefore more useful for decision makers to make investment choices with greater awareness. We reached the conclusion that although there may be scope for improvement, this implementation is a step forward toward the goal of building a "solid bridge" between the scientific evidence and the final decision

  3. Health Literacy, Social Support, and Health Status among Older Adults

    Science.gov (United States)

    Lee, Shoou-Yih D.; Arozullah, Ahsan M.; Cho, Young Ik; Crittenden, Kathleen; Vicencio, Daniel

    2009-01-01

    The study examines whether social support interacts with health literacy in affecting the health status of older adults. Health literacy is assessed using the short version of the Test of Functional Health Literacy in Adults. Social support is measured with the Medical Outcome Study social support scale. Results show, unexpectedly, that rather…

  4. Guidance for Considering and Using Open Literature Toxicity Studies to Support Human Health Risk Assessment

    Science.gov (United States)

    This guidance was developed to assist OPP scientists and is intended for use in OPP’s risk assessments. It is intended to ensure consistent consideration, use, and documentation of information in the open literature by OPP scientists and risk assessors.

  5. Participatory health impact assessment used to support decision-making in waste management planning: A replicable experience from Italy.

    Science.gov (United States)

    Linzalone, Nunzia; Coi, Alessio; Lauriola, Paolo; Luise, Daniela; Pedone, Alessandra; Romizi, Roberto; Sallese, Domenico; Bianchi, Fabrizio

    2017-01-01

    The lack of participatory tools in Health Impact Assessment (HIA) to support decision-makers is a critical factor that negatively affects the impacts of waste policies. This study describes the participatory HIA used in deciding on the possible doubling of the municipal solid waste incinerating plant located near the city of Arezzo, Italy. Within the framework of the new waste management plan, a methodology for the democratic participation of stakeholders was designed adopting the Local Agenda 21 methodology. Communication and participation events with the stakeholders were set up from the plan's development to its implementation. Eleven different categories of stakeholders including individual citizens were involved in 21 local events, reaching over 500 participants in three years. Actions were performed to build the commitment and ownership of the local administrators. Then, together with the environment and health agencies and a representative from the local committees, the local administrators collaborated with scientists and technicians in the knowledge-building and scoping stages. Focus groups of voluntary citizens worked together with the researchers to provide qualitative and quantitative evidence in the assessment stage. Periodic public forums were held to discuss processes, methods and findings. The local government authority considered the HIA results in the final decision and a new waste strategy was adopted both in the short term (increased curbside collection, waste sustainability program) and in the long term (limited repowering of the incinerator, new targets for separate collection). In conclusion, an effective participatory HIA was carried out at the municipal level to support decision makers in the waste management plan. The HIA21 study contributed to evidence-based decisions and to make a broadly participatory experience. The authors are confident that these achievements may improve the governance of the waste cycle and the trust in the public

  6. Supporting analyses and assessments

    Energy Technology Data Exchange (ETDEWEB)

    Ohi, J. [National Renewable Energy Lab., Golden, CO (United States)

    1995-09-01

    Supporting analysis and assessments can provide a sound analytic foundation and focus for program planning, evaluation, and coordination, particularly if issues of hydrogen production, distribution, storage, safety, and infrastructure can be analyzed in a comprehensive and systematic manner. The overall purpose of this activity is to coordinate all key analytic tasks-such as technology and market status, opportunities, and trends; environmental costs and benefits; and regulatory constraints and opportunities-within a long-term and systematic analytic foundation for program planning and evaluation. Within this context, the purpose of the project is to help develop and evaluate programmatic pathway options that incorporate near and mid-term strategies to achieve the long-term goals of the Hydrogen Program. In FY 95, NREL will develop a comprehensive effort with industry, state and local agencies, and other federal agencies to identify and evaluate programmatic pathway options to achieve the long-term goals of the Program. Activity to date is reported.

  7. Assessment of the health system to support tuberculosis and AIDS care. A study of three rural health districts of Burkina Faso

    Directory of Open Access Journals (Sweden)

    Koine Maxime Drabo

    2010-09-01

    Full Text Available There is increasing evidence demonstrating the importance of healthcare systems for improvement of chronic illness care. The aims of this study were to develop a comprehensive assessment of the health services capacity to provide tuberculosis (TB and human immunodeficiency virus (HIV care but also to enhance patient empowerment, social network and community support. A cross-sectional study was conducted from 1 to 31 of August 2007 in 3 districts of Burkina Faso. We used a step-by-step model and the assessment of chronic illness care (ACIC scale to assess capacities of 24 first line health centres (FLHC and 3 district hospitals (DH for providing TB and HIV/AIDS care. Data for the step-by-step model were extracted from medical records of 75 TB and 66 HIV patients. The ACIC scale was completed by health professionals, 6 medical doctors and 18 nurses, working at the DH level and at the FLHC level, respectively. The biological test for confirmation was free of charge for all the TB patients but only for 10.6% (7/66 HIV cases. Up to the time of the survey, 5 TB (6.6% and 18 HIV+ patients (27.3% have been hospitalised for care at least once, 64 TB (85.3% had been declared cured and 38 HIV (54.5% were under antiretroviral treatment. Health care process organisation for TB and HIV care had distinct areas of weaknesses. From a maximum ACIC score of 11, the overall score for TB care ranged between 1.9 and 4.9 with a median of 3.7 and for HIV care between 2.1 and 6.7 with a median of 4.1. This study provides an illustration of assessing the HIV and TB care combining data from the routine information system and from the chronic illness care assessment tool, to encompass both disease control and patient health perspective. It provides to health managers arguments for clear conclusions and sufficient data for action.

  8. Context-Dependent Prognostics and Health Assessment: A Condition-Based Maintenance Approach That Supports Mission Compliance

    Energy Technology Data Exchange (ETDEWEB)

    Allgood, G.O.; Kercel, S.W.

    1999-04-19

    In today's manufacturing environment, plants, systems, and equipment are being asked to perform at levels not thought possible a decade ago. The intent is to improve process operations and equipment reliability, availability, and maintainability without costly upgrades. Of course these gains must be achieved without impacting operational performance. Downsizing is also taking its toll on operations. Loss of personnel, particularly those who represent the corporate history, is depleting US industries of their valuable experiential base which has been relied on so heavily in the past. These realizations are causing companies to rethink their condition-based maintenance policies by moving away from reacting to equipment problems to taking a proactive approach by anticipating needs based on market and customer requirements. This paper describes a different approach to condition-based maintenance-context-dependent prognostics and health assessment. This diagnostic capability is developed around a context-dependent model that provides a capability to anticipate impending failures and determine machine performance over a protracted period of time. This prognostic capability links operational requirements to an economic performance model. In this context, a system may provide 100% operability with less than 100% functionality. This paradigm is used to facilitate optimal logistic supply and support.

  9. [Supporting health through sports].

    Science.gov (United States)

    Truong, Laurent

    2014-02-01

    In spring 2013, the regional directorate for youth, sports and social cohesion and the regional healthcare agency in Franche-Comté presented and signed the first regional health, sports and well-being plan.

  10. Ready for a goodbye to tobacco? - Assessment of support for endgame strategies on smoking among adults in a Danish regional health survey.

    Science.gov (United States)

    Lykke, Maja; Pisinger, Charlotta; Glümer, Charlotte

    2016-02-01

    To assess support for a future ban on smoking and for increasing tobacco taxes in Denmark, and to explore if support differed across sex, age, educational attainment, smoking status and intention to quit. Data from a 2013 health survey representative of the population aged ≥16years in the Capital Region of Denmark (N=41,356, response rate=43.5) was linked with data on sex, age and education from central registers. Participants were asked if they supported: 1) a future ban on smoking in Denmark, and 2) increased taxes on tobacco products. Subgroup differences were explored using logistic regression. 30.6% supported a future ban on smoking, while 59.0% supported increased taxes. Women were less supportive of a future ban (OR=0.83 (0.78-0.88)) and more supportive of increasing taxes (OR=1.11 (1.06-1.18)) than men. Support for both measures was higher among the youngest. Only small differences were found in ban support across educational attainment, while support for taxes increased with increasing education. Support for both measures were greatest among never smokers (OR=2.66 (2.40-2.93) and OR=9.69 (8.83-10.63)) compared to daily smokers. Smokers intending to quit were two to three times as likely to support a future ban or increased taxes compared to smokers with no quit intensions. One third supported a future ban on smoking, while six out of ten supported increasing taxes. This first Danish study of support for more radical tobacco control adds to the growing literature on tobacco endgame and sets a baseline for future assessments of public support. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Health care technology assessment

    Science.gov (United States)

    Goodman, Clifford

    1994-12-01

    The role of technology in the cost of health care is a primary issue in current debates concerning national health care reform. The broad scope of studies for understanding technological impacts is known as technology assessment. Technology policy makers can improve their decision making by becoming more aware, and taking greater advantage, of key trends in health care technology assessment (HCTA). HCTA is the systematic evaluation of the properties, impacts, and other attributes of health care technologies, including: technical performance; clinical safety and efficacy/effectiveness; cost-effectiveness and other economic attributes; appropriate circumstances/indications for use; and social, legal, ethical, and political impacts. The main purpose of HCTA is to inform technology-related policy making in health care. Among the important trends in HCTA are: (1) proliferation of HCTA groups in the public and private sectors; (2) higher standards for scientific evidence concerning technologies; (3) methodological development in cost analyses, health-related quality of life measurement, and consolidation of available scientific evidence (e.g., meta-analysis); (4) emphasis on improved data on how well technologies work in routine practice and for traditionally under-represented patient groups; (5) development of priority-setting methods; (6) greater reliance on medical informatics to support and disseminate HCTA findings.

  12. Exploring Systems That Support Good Clinical Care in Indigenous Primary Health-care Services: A Retrospective Analysis of Longitudinal Systems Assessment Tool Data from High-Improving Services.

    Science.gov (United States)

    Woods, Cindy; Carlisle, Karen; Larkins, Sarah; Thompson, Sandra Claire; Tsey, Komla; Matthews, Veronica; Bailie, Ross

    2017-01-01

    Continuous Quality Improvement is a process for raising the quality of primary health care (PHC) across Indigenous PHC services. In addition to clinical auditing using plan, do, study, and act cycles, engaging staff in a process of reflecting on systems to support quality care is vital. The One21seventy Systems Assessment Tool (SAT) supports staff to assess systems performance in terms of five key components. This study examines quantitative and qualitative SAT data from five high-improving Indigenous PHC services in northern Australia to understand the systems used to support quality care. High-improving services selected for the study were determined by calculating quality of care indices for Indigenous health services participating in the Audit and Best Practice in Chronic Disease National Research Partnership. Services that reported continuing high improvement in quality of care delivered across two or more audit tools in three or more audits were selected for the study. Precollected SAT data (from annual team SAT meetings) are presented longitudinally using radar plots for quantitative scores for each component, and content analysis is used to describe strengths and weaknesses of performance in each systems' component. High-improving services were able to demonstrate strong processes for assessing system performance and consistent improvement in systems to support quality care across components. Key strengths in the quality support systems included adequate and orientated workforce, appropriate health system supports, and engagement with other organizations and community, while the weaknesses included lack of service infrastructure, recruitment, retention, and support for staff and additional costs. Qualitative data revealed clear voices from health service staff expressing concerns with performance, and subsequent SAT data provided evidence of changes made to address concerns. Learning from the processes and strengths of high-improving services may be useful

  13. Assessing Teachers' Behavior Support Skills

    Science.gov (United States)

    Myers, Diane; Sugai, George; Simonsen, Brandi; Freeman, Jennifer

    2017-01-01

    In this article, the authors provide an overview of empirically supported practices and techniques for monitoring and assessing teachers' use of effective behavior support practices. They focus on how teacher preparation programs, administrators, and supervising teachers provide pre-service teachers with helpful feedback on their teaching…

  14. Assessment of the quality of antenatal care services provided by health workers using a mobile phone decision support application in northern Nigeria: a pre/post-intervention study.

    Science.gov (United States)

    McNabb, Marion; Chukwu, Emeka; Ojo, Oluwayemisi; Shekhar, Navendu; Gill, Christopher J; Salami, Habeeb; Jega, Farouk

    2015-01-01

    Given the shortage of skilled healthcare providers in Nigeria, frontline community health extension workers (CHEWs) are commonly tasked with providing maternal and child health services at primary health centers. In 2012, we introduced a mobile case management and decision support application in twenty primary health centers in northern Nigeria, and conducted a pre-test/post-test study to assess whether the introduction of the app had an effect on the quality of antenatal care services provided by this lower-level cadre. Using the CommCare mobile platform, the app dynamically guides CHEWs through antenatal care protocols and collects client data in real time. Thirteen health education audio clips are also embedded in the app for improving and standardizing client counseling. To detect changes in quality, we developed an evidence-based quality score consisting of 25 indicators, and conducted a total of 266 client exit interviews. We analyzed baseline and endline data to assess changes in the overall quality score as well as changes in the provision of key elements of antenatal care. Overall, the quality score increased from 13.3 at baseline to 17.2 at endline (peducation. These study results suggest that the introduction of a low-cost mobile case management and decision support application can spur behavior change and improve the quality of services provided by a lower level cadre of healthcare workers. Future research should employ a more rigorous experimental design to explore potential longer-term effects on client health outcomes.

  15. The Wild Wild West: A Framework to Integrate mHealth Software Applications and Wearables to Support Physical Activity Assessment, Counseling and Interventions for Cardiovascular Disease Risk Reduction.

    Science.gov (United States)

    Lobelo, Felipe; Kelli, Heval M; Tejedor, Sheri Chernetsky; Pratt, Michael; McConnell, Michael V; Martin, Seth S; Welk, Gregory J

    2016-01-01

    Physical activity (PA) interventions constitute a critical component of cardiovascular disease (CVD) risk reduction programs. Objective mobile health (mHealth) software applications (apps) and wearable activity monitors (WAMs) can advance both assessment and integration of PA counseling in clinical settings and support community-based PA interventions. The use of mHealth technology for CVD risk reduction is promising, but integration into routine clinical care and population health management has proven challenging. The increasing diversity of available technologies and the lack of a comprehensive guiding framework are key barriers for standardizing data collection and integration. This paper reviews the validity, utility and feasibility of implementing mHealth technology in clinical settings and proposes an organizational framework to support PA assessment, counseling and referrals to community resources for CVD risk reduction interventions. This integration framework can be adapted to different clinical population needs. It should also be refined as technologies and regulations advance under an evolving health care system landscape in the United States and globally. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Rapid Assessment of Environmental Health Impacts for Policy Support: The Example of Road Transport in New Zealand

    Directory of Open Access Journals (Sweden)

    David Briggs

    2015-12-01

    Full Text Available An integrated environmental health impact assessment of road transport in New Zealand was carried out, using a rapid assessment. The disease and injury burden was assessed from traffic-related accidents, air pollution, noise and physical (inactivity, and impacts attributed back to modal source. In total, road transport was found to be responsible for 650 deaths in 2012 (2.1% of annual mortality: 308 from traffic accidents, 283 as a result of air pollution, and 59 from noise. Together with morbidity, these represent a total burden of disease of 26,610 disability-adjusted life years (DALYs. An estimated 40 deaths and 1874 DALYs were avoided through active transport. Cars are responsible for about 52% of attributable deaths, but heavy goods vehicles (6% of vehicle kilometres travelled, vkt accounted for 21% of deaths. Motorcycles (1 per cent of vkt are implicated in nearly 8% of deaths. Overall, impacts of traffic-related air pollution and noise are low compared to other developed countries, but road accident rates are high. Results highlight the need for policies targeted at road accidents, and especially at heavy goods vehicles and motorcycles, along with more general action to reduce the reliance on private road transport. The study also provides a framework for national indicator development.

  17. Assessment of the quality of antenatal care services provided by health workers using a mobile phone decision support application in northern Nigeria: a pre/post-intervention study.

    Directory of Open Access Journals (Sweden)

    Marion McNabb

    Full Text Available Given the shortage of skilled healthcare providers in Nigeria, frontline community health extension workers (CHEWs are commonly tasked with providing maternal and child health services at primary health centers. In 2012, we introduced a mobile case management and decision support application in twenty primary health centers in northern Nigeria, and conducted a pre-test/post-test study to assess whether the introduction of the app had an effect on the quality of antenatal care services provided by this lower-level cadre.Using the CommCare mobile platform, the app dynamically guides CHEWs through antenatal care protocols and collects client data in real time. Thirteen health education audio clips are also embedded in the app for improving and standardizing client counseling. To detect changes in quality, we developed an evidence-based quality score consisting of 25 indicators, and conducted a total of 266 client exit interviews. We analyzed baseline and endline data to assess changes in the overall quality score as well as changes in the provision of key elements of antenatal care.Overall, the quality score increased from 13.3 at baseline to 17.2 at endline (p<0.0001, out of a total possible score of 25, with the most significant improvements related to health counseling, technical services provided, and quality of health education.These study results suggest that the introduction of a low-cost mobile case management and decision support application can spur behavior change and improve the quality of services provided by a lower level cadre of healthcare workers. Future research should employ a more rigorous experimental design to explore potential longer-term effects on client health outcomes.

  18. iHealth: supporting health by technology

    NARCIS (Netherlands)

    Ossebaard, Hans Cornelis

    2012-01-01

    This thesis is about how people support their health through the use of technology. It focuses on web-based information and communication technology (ICT). Many factors play a role in the interaction between people, technology and context. In five studies we have investigated a few of them. The

  19. Development and trialling of a tool to support a systems approach to improve social determinants of health in rural and remote Australian communities: the healthy community assessment tool.

    Science.gov (United States)

    McDonald, Elizabeth L; Bailie, Ross; Michel, Thomas

    2013-02-26

    The residents of many Australian rural and remote communities do not have the essential infrastructure and services required to support healthy living conditions and community members choosing healthy lifestyle options. Improving these social determinants of health is seen to offer real opportunities to improve health among such disadvantaged populations. In this paper, we describe the development and trialling of a tool to measure, monitor and evaluate key social determinants of health at community level. The tool was developed and piloted through a multi-phase and iterative process that involved a series of consultations with community members and key stakeholders and trialling the tool in remote Indigenous communities in the Northern Territory of Australia. The indicators were found to be robust, and by testing the tool on a number of different levels, face validity was confirmed. The scoring system was well understood and easily followed by Indigenous and non-Indigenous study participants. A facilitated small group process was found to reduce bias in scoring of indicators. The Healthy Community Assessment Tool offers a useful vehicle and process to help those involved in planning, service provision and more generally promoting improvements in community social determinants of health. The tool offers many potential uses and benefits for those seeking to address inequities in the social determinants of health in remote communities. Maximum benefits in using the tool are likely to be gained with cross-sector involvement and when assessments are part of a continuous quality improvement program.

  20. Health technology assessment in Finland

    DEFF Research Database (Denmark)

    Mäkelä, Marjukka; Roine, Risto P

    2010-01-01

    Since the 1990s, health policy makers in Finland have been supportive of evidence-based medicine and approaches to implement its results. The Finnish Office for Health Technology Assessment (Finohta) has grown from a small start in 1995 to a medium-sized health technology assessment (HTA) agency,...... findings. The Managed Uptake of Medical Methods program links the hospital districts to agree on introduction of technologies. The Ohtanen database provides Finnish-language summaries of major assessments made in other countries.......Since the 1990s, health policy makers in Finland have been supportive of evidence-based medicine and approaches to implement its results. The Finnish Office for Health Technology Assessment (Finohta) has grown from a small start in 1995 to a medium-sized health technology assessment (HTA) agency......, with special responsibility in providing assessments to underpin national policies in screening. External evaluations enhanced the rapid growth. In the Finnish environment, decision making on health technologies is extremely decentralized, so Finohta has developed some practical tools for implementing HTA...

  1. Health assessments for health governance-concepts and methodologies.

    Science.gov (United States)

    Fehr, Rainer; Alexanderson, Kristina; Favaretti, Carlo; de Jong, Judith; La Torre, Giuseppe; Lim, Tek-Ang; Martin-Olmedo, Piedad; Mekel, Odile C L; Michelsen, Kai; Rosenkötter, Nicole; Verschuuren, Marieke; de Waure, Chiara; Zeegers Paget, Dineke

    2017-08-01

    For better supporting the science-governance interface, the potential of health assessments appears underrated. To identify what various types of health assessment have in common; how they differ; which assessment(s) to apply for which purpose; and what needs and options there are for future joint development. This review is based on five types of health assessment: monitoring/surveillance/reporting, assessment of health impact, of health technology, of health systems performance, health-related economic assessment. The approach is exploratory and includes: applying an agreed set of comparative criteria; circulating and supplementing synoptic tables; and interpreting the results. Two of the assessments deal with the question 'Where do we stand?', two others with variants of 'What if' questions. Economic Assessment can take place in combination with any of the others. The assessments involve both overall 'procedures' and a variety of 'methods' which inescapably reflect some subjective assumptions and decisions, e.g. on issue framing. Resources and assistance exist for all these assessments. The paper indicates which type of assessment is appropriate for what purpose. Although scientific soundness of health assessments is not trivial to secure, existing types of health assessment can be interpreted as a useful 'toolkit' for supporting governance. If current traces of 'silo' thinking can be overcome, the attainability of a more unified culture of health assessments increases and such assessments might more widely be recognized as a prime, 'tried and tested' way to voice Public Health knowledge and to support rational governance and policy-making.

  2. A Qualitative Assessment of the Evidence Utilization for Health Policy-Making on the Basis of SUPPORT Tools in a Developing Country

    Directory of Open Access Journals (Sweden)

    Mohammad Hasan Imani-Nasab

    2017-08-01

    Full Text Available Background SUPPORT tools consist of 18 articles addressing the health policy-makers so that they can learn how to make evidence-informed health policies. These tools have been particularly recommended for developing countries. The present study tries to explain the process of evidence utilization for developing policy documents in the Iranian Ministry of Health and Medical Education (MoHME and to compare the findings with those of SUPPORT tools. Methods A qualitative research was conducted, using the framework analysis approach. Participants consisted of senior managers and technicians in MoHME. Purposeful sampling was done, with a maximum variety, for the selection of research participants: individuals having at least 5 years of experience in preparing evidence-based policy documents. Face-to-face interviews were conducted for data collection. As a guideline for the interviews, ‘the Utilization of Evidence in Policy Making Organizations’ procedure was used. The data were analyzed through the analysis of the framework method using MAXQDA 10 software. Results The participants acquired the research evidence in a topic-based form, and they were less likely to search on the basis of the evidence pyramid. To assess the quality of evidence, they did not use standard critical tools; to adapt the evidence and interventions with the local setting, they did not use the ideas and experiences of all stakeholders, and in preparing the evidence-based policy documents, they did not take into consideration the window of opportunity, did not refrain from using highly technical terms, did not write user-friendly summaries, and did not present alternative policy options. In order to develop health policies, however, they used the following innovations: attention to the financial burden of policy issues on the agenda, sensitivity analysis of the preferred policy option on the basis of technical, sociopolitical, and economic feasibility, advocacy from other

  3. Exploring a clinically friendly web-based approach to clinical decision support linked to the electronic health record: design philosophy, prototype implementation, and framework for assessment.

    Science.gov (United States)

    Miller, Perry; Phipps, Michael; Chatterjee, Sharmila; Rajeevan, Nallakkandi; Levin, Forrest; Frawley, Sandra; Tokuno, Hajime

    2014-07-01

    Computer-based clinical decision support (CDS) is an important component of the electronic health record (EHR). As an increasing amount of CDS is implemented, it will be important that this be accomplished in a fashion that assists in clinical decision making without imposing unacceptable demands and burdens upon the provider's practice. The objective of our study was to explore an approach that allows CDS to be clinician-friendly from a variety of perspectives, to build a prototype implementation that illustrates features of the approach, and to gain experience with a pilot framework for assessment. The paper first discusses the project's design philosophy and goals. It then describes a prototype implementation (Neuropath/CDS) that explores the approach in the domain of neuropathic pain and in the context of the US Veterans Administration EHR. Finally, the paper discusses a framework for assessing the approach, illustrated by a pilot assessment of Neuropath/CDS. The paper describes the operation and technical design of Neuropath/CDS, as well as the results of the pilot assessment, which emphasize the four areas of focus, scope, content, and presentation. The work to date has allowed us to explore various design and implementation issues relating to the approach illustrated in Neuropath/CDS, as well as the development and pilot application of a framework for assessment.

  4. Onboard System Health Assessment

    Science.gov (United States)

    Barry, Tom; Cunningham, Harry

    1990-01-01

    Viewgraphs and discussion of onboard system health assessment are presented. Success of the space station program will be measured by how well it addresses the basic requirements for (1) maintaining the orbiting Space Station Freedom fully operational for its projected life of thirty years, and (2) the cost-effective execution of the overall space station program. Onboard system health assessment must provide complete and thorough testing capabilities along with effective associated redundancy/fault management.

  5. Improving health worker performance of abortion services: an assessment of post-training support to providers in India, Nepal and Nigeria.

    Science.gov (United States)

    Benson, Janie; Healy, Joan; Dijkerman, Sally; Andersen, Kathryn

    2017-11-21

    Health worker performance has been the focus of numerous interventions and evaluation studies in low- and middle-income countries. Few have examined changes in individual provider performance with an intervention encompassing post-training support contacts to improve their clinical practice and resolve programmatic problems. This paper reports the results of an intervention with 3471 abortion providers in India, Nepal and Nigeria. Following abortion care training, providers received in-person visits and virtual contacts by a clinical and programmatic support team for a 12-month period, designed to address their individual practice issues. The intervention also included technical assistance to and upgrades in facilities where the providers worked. Quantitative measures to assess provider performance were established, including: 1) Increase in service provision; 2) Consistent service provision; 3) Provision of high quality of care through use of World Health Organization-recommended uterine evacuation technologies, management of pain and provision of post-abortion contraception; and 4) Post-abortion contraception method mix. Descriptive univariate analysis was conducted, followed by examination of the bivariate relationships between all independent variables and the four dependent performance outcome variables by calculating unadjusted odds ratios, by country and overall. Finally, multivariate logistic regression was performed for each outcome. Providers received an average of 5.7 contacts. Sixty-two percent and 46% of providers met measures for consistent service provision and quality of care, respectively. Fewer providers achieved an increased number of services (24%). Forty-six percent provided an appropriate postabortion contraceptive mix to clients. Most providers met the quality components for use of WHO-recommended abortion methods and provision of pain management. Factors significantly associated with achievement of all measures were providers working in

  6. Integrated Clinical Decision Support Systems Promote Absolute Cardiovascular Risk Assessment: An Important Primary Prevention Measure in Aboriginal and Torres Strait Islander Primary Health Care

    Directory of Open Access Journals (Sweden)

    Veronica Matthews

    2017-09-01

    Full Text Available BackgroundAboriginal and Torres Strait Islander Australians experience a greater burden of disease compared to non-Indigenous Australians. Around one-fifth of the health disparity is caused by cardiovascular disease (CVD. Despite the importance of absolute cardiovascular risk assessment (CVRA as a screening and early intervention tool, few studies have reported its use within the Australian Indigenous primary health care (PHC sector. This study utilizes data from a large-scale quality improvement program to examine variation in documented CVRA as a primary prevention strategy for individuals without prior CVD across four Australian jurisdictions. We also examine the proportion with elevated risk and follow-up actions recorded.MethodsWe undertook cross-sectional analysis of 2,052 client records from 97 PHC centers to assess CVRA in Indigenous adults aged ≥20 years with no recorded chronic disease diagnosis (2012–2014. Multilevel regression was used to quantify the variation in CVRA attributable to health center and client level factors. The main outcome measure was the proportion of eligible adults who had CVRA recorded. Secondary outcomes were the proportion of clients with elevated risk that had follow-up actions recorded.ResultsApproximately 23% (n = 478 of eligible clients had documented CVRA. Almost all assessments (99% were conducted in the Northern Territory. Within this jurisdiction, there was wide variation between centers in the proportion of clients with documented CVRA (median 38%; range 0–86%. Regression analysis showed health center factors accounted for 48% of the variation. Centers with integrated clinical decision support systems were more likely to document CVRA (OR 21.1; 95% CI 5.4–82.4; p < 0.001. Eleven percent (n = 53 of clients were found with moderate/high CVD risk, of whom almost one-third were under 35 years (n = 16. Documentation of follow-up varied with respect to the targeted risk factor

  7. Identifying the unmet health needs of patients with congenital hypogonadotropic hypogonadism using a web-based needs assessment: implications for online interventions and peer-to-peer support.

    Science.gov (United States)

    Dwyer, Andrew A; Quinton, Richard; Morin, Diane; Pitteloud, Nelly

    2014-06-11

    Patients with rare diseases such as congenital hypogonadotropic hypogonadism (CHH) are dispersed, often challenged to find specialized care and face other health disparities. The internet has the potential to reach a wide audience of rare disease patients and can help connect patients and specialists. Therefore, this study aimed to: (i) determine if web-based platforms could be effectively used to conduct an online needs assessment of dispersed CHH patients; (ii) identify the unmet health and informational needs of CHH patients and (iii) assess patient acceptability regarding patient-centered, web-based interventions to bridge shortfalls in care. A sequential mixed-methods design was used: first, an online survey was conducted to evaluate health promoting behavior and identify unmet health and informational needs of CHH men. Subsequently, patient focus groups were held to explore specific patient-identified targets for care and to examine the acceptability of possible online interventions. Descriptive statistics and thematic qualitative analyses were used. 105 male participants completed the online survey (mean age 37 ± 11, range 19-66 years) representing a spectrum of patients across a broad socioeconomic range and all but one subject had adequate healthcare literacy. The survey revealed periods of non-adherence to treatment (34/93, 37%) and gaps in healthcare (36/87, 41%) exceeding one year. Patient focus groups identified lasting psychological effects related to feelings of isolation, shame and body-image concerns. Survey respondents were active internet users, nearly all had sought CHH information online (101/105, 96%), and they rated the internet, healthcare providers, and online community as equally important CHH information sources. Focus group participants were overwhelmingly positive regarding online interventions/support with links to reach expert healthcare providers and for peer-to-peer support. The web-based needs assessment was an effective way

  8. Revised Human Health Risk Assessment on Chlorpyrifos

    Science.gov (United States)

    We have revised our human health risk assessment and drinking water exposure assessment for chlorpyrifos that supported our October 2015 proposal to revoke all food residue tolerances for chlorpyrifos. Learn about the revised analysis.

  9. Parental support and mental health among transgender adolescents.

    Science.gov (United States)

    Simons, Lisa; Schrager, Sheree M; Clark, Leslie F; Belzer, Marvin; Olson, Johanna

    2013-12-01

    Family support is protective against health risks in sexual minority individuals. However, few studies have focused specifically on transgender youth, who often experience rejection, marginalization, and victimization that place them at risk for poor mental health. This study investigated the relationships among parental support, quality of life, and depression in transgender adolescents. A total of 66 transgender youth presenting for care at Children's Hospital Los Angeles completed a survey assessing parental support (defined as help, advice, and confidante support), quality of life, and depression. Regression analyses assessed the associations between parental support and mental health outcomes. Parental support was significantly associated with higher life satisfaction, lower perceived burden of being transgender, and fewer depressive symptoms. Parental support is associated with higher quality of life and is protective against depression in transgender adolescents. Interventions that promote parental support may significantly affect the mental health of transgender youth. Copyright © 2013 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  10. Peer support telephone calls for improving health.

    Science.gov (United States)

    Dale, Jeremy; Caramlau, Isabela O; Lindenmeyer, Antje; Williams, Susan M

    2008-10-08

    Peer support telephone calls have been used for a wide range of health-related concerns. However, little is known about their effects. To assess the effects of peer support telephone calls in terms of physical (e.g. blood pressure), psychological (e.g. depressive symptoms), and behavioural health outcomes (e.g. uptake of mammography) and other outcomes. We searched: The Cochrane Library databases (CENTRAL, DARE, CDSR) (issue 4 2007); MEDLINE (OVID) (January 1966 to December 2007); EMBASE (OVID) (January 1985 to December 2007); CINAHL (Athens) (January 1966 to December 2007), trials registers and reference lists of articles, with no language restrictions. Randomised controlled trials of peer support interventions delivered by telephone call. Two review authors independently extracted data. We present results narratively and in tabular format. Meta-analysis was not possible due to heterogeneity between studies. We included seven studies involving 2492 participants.Peer support telephone calls were associated with an increase in mammography screening, with 49% of women in the intervention group and 34% of women in the control group receiving a mammogram since the start of the intervention (P peer telephone support calls were found to maintain mammography screening uptake for baseline adherent women (P = 0.029).Peer support telephone calls for post myocardial infarction patients were associated at six months with a change in diet in the intervention and usual care groups of 54% and 44% respectively (P = 0.03). In another study for post myocardial infarction patients there were no significant differences between groups for self-efficacy, health status and mental health outcomes.Peer support telephone calls were associated with greater continuation of breastfeeding in mothers at 3 months post partum (P = 0.01).Peer support telephone calls were associated with reduced depressive symptoms in mothers with postnatal depression (Edinburgh Postnatal Depression Scale (EPDS

  11. Combining multi-criteria decision analysis and mini-health technology assessment: A funding decision-support tool for medical devices in a university hospital setting.

    Science.gov (United States)

    Martelli, Nicolas; Hansen, Paul; van den Brink, Hélène; Boudard, Aurélie; Cordonnier, Anne-Laure; Devaux, Capucine; Pineau, Judith; Prognon, Patrice; Borget, Isabelle

    2016-02-01

    At the hospital level, decisions about purchasing new and oftentimes expensive medical devices must take into account multiple criteria simultaneously. Multi-criteria decision analysis (MCDA) is increasingly used for health technology assessment (HTA). One of the most successful hospital-based HTA approaches is mini-HTA, of which a notable example is the Matrix4value model. To develop a funding decision-support tool combining MCDA and mini-HTA, based on Matrix4value, suitable for medical devices for individual patient use in French university hospitals - known as the IDA tool, short for 'innovative device assessment'. Criteria for assessing medical devices were identified from a literature review and a survey of 18 French university hospitals. Weights for the criteria, representing their relative importance, were derived from a survey of 25 members of a medical devices committee using an elicitation technique involving pairwise comparisons. As a test of its usefulness, the IDA tool was applied to two new drug-eluting beads (DEBs) for transcatheter arterial chemoembolization. The IDA tool comprises five criteria and weights for each of two over-arching categories: risk and value. The tool revealed that the two new DEBs conferred no additional value relative to DEBs currently available. Feedback from participating decision-makers about the IDA tool was very positive. The tool could help to promote a more structured and transparent approach to HTA decision-making in French university hospitals. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Health equity impact assessment.

    Science.gov (United States)

    Povall, Susan L; Haigh, Fiona A; Abrahams, Debbie; Scott-Samuel, Alex

    2014-12-01

    The World Health Organization's Commission on Social Determinants of Health has called for 'health equity impact assessments' of all economic agreements, market regulation and public policies. We carried out an international study to clarify if existing health impact assessment (HIA) methods are adequate for the task of global health equity assessments. We triangulated data from a scoping review of the international literature, in-depth interviews with health equity and HIA experts and an international stakeholder workshop. We found that equity is not addressed adequately in HIAs for a variety of reasons, including inadequate guidance, absence of definitions, poor data and evidence, perceived lack of methods and tools and practitioner unwillingness or inability to address values like fairness and social justice. Current methods can address immediate, 'downstream' factors, but not the root causes of inequity. Extending HIAs to cover macro policy and global equity issues will require new tools to address macroeconomic policies, historical roots of inequities and upstream causes like power imbalances. More sensitive, participatory methods are also required. There is, however, no need for the development of a completely new methodology. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  13. Introducing Health Impact Assessment

    DEFF Research Database (Denmark)

    Mannheimer, L N; Gulis, G; Lehto, J

    2007-01-01

    BACKGROUND: Intersectoral Action for Health (IAH) and its Health Impact Assessment (HIA) tool are built on collaboration between actors and sectors, requiring multidimensional and horizontal way of working. The study aims to analyse the enablers and barriers when such a new way of working and tool...... used by which the actual problems, the governmental actions (or non-actions) (politics) and the understanding, implementation and evaluation of the initiative (policy) could be analysed. All actors involved, civil servants, politicians, representatives of the local public health institute...

  14. A Framework to Assist Health Professionals in Recommending High-Quality Apps for Supporting Chronic Disease Self-Management: Illustrative Assessment of Type 2 Diabetes Apps

    Science.gov (United States)

    Capra, Sandra; Bauer, Judith

    2015-01-01

    Background This paper presents an approach to assist health professionals in recommending high quality apps for supporting chronic disease self-management. Most app reviews focus on popularity, aesthetics, functionality, usability, and information quality. There is no doubt these factors are important in selecting trustworthy apps which are appealing to users, but behavioral theory may be also be useful in matching the apps to user needs. Objective The framework developed aims to be methodologically sound, capable of selecting popular apps which include content covered by evidence-based programs, consistent with behavioral theory, as well as a patient-centered approach for matching apps to patients’ individual needs. Methods A single disease—type 2 diabetes—was selected to illustrate how the framework can be applied as this was deemed to represent the types of strategies used in many chronic diseases. A systematic approach based on behavioral theory and recommendations from best practice guidelines was developed for matching apps to patients’ needs. In March 2014, a series of search strategies was used to identify top-rated iPhone and Android health apps, representing 29 topics from five categories of type 2 diabetes self-management strategies. The topics were chosen from published international guidelines for the management of diabetes. The senior author (KH) assessed the most popular apps found that addressed these topics using the Behavioral Theory Content Survey (BTS), which is based on traditional behavioral theory. A tool to assist decision making when using apps was developed and trialed with health professionals for ease of use and understanding. Results A total of 14 apps were assessed representing all five topic categories of self-management. Total theoretical scores (BTS scores) were less than 50 on a 100-point scale for all apps. Each app scored less than 50% of the total possible BTS score for all four behavioral theories and for most of the 20

  15. A Framework to Assist Health Professionals in Recommending High-Quality Apps for Supporting Chronic Disease Self-Management: Illustrative Assessment of Type 2 Diabetes Apps.

    Science.gov (United States)

    Hale, Kelli; Capra, Sandra; Bauer, Judith

    2015-09-14

    This paper presents an approach to assist health professionals in recommending high quality apps for supporting chronic disease self-management. Most app reviews focus on popularity, aesthetics, functionality, usability, and information quality. There is no doubt these factors are important in selecting trustworthy apps which are appealing to users, but behavioral theory may be also be useful in matching the apps to user needs. The framework developed aims to be methodologically sound, capable of selecting popular apps which include content covered by evidence-based programs, consistent with behavioral theory, as well as a patient-centered approach for matching apps to patients' individual needs. A single disease-type 2 diabetes-was selected to illustrate how the framework can be applied as this was deemed to represent the types of strategies used in many chronic diseases. A systematic approach based on behavioral theory and recommendations from best practice guidelines was developed for matching apps to patients' needs. In March 2014, a series of search strategies was used to identify top-rated iPhone and Android health apps, representing 29 topics from five categories of type 2 diabetes self-management strategies. The topics were chosen from published international guidelines for the management of diabetes. The senior author (KH) assessed the most popular apps found that addressed these topics using the Behavioral Theory Content Survey (BTS), which is based on traditional behavioral theory. A tool to assist decision making when using apps was developed and trialed with health professionals for ease of use and understanding. A total of 14 apps were assessed representing all five topic categories of self-management. Total theoretical scores (BTS scores) were less than 50 on a 100-point scale for all apps. Each app scored less than 50% of the total possible BTS score for all four behavioral theories and for most of the 20 behavioral strategies; however, apps scored

  16. Health needs assessment

    Directory of Open Access Journals (Sweden)

    Ibrahim A Bani

    2008-01-01

    The findings of the assessment of the health needs of Jazan presented in this review could be utilized as a baseline and reference information for policy formulation, subsequent planning and cost effective intervention programs. It could also be utilized for the curriculum development or review for a community oriented medical schools.

  17. Perceived workplace health support is associated with employee productivity.

    Science.gov (United States)

    Chen, Lu; Hannon, Peggy A; Laing, Sharon S; Kohn, Marlana J; Clark, Kathleen; Pritchard, Scott; Harris, Jeffrey R

    2015-01-01

    To examine the relationship between perceived workplace health support and employee productivity. A quantitative cross-sectional study. Washington State agencies. A total of 3528 employees from six state agencies were included in this analysis. Perceived workplace health support was assessed by two questions that queried respondents on how often they felt supported by the workplace for healthy living and physical activity. The Work Productivity and Activity Impairment Questionnaire was used to measure health-related absenteeism and presenteeism in the past 7 days. Multivariate linear regression was used to estimate the mean differences in productivity by levels of perceived health support. Most participants were between 45 and 64 years of age and were predominantly non-Hispanic white. Presenteeism varied significantly by the level of perceived workplace health support, with those who felt least supported having higher presenteeism than those who felt most supported. The difference in presenteeism by perceived workplace support remained significant in models adjusting for sociodemographic and health characteristics (mean difference: 7.1% for support for healthy living, 95% confidence interval: 3.7%, 10.4%; 4.3% for support for physical activity, 95% confidence interval: 1.7%, 6.8%). Absenteeism was not associated with perceived workplace health support. Higher perceived workplace health support is independently associated with higher work productivity. Employers may see productivity benefit from wellness programs through improved perceptions of workplace health support.

  18. Social support and physical health: understanding the health consequences of relationships

    National Research Council Canada - National Science Library

    Uchino, Bert N

    2004-01-01

    .... It surveys and assesses the research that shows not only that supportive relationships protect us from a multitude of mental health problems but also that the absence of supportive relationships...

  19. ITSM process assessment supporting ITIL

    CERN Document Server

    Barafort, Béatrix; Cortina, Stéphane

    2009-01-01

    The key to any successful IT Service Management solution are strong, clear processes that are fit for purpose. The continual cycle of service improvements must therefore look at the existing processes and assess how effective they are within changing business requirements.This innovative title not only looks at this fundamental process assessment, it does it using the key ISO/IEC standard in this area. In brief, this title explains the meeting between two standards:ITIL: the de facto standard in IT Service Management.ISO/IEC 15504 Information technology - Process assessmentReaders can therefor

  20. Comparative environmental health assessments.

    Science.gov (United States)

    Smith, Kirk R

    2008-10-01

    Conceptual and methodological issues in calculating and comparing the health impacts from environmental risk factors in ways that are not only compatible across environmental hazards but also can be fairly compared to burdens from nonenvironmental risk factors, such as poor nutrition, unsafe sex, and smoking, are discussed. It is emphasized that a focus on environmental health burden does not always produce priorities that correspond to those related to environmental quality alone. The methods when applied to China's environmental and other risks using the Chinese burden of disease in terms of lost healthy life years as the metric are illustrated. Household environmental risks are still quite important in China, because of rural poverty, but have been exceeded by community environmental risks nationally. Global risks from climate are small at present, but have the potential to rise. Although not a major greenhouse gas emitter on a per capita basis compared to rich countries, China has already passed the threshold of imposing more global risk than it receives. The study ends with the suggestion that environmental risk assessment should use as a baseline estimates that are based on methods developed in international collaborative assessments, such as those in the WHO Comparative Risk Assessment, in order to foster comparability and policy and public confidence in the methods.

  1. How Positive Is Their Future? Assessing the Role of Optimism and Social Support in Understanding Mental Health Symptomatology among Homeless Adults.

    Science.gov (United States)

    Fitzpatrick, Kevin M

    2017-04-01

    Optimism has been noted as a primary protective factor in understanding mental health symptomatology in clinical and non-clinical settings. Any exploration of optimism has been absent in understanding mental health outcomes among homeless people. This study, using intensive interviews with 168 homeless adults in Northwest Arkansas, examines the role that social support and optimism play in lessening the negative impact of homeless circumstances/experiences on mental health symptomatology. Using OLS, findings support a mediating/protective role that social support and optimism play in lowering the negative effects of childhood life experiences on depressive symptoms among homeless persons. Despite the overwhelming conditions of homelessness, persons with higher levels of optimism and social support report lower depression and anxiety symptoms. The findings are discussed paying particular attention to the importance of developing and maintaining the perception of support and resiliency in preserving a positive outlook for the future among homeless persons facing often-debilitating circumstances. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  2. Community factors supporting child mental Health.

    Science.gov (United States)

    Earls, F

    2001-10-01

    A principal purpose of this article has been to examine the gap between research and practice in relation to community factors in child mental health. Two caveats were introduced in preparation for this assessment. First, it was pointed out that the definition of communities has been expanded by considering the organizing properties of social aggregates that are not simply a function of the race, ethnicity, or social class of individuals who compose them. Having these definitions grounded in theory substantially advances the needs of research and the design and goals of community-level interventions. The second caveat relates to the boundaries of the disciplines that cater to the needs of children. During the same era when child psychiatry is largely occupied with placing psychotropic medications at the center of clinical approaches, there is an important effort in child psychology and sociology to cut across their disciplinary confines to form more comprehensive designs that are sensitive to experiences and circumstances that emerge from specific aspects of community context. Research from the PHDCN was used as an example of this new interdisciplinary approach. Several community-based research projects were selected for review based on their clear implications to improve context-sensitive assessment of child mental health and design effective community-based interventions to improve child mental health. The Healthy Start and CATCH programs indicate that involving child professionals at the grassroots of community life requires skill and patience but that the effort is satisfying and potentially effective. Other examples, exemplified by North Carolina's Smart Start initiative and the program of developmental assets from the Search Institute, demonstrate coherent approaches that provide a foundation for long-term capacity building in assessment, local decision making, and the design and evaluation of interventions. Three conclusions are warranted from this

  3. Establishment of Health Technology Assessment in Iran

    Directory of Open Access Journals (Sweden)

    Shila Doaee

    2012-06-01

    Full Text Available Objective: Health Technology Assessment (HTA aims at informing healthcare policymakers, managers and practitioners of the "clinical consequences, but also the economic, ethical, and other social implications of the diffusion and use of a specific procedure or technique on medical practice". So considering the policy-oriented nature of HTA that calls for a close integration into the functioning and governance of health systems the present study focuses on executive processes and function of the HTA office of Iran.Materials and methods: Data of this review study were collected through documented sources and observations from 2007 to 2010.Results: Health Technology Assessment began its activities as a secretariat in the Deputy of Health in 2007 and it continues as a Health Technology Assessment Office at the Management of Health Technology Assessment, Standardization, and Tariff at the Deputy of curative affairs of MOHME in the beginning of 2010.14 Technology of modern medical equipment and 8 pharmaceutical medicine are assessed, Now many of measures for HTA establishment  such as cooperation National Institute of Health Research (NIHR, Holding scientific committee meetings, Establishing  the  Master's degree of  health technology assessment ,Building capacities for health technology assessment through education in major universities of the country.Conclusion: pay attention to health technology assessment, selection and application of proper technologies in the frameworks of policy-making and managerial strategies and make efforts to develop it with the support of the governmental in Iran is necessary.

  4. Academic Stress, Supportive Communication, and Health

    Science.gov (United States)

    MacGeorge, Erina L.; Samter, Wendy; Gillihan, Seth J.

    2005-01-01

    Academic stress is associated with a variety of negative health outcomes, including depression and physical illness. The current study examined the capacity of supportive communication reported as being received from friends and family to buffer the association between academic stress and health. College students completed measures of academic…

  5. Development, features and application of DIET ASSESS & PLAN (DAP) software in supporting public health nutrition research in Central Eastern European Countries (CEEC).

    Science.gov (United States)

    Gurinović, Mirjana; Milešević, Jelena; Kadvan, Agnes; Nikolić, Marina; Zeković, Milica; Djekić-Ivanković, Marija; Dupouy, Eleonora; Finglas, Paul; Glibetić, Maria

    2018-01-01

    In order to meet growing public health nutrition challenges in Central Eastern European Countries (CEEC) and Balkan countries, development of a Research Infrastructure (RI) and availability of an effective nutrition surveillance system are a prerequisite. The building block of this RI is an innovative tool called DIET ASSESS & PLAN (DAP), which is a platform for standardized and harmonized food consumption collection, comprehensive dietary intake assessment and nutrition planning. Its unique structure enables application of national food composition databases (FCDBs) from the European food composition exchange platform (28 national FCDBs) developed by EuroFIR (http://www.eurofir.org/) and in addition allows communication with other tools. DAP is used for daily menu and/or long-term diet planning in diverse public sector settings, foods design/reformulation, food labelling, nutrient intake assessment and calculation of the dietary diversity indicator, Minimum Dietary Diversity-Women (MDD-W). As a validated tool in different national and international projects, DAP represents an important RI in public health nutrition epidemiology in the CEEC region. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. A Process Evaluation to Assess Contextual Factors Associated With the Uptake of a Rapid Response Service to Support Health Systems’ Decision-Making in Uganda

    Directory of Open Access Journals (Sweden)

    Rhona Mijumbi-Deve

    2017-10-01

    Full Text Available Background Although proven feasible, rapid response services (RRSs to support urgent decision and policymaking are still a fairly new and innovative strategy in several health systems, more especially in low-income countries. There are several information gaps about these RRSs that exist including the factors that make them work in different contexts and in addition what affects their uptake by potential end users. Methods We used a case study employing process evaluation methods to determine what contextual factors affect the utilization of a RRS in Uganda. We held in-depth interviews with researchers, knowledge translation (KT specialists and policy-makers from several research and policy-making institutions in Uganda’s health sector. We analyzed the data using thematic analysis to develop categories and themes about activities and structures under given program components that affected uptake of the service. Results We identified several factors under three themes that have both overlapping relations and also reinforcing loops amplifying each other: Internal factors (those factors that were identified as over which the RRS had full [or almost full] control; external factors (factors over which the service had only partial influence, a second party holds part of this influence; and environmental factors (factors over which the service had no or only remote control if at all. Internal factors were the design of the service and resources available for it, while the external factors were the service’s visibility, integrity and relationships. Environmental factors were political will and health system policy and decision-making infrastructure. Conclusion For health systems practitioners considering RRSs, knowing what factors will affect uptake and therefore modifying them within their contexts is important to ensure efficient use and successful utilization of the mechanisms.

  7. Knowledge in health technology assessment

    DEFF Research Database (Denmark)

    Tjørnhøj-Thomsen, Tine; Hansen, Helle Ploug

    2011-01-01

    Health systems are placing more and more emphasis on designing and delivering services that are focused on the patient, and there is a growing interest in patient aspects of health policy research and health technology assessment (HTA). Only a few HTA agencies use and invest in scientific methods...

  8. An Assessment of Environmental Health Needs

    Science.gov (United States)

    Macatangay, Ariel V.

    2013-01-01

    Environmental health fundamentally addresses the physical, chemical, and biological risks external to the human body that can impact the health of a person by assessing and controlling these risks in order to generate and maintain a health-supportive environment. In manned spacecraft, environmental health risks are mitigated by a multi-disciplinary effort, employing several measures including active and passive controls, by establishing environmental standards (SMACs, SWEGs, microbial and acoustics limits), and through environmental monitoring. Human Health and Performance (HHP) scientists and Environmental Control and Life Support (ECLS) engineers consider environmental monitoring a vital component to an environmental health management strategy for maintaining a healthy crew and achieving mission success. ECLS engineers use environmental monitoring data to monitor and confirm the health of ECLS systems, whereas HHP scientists use the data to manage the health of the human system. Because risks can vary between missions and change over time, environmental monitoring is critical. Crew health risks associated with the environment were reviewed by agency experts with the goal of determining risk-based environmental monitoring needs for future NASA manned missions. Once determined, gaps in environmental health knowledge and technology, required to address those risks, were identified for various types of exploration missions. This agency-wide assessment of environmental health needs will help guide the activities/hardware development efforts to close those gaps and advance the knowledge required to meet NASA manned space exploration objectives. Details of the roadmap development and findings are presented in this paper.

  9. Assessment of (Computer-Supported) Collaborative Learning

    Science.gov (United States)

    Strijbos, J. -W.

    2011-01-01

    Within the (Computer-Supported) Collaborative Learning (CS)CL research community, there has been an extensive dialogue on theories and perspectives on learning from collaboration, approaches to scaffold (script) the collaborative process, and most recently research methodology. In contrast, the issue of assessment of collaborative learning has…

  10. Mobile phone tracking: in support of modelling traffic-related air pollution contribution to individual exposure and its implications for public health impact assessment

    Science.gov (United States)

    2013-01-01

    We propose a new approach to assess the impact of traffic-related air pollution on public health by mapping personal trajectories using mobile phone tracking technology in an urban environment. Although this approach is not based on any empirical studies, we believe that this method has great potential and deserves serious attention. Mobile phone tracking technology makes it feasible to generate millions of personal trajectories and thereby cover a large fraction of an urban population. Through analysis, personal trajectories are not only associated to persons, but it can also be associated with vehicles, vehicle type, vehicle speed, vehicle emission rates, and sources of vehicle emissions. Pollution levels can be estimated by dispersion models from calculated traffic emissions. Traffic pollution exposure to individuals can be estimated based on the exposure along the individual human trajectories in the estimated pollution concentration fields by utilizing modelling tools. By data integration, one may identify trajectory patterns of particularly exposed human groups. The approach of personal trajectories may open a new paradigm in understanding urban dynamics and new perspectives in population-wide empirical public health research. This new approach can be further applied to individual commuter route planning, land use planning, urban traffic network planning, and used by authorities to formulate air pollution mitigation policies and regulations. PMID:24188173

  11. Stress, psychological symptoms, social support and health ...

    African Journals Online (AJOL)

    The study investigated stress events, perceived stress and social support in relation to various common health behaviours among black South African students. The sample included 624 students: 314 Grade 12 Secondary school students and 310 third year social science university students in South Africa. The study found ...

  12. Health care, quality certification and institutional support: a focus on primary health care in Brazil

    Directory of Open Access Journals (Sweden)

    Antônio Thomaz Gonzaga da Matta-Machado

    2016-05-01

    Full Text Available Objective. To provide an overview of the distribution of institutional support in primary care in Brazil and to identify associations between the activities of institutional support and the outcome of the certification of the National Programme for Improving Access and Quality in Primary Health Care (PMAQ. Materials and methods. A cross-sectional study was conducted through interviews with 16 960 profes- sionals in Brazil in 2012. To examine the relationship between the received support and the quality of health care it was made a multiple binary logistic regression. Results. A positive relationship between high-level support and certification in the sub-dimensions analyzed was observed: women and child care, diabetes mellitus/ hypertension and mental health. The support activities which contributed most were: self-assessment, shared assessment, targeted workshops and training. Conclusion. Institutional support activities have helped to improve the quality and access of the population to healthcare in the country.

  13. Cross-vendor evaluation of key user-defined clinical decision support capabilities: a scenario-based assessment of certified electronic health records with guidelines for future development.

    Science.gov (United States)

    McCoy, Allison B; Wright, Adam; Sittig, Dean F

    2015-09-01

    Clinical decision support (CDS) is essential for delivery of high-quality, cost-effective, and safe healthcare. The authors sought to evaluate the CDS capabilities across electronic health record (EHR) systems. We evaluated the CDS implementation capabilities of 8 Office of the National Coordinator for Health Information Technology Authorized Certification Body (ONC-ACB)-certified EHRs. Within each EHR, the authors attempted to implement 3 user-defined rules that utilized the various data and logic elements expected of typical EHRs and that represented clinically important evidenced-based care. The rules were: 1) if a patient has amiodarone on his or her active medication list and does not have a thyroid-stimulating hormone (TSH) result recorded in the last 12 months, suggest ordering a TSH; 2) if a patient has a hemoglobin A1c result >7% and does not have diabetes on his or her problem list, suggest adding diabetes to the problem list; and 3) if a patient has coronary artery disease on his or her problem list and does not have aspirin on the active medication list, suggest ordering aspirin. Most evaluated EHRs lacked some CDS capabilities; 5 EHRs were able to implement all 3 rules, and the remaining 3 EHRs were unable to implement any of the rules. One of these did not allow users to customize CDS rules at all. The most frequently found shortcomings included the inability to use laboratory test results in rules, limit rules by time, use advanced Boolean logic, perform actions from the alert interface, and adequately test rules. Significant improvements in the EHR certification and implementation procedures are necessary. © 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.

  14. Health Impact Assessment: Linking Public Health to ...

    Science.gov (United States)

    The goal of this presentation is to explore how HIA can help inform hazardous waste permitting regulations and incorporate community vulnerability and cumulative impacts to their potential health risks into permitting decision making by the California Department of Toxic Substances Control. Presented the Health Impact Assessment (HIA) at the State of California Cumulative Impacts and Community Vulnerability Symposium on July 27 in Diamond Bar, CA.

  15. RISK ASSESSMENT SUPPORTING THE FINAL RULE FOR ...

    Science.gov (United States)

    This analysis evaluates potential risks due to release of solvents from laundry sludge and disposable wipes sent to a landfill. Receptors for air and groundwater in lined and unlined landfills were evaluated. The potential solvent concentrations were calculated to determine the solvent loadings from the wipes and sludge. The mass based solvent quantity loadings were compared to the risk based loadings to determine the risk potential for specific solvents. This risk analysis also addressed previous peer reviewers’ and general public comments on the initial risk assessment conducted for the proposed rule. The final rule, supported by the risk assessment, will be prepared after the consideration of all comments for the proposed rule and the risk analysis Notice of Data Availability. The risk analysis will be used to support the development of a final rule for solvent-contaminated wipes. To ensure the adequacy of the modeling and solvent concentrations, the analysis was peer reviewed by external reviewers.

  16. Measurement of Health Disparities, Health Inequities, and Social Determinants of Health to Support the Advancement of Health Equity.

    Science.gov (United States)

    Penman-Aguilar, Ana; Talih, Makram; Huang, David; Moonesinghe, Ramal; Bouye, Karen; Beckles, Gloria

    2016-01-01

    Reduction of health disparities and advancement of health equity in the United States require high-quality data indicative of where the nation stands vis-à-vis health equity, as well as proper analytic tools to facilitate accurate interpretation of these data. This article opens with an overview of health equity and social determinants of health. It then proposes a set of recommended practices in measurement of health disparities, health inequities, and social determinants of health at the national level to support the advancement of health equity, highlighting that (1) differences in health and its determinants that are associated with social position are important to assess; (2) social and structural determinants of health should be assessed and multiple levels of measurement should be considered; (3) the rationale for methodological choices made and measures chosen should be made explicit; (4) groups to be compared should be simultaneously classified by multiple social statuses; and (5) stakeholders and their communication needs can often be considered in the selection of analytic methods. Although much is understood about the role of social determinants of health in shaping the health of populations, researchers should continue to advance understanding of the pathways through which they operate on particular health outcomes. There is still much to learn and implement about how to measure health disparities, health inequities, and social determinants of health at the national level, and the challenges of health equity persist. We anticipate that the present discussion will contribute to the laying of a foundation for standard practice in the monitoring of national progress toward achievement of health equity.

  17. Health effects of toxicants: Online knowledge support

    Science.gov (United States)

    Judson, Richard; de Marcellus, Sally; de Knecht, Joop; Leinala, Eeva

    2016-01-01

    Research in toxicology generates vast quantities of data which reside on the Web and are subsequently appropriated and utilized to support further research. This data includes a broad spectrum of information about chemical, biological and radiological agents which can affect health, the nature of the effects, treatment, regulatory measures, and more. Information is structured in a variety of formats, including traditional databases, portals, prediction models, and decision making support tools. Online resources are created and housed by a variety of institutions, including libraries and government agencies. This paper focuses on three such institutions and the tools they offer to the public: the National Library of Medicine (NLM) and its Toxicology and Environmental Health Information Program, the United States Environmental Protection Agency (EPA), and the Organisation for Economic Co-operation and Development (OECD). Reference is also made to other relevant organizations. PMID:26506572

  18. Health and Social Support of the Elderly

    Science.gov (United States)

    1992-01-01

    health to the incidence of heart disease. Additionally, "social support" definitions varied from social networks to acculturation . Therefore, although...chronic conditions based on prevalence in the United States for this age group. During the baseline interview, the interviewer read the list of...conditions and asked the respondents if they had that condition at the present time. The interviewer asked about 13 specific conditions: arthritis, diabetes

  19. Assessing Ontario's Personal Support Worker Registry

    Directory of Open Access Journals (Sweden)

    Audrey Laporte

    2013-08-01

    Full Text Available In response to the growing role of personal support workers (PSWs in the delivery of health care services to Ontarians, the Ontario government has moved forward with the creation of a PSW registry. This registry will be mandatory for all PSWs employed by publicly funded health care employers, and has the stated objectives of better highlighting the work that PSWs do in Ontario, providing a platform for PSWs and employers to more easily access the labour market, and to provide government with information for human resources planning. In this paper we consider the factors that brought the creation of a PSW registry onto the Ontario government’s policy agenda, discuss how the registry is being implemented, and provide an analysis of the strengths and weaknesses of this policy change.

  20. Measuring Use of Health-Related Support on the Internet: Development of the Health Online Support Questionnaire (HOSQ).

    Science.gov (United States)

    Mattsson, Susanne; Olsson, Erik Martin Gustaf; Alfonsson, Sven; Johansson, Birgitta; Carlsson, Maria

    2015-11-20

    Social support plays an important role for the perceived health in people with health problems and chronic diseases. Provision of different kinds of support during the disease trajectory is crucial for many people. Online support is ubiquitous and represents a promising modality for people with chronic diseases. There are no existing instruments that measure various aspects of online support. The objective of this study was to create a generic questionnaire regarding health-related support online that can be applied to people with various health problems and illnesses. Additionally, we wanted to test the questionnaire in a cancer population to assess its adequacy in the context of severe disease. Initial items for the Health Online Support Questionnaire (HOSQ) were inspired by sociologist James House regarding social support. An exploratory factor analysis was conducted in healthy persons or with minor health problems (n=243) on 31 initial items. The scale was reduced to 18 items and the internal consistency and reliability of the scale was examined along with content validity. Further validation was conducted by a confirmatory analysis on the 18-item scale in a cancer population (n=215). In addition, data on demographics, health problems experienced, and Internet use were collected. The exploratory factor analysis on the final 18-item scale resulted in 2 factors. After scrutinizing the content, these factors were labeled "reading" and "interacting" and they demonstrated good internal consistency (Cronbach alphas .88 and .77, respectively). The factors were confirmed in the cancer population. The response pattern revealed expected differences both between the interaction and reading scales and according to age, gender, education, and health problems thereby supporting the validity of the HOSQ. The HOSQ may be a reliable and valid instrument for measuring the use of online support for people with health problems, but the results ought to be replicated in more

  1. Health care policy: qualitative evidence and health technology assessment.

    Science.gov (United States)

    Leys, Mark

    2003-09-01

    Since the late 1990s health technology assessment (HTA) has gained influence as a research and evaluation approach supporting health care policy. The focus on this methodology is congruent with the growing importance of evidence-based health care. Although HTA is a multidisciplinary discipline from a theoretical point of view, practice shows that social, ethical and psychological aspects are seldom truly integrated into the assessment of health technology. HTA is still very much biased by the medical and pharmaceutical research traditions. This contribution focuses on the question of how qualitative research findings could be useful as an additional source of information or as 'evidence' in HTA. Medical and health care scientists are seldom acquainted with qualitative research or judge it as a less (or un-)reliable form of research. 'Qualitative dimensions' of health care are not considered 'real' evidence. This contribution argues that qualitative findings could be put higher in the hierarchy of evidence generating research in health care. First it can be realized by improving the knowledge of the nature of qualitative research. Second qualitative findings can become more trustworthy information, if researchers themselves respect methodological prerequisites and clarify their theoretical perspective, research aims and use of research methods. Some methodological characteristics of qualitative research and 'evidence' are discussed for their contribution to HTA and evidence-based health care.

  2. General budget support: has it benefited the health sector?

    Science.gov (United States)

    Fernandes Antunes, Adelio; Xu, Ke; James, Chris D; Saksena, Priyanka; Van de Maele, Nathalie; Carrin, Guy; Evans, David B

    2013-12-01

    There has been recent controversy about whether aid directed specifically to health has caused recipient governments to reallocate their own funds to non-health areas. At the same time, general budget support (GBS) has been increasing. GBS allows governments to set their own priorities, but little is known about how these additional resources are subsequently used. This paper uses cross-country panel data to assess the impact of GBS programmes on health spending in low-income and middle-income countries, using dynamic panel techniques to estimate unbiased coefficients in the presence of serial correlation. We found no clear evidence that GBS had any impact, positive or negative, on government health spending derived from domestic sources. GBS also had no observed impact on total government health spending from all sources (external as well as domestic). In contrast, health-specific aid was associated with a decline in health expenditures from domestic sources, but there was not a full substitution effect. That is, despite this observed fungibility, health-specific aid still increases total government health spending from all sources. Finally, increases in total government expenditure led to substantial increases in domestic government health expenditures. Copyright © 2012 John Wiley & Sons, Ltd.

  3. Sensor based soil health assessment

    Science.gov (United States)

    Quantification and assessment of soil health involves determining how well a soil is performing its biological, chemical, and physical functions relative to its inherent potential. Due to high cost, labor requirements, and soil disturbance, traditional laboratory analyses cannot provide high resolut...

  4. Realising the potential of health needs assessments.

    Science.gov (United States)

    Anstey, Matthew; Burgess, Paul; Angus, Lisa

    2017-05-15

    Population-level assessment and planning has traditionally been the role of public health departments but in establishing Primary Health Networks (PHNs), the Australian Government has instituted a new mechanism for identifying community needs and commissioning services to meet those needs. If PHNs are to achieve the vision of nimble organisations capable of identifying and addressing local health needs via integrated health and social services, several things need to occur. First, PHN funding schedules must become more flexible. Second, the Federal health department must maintain an open dialogue with PHNs, permit waivers in funding schedules to suit local conditions and be prepared to back innovations with seed investment. Third, health data exchange and linkage must be accelerated to better inform community needs assessments and commissioning. Finally, PHNs must be encouraged and supported to develop collaborations both within and outside the health sector in order to identify and address a broad set of health issues and determinants. By following these principles, PHNs may become leading change agents in the Australian healthcare system.

  5. Social support, health, and illness: a complicated relationship

    National Research Council Canada - National Science Library

    Roy, R

    2011-01-01

    .... A useful resource for clinical practitioners and researchers, Social Support, Health, and Illness addresses the effects of intimate support on a wide variety of medical and psychiatric conditions...

  6. Assessing health professional education: workshop summary

    National Research Council Canada - National Science Library

    Cuff, Patricia A

    2014-01-01

    "Assessing health professional education is the summary of a workshop hosted by the Institute of Medicine's Global Forum on Innovation in Health Professional Education to explore assessment of health...

  7. Supporting global health goals with information and communications technology.

    Science.gov (United States)

    Boman, Magnus; Kruse, Erik

    2017-06-01

    The objective of this study is to critically assess the possible roles of information and communications technology (ICT) in supporting global health goals. This is done by considering privilege and connectibility. In short, ICT can contribute by providing health information via four different kinds of access, each with its own history and prospective future. All four are analyzed here, in two perspectives: business-as-usual and disruptive. Health data analytics is difficult since the digital representation of past, current, and future health information is lacking. The flow of analytics that may prove beneficial to the individual and not just meet abstract population-level goals or ambitions is analyzed in detail. Sensemaking is also needed, to meet the minimum requirement of making prospective future services understandable to policymakers. Drivers as well as barriers for areas in which policy decisions have the potential to drive positive developments for meeting the Sustainable Development Goals are identified.

  8. Patients utilizing a free clinic: physical and mental health, health literacy, and social support.

    Science.gov (United States)

    Kamimura, Akiko; Christensen, Nancy; Tabler, Jennifer; Ashby, Jeanie; Olson, Lenora M

    2013-08-01

    This cross sectional study assessed the physical and mental health, health literacy and social support of the uninsured utilizing a free clinic to develop intervention programs and research projects to improve the health of free clinic patients. Free clinics are nonprofit organizations that provide underserved and uninsured individuals access to a broad array of free or low cost healthcare services. English or Spanish speaking patients (N = 187) aged 18 years or older completed a self-administered survey. Physical, mental and oral health, health literacy, and social support were measured using standardized instruments. Eighty-two participants (45 US born and 37 non-US born) chose the English version of the survey (English speakers) while 105 participants (2 US born and 103 non-US born) chose the Spanish version (Spanish speakers). Overall, both the physical and mental health functioning of the participants was lower than that of the US general population. The participants reported being moderately depressed. US-born English speakers reported the poorest physical and mental health while Spanish speakers reported the best physical health and the lowest level of depression. A higher level of health literacy was associated with better physical health functioning, whereas reporting higher social support was associated with better mental health functioning and less severe depression. Because most free clinics have limited resources, developing services and programs that fit free clinics' circumstances are needed. Our study finding indicates that health literacy education, mental health services, and social support are key services needed by free clinic patients to achieve better health.

  9. mHealth Assessment: Conceptualization of a Global Framework

    OpenAIRE

    Bradway, Meghan; Carrión Ribas, Carme; Vallespin, Bárbara; Saadatfard, Omid; Puigdomènech, Elisa; Espallargues, Mireia; Kotzeva, Anna

    2017-01-01

    Background The mass availability and use of mobile health (mHealth) technologies offers the potential for these technologies to support or substitute medical advice. However, it is worrisome that most assessment initiatives are still not able to successfully evaluate all aspects of mHealth solutions. As a result, multiple strategies to assess mHealth solutions are being proposed by medical regulatory bodies and similar organizations. Objective We aim to offer a collective description of a uni...

  10. Health technology assessment in Belgium.

    Science.gov (United States)

    Cleemput, I; Kesteloot, K

    2000-01-01

    The Belgian healthcare system has a Bismarck-type compulsory health insurance, covering almost the entire population, combined with private provision of care. Providers are public health services, independent pharmacists, independent ambulatory care professionals, and hospitals and geriatric care facilities. Healthcare responsibilities are shared between the national Ministries of Public Health and Social Affairs, and the Dutch-, French-, and German-speaking Community Ministries of Health. The national ministries are responsible for sickness and disability insurance, financing, determination of accreditation criteria for hospitals and heavy medical care units, and construction of new hospitals. The six sickness and disability insurance funds are responsible for reimbursing health service benefits and paying disability benefits. The system's strength is that care is highly accessible and responsive to patients. However, the healthcare system's size remained relatively uncontrolled until recently, there is an excess supply of certain types of care, and there is a large number of small hospitals. The national government created a legal framework to modernize the insurance system to control budgetary deficits. Measures for reducing healthcare expenditures include regulating healthcare supply, healthcare evaluation, medical practice organization, and hospital budgets. The need to control healthcare facilities and quality of care in hospitals led to formal procedures for opening hospitals, acquiring expensive medical equipment, and developing highly specialized services. Reforms in payment and regulation are being considered. Health technology assessment (HTA) has played little part in the reforms so far. Belgium has no formal national program for HTA. The future of HTA in Belgium depends on a changing perception by providers and policy makers that health care needs a stronger scientific base.

  11. Decision support for health care: the PROforma evidence base

    Directory of Open Access Journals (Sweden)

    John Fox

    2006-03-01

    Full Text Available Cancer Research UK has developed PROforma, a formal language for modelling clinical processes, along with associated tools for creating decision support, care planning, clinical workflow management and other applications. The PROforma method has been evaluated in a variety of settings: in primary health care (prescribing, referral of suspected cancer patients, genetic risk assessment and in specialist care of patients with breast cancer, leukaemia, HIV infection and other conditions. About nine years of experience have been gained with PROforma technologies. Seven trials of decision support applications have been published or are in preparation. Each of these has shown significant positive effects on a variety of measures of quality and/or outcomes of care. This paper reviews the evidence base for the clinical effectiveness of these PROforma applications, and previews the CREDO project _a multi-centre trial of a complex PROforma application for supporting integrated breast cancer care across primary and secondary care settings.

  12. Green spaces and General Health: Roles of mental health status, social support, and physical activity.

    Science.gov (United States)

    Dadvand, Payam; Bartoll, Xavier; Basagaña, Xavier; Dalmau-Bueno, Albert; Martinez, David; Ambros, Albert; Cirach, Marta; Triguero-Mas, Margarita; Gascon, Mireia; Borrell, Carme; Nieuwenhuijsen, Mark J

    2016-05-01

    Green spaces are associated with improved health, but little is known about mechanisms underlying such association. We aimed to assess the association between greenness exposure and subjective general health (SGH) and to evaluate mental health status, social support, and physical activity as mediators of this association. This cross-sectional study was based on a population-based sample of 3461 adults residing in Barcelona, Spain (2011). We characterized outcome and mediators using the Health Survey of Barcelona. Objective and subjective residential proximity to green spaces and residential surrounding greenness were used to characterize greenness exposure. We followed Baron and Kenny's framework to establish the mediation roles and we further quantified the relative contribution of each mediator. Residential surrounding greenness and subjective residential proximity to green spaces were associated with better SGH. We found indications for mediation of these associations by mental health status, perceived social support, and to less extent, by physical activity. These mediators altogether could explain about half of the surrounding greenness association and one-third of the association for subjective proximity to green spaces. We observed indications that mental health and perceived social support might be more relevant for men and those younger than 65years. The results for objective residential proximity to green spaces were not conclusive. In conclusion, our observed association between SGH and greenness exposure was mediated, in part, by mental health status, enhanced social support, and physical activity. There might be age and sex variations in these mediation roles. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Family health conversations: how do they support health?

    Science.gov (United States)

    Persson, Carina; Benzein, Eva

    2014-01-01

    Research shows that living with illness can be a distressing experience for the family and may result in suffering and reduced health. To meet families' needs, family systems intervention models are developed and employed in clinical contexts. For successful refinement and implementation it is important to understand how these models work. The aim of this study was therefore to describe the dialogue process and possible working mechanisms of one systems nursing intervention model, the Family Health Conversation model. A descriptive evaluation design was applied and 15 transcribed conversations with five families were analyzed within a hermeneutic tradition. Two types of interrelated dialogue events were identified: narrating and exploring. There was a flow between these events, a movement that was generated by the interaction between the participants. Our theoretically grounded interpretation showed that narrating, listening, and reconsidering in interaction may be understood as supporting family health by offering the families the opportunity to constitute self-identity and identity within the family, increasing the families' understanding of multiple ways of being and acting, to see new possibilities and to develop meaning and hope. Results from this study may hopefully contribute to the successful implementation of family systems interventions in education and clinical praxis.

  14. Community health assessment. The first step in community health planning.

    Science.gov (United States)

    Rice, J A

    1993-01-01

    analyzing data: obtaining community input, identifying problems already being addressed, consulting with professional experts, and analyzing existing data. Demographics are one way of analyzing data; another is using a "community scoreboard" that groups causal factors into four categories: lifestyle, environment, human biology, and health services. Once the community assessment is complete, planning and implementation of programs can begin. At the same time, it is essential to mobilize the community to support your initiative. Again, you must look beyond the hospital walls to build a constituency for change, to community leaders in education, employment, transportation and recreation, housing, and the physical environment, as well as health education and preventive services.(ABSTRACT TRUNCATED AT 400 WORDS)

  15. Assessing and Supporting Argumentation with Online Rubrics

    Science.gov (United States)

    Lu, Jingyan; Zhang, Zhidong

    2013-01-01

    Writing and assessing arguments are important skills and there is evidence that using rubrics to assess the arguments of others can help students write better arguments. Thus, this study investigated whether students were able to write better arguments after using rubrics to assess the written arguments by peers. Students in 4 secondary 4 classes…

  16. Mental health and psychosocial support in humanitarian emergencies.

    Science.gov (United States)

    van Ommeren, M; Hanna, F; Weissbecker, I; Ventevogel, P

    2015-09-28

    Armed conflicts and natural disasters impact negatively on the mental health and well-being of affected populations in the short- and long-term and affect the care of people with pre-existing mental health conditions. This paper outlines specific actions for mental health and psychosocial support by the health sector in the preparedness, response and recovery phases of emergencies. Broad recommendations for ministries of health are to: (1) embed mental health and psychosocial support in national health and emergency preparedness plans; (2) put in place national guidelines, standards and supporting tools for the provision of mental health and psychosocial support during emergencies; (3) strengthen the capacity of health professionals to identify and manage priority mental disorders during emergencies; and (4) utilize opportunities generated by the emergency response to contribute to development of sustainable mental health-care services.

  17. Effects of Mental Health Support on the Grief of Bereaved People Caused by Sewol Ferry Accident

    NARCIS (Netherlands)

    Han, Hyesung; Noh, Jin-Won; Huh, Hyu Jung; Huh, Seung; Joo, Ji-Young; Hong, Jin Hyuk; Chae, Jeong-Ho

    Few studies have assessed the overall effects of multi-centered, complicated mental health support on the grief process. This study investigated the broader influence of mental health support provided practically to the bereaved family on the severity of complicated grief. Ninety-three bereaved

  18. Assessment of social support and its association to depression, self-perceived health and chronic diseases in elderly individuals residing in an area of poverty and social vulnerability in rio de janeiro city, Brazil.

    Directory of Open Access Journals (Sweden)

    Valeria T S Lino

    Full Text Available OBJECTIVES: Social support (SS influences the elderly ability to cope with the losses of ageing process. This study was aimed at assessing SS among elderly users of a primary healthcare unit in a poor and violent area of Rio de Janeiro City, and at verifying its association with depression, self-perceived health (SPH, marital status and chronic illnesses. METHODS: A cross-sectional study was performed based on a convenience sample of 180 individuals aged 60 years or older. SS was measured with part of the Brazilian version of Medical Outcomes Study's SS scale, and SPH and depression were assessed, respectively, through one question and the Brazilian version of the Structured Clinical Interview for DSM-IV Axis I Disorders. SS medians were calculated for the categories of SPH, depression, marital status and chronic illnesses variables, and differences were evaluated with the Kruskal-Wallis and Mann-Whitney tests. Additionally, Pearson's chi-square test and logistic regression were employed to identify unadjusted and adjusted associations between SS and those variables. RESULTS: The participant's mean age was 73 years old, and level of education was 3 years of school education on average. They were predominantly females (73.3%, and non-married (55.0%. Among them, 74.4% perceived their SS as satisfactory, 55.0% perceived their health as good, 27.8% were diagnosed with major depression and 83.3% had hypertension. Especially for those depressed and with bad SPH, the medians of SS measure were much lower than for others, reaching an unsatisfactory level. Moreover, controlling for other factors, non-depressed individuals were more likely (OR = 2.32 to have satisfactory SS. CONCLUSION: in the violent and poor area explored in this research low SS is highly prevalent in the elderly. Depressed individuals are more likely to have low SS and this condition should be investigated in depressed elderly. The reduced scale is useful for low education

  19. Resilience Mediates the Longitudinal Relationships Between Social Support and Mental Health Outcomes in Multiple Sclerosis.

    Science.gov (United States)

    Koelmel, Emily; Hughes, Abbey J; Alschuler, Kevin N; Ehde, Dawn M

    2017-06-01

    To investigate the longitudinal relationships between social support and subsequent mental health outcomes in individuals with multiple sclerosis (MS), and to examine resilience as a mediator between social support and subsequent mental health outcomes in this population. Observational, longitudinal cohort study. Participants were assessed at 4 time points over 12 months in the context of a previously reported randomized controlled trial. Telephone-based measures administered to community-based participants. Individuals (N=163) with MS and 1 or more of the following symptoms: depression, fatigue, and pain. Not applicable. Mental health outcomes included (1) depressive symptomatology, assessed using the Patient Health Questionnaire-9; (2) anxious symptomatology, assessed using the short form of the Emotional Distress-Anxiety Scale from the Patient-Reported Outcomes Measurement Information System; and (3) general mental health status, assessed using the Mental Component Summary score from the Short Form-8 Health Survey. Resilience was assessed using the Connor-Davidson Resilience Scale. At any given time, social support from significant others, family members, and friends was significantly associated with subsequent mental health outcomes for all 3 measures assessed (all P values social support significantly mediated the relationships between social support and subsequent mental health outcomes. After controlling for resilience, most of the direct relationships between social support and mental health outcomes were no longer significant. There are significant longitudinal relationships between social support, resilience, and mental health outcomes for people with MS. Given the mediating role of resilience in supporting better mental health outcomes, future clinical research and practice may benefit from an emphasis on resilience-focused psychological interventions. Copyright © 2016 American Congress of Rehabilitation Medicine. All rights reserved.

  20. Health system governance to support scale up of mental health care in Ethiopia: a qualitative study.

    Science.gov (United States)

    Hanlon, Charlotte; Eshetu, Tigist; Alemayehu, Daniel; Fekadu, Abebaw; Semrau, Maya; Thornicroft, Graham; Kigozi, Fred; Marais, Debra Leigh; Petersen, Inge; Alem, Atalay

    2017-01-01

    Ethiopia is embarking upon a ground-breaking plan to address the high levels of unmet need for mental health care by scaling up mental health care integrated within primary care. Health system governance is expected to impact critically upon the success or otherwise of this important initiative. The objective of the study was to explore the barriers, facilitators and potential strategies to promote good health system governance in relation to scale-up of mental health care in Ethiopia. A qualitative study was conducted using in-depth interviews. Key informants were selected purposively from national and regional level policy-makers, planners and service developers (n = 7) and district health office administrators and facility heads (n = 10) from a district in southern Ethiopia where a demonstration project to integrate mental health into primary care is underway. Topic guide development and analysis of transcripts were guided by an established framework for assessing health system governance, adapted for the Ethiopian context. From the perspective of respondents, particular strengths of health system governance in Ethiopia included the presence of high level government support, the existence of a National Mental Health Strategy and the focus on integration of mental health care into primary care to improve the responsiveness of the health system. However, both national and district level respondents expressed concerns about low baseline awareness about mental health care planning, the presence of stigmatising attitudes, the level of transparency about planning decisions, limited leadership for mental health, lack of co-ordination of mental health planning, unreliable supplies of medication, inadequate health management information system indicators for monitoring implementation, unsustainable models for specialist mental health professional involvement in supervision and mentoring of primary care staff, lack of community mobilisation for mental health and low

  1. Supporting Classroom Assessment Practice: Lessons from a Small High School

    Science.gov (United States)

    Allen, David; Ort, Suzanna Wichterle; Schmidt, Joseph

    2009-01-01

    Assessment, particularly formative assessment, is critical to knowing how a student is performing academically and how best to support that student. Teachers, especially new teachers, need ongoing support in developing and using both summative and formative assessments as an integral part of their instructional practice. Written collaboratively by…

  2. Transforming youth mental health services and supports in Ireland.

    Science.gov (United States)

    Illback, Robert J; Bates, Tony

    2011-02-01

    Young people in the Republic of Ireland do not have access to appropriate mental health services and supports, necessitating transformational change in delivery systems. Describe ongoing development and change efforts facilitated by Headstrong--The National Centre for Youth Mental Health. Discusses findings from a national needs assessment, core strategies within the change initiative, progress in system-building, and preliminary descriptive and outcome data. Five demonstration sites comprised of four counties and a city neighbourhood are operational and preliminary data are promising with respect to implementation and outcomes. Effective change initiatives require vision and leadership, competence- and capacity-building, participative planning and engagement, adequate and thoughtfully deployed resources, and a comprehensive change management approach. © 2011 Blackwell Publishing Asia Pty Ltd.

  3. The Contribution of Health Technology Assessment, Health Needs Assessment, and Health Impact Assessment to the Assessment and Translation of Technologies in the Field of Public Health Genomics

    DEFF Research Database (Denmark)

    Rosenkotter, N.; Vondeling, H.; Blancquaert, I.

    2011-01-01

    The European Union has named genomics as one of the promising research fields for the development of new health technologies. Major concerns with regard to these fields are, on the one hand, the rather slow and limited translation of new knowledge and, on the other hand, missing insights...... into the impact on public health and health care practice of those technologies that are actually introduced. This paper aims to give an overview of the major assessment instruments in public health [ health technology assessment (HTA), health needs assessment (HNA) and health impact assessment (HIA)] which could...... contribute to the systematic translation and assessment of genomic health applications by focussing at population level and on public health policy making. It is shown to what extent HTA, HNA and HIA contribute to translational research by using the continuum of translational research (T1-T4) in genomic...

  4. Risk assessment and toxicology databases for health effects assessment

    Energy Technology Data Exchange (ETDEWEB)

    Lu, P.Y.; Wassom, J.S. [Oak Ridge National Laboratory, TN (United States)

    1990-12-31

    Scientific and technological developments bring unprecedented stress to our environment. Society has to predict the results of potential health risks from technologically based actions that may have serious, far-reaching consequences. The potential for error in making such predictions or assessment is great and multiplies with the increasing size and complexity of the problem being studied. Because of this, the availability and use of reliable data is the key to any successful forecasting effort. Scientific research and development generate new data and information. Much of the scientific data being produced daily is stored in computers for subsequent analysis. This situation provides both an invaluable resource and an enormous challenge. With large amounts of government funds being devoted to health and environmental research programs and with maintenance of our living environment at stake, we must make maximum use of the resulting data to forecast and avert catastrophic effects. Along with the readily available. The most efficient means of obtaining the data necessary for assessing the health effects of chemicals is to utilize applications include the toxicology databases and information files developed at ORNL. To make most efficient use of the data/information that has already been prepared, attention and resources should be directed toward projects that meticulously evaluate the available data/information and create specialized peer-reviewed value-added databases. Such projects include the National Library of Medicine`s Hazardous Substances Data Bank, and the U.S. Air Force Installation Restoration Toxicology Guide. These and similar value-added toxicology databases were developed at ORNL and are being maintained and updated. These databases and supporting information files, as well as some data evaluation techniques are discussed in this paper with special focus on how they are used to assess potential health effects of environmental agents. 19 refs., 5 tabs.

  5. Sports medical app support the health and fitness of workers

    NARCIS (Netherlands)

    Hilco Prins; Wasim Alsaqaf; Marike Hettinga; Sietske van Berkel; Jaap Stomphorst

    2015-01-01

    This paper describes the development and first version of an eHealth system for sports physicians who support employees in improving their health and fitness. Regular physical activity improves quality of life and has various health benefits. Companies have an interest in the health and

  6. [Hospital-based Health Technology Assessment].

    Science.gov (United States)

    Zavadil, Martin; Rogalewicz, Vladimír; Kubátová, Ivana; Matloňová, Veronika; Salačová, Kristýna

    Hospital-based HTA (HB-HTA) consists in implementation of assessment activities "in" or "for" hospitals; hence, it covers processes and methods supporting organization and execution of health technology assessment (HTA) at the level of individual hospitals. This process is multidisciplinary, systematic and evidence-based.HB-HTA objectives and methods differ from the classic utilization of HTA at the national regulator level. Most experience and information concerning HB-HTA has originated in two large recent projects: activities of the HB-HTA Interest Group of the HTAi international association established in 2006, and the AdHopHTA European research project (20122015).This paper describes four basic organizational models of HB-HTA, their characteristics and utilization in various countries and hospital types. Results of the AdHopHTA project are analyzed, and recommendations for HB-HTA implementation in Czech hospitals are formulated.Key words: hospital-based HTA, medical device, implementation, hospital strategy.

  7. Exploration Health Risks: Probabilistic Risk Assessment

    Science.gov (United States)

    Rhatigan, Jennifer; Charles, John; Hayes, Judith; Wren, Kiley

    2006-01-01

    conservative and nonconservative assumptions on the probability results. We discuss the methods necessary to assess mission risks once exploration mission scenarios are characterized. Preliminary efforts have produced results that are commensurate with earlier qualitative estimates of risk probabilities in this and other operational contexts, indicating that our approach may be usefully applied in support of the development of human health and performance standards for long-duration space exploration missions. This approach will also enable mission-specific probabilistic risk assessments for space exploration missions.

  8. Functionality Assessment of Ecodesign Support System

    Directory of Open Access Journals (Sweden)

    Dostatni Ewa

    2015-02-01

    Full Text Available In the paper the issue of ecological-oriented product design is addressed. The definitions that concern product design are listed and the factors that make them important for the manufacturers are indicated. The method of ecological-oriented product assessment during the design process (implemented in the 3D CAD system, drawn-up by authors, is used for the analysis. The assessment of real household appliance using the method is presented and the conclusions from the evaluation are drawn.

  9. Supporting visual quality assessment with machine learning

    NARCIS (Netherlands)

    Gastaldo, P.; Zunino, R.; Redi, J.

    2013-01-01

    Objective metrics for visual quality assessment often base their reliability on the explicit modeling of the highly non-linear behavior of human perception; as a result, they may be complex and computationally expensive. Conversely, machine learning (ML) paradigms allow to tackle the quality

  10. A Support Database System for Integrated System Health Management (ISHM)

    Science.gov (United States)

    Schmalzel, John; Figueroa, Jorge F.; Turowski, Mark; Morris, John

    2007-01-01

    The development, deployment, operation and maintenance of Integrated Systems Health Management (ISHM) applications require the storage and processing of tremendous amounts of low-level data. This data must be shared in a secure and cost-effective manner between developers, and processed within several heterogeneous architectures. Modern database technology allows this data to be organized efficiently, while ensuring the integrity and security of the data. The extensibility and interoperability of the current database technologies also allows for the creation of an associated support database system. A support database system provides additional capabilities by building applications on top of the database structure. These applications can then be used to support the various technologies in an ISHM architecture. This presentation and paper propose a detailed structure and application description for a support database system, called the Health Assessment Database System (HADS). The HADS provides a shared context for organizing and distributing data as well as a definition of the applications that provide the required data-driven support to ISHM. This approach provides another powerful tool for ISHM developers, while also enabling novel functionality. This functionality includes: automated firmware updating and deployment, algorithm development assistance and electronic datasheet generation. The architecture for the HADS has been developed as part of the ISHM toolset at Stennis Space Center for rocket engine testing. A detailed implementation has begun for the Methane Thruster Testbed Project (MTTP) in order to assist in developing health assessment and anomaly detection algorithms for ISHM. The structure of this implementation is shown in Figure 1. The database structure consists of three primary components: the system hierarchy model, the historical data archive and the firmware codebase. The system hierarchy model replicates the physical relationships between

  11. Attachment as a Moderating Factor Between Social Support, Physical Health, and Psychological Symptoms

    Directory of Open Access Journals (Sweden)

    Kimberly A. Rapoza

    2016-12-01

    Full Text Available This study investigated the extent to which perceived social support functioned as a protective factors, and dimensions of insecure attachment (i.e., avoidant and anxious functioned as risks factors for physical and psychological health. We explored whether insecure attachment was a mechanism that modified the relationship (i.e., protect against or increases risk between social support and adult health. Participants were 155 non-traditional adult college students from demographically diverse backgrounds. Students were approached in common areas on campus or in classrooms during break and were asked to complete the questionnaire. Bartholomew and Horowitz’s Attachment Questionnaire assessed avoidant and anxious attachment dimensions, the Brief Social Support Questionnaire assessed perceived social support, and the Memorial Symptom Assessment Scale measured physical and psychological symptoms. Model results indicated that the anxious dimension of insecure attachment was more directly and positively associated with poorer general physical health and psychological symptoms, whereas greater perceived social support was linked with better reported health. However, an interesting pattern emerged with avoidant attachment through a moderated relationship with social support. The absence of a satisfying supportive network was significantly related to poorer physical and psychological health outcomes for those low in avoidant attachment, but not for those high in avoidant attachment. Results from this work suggest that insecure attachment plays a detrimental role in adult health. Perceived social support does not necessarily function as a blanket protective factor for health, as it seemed to offer less benefit to those high in attachment avoidance.

  12. Assessing Health Professional Education: Workshop Summary

    Science.gov (United States)

    Cuff, Patricia A.

    2014-01-01

    "Assessing Health Professional Education" is the summary of a workshop hosted by the Institute of Medicine's Global Forum on Innovation in Health Professional Education to explore assessment of health professional education. At the event, Forum members shared personal experiences and learned from patients, students, educators, and…

  13. Mobile health: assessing the barriers.

    Science.gov (United States)

    Terry, Nicolas P

    2015-05-01

    Mobile health (mHealth) combines the decentralization of health care with patient centeredness. Mature mHealth applications (apps) and services could provide actionable information, coaching, or alerts at a fraction of the cost of conventional health care. Different categories of apps attract diverse safety and privacy regulation. It is too early to tell whether these apps can overcome questions about their use cases, business models, and regulation.

  14. Health technology assessment in South Korea.

    Science.gov (United States)

    Kim, Chang-yup

    2009-07-01

    To analyze evolution of the health technology assessment (HTA) at the national level in South Korea. Analysis of public documents, personal communication, and literative review. HTA in South Korea has been developed since 1990s, first introduced by academia and institutionalized within the National Health Insurance (NHI). Rapidly increasing expenditure had been a challenge of the NHI, which considered health technology management as a cost controlling measure. An amendment was made to the NHI Law in 2000, and provision was made to regulate the process of determining new insurance benefits including procedures, drugs, and equipment. This requirement made the NHI agencies to promote HTA approaches in connection with the government and professional organizations. Also the Healthcare Act was revised in October 2006 ruling that HTA focusing on safety and effectiveness be responsible for new health technologies. Currently, the HTA process is governed by a governmental committee comprising twenty members and technically supported by the HTA center created in the NHI structure. Institutionalized HTA in Korea has been driven mainly by the requirements of the NHI and manifested strengths as well as weaknesses. The government is establishing a new organization for HTA, independent from the NHI.

  15. Use of electronic health records to support smoking cessation.

    Science.gov (United States)

    Boyle, Raymond; Solberg, Leif; Fiore, Michael

    2014-12-30

    Health information systems such as electronic health records (EHR), computerized decision support systems, and electronic prescribing are potentially valuable components to improve the quality and efficiency of clinical interventions for tobacco use. To assess the effectiveness of electronic health record-facilitated interventions on smoking cessation support actions by clinicians, clinics, and healthcare delivery systems and on patient smoking cessation outcomes. We searched the Cochrane Tobacco Addiction Group Specialised Register, CENTRAL, MEDLINE, EMBASE, PsycINFO, CINAHL, and reference lists and bibliographies of included studies. We searched for studies published between January 1990 and July 2014. We included both randomized studies and non-randomized studies that reported interventions targeting tobacco use through an EHR in healthcare settings. The intervention could include any use of an EHR to improve smoking status documentation or cessation assistance for patients who use tobacco, either by direct action or by feedback of clinical performance measures. Characteristics and content of the interventions, participants, outcomes and methods of the included studies were extracted by one author and checked by a second. Because of wide variation in measurement of outcomes, we were not able to conduct a meta-analysis. We included six group randomized trials, one patient randomized study, and nine non-randomized observational studies of fair to good quality that tested the use of an existing EHR to improve documentation and/or treatment of tobacco use. None of the studies included a direct assessment of patient quit rates. Overall, these studies found only modest improvements in some of the recommended clinician actions on tobacco use. Documentation of tobacco status and referral to cessation counselling appears to increase following EHR modifications designed to prompt the recording and treating of tobacco use at healthcare visits. There is a need for

  16. Perceived Social Support and Mental Health: Cultural Orientations as Moderators

    Science.gov (United States)

    Shelton, Andrew J.; Wang, Chiachih D. C.; Zhu, Wenzhen

    2017-01-01

    This study investigated unique and shared effects of social support and cultural orientation on mental health indicators (depressive and anxiety symptoms, stress, and life satisfaction) of 896 college students. Results indicated that perceived social support predicted mental health variables and that cultural orientation variables (independent and…

  17. Social Support and Physical Health: The Importance of Belonging.

    Science.gov (United States)

    Hale, Cara J.; Hannum, James W.; Espelage, Dorothy L.

    2005-01-01

    Social support is a multifaceted construct recognized as a significant predictor of physical health. In this study, the authors examined several support domains simultaneously in a sample of 247 college students to determine their unique prediction of physical health perceptions and physical symptoms. They also examined gender differences across…

  18. Examining the breastfeeding support resources of the public health nursing services in Ireland.

    Science.gov (United States)

    Mulcahy, Helen; Phelan, Agnes; Corcoran, Paul; Leahy-Warren, Patricia

    2012-04-01

    The aim of the study was to review breastfeeding support provided by Public Health Nurses in Ireland. The objectives were to identify the availability of appropriate guiding policies, educational preparation, attitude of Public Health Nurses and the availability and use of other supportive services. Breastfeeding rates in Ireland are among the lowest in Europe. The main source of formal support for breastfeeding mothers in the community in Ireland is from Public Health Nurses who can make referral to other non-statutory resources. The nature of this support is determined by policies guiding clinical practice and education that increases breastfeeding confidence and competence of all personnel. Consequently, an assessment of breastfeeding resources requires an analysis of all these variables. A large quantitative, cross-sectional study was conducted, involving Public Health Nurses and mothers. This paper represents the results from the perspective of Public Health Nurses. Directors of Public Health Nursing (n = 24) and Public Health Nurses (n = 204) completed self-report questionnaires by mail and online. Data were analysed using the Statistical Package for Social Sciences and reported using descriptive and inferential statistics. Public Health Nurses are well educated to support breastfeeding and have a positive attitude and a high degree of self-assessed confidence and competence. A wide variety of non-statutory support exists for breastfeeding but is not always used to their full potential. Standardising educational requirements for Public Health Nurses in supporting breastfeeding is an area that requires attention. Ultimately, service delivery in relation to supporting breastfeeding mothers would benefit from being more timely and responsive. Awareness of support resources is necessary for Public Health Nurses to make appropriate referrals for breastfeeding mothers. Furthermore, Directors of Public Health Nursing need to encourage the breastfeeding supportive

  19. [Health impact assessment: one way to introduce health in all policies. SESPAS Report 2010].

    Science.gov (United States)

    Esnaola, Santiago; Bacigalupe, Amaia; Sanz, Elvira; Aldasoro, Elena; Calderón, Carlos; Zuazagoitia, Juan; Cambra, Koldo

    2010-12-01

    Health impact assessment is a predictive tool to support decisions in policy-making. Current experience shows that health impact assessment could play an important role in the development of the Health in All Policies strategy. This strategy has been extensively used in other European countries and in a wide range of policy and administrative sectors. Health impact assessment is hardly ever mandatory and is frequently carried out separately from other impact assessments. The use of this process in Spain is relatively new, limited and fundamentally based on local level experiences and the screening of regional interventions. The current normative and organizational reform of public health in Spain provides an excellent opportunity to promote the development of health impact assessment. Some of the barriers to the development of this process are related to the biomedical model of health prevailing among health professionals, politicians, and the general population, political disaffection, lack of assessment culture, underdevelopment of community participation processes, and insufficient intersectoral work. Health impact assessment provides an opportunity to move toward improving the population's health and reducing inequalities in health. Consequently, political commitment, as well as investment in education and research, is needed to introduce and develop health impact assessment in all administrative settings and policy sectors. Copyright © 2010 SESPAS. Published by Elsevier Espana. All rights reserved.

  20. Confronting Uncertainty in Life Cycle Assessment Used for Decision Support

    DEFF Research Database (Denmark)

    Herrmann, Ivan Tengbjerg; Hauschild, Michael Zwicky; Sohn, Michael D.

    2014-01-01

    The aim of this article is to help confront uncertainty in life cycle assessments (LCAs) used for decision support. LCAs offer a quantitative approach to assess environmental effects of products, technologies, and services and are conducted by an LCA practitioner or analyst (AN) to support...

  1. Community mental health work: Negotiating support of users' recovery.

    Science.gov (United States)

    Reed, Nina Petersen; Josephsson, Staffan; Alsaker, Sissel

    2017-06-23

    Mental health services have changed over the past decades through an increased emphasis on deinstitutionalization and normalization, and with recovery processes situated in everyday life as a new locus of support. These changes have led to a need for new knowledge and methods concerning the provision of community mental health services. The aim of the present study was to explore how community mental health workers provide support to users, by investigating professionals' own narratives of how they work. Seven community mental health workers participated in narrative interviews, which were subject to a qualitative, interpretive analysis. A primary finding was that community mental health workers provide flexible and individually-adjusted support through engaging in negotiations with users, management, and others. Our findings show both opportunities and challenges of negotiating support, raising the following question for discussion: How and when are negotiations a valuable way for professionals and users to collaborate? © 2017 Australian College of Mental Health Nurses Inc.

  2. Health Risk Assessments for Alumina Refineries

    OpenAIRE

    Donoghue, A Michael; Coffey, Patrick S.

    2014-01-01

    Objective: To describe contemporary air dispersion modeling and health risk assessment methodologies applied to alumina refineries and to summarize recent results. Methods: Air dispersion models using emission source and meteorological data have been used to assess ground-level concentrations (GLCs) of refinery emissions. Short-term (1-hour and 24-hour average) GLCs and annual average GLCs have been used to assess acute health, chronic health, and incremental carcinogenic risks. Results: The ...

  3. Supporting frail seniors through a family physician and Home Health integrated care model in Fraser Health

    Directory of Open Access Journals (Sweden)

    Grace Haeson Park

    2014-03-01

    Full Text Available Background: A major effort is underway to integrate primary and community care in Canada's western province of British Columbia and in Fraser Health, its largest health authority. Integrated care is a critical component of Fraser Health's planning, to meet the challenges of caring for a growing, elderly population that is presenting more complex and chronic medical conditions.Description of integrated practice: An integrated care model partners family physicians with community-based home health case managers to support frail elderly patients who live at home. It is resulting in faster response times to patient needs, more informed assessments of a patient's state of health and pro-active identification of emerging patient issues.Early results: The model is intended to improve the quality of patient care and maintain the patients’ health status, to help them live at home confidently and safely, as long as possible. Preliminary pilot data measuring changes in home care services is showing positive trends when it comes to extending the length of a person's survival/tenure in the community (living in their home vs. admitted to residential care or deceased.Conclusion: Fraser Health's case manager–general practitioner partnership model is showing promising results including higher quality, appropriate, coordinated and efficient care; improved patient, caregiver and physician interactions with the system; improved health and prevention of acute care visits by senior adult patients.

  4. Supporting frail seniors through a family physician and Home Health integrated care model in Fraser Health.

    Science.gov (United States)

    Park, Grace; Miller, Diane; Tien, George; Sheppard, Irene; Bernard, Michael

    2014-01-01

    A major effort is underway to integrate primary and community care in Canada's western province of British Columbia and in Fraser Health, its largest health authority. Integrated care is a critical component of Fraser Health's planning, to meet the challenges of caring for a growing, elderly population that is presenting more complex and chronic medical conditions. An integrated care model partners family physicians with community-based home health case managers to support frail elderly patients who live at home. It is resulting in faster response times to patient needs, more informed assessments of a patient's state of health and pro-active identification of emerging patient issues. The model is intended to improve the quality of patient care and maintain the patients' health status, to help them live at home confidently and safely, as long as possible. Preliminary pilot data measuring changes in home care services is showing positive trends when it comes to extending the length of a person's survival/tenure in the community (living in their home vs. admitted to residential care or deceased). Fraser Health's case manager-general practitioner partnership model is showing promising results including higher quality, appropriate, coordinated and efficient care; improved patient, caregiver and physician interactions with the system; improved health and prevention of acute care visits by senior adult patients.

  5. Supporting frail seniors through a family physician and Home Health integrated care model in Fraser Health

    Directory of Open Access Journals (Sweden)

    Grace Haeson Park

    2014-03-01

    Full Text Available Background: A major effort is underway to integrate primary and community care in Canada's western province of British Columbia and in Fraser Health, its largest health authority. Integrated care is a critical component of Fraser Health's planning, to meet the challenges of caring for a growing, elderly population that is presenting more complex and chronic medical conditions. Description of integrated practice: An integrated care model partners family physicians with community-based home health case managers to support frail elderly patients who live at home. It is resulting in faster response times to patient needs, more informed assessments of a patient's state of health and pro-active identification of emerging patient issues. Early results: The model is intended to improve the quality of patient care and maintain the patients’ health status, to help them live at home confidently and safely, as long as possible. Preliminary pilot data measuring changes in home care services is showing positive trends when it comes to extending the length of a person's survival/tenure in the community (living in their home vs. admitted to residential care or deceased. Conclusion: Fraser Health's case manager–general practitioner partnership model is showing promising results including higher quality, appropriate, coordinated and efficient care; improved patient, caregiver and physician interactions with the system; improved health and prevention of acute care visits by senior adult patients.

  6. Whole genome sequencing in support of wellness and health maintenance

    National Research Council Canada - National Science Library

    Patel, Chirag J; Sivadas, Ambily; Tabassum, Rubina; Preeprem, Thanawadee; Zhao, Jing; Arafat, Dalia; Chen, Rong; Morgan, Alexander A; Martin, Gregory S; Brigham, Kenneth L; Butte, Atul J; Gibson, Greg

    2013-01-01

    .... The present study illustrates novel approaches for integrating genotypic and clinical information for assessment of generalized health risks and to assist individuals in the promotion of wellness...

  7. Health effects of risk-assessment categories

    Energy Technology Data Exchange (ETDEWEB)

    Kramer, C.F.; Rybicka, K.; Knutson, A.; Morris, S.C.

    1983-10-01

    Environmental and occupational health effects associated with exposures to various chemicals are a subject of increasing concern. One recently developed methodology for assessing the health impacts of various chemical compounds involves the classification of similar chemicals into risk-assessment categories (RACs). This report reviews documented human health effects for a broad range of pollutants, classified by RACs. It complements other studies that have estimated human health effects by RAC based on analysis and extrapolation of data from animal research.

  8. Bridging Grant : Building Canadian Support for Global Health ...

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

    The Canadian Coalition for Global Health Research (CCGHR) is a not-for-profit organization dedicated to supporting research for global health equity. The CCGHR provides a networking and action platform for the Canadian global health research community and partners in low- and middle-income countries. This grant will ...

  9. Rationale and scientific support for health claims on foods

    African Journals Online (AJOL)

    Nicky

    Rationale and scientific support for health claims on foods. The role of diet and physical activity in health has been increasingly documented and pinpointed as a major target for health-promoting strategies. The supply, availability, marketing and price of food products have a strong impact on consumers' diets.1 Therefore,.

  10. What Type of Social Support Influences Self-Reported Physical and Mental Health Among Older Women?

    Science.gov (United States)

    Wong, Sabrina T; Wu, Amery; Gregorich, Steven; Pérez-Stable, Eliseo J

    2014-06-01

    We examined which types of social support were associated with older women's self-report of physical and mental health and whether the effects of social support were moderated by race/ethnicity. Women completed a health behavior survey that included the Medical Outcomes Study-Short Form-12 (MOS SF-12). Single race/ethnic group regressions examined whether different types of social support were related to health. We also examined Pratt's relative importance measures. Emotional support had the strongest effect on both physical and mental health, explaining the highest amount of variation, except among African Americans. Race/ethnicity moderated the association of informational support for Asian women's reports of their mental health. For clinicians, assessing individuals' emotional support is important for maintaining or increasing physical and mental health. Clinicians can also assess Asian women's stress, providing informational support accordingly as too much information could be detrimental to their health. For researchers, the inclusion of emotional support items is the most important. © The Author(s) 2014.

  11. The role of autonomy and social support in the relation between psychosocial safety climate and stress in health care workers

    National Research Council Canada - National Science Library

    Havermans, B.M; Boot, C.R.L; Houtman, I.L.D; Brouwers, E.P.M; Anema, J.R; van der Beek, A.J

    2017-01-01

    .... Methods In a cross-sectional study, psychosocial safety climate, stress, autonomy, co-worker support, and supervisor support were assessed using questionnaires, in a sample of health care workers (N = 277...

  12. Supporting a movement for health and health equity: lessons from social movements : workshop summary

    National Research Council Canada - National Science Library

    Mack, Alison; Baciu, Alina; Goel, Nirupa

    2014-01-01

    "Supporting a Movement for Health and Health Equity is the summary of a workshop convened in December 2013 by the Institute of Medicine Roundtable on the Promotion of Health Equity and the Elimination...

  13. Consumer support for health information exchange and personal health records: a regional health information organization survey.

    Science.gov (United States)

    Patel, Vaishali N; Dhopeshwarkar, Rina V; Edwards, Alison; Barrón, Yolanda; Sparenborg, Jeffrey; Kaushal, Rainu

    2012-06-01

    In order to characterize consumer support for electronic health information exchange (HIE) and personal health records (PHRs) in a community where HIE is underway, we conducted a survey of English speaking adults who visited primary care practices participating in a regional community-wide clinical data exchange, during August, 2008. Amongst the 117 respondents, a majority supported physicians' use of HIE (83%) or expressed interest in potentially using PHRs (76%). Consumers' comfort sending personal information electronically over the Internet and their perceptions regarding the potential benefits of HIE were independently associated with their support for HIE. Consumers' prior experience using the Internet to manage their healthcare, perceptions regarding the potential benefits of PHRs and college education were independently associated with potential PHR use. Bolstering consumer support for HIE and PHRs will require addressing privacy and security concerns, demonstrating clinical benefits, and reaching out to those who are less educated and computer literate.

  14. Health Awareness Days: Sufficient Evidence to Support the Craze?

    Science.gov (United States)

    Roman, Leah A.

    2015-01-01

    Health awareness initiatives are a ubiquitous intervention strategy. Nearly 200 health awareness days, weeks, and months are on the US National Health Observances calendar, and more than 145 awareness day bills have been introduced in Congress since 2005. We contend that health awareness days are not held to appropriate scrutiny given the scale at which they have been embraced and are misaligned with research on the social determinants of health and the tenets of ecological models of health promotion. We examined health awareness days from a critical public health perspective and offer empirically supported recommendations to advance the intervention strategy. If left unchecked, health awareness days may do little more than reinforce ideologies of individual responsibility and the false notion that adverse health outcomes are simply the product of misinformed behaviors. PMID:25879148

  15. Health Behaviour and Health Assessment: Evidence from German Microdata

    Directory of Open Access Journals (Sweden)

    Brit S. Schneider

    2012-01-01

    Full Text Available The importance of the individual’s health behaviour for the health production process is beyond controversy. Health relevant behaviour can be viewed as a key variable in the health production process. Changes in the behaviour may influence individual’s assessment of health. Following this idea, we use German microdata to identify determinants of smoking, drinking, and obesity and their impact on health. Our empirical approach allows for the simultaneity of behaviours and self-reported health. In addition, we account for endogeneity of health behaviours and take aspects of reporting heterogeneity of self-reported health into account. We find that health behaviour is directly related to the socioeconomic status and observe gender-specific differences in the determinants of drinking, smoking, and heavy body weight in particular. The influence on health is also gender specific. While we do not find any impact of smoking, overweight is relevant only for males and no clear pattern for alcohol exists.

  16. Differences in Osteoarthritis Self-Management Support Intervention Outcomes According to Race and Health Literacy

    Science.gov (United States)

    Sperber, Nina R.; Bosworth, Hayden B.; Coffman, Cynthia J.; Lindquist, Jennifer H.; Oddone, Eugene Z.; Weinberger, Morris; Allen, Kelli D.

    2013-01-01

    We explored whether the effects of a telephone-based osteoarthritis (OA) self-management support intervention differed by race and health literacy. Participants included 515 veterans with hip and/or knee OA. Linear mixed models assessed differential effects of the intervention compared with health education (HE) and usual care (UC) on pain…

  17. Science to support aquatic animal health

    Science.gov (United States)

    Purcell, Maureen K.; Harris, M. Camille

    2016-10-18

    Healthy aquatic ecosystems are home to a diversity of plants, invertebrates, fish and wildlife. Aquatic animal populations face unprecedented threats to their health and survival from climate change, water shortages, habitat alteration, invasive species and environmental contaminants. These environmental stressors can directly impact the prevalence and severity of disease in aquatic populations. For example, periodic fish kills in the upper Chesapeake Bay Watershed are associated with many different opportunistic pathogens that proliferate in stressed fish populations. An estimated 80 percent of endangered juvenile Puget Sound steelhead trout die within two weeks of entering the marine environment, and a role for disease in these losses is being investigated. The introduction of viral hemorrhagic septicemia virus (VHSV) into the Great Lakes—a fishery worth an estimated 7 billion dollars annually—resulted in widespread fish die-offs and virus detections in 28 different fish species. Millions of dying sea stars along the west coast of North America have led to investigations into sea star wasting disease. U.S. Geological Survey (USGS) scientists are assisting managers with these issues through ecological investigations of aquatic animal diseases, field surveillance, and research to promote the development of mitigation strategies.

  18. Future of electronic health records: implications for decision support.

    Science.gov (United States)

    Rothman, Brian; Leonard, Joan C; Vigoda, Michael M

    2012-01-01

    The potential benefits of the electronic health record over traditional paper are many, including cost containment, reductions in errors, and improved compliance by utilizing real-time data. The highest functional level of the electronic health record (EHR) is clinical decision support (CDS) and process automation, which are expected to enhance patient health and healthcare. The authors provide an overview of the progress in using patient data more efficiently and effectively through clinical decision support to improve health care delivery, how decision support impacts anesthesia practice, and how some are leading the way using these systems to solve need-specific issues. Clinical decision support uses passive or active decision support to modify clinician behavior through recommendations of specific actions. Recommendations may reduce medication errors, which would result in considerable savings by avoiding adverse drug events. In selected studies, clinical decision support has been shown to decrease the time to follow-up actions, and prediction has proved useful in forecasting patient outcomes, avoiding costs, and correctly prompting treatment plan modifications by clinicians before engaging in decision-making. Clinical documentation accuracy and completeness is improved by an electronic health record and greater relevance of care data is delivered. Clinical decision support may increase clinician adherence to clinical guidelines, but educational workshops may be equally effective. Unintentional consequences of clinical decision support, such as alert desensitization, can decrease the effectiveness of a system. Current anesthesia clinical decision support use includes antibiotic administration timing, improved documentation, more timely billing, and postoperative nausea and vomiting prophylaxis. Electronic health record implementation offers data-mining opportunities to improve operational, financial, and clinical processes. Using electronic health record data

  19. Assessment of health informatics competencies in undergraduate ...

    African Journals Online (AJOL)

    Assessment of health informatics competencies in undergraduate training of healthcare professionals in Rwanda. ... Furthermore, the establishment of continuous on-the-job training in health informatics for those who are already practicing is also essential. Keywords: Health informatics, competencies, undergraduate ...

  20. Real-world implementation and outcomes of health behavior and mental health assessment.

    Science.gov (United States)

    Rodriguez, Hector P; Glenn, Beth A; Olmos, Tanya T; Krist, Alex H; Shimada, Stephanie L; Kessler, Rodger; Heurtin-Roberts, Suzanne; Bastani, Roshan

    2014-01-01

    Assessing patient-reported health behaviors is a critical first step in prioritizing prevention in primary care. We assessed the feasibility of point-of-care behavioral health assessment in 9 diverse primary care practices, including 4 federally qualified health centers (FQHCs), 4 practice-based research network practices, and a Department of Veterans Affairs practice. In this prospective mixed-methods study, practices were asked to integrate a standardized paper-based health behavior and mental health assessment into their workflow for ≥50 patients. We used 3 data sources to examine the implementation process: (1) patient responses to the health assessment, (2) patient feedback surveys about how assessments were used during encounters, and (3) postimplementation interviews. Most nonurgent patients (71%) visiting the participating practices during the implementation period completed the health assessment, but reach varied by practice (range, 59% to 88%). Unhealthy diet, sedentary lifestyle, and stress were the most common patient problems, with similar frequencies observed across practices. The median number of "positive screens" per patient was similar among FQHCs (3.7 positives; standard deviation [SD], 1.8), practice-based research network practices (3.8 positives; SD, 1.9), and the Veterans Affairs clinic (4.1 positives; SD, 2.0). Primary care clinicians discussed assessment results with patients about half of the time (54%), with considerable variation between practices (range, 13% to 66%; lowest use among FQHC clinicians). Although clinicians were interested in routinely implementing assessments, many reported not feeling confident of having resources or support to address all patients' behavioral health needs. Primary care practices will need to revamp their patient-reported data collection processes to integrate routine health behavior assessments. Implementation support will be required if health assessments are to be actively used as part of routine

  1. Real world implementation and outcomes of health behavior and mental health assessment

    Science.gov (United States)

    Rodriguez, Hector P.; Glenn, Beth A.; Olmos, Tanya; Krist, Alex H.; Shimada, Stephanie L.; Kessler, Rodger; Heurtin-Roberts, Suzanne; Bastani, Roshan

    2014-01-01

    Background Assessing patient-reported health behaviors is a critical first step to prioritizing prevention in primary care. We assessed the feasibility of point-of-care behavioral health assessment in nine diverse primary care practices, including four federally-qualified health centers (FQHCs), four Practice-based Research Network (PBRN) practices, and a Department of Veterans Affairs (VA) practice. Methods In this prospective mixed-methods study, practices were asked to integrate a standardized paper-based health behavior and mental health assessment into their workflow for 50 or more patients. We used three data sources to examine the implementation process: 1) patient responses to the health assessment, 2) patient feedback surveys about how assessments were used during encounters, and 3) post-implementation interviews. Results Most (71%) non-urgent patients visiting the participating practices during the implementation period completed the health assessment, but reach varied by practice (range: 59-88%). Unhealthy diet, sedentary lifestyle, and stress were the most common patient problems with similar frequencies observed across practices. The median number of “positive screens” per patient was similar across FQHCs (3.7-positives, SD=1.8), PBRN practices (3.8-positives, SD=1.9), and the VA clinic (4.1-positives, SD=2.0). Primary care clinicians discussed assessment results with patients about half of the time (54%), with considerable between practice variation (range: 13%-66% with lowest use among FQHC clinicians). Although clinicians were interested in routinely implementing assessments, many reported not feeling confident of having resources or support to address all patients’ behavioral health needs. Conclusions Primary care practices will need to revamp their patient-reported data collection processes in order to integrate routine health behavior assessments. Implementation support will be required if health assessments are to be actively used as part

  2. Social support as moderator of the stress on unemployed people’s health

    OpenAIRE

    Leticia Rosaria Guarino; Victor Sojo

    2011-01-01

    The aim of this research was to assess moderating role of two indexes of social support in the relationship between the length of unemployment and the physical and mental health of Venezuelan unemployed. Self-report measures were administered to a sample of 328 unemployed residents in Caracas, Venezuela. Results indicated that perceived social support acted as moderator in predicting better general health and lower somatization in the unemployed, acting as buffer of longer periods of unemploy...

  3. The contribution of health technology assessment, health needs assessment, and health impact assessment to the assessment and translation of technologies in the field of public health genomics.

    Science.gov (United States)

    Rosenkötter, N; Vondeling, H; Blancquaert, I; Mekel, O C L; Kristensen, F B; Brand, A

    2011-01-01

    The European Union has named genomics as one of the promising research fields for the development of new health technologies. Major concerns with regard to these fields are, on the one hand, the rather slow and limited translation of new knowledge and, on the other hand, missing insights into the impact on public health and health care practice of those technologies that are actually introduced. This paper aims to give an overview of the major assessment instruments in public health [health technology assessment (HTA), health needs assessment (HNA) and health impact assessment (HIA)] which could contribute to the systematic translation and assessment of genomic health applications by focussing at population level and on public health policy making. It is shown to what extent HTA, HNA and HIA contribute to translational research by using the continuum of translational research (T1-T4) in genomic medicine as an analytic framework. The selected assessment methodologies predominantly cover 2 to 4 phases within the T1-T4 system. HTA delivers the most complete set of methodologies when assessing health applications. HNA can be used to prioritize areas where genomic health applications are needed or to identify infrastructural needs. HIA delivers information on the impact of technologies in a wider scope and promotes informed decision making. HTA, HNA and HIA provide a partly overlapping and partly unique set of methodologies and infrastructure for the translation and assessment of genomic health applications. They are broad in scope and go beyond the continuum of T1-T4 translational research regarding policy translation. Copyright © 2010 S. Karger AG, Basel.

  4. Center for Global Health announces grants to support portable technologies

    Science.gov (United States)

    NCI's Center for Global Health announced grants that will support the development and validation of low-cost, portable technologies. These technologies have the potential to improve early detection, diagnosis, and non-invasive or minimally invasive treatm

  5. A decade of NHMRC People Support expenditure in review: is support for Indigenous health research increasing?

    Science.gov (United States)

    Leon de la Barra, Sophia; Redman, Sally; Eades, Sandra; Lonsdale, Carey

    2009-01-05

    To investigate National Health and Medical Research Council (NHMRC) support over the decade to 2006 for researchers studying Indigenous health and researchers who self-identified as Indigenous. Review of data on all recipients of People Support awards and Capacity Building Grants in Population Health Research who were researching Indigenous health or who self-identified as Indigenous between 1996 and 2006. Annual People Support and Capacity Building grants and expenditure, by broad research area, state or territory, administering institution, and Indigenous status (as self-identified by award recipients in their applications). Between 1996 and 2006, 134 People Support awards were made to researchers studying Indigenous health; of these, 27 (20%) were to researchers who self-identified as Aboriginal or Torres Strait Islander. In 2006, about 2.9% of the annual expenditure on all People Support funding was for Indigenous health research, representing a doubling in the proportion of funds since 2001. There was no increase in the number of self-identified Indigenous researchers funded under People Support, but Capacity Building Grants increased the number of people from Indigenous backgrounds supported by the NHMRC, with funds allocated to 36 Indigenous researchers from 2002 to 2006, compared with 14 funded by People Support during the same period. Funding to support Indigenous health research through the People Support scheme has increased since the NHMRC adopted policy changes in 2002, but it has not reached the targeted expenditure of at least 5% of agency allocations. The Capacity Building Grants have been a more effective vehicle for funding researchers from Indigenous backgrounds.

  6. Integrated Modelling Frameworks for Environmental Assessment and Decision Support

    NARCIS (Netherlands)

    Rizzoli, A.E.; Leavesley, G.; Ascough, J.C.; Argent, R.M.; Athanasiadis, I.N.; Brilhante, V.; Claeys, F.H.A.; David, O.; Donatelli, M.; Gijsbers, P.; Havlik, D.; Kassahun, A.; Krause, P.; Quinn, N.W.T.; Scholten, H.; Sojda, R.S.; Villa, F.

    2008-01-01

    Modern management of environmental resources defines problems from a holistic and integrated perspective, imposing strong requirements to Environmental Decision Support Systems (EDSSs) and Integrated Assessment Tools (IATs), which tend to be increasingly complex in terms of software architecture and

  7. Analysis and Assessment of Computer-Supported Collaborative Learning Conversations

    NARCIS (Netherlands)

    Trausan-Matu, Stefan

    2008-01-01

    Trausan-Matu, S. (2008). Analysis and Assessment of Computer-Supported Collaborative Learning Conversations. Workshop presentation at the symposium Learning networks for professional. November, 14, 2008, Heerlen, Nederland: Open Universiteit Nederland.

  8. Chemical Risk Assessment: Traditional vs Public Health ...

    Science.gov (United States)

    Preventing adverse health impacts from exposures to environmental chemicals is fundamental to protecting individual and public health. When done efficiently and properly, chemical risk assessment enables risk management actions that minimize the incidence and impacts of environmentally-induced diseases related to chemical exposure. However, traditional chemical risk assessment is faced with multiple challenges with respect to predicting and preventing disease in human populations, and epidemiological studies increasingly report observations of adverse health effects at exposure levels predicted from animal studies to be safe for humans. This discordance reinforces concerns about the adequacy of contemporary risk assessment practices (Birnbaum, Burke, & Jones, 2016) for protecting public health. It is becoming clear that to protect public health more effectively, future risk assessments will need to use the full range of available data, draw on innovative methods to integrate diverse data streams, and consider health endpoints that also reflect the range of subtle effects and morbidities observed in human populations. Given these factors, there is a need to reframe chemical risk assessment to be more clearly aligned with the public health goal of minimizing environmental exposures associated with disease. Preventing adverse health impacts from exposures to environmental chemicals is fundamental to protecting individual and public health. Chemical risk assessments

  9. Case-based reasoning in Intelligent Health Decision Support Systems.

    Science.gov (United States)

    González, Carolina; López, Diego M; Blobel, Bernd

    2013-01-01

    Decision-making is a crucial task for decision makers in healthcare, especially because decisions have to be made quickly, accurately and under uncertainty. Taking into account the importance of providing quality decisions, offering assistance in this complex process has been one of the main challenges of Artificial Intelligence throughout history. Decision Support Systems (DSS) have gained popularity in the medical field for their efficacy to assist decision-making. In this sense, many DSS have been developed, but only few of them consider processing and analysis of information contained in electronic health records, in order to identify individual or population health risk factors. This paper deals with Intelligent Decision Support Systems that are integrated into Electronic Health Records Systems (EHRS) or Public Health Information Systems (PHIS). It provides comprehensive support for a wide range of decisions with the purpose of improving quality of care delivered to patients or public health planning, respectively.

  10. Social ties and perceived support: two dimensions of social relationships and health among the elderly in Taiwan.

    Science.gov (United States)

    Cornman, Jennifer C; Goldman, Noreen; Glei, Dana A; Weinstein, Maxine; Chang, Ming-Cheng

    2003-11-01

    Assess the effects of social relationships on physical and mental health among the elderly in Taiwan. Using 4 waves of a survey of the elderly, we examine the relationship between social ties and perceived support and four health outcomes--mortality, functional status, self-assessed health, and depression. Perceived support and social ties are related to health, but many of the apparent effects are attenuated in the presence of controls for prior health. However, positive perceptions about support are protective of mental (but not physical) health. If baseline health is ignored, estimates of the effects of social relationships on health at a given stage of life are likely to be inflated by reverse causality or by effects occurring prior to baseline. Inclusion of controls for initial health reveals that, in general, the relationship between social support and health at the older ages in Taiwan is relatively modest.

  11. Impact Assessment of Public Innovation Support in European Economic Area

    Directory of Open Access Journals (Sweden)

    Mantas Vilys

    2015-12-01

    Full Text Available The object of this paper is related to the public innovation support in Euro-pean Economic Area and its effectiveness assessment. Main aim of the re-search presented in this paper is to propose new model for public innovation support effectiveness assessment, which could be relevant to the contempo-rary needs and would be based on new explored practice of public innova-tion support developments. The methods of comparative, regression, model-ling analysis, multi-criteria evaluation, analogy search, logical abstraction and impact evaluation have been applied for the research presented in this paper. Proposed original system of quantitative and qualitative indicators that characterize any public innovation support system (public innovation support index enables creation and implementation of measures devoted to the public innovation support impact improvement at EU and national level.

  12. Public support for graphic health warning labels in the U.S.

    Science.gov (United States)

    Kamyab, Kian; Nonnemaker, James M; Farrelly, Matthew C

    2015-01-01

    In 2009, the U.S. Food and Drug Administration was required to mandate that graphic health warning labels be placed on cigarette packages and advertisements. To assess public support in the U.S. for graphic health warning labels from 2007 to 2012. Data from 17,498 respondents from 13 waves of the National Adult Tobacco Survey, a list-assisted random-digit-dial survey, were used. Overall support for graphic health warning labels, as well as support by smoking status, and by sociodemographics and smoker characteristics are estimated. Analyses were conducted in 2014. Since 2007, a majority of the public overall has been in favor of labels. Support increased significantly among the public overall and among non-smokers from 2007 through 2009 (pgraphic health warning labels for cigarette packs, though support among smokers declined after 2011. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  13. Health technology assessment as a template for assessments in laboratory animal science with a focus on phenotyping protocols

    NARCIS (Netherlands)

    Thon, R.; Ritskes-Hoitinga, M.; Vondeling, Hindrik

    2010-01-01

    This study introduces Health Technology Assessment (HTA) — a systematic, evidence-based, multidisciplinary approach to assessing human health technologies, aimed at supporting decision-making in health policy and clinical practice — into laboratory animal science. A conceptual presentation is

  14. Emotional support, education and self-rated health in 22 European countries.

    Science.gov (United States)

    von dem Knesebeck, Olaf; Geyer, Siegfried

    2007-10-01

    The analyses focus on three aims: (1) to explore the associations between education and emotional support in 22 European countries, (2) to explore the associations between emotional support and self-rated health in the European countries, and (3) to analyse whether the association between education and self-rated health can be partly explained by emotional support. The study uses data from the European Social Survey 2003. Probability sampling from all private residents aged 15 years and older was applied in all countries. The European Social Survey includes 42,359 cases. Persons under age 25 were excluded to minimise the number of respondents whose education was not complete. Education was coded according to the International Standard Classification of Education. Perceived emotional support was assessed by the availability of a confidant with whom one can discuss intimate and personal matters with. Self-rated health was used as health indicator. Results of multiple logistic regression analyses show that emotional support is positively associated with education among women and men in most European countries. However, the magnitude of the association varies according to country and gender. Emotional support is positively associated with self-rated health. Again, gender and country differences in the association were observed. Emotional support explains little of the educational differences in self-rated health among women and men in most European countries. Results indicate that it is important to consider socio-economic factors like education and country-specific contexts in studies on health effects of emotional support.

  15. Paediatric death and dying: exploring coping strategies of health professionals and perceptions of support provision.

    Science.gov (United States)

    Forster, Elizabeth; Hafiz, Alaa

    2015-06-01

    Without question a child's death is a devastating event for parents and families. Health professionals working with the dying child and family draw upon their expertise and experience to engage with children, parents and families on this painful journey. This is a delicate and sensitive area of practice and has strong and penetrating effects on health professionals. They employ physical, emotional, spiritual and problem solving strategies to continue to perform this role effectively and to protect their continued sense of wellbeing. To explore health professionals' perceptions of bereavement support surrounding the loss of a child. The research was underpinned by social constructionism. Semi-structured interviews were held with 10 health professionals including doctors, nurses and social workers who were directly involved in the care of the dying child and family in 7 cases of paediatric death. Health professional narratives were analysed consistent with Charmarz's (2006) approach. For health professionals, constructions around coping emerged as peer support, personal coping strategies, family support, physical impact of support and spiritual beliefs. Analysis of the narratives also revealed health professionals' perceptions of their support provision. Health professionals involved in caring for dying children and their families use a variety of strategies to cope with the emotional and physical toll of providing support. They also engage in self-assessment to evaluate their support provision and this highlights the need for self-evaluation tools in paediatric palliative care.

  16. 78 FR 54967 - Rural Health Care Support Mechanism

    Science.gov (United States)

    2013-09-09

    ... conduct or sponsor a collection of information unless it displays a current, valid OMB Control Number. No... Skilled Nursing Facilities Pilot (SNF Pilot) to test how to support broadband connections for skilled nursing facilities. All the requirements herein are necessary to administer the Rural Health Care support...

  17. Experiences of health professionals with nutritional support of ...

    African Journals Online (AJOL)

    Development of critical care services in low-income countries has not been accompanied by certain appropriate ancillary services and interventions, such as adequate nutritional support. This study was designed to investigate the experiences of health professionals who have provided nutritional supportive care to critically ...

  18. Family Support in Children's Mental Health: A Review and Synthesis

    Science.gov (United States)

    Hoagwood, Kimberly E.; Cavaleri, Mary A.; Olin, S. Serene; Burns, Barbara J.; Slaton, Elaine; Gruttadaro, Darcy; Hughes, Ruth

    2010-01-01

    A comprehensive review of structured family support programs in children's mental health was conducted in collaboration with leadership from key national family organizations. The goals were to identify typologies of family support services for which evaluation data existed and identify research gaps. Over 200 programs were examined; 50 met…

  19. [Health impact assessment of building and investment projects].

    Science.gov (United States)

    Thriene, B

    2003-02-01

    -term consideration. Assessing the direct impact of projects on human beings should be rank first in the list of priorities. The Hygiene Institute supports the efforts of the Public Health departments by providing professional consultant services to ensure consistency in the application of procedures.

  20. Evaluating the rural health placements of the Rural Support Network ...

    African Journals Online (AJOL)

    Evaluating the rural health placements of the Rural Support Network at the Faculty of Health Sciences, University of Cape Town. ... The importance of community empowerment and of connecting and building relationships with communities was also emphasised. Challenges pertained to conflict within groups, incidents of ...

  1. Emergency mental health and psychosocial support for survivors of ...

    African Journals Online (AJOL)

    Objective: To describe the design and delivery of emergency mental health and psychosocial support services for the survivors of Post-Election Violence in Eldoret, Kenya. Design: A longitudinal intervention. Setting: The North Rift Valley region in western Kenya. Subjects: A total of 80,772 survivors received mental health ...

  2. Support For Organizational Reproductive Health Policies: Is Sexism ...

    African Journals Online (AJOL)

    This study focuses on the realities of organizational policies and practices for women's reproductive health in Nigeria. It examines the relationship between sexism and several indices of support for organizational reproductive health policies, particularly those relating to family-friendly policies. Data was collected from 419 ...

  3. Supporting Children with Mental Health Concerns in Classrooms

    Science.gov (United States)

    Climie, Emma; Altomare, Alyssa A.

    2013-01-01

    There are a growing number of children who begin to develop mental concerns during the school-age years. As such, it is important that schools recognize and understand mental health issues and are actively engaged in supporting these students. This article provides a review of mental health in schools, highlighting the importance of school-health…

  4. Mentoring, training and support to global health innovators: a scoping review.

    Science.gov (United States)

    Cho, Dan-Bi; Cole, Donald; Simiyu, Ken; Luong, Winnie; Neufeld, Vic

    2013-06-28

    Global health innovators must navigate substantial complexities to successfully develop, implement and sustain global health innovations with impact through application of an Integrated InnovationTM approach. We sought to examine the nature of the literature and evidence around mentoring, training and support of global health innovators. We conducted a scoping review searching eight databases with terms capturing different kinds of innovation and support. Assessment of relevance and mapping was completed by two reviewers, with interpretation by the review team. Twenty-eight relevant papers provided perspectives on fostering global health innovators and innovation. Fifteen included empirical data on supports to global health innovators involving a wide range of innovators. Eight included documentation of outcomes but without designs to determine effectiveness. The diverse mentoring, training and support activities included: business incubators, support organizations and centres for entrepreneurship, technology transfer and intellectual property management, internship programs for business skill development, initiatives to bridge industry and researchers, and platforms for South-led innovation for global health. We propose the cultivation of a pipeline of global health innovators to increase the number of appropriate, sustainable innovations with impact in global health. Further empirical work on how to effectively support global health innovators is needed.

  5. Assessing river health in Europe and Switzerland

    Science.gov (United States)

    Milano, Marianne; Chèvre, Nathalie; Reynard, Emmanuel

    2017-04-01

    River conditions and welfare of aquatic ecosystems are threatened by anthropogenic and climatic changes. The release of personal-care products, pharmaceuticals and crop protection products is increasing and climate change is likely to cause significant changes in hydrological regimes affecting water resources' capacity to dissolve pollutants. Assessing river health, i.e. the ability of a river to support and maintain a balanced ecosystem close to the natural habitat, is thus of major concern to ensure the development of ecosystems and to provide enough clean useable water to users. Such studies involve physical, chemical and biological processes and characteristics. In Europe and Switzerland, standardized procedures have been developed to assess the hydromorphological, ecological and toxicological status of rivers. The European Water Framework Directive sets ecological requirements and chemical guidelines while the Swiss Modular Stepwise Procedure suggests methods to apprehend ecological deficits and promote water management plans. In this study, both procedures were applied and compared in order (i) to address their capacity to follow-up the spatial and temporal variability of the river's water quality and (ii) to identify challenges that still need to be addressed to assess river's health. Applied on the Boiron River (canton of Vaud, Switzerland) for a 11-year period (2005-2015), both frameworks highlight that no section of the river currently meets a good environmental state. This river flows through a diversified agricultural area causing a progressive deterioration of its chemical and biological quality. The two methods also identify two periods of time with significant changes of the river's water quality. The 2009-2011 period is characterized by a significant deterioration of the river's ecological and toxicological state due to severe low flows and an increased use of pesticides. However, since 2013, an improvement in water quality is identified in

  6. Supportive accountability: a model for providing human support to enhance adherence to eHealth interventions.

    Science.gov (United States)

    Mohr, David C; Cuijpers, Pim; Lehman, Kenneth

    2011-03-10

    The effectiveness of and adherence to eHealth interventions is enhanced by human support. However, human support has largely not been manualized and has usually not been guided by clear models. The objective of this paper is to develop a clear theoretical model, based on relevant empirical literature, that can guide research into human support components of eHealth interventions. A review of the literature revealed little relevant information from clinical sciences. Applicable literature was drawn primarily from organizational psychology, motivation theory, and computer-mediated communication (CMC) research. We have developed a model, referred to as "Supportive Accountability." We argue that human support increases adherence through accountability to a coach who is seen as trustworthy, benevolent, and having expertise. Accountability should involve clear, process-oriented expectations that the patient is involved in determining. Reciprocity in the relationship, through which the patient derives clear benefits, should be explicit. The effect of accountability may be moderated by patient motivation. The more intrinsically motivated patients are, the less support they likely require. The process of support is also mediated by the communications medium (eg, telephone, instant messaging, email). Different communications media each have their own potential benefits and disadvantages. We discuss the specific components of accountability, motivation, and CMC medium in detail. The proposed model is a first step toward understanding how human support enhances adherence to eHealth interventions. Each component of the proposed model is a testable hypothesis. As we develop viable human support models, these should be manualized to facilitate dissemination.

  7. Enact legislation supporting residential property assessed clean energy financing (PACE)

    Energy Technology Data Exchange (ETDEWEB)

    Saha, Devashree

    2012-11-15

    Congress should enact legislation that supports residential property assessed clean energy (PACE) programs in the nation’s states and metropolitan areas. Such legislation should require the Federal Housing Finance Agency (FHFA) to allow Fannie Mae and Freddie Mac to purchase residential mortgages with PACE assessments while at the same time providing responsible underwriting standards and a set of benchmarks for residential PACE assessments in order to minimize financial risks to mortgage holders. Congressional support of residential PACE financing will improve energy efficiency, encourage job creation, and foster economic growth in the nation’s state and metropolitan areas.

  8. Health Information: What Can Mobile Phone Assessments Add?

    OpenAIRE

    Stomberg, Margareta Warrén; Platon, Birgitta; Widén, Annette; Wallner, Ingegerd; Karlsson, Ove

    2012-01-01

    In healthcare, pain assessment is a key factor in effectively treating postoperative pain and reducing the risk of developing chronic pain. The overall aim of this study was to investigate whether a mobile phone support system can be used as a basis to continuously document patients’ health information in real time and provide conditions for optimal, individual pain management after cholecystectomy and hysterectomy procedures.

  9. Synthetic social support: Theorizing lay health worker interventions.

    Science.gov (United States)

    Gale, Nicola K; Kenyon, Sara; MacArthur, Christine; Jolly, Kate; Hope, Lucy

    2018-01-01

    Levels of social support are strongly associated with health outcomes and inequalities. The use of lay health workers (LHWs) has been suggested by policy makers across the world as an intervention to identify risks to health and to promote health, particularly in disadvantaged communities. However, there have been few attempts to theorize the work undertaken by LHWs to understand how interventions work. In this article, the authors present the concept of 'synthetic socialsupport' and distinguish it from the work of health professionals or the spontaneous social support received from friends and family. The authors provide new empirical data to illustrate the concept based on qualitative, observational research, using a novel shadowing method involving clinical and non-clinical researchers, on the everyday work of 'pregnancy outreach workers' (POWs) in Birmingham, UK. The service was being evaluated as part of a randomized controlled trial. These LHWs provided instrumental, informational, emotional and appraisal support to the women they worked with, which are all key components of social support. The social support was 'synthetic' because it was distinct from the support embedded in spontaneous social networks: it was non-reciprocal; it was offered on a strictly time-limited basis; the LHWs were accountable for the relationship, and the social networks produced were targeted rather than spontaneous. The latter two qualities of this synthetic form of social support may have benefits over spontaneous networks by improving the opportunities for the cultivation of new relationships (both strong and weak ties) outside the women's existing spontaneous networks that can have a positive impact on them and by offering a reliable source of health information and support in a chaotic environment. The concept of SSS can help inform policy makers about how deploying lay workers may enable them to achieve desired outcomes, specify their programme theories and evaluate

  10. Mental health and psychosocial support in crisis and conflict: report of the Mental Health Working Group.

    Science.gov (United States)

    Allden, K; Jones, L; Weissbecker, I; Wessells, M; Bolton, P; Betancourt, T S; Hijazi, Z; Galappatti, A; Yamout, R; Patel, P; Sumathipala, A

    2009-01-01

    The Working Group on Mental Health and Psychosocial Support was convened as part of the 2009 Harvard Humanitarian Action Summit. The Working Group chose to focus on ethical issues in mental health and psychosocial research and programming in humanitarian settings. The Working Group built on previous work and recommendations, such as the Inter-Agency Standing Committee's Guidelines on Mental Health and Psychosocial Support in Emergency Settings. The objective of this working group was to address one of the factors contributing to the deficiency of research and the need to develop the evidence base on mental health and psychosocial support interventions during complex emergencies by proposing ethical research guidelines. Outcomes research is vital for effective program development in emergency settings, but to date, no comprehensive ethical guidelines exist for guiding such research efforts. Working Group members conducted literature reviews which included peer-reviewed publications, agency reports, and relevant guidelines on the following topics: general ethical principles in research, cross-cultural issues, research in resource-poor countries, and specific populations such as trauma and torture survivors, refugees, minorities, children and youth, and the mentally ill. Working Group members also shared key points regarding ethical issues encountered in their own research and fieldwork. The group adapted a broad definition of the term "research", which encompasses needs assessments and data gathering, as well as monitoring and evaluation. The guidelines are conceptualized as applying to formal and informal processes of assessment and evaluation in which researchers as well as most service providers engage. The group reached consensus that it would be unethical not to conduct research and evaluate outcomes of mental health and psychosocial interventions in emergency settings, given that there currently is very little good evidence base for such interventions

  11. Smart Sensors Assess Structural Health

    Science.gov (United States)

    2010-01-01

    NASA frequently inspects launch vehicles, fuel tanks, and other components for structural damage. To perform quick evaluation and monitoring, the Agency pursues the development of structural health monitoring systems. In 2001, Acellent Technologies Inc., of Sunnyvale, California, received Small Business Innovation Research (SBIR) funding from Marshall Space Flight Center to develop a hybrid Stanford Multi-Actuator Receiver Transduction (SMART) Layer for aerospace vehicles and structures. As a result, Acellent expanded the technology's capability and now sells it to aerospace and automotive companies; construction, energy, and utility companies; and the defense, space, transportation, and energy industries for structural condition monitoring, damage detection, crack growth monitoring, and other applications.

  12. Health promotion and illness demotion at prostate cancer support groups.

    Science.gov (United States)

    Oliffe, John L; Gerbrandt, Julieta S; Bottorff, Joan L; Hislop, T Gregory

    2010-07-01

    Although health promotion programs can positively influence health practices, men typically react to symptoms, rather than maintain their health, and are more likely to deny than discuss illness-related issues. Prostate cancer support groups (PCSGs) provide an intriguing exception to these practices, in that men routinely discuss ordinarily private illness experiences and engage with self-health. This article draws on individual interview data from 52 men, and participant observations conducted at the meetings of 15 groups in British Columbia, Canada to provide insights to how groups simultaneously facilitate health promotion and illness demotion. The study findings reveal how an environment conducive to men's talk was established to normalize prostate cancer and promote the individual and collective health of group members. From a gendered perspective, men both disrupted and embodied dominant ideals of masculinity in how they engaged with their health at PCSGs.

  13. Assessment and support during early labour for improving birth outcomes.

    Science.gov (United States)

    Kobayashi, Shinobu; Hanada, Nobutsugu; Matsuzaki, Masayo; Takehara, Kenji; Ota, Erika; Sasaki, Hatoko; Nagata, Chie; Mori, Rintaro

    2017-04-20

    The progress of labour in the early or latent phase is usually slow and may include painful uterine contractions. Women may feel distressed and lose their confidence during this phase. Support and assessment interventions have been assessed in two previous Cochrane Reviews. This review updates and replaces these two reviews, which have become out of date. To investigate the effectiveness of assessment and support interventions for women during early labour.In order to measure the effectiveness of the interventions, we compared the duration of labour, the rate of obstetrical interventions, and the rate of other maternal or neonatal outcomes. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register, ClinicalTrials.gov, the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (31 October 2016) and reference lists of retrieved studies. Randomised controlled trials of any assessment or support intervention in the latent phase of labour. We planned to include cluster-randomised trials if they were eligible. We did not include quasi-randomised trials. Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. We resolved any disagreement by discussion or by involving a third assessor. The quality of the evidence was assessed using the GRADE approach. We included five trials with a total of 10,421 pregnant women in this review update. The trials were conducted in the UK, Canada and America. The trials compared interventions in early labour versus usual care. We examined three comparisons: early labour assessment versus immediate admission to hospital; home visits by midwives versus usual care (telephone triage); and one-to-one structured midwifery care versus usual care. These trials were at moderate- risk of bias mainly because blinding women and staff to these interventions is not generally feasible. For important outcomes we assessed evidence using

  14. Health risk assessments for alumina refineries.

    Science.gov (United States)

    Donoghue, A Michael; Coffey, Patrick S

    2014-05-01

    To describe contemporary air dispersion modeling and health risk assessment methodologies applied to alumina refineries and to summarize recent results. Air dispersion models using emission source and meteorological data have been used to assess ground-level concentrations (GLCs) of refinery emissions. Short-term (1-hour and 24-hour average) GLCs and annual average GLCs have been used to assess acute health, chronic health, and incremental carcinogenic risks. The acute hazard index can exceed 1 close to refineries, but it is typically less than 1 at neighboring residential locations. The chronic hazard index is typically substantially less than 1. The incremental carcinogenic risk is typically less than 10(-6). The risks of acute health effects are adequately controlled, and the risks of chronic health effects and incremental carcinogenic risks are negligible around referenced alumina refineries.

  15. Assessing Human Health Risk from Pesticides

    Science.gov (United States)

    EPA protects human health and the environment by evaluating the risk associated with pesticides before allowing them to be used in the United States. Learn about the tools and processes used in risk assessment for pesticides.

  16. Procedures for health risk assessment in Europe

    NARCIS (Netherlands)

    Seeley, M.R.; Tonner-Navarro, L.E.; Beck, B.D.; Deskin, R.; Feron, V.J.; Johanson, G.; Bolt, H.M.

    2001-01-01

    This report compares cancer classification systems, health risk assessment approaches, and procedures used for establishing occupational exposure limits (OELs), in various European countries and scientific organizations. The objectives were to highlight and compare key aspects of these processes and

  17. Using action research to develop midwives' skills to support women with perinatal mental health needs.

    Science.gov (United States)

    Madden, Deirdre; Sliney, Annmarie; O'Friel, Aoife; McMackin, Barbara; O'Callaghan, Bernie; Casey, Kate; Courtney, Lisa; Fleming, Valerie; Brady, Vivienne

    2017-05-30

    The aim of the research was to identify and develop midwives' skills to support women with mental health needs during pregnancy, using an action research approach. A review of perinatal mental health services in a large Dublin maternity unit revealed a high number of referred women who 'did not attend' the perinatal mental health service with few guidelines in place to support midwives in identifying and referring women for specialist help. Action research using cooperative inquiry involved a mental health nurse specialist and a team of midwives, who were drawn to each other in mutual concern about an area of practice. Data were gathered from three Cooperative Inquiry meetings, which incorporated one main Action Research Cycle of constructing, planning, taking and evaluating action. Data were analysed using a thematic content analysis framework. Participants experienced varying levels of uncertainty about how to support women with perinatal mental health needs. Cooperative inquiry supported participants in making sense of how they understood perinatal mental health and how they managed challenges experienced when caring for women with perinatal mental health issues. Participants developed a referral pathway, highlighted the significance of education to support women with perinatal mental health issues and identified the value of using open questions to promote conversation with pregnant women about mental health. Midwives value education and support to identify and refer women at risk of perinatal mental health issues. Cooperative inquiry, with a focus on action and shared reflection, facilitated the drawing together of two professional groups with diverse knowledge bases to work together to develop practice in an area of mutual concern. Perinatal mental health is a significant public health issue and midwives need support to make psychosocial assessments and to negotiate access to specialist services where available and when required. © 2017 John Wiley & Sons

  18. Prioritizing young people's emotional health support needs via participatory research.

    Science.gov (United States)

    Kendal, S E; Milnes, L; Welsby, H; Pryjmachuk, S

    2017-06-01

    WHAT IS KNOWN ON THIS SUBJECT?: Young people's mental health is a concern to people around the world. Good emotional health promotes mental health and protects against mental illness, but we need to know more about how to help young people look after their emotional health. We are learning that research is better if the public are involved in it, including children and young people. Therefore, we need to listen carefully to what young people have to say. In this paper, we describe some research that involved young people from start to finish. We were asking what kind of emotional health support would be useful to them. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: We developed a useful way to involve young people in research so their voice can be heard. Young people like to use the Internet to find emotional health support and information, but need to know which web sites they can trust. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Our method of bringing young people together to tell us their views was successful. It is important to explore ways to help young people judge the quality of emotional health web sites. Introduction Youth mental health is a global concern. Emotional health promotes mental health and protects against mental illness. Youth value self-care for emotional health, but we need better understanding of how to help them look after their emotional health. Participatory research is relevant, since meaningful engagement with youth via participatory research enhances the validity and relevance of research findings and supports young people's rights to involvement in decisions that concern them. Aim We aimed to develop a participatory approach for involving youth in research about their emotional health support preferences. Method Our team included a young expert-by-experience. We developed a qualitative, participatory research design. Eleven youth (16-18 years) participated in focus groups, followed immediately by a nominal group exercise in which they

  19. Framework for securing personal health data in clinical decision support systems.

    Science.gov (United States)

    Sandell, Protik

    2007-01-01

    If appropriate security mechanisms aren't in place, individuals and groups can get unauthorized access to personal health data residing in clinical decision support systems (CDSS). These concerns are well founded; there has been a dramatic increase in reports of security incidents. The paper provides a framework for securing personal health data in CDSS. The framework breaks down CDSS into data gathering, data management and data delivery functions. It then provides the vulnerabilities that can occur in clinical decision support activities and the measures that need to be taken to protect the data. The framework is applied to protect the confidentiality, integrity and availability of personal health data in a decision support system. Using the framework, project managers and architects can assess the potential risk of unauthorized data access in their decision support system. Moreover they can design systems and procedures to effectively secure personal health data.

  20. Technical support for universal health coverage pilots in Karnataka ...

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

    The project team will provide technical assistance to these early adopter states to assist with UHC intervention activities. The project ... They provided technical assistance to help officials design and develop their universal health coverage action plans based on an extensive baseline assessment and top health priorities.

  1. Mental health of farmers in Southern Queensland: issues and support.

    Science.gov (United States)

    Hossain, Delwar; Eley, Rob; Coutts, Jeff; Gorman, Don

    2008-12-01

    To inform the development of an initiative designed to support the mental well-being of farmers in Queensland. Interactive focus groups. Rural and remote Queensland. Health professionals, farmers and representatives of organisations and agencies working with farmers. Determination of factors contributing to the declining mental health of rural landholders. Content material for inclusion into mental health first aid programs held for field officers. Key areas identified to contribute to the decline in mental health of farmers were: increasing isolation in its varying forms, the ongoing drought, increased government regulations and widening of the schism between urban and rural Australians. The issues that affect farmers are recognised to have a 'knock-on' effect on the people who interact with them. In particular, rural support organisations are concerned for the well-being of their staff, prompting some to begin to put protocols in place to address their staff need for mental health support. Additional mental health training of field officers that involves awareness, recognition, communication skills, understanding and empathy was recognised by participants to be beneficial. Training of field officers was considered to be of benefit to the support of farmers. An understanding of the various and diverse issues that rural landholders face should be a fundamental component of that training.

  2. Health workers' support for hepatitis C treatment uptake among clients with a history of injecting.

    Science.gov (United States)

    Brener, Loren; von Hippel, Courtney; Wilson, Hannah; Hopwood, Max

    2016-04-01

    Hepatitis C virus is stigmatised because of its association with injecting drug use. Although treatment is available, uptake remains low, especially among people who inject drugs. Ninety health workers completed a survey assessing attitudes towards people who inject drugs and support for treatment for three client scenarios: one who stopped injecting, one on methadone, and one continuing to inject. Support for hepatitis C virus treatment was significantly higher, where the client was not injecting. Participants who showed more negative attitudes towards people who inject drugs were less supportive of clients entering hepatitis C virus treatment, illustrating the influence of health workers' attitudes in determining treatment options offered to clients.

  3. Support for health promoting schools: a typology of supporting strategies in Austrian provinces.

    Science.gov (United States)

    Gugglberger, Lisa

    2011-12-01

    Schools that want to implement health promotion (HP) are often confronted with obstacles that they cannot overcome by themselves and therefore need support from their environment. However, the issue of which kind of support is needed for HP implementation is complex. A systems approach suggests that the individual logic of each school be considered and that supporting strategies be flexible to specific needs. This article pursues the question which types of support for health promoting schools are offered on a provincial level in Austria. Using a grounded theory approach, 18 in-depth interviews with representatives of provincial organizations and 26 documents relevant for school HP were analysed. As a result, five different strategies of supporting health promoting schools have been identified in Austria: (i) organize exchange among schools, (ii) establish certification and quality control of school health efforts, (iii) offer consultation and information, (iv) carry out a specific HP programme and (v) coordinate HP actors and information. These strategies are usually combined and rarely occur in their pure form. It was also determined that the coordination of the different strategies and human resources for HP are missing for schools in Austria. It is argued that each of these supporting strategies has benefits and limitations for schools and the providers, and that they all have the potential to respond to the school as a complex social system.

  4. Decision support system for health care resources allocation.

    Science.gov (United States)

    Sebaa, Abderrazak; Nouicer, Amina; Tari, AbdelKamel; Tarik, Ramtani; Abdellah, Ouhab

    2017-06-01

    A study about healthcare resources can improve decisions regarding the allotment and mobilization of medical resources and to better guide future investment in the health sector. The aim of this work was to design and implement a decision support system to improve medical resources allocation of Bejaia region. To achieve the retrospective cohort study, we integrated existing clinical databases from different Bejaia department health sector institutions (an Algerian department) to collect information about patients from January 2015 through December 2015. Data integration was performed in a data warehouse using the multi-dimensional model and OLAP cube. During implementation, we used Microsoft SQL server 2012 and Microsoft Excel 2010. A medical decision support platform was introduced, and was implemented during the planning stages allowing the management of different medical orientations, it provides better apportionment and allotment of medical resources, and ensures that the allocation of health care resources has optimal effects on improving health. In this study, we designed and implemented a decision support system which would improve health care in Bejaia department to especially assist in the selection of the optimum location of health center and hospital, the specialty of the health center, the medical equipment and the medical staff.

  5. Hispanic Medical Organizations' Support for LGBT Health Issues.

    Science.gov (United States)

    Sánchez, John Paul; Sola, Orlando; Ramallo, Jorge; Sánchez, Nelson Felix; Dominguez, Kenneth; Romero-Leggott, Valerie

    2014-09-01

    Hispanics represent the fastest growing ethnic segment of the lesbian, gay, bisexual, and transgender (LGBT) community in the United States and are disproportionately burdened by LGBT-related health issues and limited political support from Hispanic medical organizations. Recently, the Latino Medical Student Association, the National Hispanic Medical Association, and the Hispanic Serving Health Professions Schools, representing over 60,000 Hispanic students and providers and 35 institutions, collaborated to support a resolution opposing discrimination based on sexual orientation or gender identity and recognizing the obstacles encountered by LGBTQ Hispanics. The resolution provides an important framework for organizational members and leaders to address LGBT health issues and serve to support a more positive sociopolitical climate for the Hispanic LGBT community nationally and internationally.

  6. CDC Support for Global Public Health Emergency Management.

    Science.gov (United States)

    Brencic, Daniel J; Pinto, Meredith; Gill, Adrienne; Kinzer, Michael H; Hernandez, Luis; Pasi, Omer G

    2017-12-01

    Recent pandemics and rapidly spreading outbreaks of infectious diseases have illustrated the interconnectedness of the world and the importance of improving the international community's ability to effectively respond. The Centers for Disease Control and Prevention (CDC), building on a strong foundation of lessons learned through previous emergencies, international recognition, and human and technical expertise, has aspired to support nations around the world to strengthen their public health emergency management (PHEM) capacity. PHEM principles streamline coordination and collaboration in responding to infectious disease outbreaks, which align with the core capacities outlined in the International Health Regulations 2005. CDC supports PHEM by providing in-country technical assistance, aiding the development of plans and procedures, and providing fellowship opportunities for public health emergency managers. To this end, CDC partners with US agencies, international partners, and multilateral organizations to support nations around the world to reduce illness and death from outbreaks of infectious diseases.

  7. Integrating Sexual Minority Health Issues into a Health Assessment Class.

    Science.gov (United States)

    Bosse, Jordon D; Nesteby, J Aleah; Randall, Carla E

    2015-01-01

    The health needs of the lesbian, gay, bisexual, and transgender (LGBT) population are traditionally overlooked by the health care community and are rendered invisible by most nursing school curricula. Initial contact with a nurse during a health history and assessment can have an impact on whether the person will feel comfortable disclosing his or her identity, returning for services, or following plans of care. Because the first interaction with a nurse can be critical, the health assessment course is an appropriate place in the curriculum to discuss the needs of the LGBT community. This article includes a discussion of unique health risks to the LGBT population, benefits, and challenges of incorporating these issues into the classroom and recommendations for including the care of this population into a health assessment nursing course. Specific communication techniques are provided that may be helpful during history taking and physical examination with a patient who is LGBT. Guidance regarding physical examination of the transgender patient is also included. These suggestions will be helpful to nurse faculty who teach health assessment, nursing students, educators who design and implement professional development and continuing education for established nurses, preceptors in the clinical setting, and any nurse who is unfamiliar with the needs and concerns specific to the LGBT population. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. Social relationships and health: the relative roles of family functioning and social support.

    Science.gov (United States)

    Franks, P; Campbell, T L; Shields, C G

    1992-04-01

    The associations between social relationships and health have been examined using two major research traditions. Using a social epidemiological approach, much research has shown the beneficial effect of social supports on health and health behaviors. Family interaction research, which has grown out of a more clinical tradition, has shown the complex effects of family functioning on health, particularly mental health. No studies have examined the relative power of these two approaches in explicating the connections between social relationships and health. We hypothesized that social relationships (social support and family functioning) would exert direct and indirect (through depressive symptoms) effects on health behaviors. We also hypothesized that the effects of social relationships on health would be more powerfully explicated by family functioning than by social support. We mailed a pilot survey to a random sample of patients attending a family practice center, including questions on depressive symptoms, cardiovascular health behaviors, demographics, social support using the ISEL scale, and family functioning using the FEICS scale. FEICS is a self-report questionnaire designed to assess family emotional involvement and criticism, the media elements of family expressed emotion. Eighty-three useable responses were obtained. Regression analyses and structural modelling showed both direct and indirect statistically significant paths from social relationships to health behaviors. Family criticism was directly associated (standardized coefficient = 0.29) with depressive symptoms, and family emotional involvement was directly associated with both depressive symptoms (coefficient = 0.35) and healthy cardiovascular behaviors (coefficient = 0.32). The results support the primacy of family functioning factors in understanding the associations among social relationships, mental health, and health behaviors. The contrasting relationships between emotional involvement and

  9. Ethical perspectives on health technology assessment.

    NARCIS (Netherlands)

    Have, H.A.M.J. ten

    2004-01-01

    This study analyses why ethical aspects play a minor role in health technology assessment (HTA) studies, even when comprehensive approaches of technology assessment are advocated. Technology is often regarded as a value-neutral tool. At the same time, bioethics is dominated by an engineering model.

  10. Spiritual assessment in mental health recovery.

    Science.gov (United States)

    Gomi, Sachiko; Starnino, Vincent R; Canda, Edward R

    2014-05-01

    Mental health recovery-oriented and strengths model proponents recognize spirituality to be a key aspect of the recovery process. In order to incorporate spirituality in practice, practitioners need to know how to conduct spiritual assessment effectively. Although implicit and explicit spiritual assessment approaches have been identified as useful frameworks for conducting spiritual assessment, there is a gap in knowledge about what constitutes effective approaches and questions for addressing spirituality in the lives of people with psychiatric disabilities. To address this gap, focus group interviews were conducted with providers and consumers of mental health services in order to develop practical guidance for spiritual assessment. Focus group participants provided feedback about a list of sample spiritual assessment questions and then suggested principles and questions for practitioners to use. Collective insights from the focus groups formed the basis for recommendations for spiritual assessment.

  11. An Assessment of Environmental Health Needs for Manned Spacecraft

    Science.gov (United States)

    Macatangay, Ariel V.

    2013-01-01

    Environmental health fundamentally addresses the physical, chemical, and biological risks external to the human body that can impact the health of a person by assessing and controlling these risks in order to generate and maintain a health-supportive environment. Environmental monitoring coupled with other measures including active and passive controls and the implementation of environmental standards (SMACs, SWEGs, microbial and acoustics limits) are used to ensure environmental health in manned spacecraft. NASA scientists and engineers consider environmental monitoring a vital component to an environmental health management strategy for maintaining a healthy crew and achieving mission success. Environmental monitoring data confirms the health of ECLS systems, in addition to contributing to the management of the health of human systems. Crew health risks associated with the environment were reviewed by agency experts with the goal of determining risk-based environmental monitoring needs for future NASA manned missions. Once determined, gaps in knowledge and technology, required to address those risks, were identified for various types of Exploration missions. This agency-wide assessment of environmental health needs will help guide the activities/hardware development efforts to close those gaps and advance the knowledge required to meet NASA manned space exploration objectives. Details of this assessment and findings are presented in this paper.

  12. Social support and mental health among college students.

    Science.gov (United States)

    Hefner, Jennifer; Eisenberg, Daniel

    2009-10-01

    This study is the first, to our knowledge, to evaluate the relationship between mental health and social support in a large, random sample of college students. A Web-based survey was administered at a large, public university, with 1,378 students completing the measures in this analysis (response rate = 57%). The results support our hypothesis that students with characteristics differing from most other students, such as minority race or ethnicity, international status, and low socioeconomic status, are at greater risk of social isolation. In addition, the authors found that students with lower quality social support, as measured by the Multidimensional Scale of Perceived Social Support, were more likely to experience mental health problems, including a sixfold risk of depressive symptoms relative to students with high quality social support. These results may help administrators and health providers to identify more effectively the population of students at high risk for mental illness and develop effective interventions to address this significant and growing public health issue. (c) 2009 APA, all rights reserved.

  13. The relation of risk assessment and health impact assessment

    DEFF Research Database (Denmark)

    Ádám, Balázs; Gulis, Gabriel

    2013-01-01

    standardised scientific methods to characterise the probability and magnitude of harm caused by a hazard, preferably in a quantitative manner. In turn, HIA is a process to assess future impacts of recent proposals and is dominated by qualitative evaluation. It makes a projection for a future scenario rather......The level and distribution of health risks in a society is substantially influenced by measures of various policies, programmes or projects. Risk assessment can evaluate the nature, likelihood and severity of an adverse effect. Health impact assessment (HIA) provides similar function when used...... their relationship. The experiences accumulated during the preparation of several case studies in a large scale international project (RAPID) are used for argumentation and formulation of recommendations on how risk assessment can be systematically integrated into the HIA process. Risk assessment uses well...

  14. Bearing Health Assessment Based on Chaotic Characteristics

    Directory of Open Access Journals (Sweden)

    Chen Lu

    2013-01-01

    Full Text Available Vibration signals extracted from rotating parts of machinery carry a lot of useful information about the condition of operating machine. Due to the strong non-linear, complex and non-stationary characteristics of vibration signals from working bearings, an accurate and reliable health assessment method for bearing is necessary. This paper proposes to utilize the selected chaotic characteristics of vibration signal for health assessment of a bearing by using self-organizing map (SOM. Both Grassberger-Procaccia algorithm and Takens' theory are employed to calculate the characteristic vector which includes three chaotic characteristics, such as correlation dimension, largest Lyapunov exponent and Kolmogorov entropy. After that, SOM is used to map the three corresponding characteristics into a confidence value (CV which represents the health state of the bearing. Finally, a case study based on vibration datasets of a group of testing bearings was conducted to demonstrate that the proposed method can reliably assess the health state of bearing.

  15. Housing, income support and mental health: Points of disconnection

    OpenAIRE

    Csiernik Rick; Schofield Ruth; Joplin Libbey; Forchuk Cheryl; Gorlick Carolyne; Turner Katherine

    2007-01-01

    Abstract There exists a disconnection between evolving policies in the policy arenas of mental health, housing, and income support in Canada. One of the complexities associated with analysing the intersection of these policies is that federal, provincial, and municipal level policies are involved. Canada is one of the few developed countries without a national mental health policy and because of the federal policy reforms of the 1970s, the provincial governments now oversee the process of dei...

  16. Differences in Health and Social Support between Homeless Men and Women Entering Permanent Supportive Housing.

    Science.gov (United States)

    Winetrobe, Hailey; Wenzel, Suzanne; Rhoades, Harmony; Henwood, Benjamin; Rice, Eric; Harris, Taylor

    Permanent supportive housing (PSH) is the leading intervention to end chronic homelessness. Little is known, however, about gender differences, including potential disparities in physical and mental health and social support, that might inform services available through PSH. This study included 421 homeless adults, at least 39 years old, English- or Spanish-speaking, who were moving into PSH through 26 different agencies in the Los Angeles area. Compared with men entering PSH, homeless women (28% of the sample) were younger (p social networks (Coefficient, 0.79, p social support among homeless adults moving into PSH. PSH cannot be a one-size-fits-all approach. Supportive services within housing should be tailored based on gender and other individual needs. Copyright © 2017 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  17. The matrix support health by occupational therapists in Brazilian Unified Health System

    Directory of Open Access Journals (Sweden)

    Bruna de Oliveira Jacinto

    2017-03-01

    Full Text Available Introduction: The occupational therapist is one of the professionals that composes multidisciplinary team that develops the matrix support in the Unified Health System (UHS. Objective: This study aimed to describe the matrix support practice undertaken by occupational therapists in UHS based on a bibliographical research performed in Brazilian occupational therapy journals. Method: Five articles composed this study. The analysis was previously established with the following categories: types of health service where the matrix support is performed; professional involved with the matrix support; population and health or social conditions; matrix support objectives; intervention features and occupational therapists’ challenges. Data analysis was performed from the description of the data. Results: Matrix support was presented as a multiprofessional assignment in Primary Health Care (PHC. The target audience were children, adults, the elderly, familily members, caregivers and health professionals. Health assistance, social assistance and continuous health education were the matrix support demands. The objectives were to equip the professionals with health technologies for integral care in PHC and to implement actions, in shared therapeutic and institutional projects focused on occupational performance, belonging and social participation on their community, just as social control in UHS. Conclusion: The practice validity was presented as the mainly challenge for the matrix support.

  18. Is this normal? Assessing mental health in young people.

    Science.gov (United States)

    McGorry, Patrick D; Goldstone, Sherilyn

    2011-03-01

    Mental ill-health is a key health issue facing young Australians today. While the physical health of young people has improved in recent decades, their mental health appears to have worsened. Mental health and substance use disorders now account for over 50% of the burden of disease in the 15-25 years age group, and 75% of mental health disorders that will affect people across the lifespan will have emerged for the first time by the age of 25 years. This article provides the general practitioner with key factors in assessing the young person with a mental illness: when to worry and what the early stages of mental illness look like; and provides guidance and tips for effective treatment. Mental ill-health in young people is all too often accepted as a 'normal' feature of adolescence. However, the short and long term consequences of mental illness include impaired social functioning, poor educational achievement, substance abuse, self harm, suicide and violence. Distinguishing between what represents transitory and normative changes in behaviour and disturbances that may represent the early signs of the onset of a potentially serious mental illness is difficult, particularly in young people, where emotional disturbance and distress is such a common experience. The primary goal of initial assessment is not to make a definitive diagnosis but rather to assess risk and the need for clinical care. The GP has an important role to play in longitudinal assessment and ongoing review, and facilitating access to treatment and mobilising support networks.

  19. Assessing entrepreneurship in governmental public health.

    Science.gov (United States)

    Jacobson, Peter D; Wasserman, Jeffrey; Wu, Helen W; Lauer, Johanna R

    2015-04-01

    We assessed the feasibility and desirability of public health entrepreneurship (PHE) in governmental public health. Using a qualitative case study approach with semistructured interview protocols, we conducted interviews between April 2010 and January 2011 at 32 local health departments (LHDs) in 18 states. Respondents included chief health officers and senior LHD staff, representatives from national public health organizations, health authorities, and public health institutes. Respondents identified PHE through 3 overlapping practices: strategic planning, operational efficiency, and revenue generation. Clinical services offer the strongest revenue-generating potential, and traditional public health services offer only limited entrepreneurial opportunities. Barriers include civil service rules, a risk-averse culture, and concerns that PHE would compromise core public health values. Ongoing PHE activity has the potential to reduce LHDs' reliance on unstable general public revenues. Yet under the best of circumstances, it is difficult to generate revenue from public health services. Although governmental public health contains pockets of entrepreneurial activity, its culture does not sustain significant entrepreneurial activity. The question remains as to whether LHDs' current public revenue sources are sustainable and, if not, whether PHE is a feasible or desirable alternative.

  20. Assessing Entrepreneurship in Governmental Public Health

    Science.gov (United States)

    Wasserman, Jeffrey; Wu, Helen W.; Lauer, Johanna R.

    2015-01-01

    Objectives. We assessed the feasibility and desirability of public health entrepreneurship (PHE) in governmental public health. Methods. Using a qualitative case study approach with semistructured interview protocols, we conducted interviews between April 2010 and January 2011 at 32 local health departments (LHDs) in 18 states. Respondents included chief health officers and senior LHD staff, representatives from national public health organizations, health authorities, and public health institutes. Results. Respondents identified PHE through 3 overlapping practices: strategic planning, operational efficiency, and revenue generation. Clinical services offer the strongest revenue-generating potential, and traditional public health services offer only limited entrepreneurial opportunities. Barriers include civil service rules, a risk-averse culture, and concerns that PHE would compromise core public health values. Conclusions. Ongoing PHE activity has the potential to reduce LHDs’ reliance on unstable general public revenues. Yet under the best of circumstances, it is difficult to generate revenue from public health services. Although governmental public health contains pockets of entrepreneurial activity, its culture does not sustain significant entrepreneurial activity. The question remains as to whether LHDs’ current public revenue sources are sustainable and, if not, whether PHE is a feasible or desirable alternative. PMID:25689182

  1. Social Networks, Interpersonal Social Support, and Health Outcomes: A Health Communication Perspective

    OpenAIRE

    Wright, Kevin

    2016-01-01

    This manuscript discusses the development, impact, and several major research findings of studies in the area of social network support and health outcomes. The review focuses largely on the development of online social support networks and the ways in which they may interact with face-to-face support networks to influence physical and psychological health outcomes. The manuscript discusses this area, and it presents a research agenda for future work in this area from an Associate Editor’s pe...

  2. Solution-focused assessment: rethinking labels to support inclusive education

    NARCIS (Netherlands)

    Drs. José Wichers-Bots; Dr. Jacqueline van Swet; PhD Kathleen Brown

    2011-01-01

    In the Netherlands and the USA, the assessment process is changing for children who present learning and behavioural challenges in school. Evaluations for eligibility determinations and support planning are shifting along with disability models and tensions over the provision of inclusive schooling.

  3. The assessment of research support in a distance learning institution

    African Journals Online (AJOL)

    A project on postgraduate research supervision was completed, that looked at: $ The assessment of decentralised research support centres at a distance institution of higher learning $ The supervisor's perspective of the research supervision process in a distance learning institution.The findings of these two papers ...

  4. Data farming in support of HLA performance assessment

    NARCIS (Netherlands)

    Cramp, A.J.; Berg, T.W. van den; Huiskamp, W.

    2014-01-01

    Performance assessment is a key factor in designing distributed simulation environments that are fit-forpurpose and cost-effective. Simulations used for training applications should provide the required level of responsiveness and interactivity. Simulations used for analysis or decision support

  5. Health Security Intelligence: Assessing the Nascent Public Health Capability

    Science.gov (United States)

    2012-03-01

    however, that “Declining federal support for preparedness activities is translating to shuttering of 60 programs and staff layoffs at state/local health...a more humanistic management. Journal of Buisness Ethics , 445–462. Rollins, J., & Connors, T. (2007). State fusion center processes and procedures

  6. [Practical guidelines for peer support programmes for mental health problems].

    Science.gov (United States)

    Campos, Filipa; Sousa, Ana; Rodrigues, Vânia; Marques, António; Queirós, Cristina; Dores, Artemisa

    2016-01-01

    This study aims to determine the guiding principles for the implementation of peer support programmes in Portugal. The study was divided in 2 phases. In the first phase a systematic review of 112 papers indexed in ISI and EBSCO databases (2001 to 2012) was conducted. In the second phase clinicians, researchers, and people with psychiatric disabilities were invited to take part in a two-round online survey based on the Delphi process to rate the importance of statements generated from the systematic review. Data were analysed with NVivo 9 and SPSS 19. During the Delphi round 72 experts were contacted, 44 participated in the second round. A consensus was achieved on major statements, with 84% of the sentences obtaining a consensus and 8 key recommendations covering goals of peer support, selection of peer supporters, training and accreditation, role of mental health professionals, role of peer supporters, access to peer supporters, looking after peer supporters, and programme evaluation were based on these statements. Use of peer support for mental health problems is still underexplored and surrounded by some controversy and ambiguity. However, its organization and proper monitoring appears to enhance the quality of life and social inclusion of people with mental illness. This highlights the importance of conducting studies that increase our knowledge of these programmes and determining guidelines for their implementation. This national consensus may be used as a starting point for the design and implementation of peer support programmes in mental health organizations. Copyright © 2013 SEP y SEPB. Published by Elsevier España. All rights reserved.

  7. A community health report card: comprehensive assessment for tracking community health (CATCH).

    Science.gov (United States)

    Studnicki, J; Steverson, B; Myers, B; Hevner, A R; Berndt, D J

    1997-01-01

    A systematic method for assessing the health status of communities has been under development at the University of South Florida since 1991. The system, known as CATCH, draws 226 indicators from multiple sources and uses an innovative comparative framework and weighted evaluation criteria to produce a rank-ordered community problem list. The CATCH results from II Floridian counties have focused attention on high priority health problems and provided a framework for measuring the impact of health expenditures on community health status outcomes. The method and plans to create an automated data warehouse to support its expansion and enrichment are described.

  8. Assessment of complex environmental health problems: framing the structures and structuring the frameworks.

    NARCIS (Netherlands)

    Knol, A.B.; Briggs, D.J.; Lebret, E.

    2010-01-01

    Many environmental risks are multi-faceted and their health consequences can be far-ranging in both time and space. It can be a challenging task to develop informed policies for such risks. Integrated environmental health impact assessment aims to support policy by assessing environmental health

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1990-12-31

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

  10. emergency mental health and psychosocial support for survivors of ...

    African Journals Online (AJOL)

    2010-11-11

    Nov 11, 2010 ... Request for reprints to: Dr. L. Atwoli, Psychiatrist and Lecturer, Moi University School of Medicine, Department of Mental Health ... support intervention into a disaster response even in limited resource settings. Further studies are ... the emergency phase of a disaster, Psychological First. Aid is one of the ...

  11. 77 FR 42185 - Rural Health Care Support Mechanism

    Science.gov (United States)

    2012-07-18

    ... Competition Bureau at (202) 418-1732 or TTY (202) 418-0484. SUPPLEMENTARY INFORMATION: This is a synopsis of... allowing the RHC Pilot networks to continue to bill and operate as a consortium would be more... Program.'' Geisinger Health Systems also states that ending Pilot Program support for HCPs on its network...

  12. 75 FR 48235 - Rural Health Care Universal Service Support Mechanism

    Science.gov (United States)

    2010-08-09

    ... nursing facilities, and renal dialysis centers. The Commission also proposes to eliminate the offset... facilities that provide services traditionally provided at hospitals, such as skilled nursing facilities and... prioritize funding requests for rural health care support to the extent demand exceeds the annual $400...

  13. Evaluating the rural health placements of the Rural Support Network ...

    African Journals Online (AJOL)

    2011-10-19

    Oct 19, 2011 ... by organising individual and group placements in rural hospitals during vacations. This paper describes a qualitative evaluation, from the students' perspective, of the 2010 RSN rural health placements in order to make recommendations for the. Abstract. Objectives: The Rural Support Network (RSN) is an ...

  14. Using Clinical Decision Support Software in Health Insurance Company

    Science.gov (United States)

    Konovalov, R.; Kumlander, Deniss

    This paper proposes the idea to use Clinical Decision Support software in Health Insurance Company as a tool to reduce the expenses related to Medication Errors. As a prove that this class of software will help insurance companies reducing the expenses, the research was conducted in eight hospitals in United Arab Emirates to analyze the amount of preventable common Medication Errors in drug prescription.

  15. (PLWHA): influence of social support, self-esteem, health locus

    African Journals Online (AJOL)

    Coping among people living with HIV/AIDS (PLWHA): influence of social support, self-esteem, health locus of control and gender. ... 73) = 5.59, p.05). It is then concluded that management of HIV/AIDS should ...

  16. Support network and social support for children with special health care need

    Directory of Open Access Journals (Sweden)

    Thaís Araújo Barbosa

    2016-02-01

    Full Text Available Objective: to understand and identify the support network and social support from the perspective of families of children with chronic conditions. Methods: a qualitative study, with content analysis of 134 records, followed by ten semi-structured interviews. Results: the analysis has revealed that the primary caregiver, the mother, participates in a network of limited support, only with the help of her husband, children, grandparents and the child´s godparents. They also have a social network through a multidisciplinary team, which in some cases is not effective. Conclusion: families have a deficient and limited support network and the demand for care rely only on the support of the husband, grandparents, children, and godparents. Social networking refers to the philanthropic institutions, while the aid of public service, basic health unit is basic.

  17. Health promoting behaviors among African American women with faith-based support.

    Science.gov (United States)

    Drayton-Brooks, Shirlee; White, Neva

    2004-01-01

    The purpose of this qualitative exploratory study was to document health perceptions, beliefs and attitudes, intentions and social pressures that influence health promoting behaviors as expressed by community level aggregates of African American women with faith support. Twenty-six African American women from two large urban congregations with an active health ministry program participated in this study. Focus group interviews guided by the Theory of Planned Behavior (Ajzen & Fishbein, 1980 & 1991) were used to identify salient health perceptions, beliefs and attitudes, intentions, and social pressures influencing health-promoting behaviors in African American women with faith-based support. Positive health perceptions, attitudes, and beliefs were identified as important to engaging in a healthy lifestyle. Exercise, well balanced diets, weight reduction and stress management were the most salient health concerns among the respondents. Key referents identified included the pastor, congregational nurses, physicians, and church/family members. Control beliefs among these women reflected salient spiritual and fatalistic beliefs concerning health-promoting behaviors. Trusting relationships, open communication, safe, comfortable, and familiar environments were identified as important considerations when planning health promotion interventions for an African American faith community. Health beliefs, attitudes, and behaviors are not developed outside of social systems, therefore, the facilitation of healthy lifestyle behaviors may be best assessed and influenced within a context of reciprocal social interaction such as in a faith-based community. In the context of a community level aggregate with faith-based support, behaviors to promote a healthy lifestyle may be positively influenced.

  18. 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

  19. Strengthening health professions regulation in Cambodia: a rapid assessment.

    Science.gov (United States)

    Clarke, David; Duke, Jan; Wuliji, Tana; Smith, Alyson; Phuong, Keat; San, Un

    2016-03-10

    This paper describes a rapid assessment of Cambodia's current system for regulating its health professions. The assessment forms part of a co-design process to set strategic priorities for strengthening health profession regulation to improve the quality and safety of health services. A health system approach for strengthening health professions' regulation is underway and aims to support the Government of Cambodia's plans for scaling up its health workforce, improving health services' safety and quality, and meeting its Association of South East Asian Nations (ASEAN) obligations to facilitate trade in health care services. The assessment used a mixed methods approach including: A desktop review of key laws, plans, reports and other documents relating to the regulation of the health professions in Cambodia (medicine, dentistry, midwifery, nursing and pharmacy); Key informant interviews with stakeholders in Cambodia (The term "stakeholders" refers to government officials, people working on health professional regulation, people working for the various health worker training institutions and health workers at the national and provincial level); Surveys and questionnaires to assess Cambodian stakeholder knowledge of regulation; Self-assessments by members of the five Cambodian regulatory councils regarding key capacities and activities of high-performing regulatory bodies; and A rapid literature review to identify: The key functions of health professional regulation; The key issues affecting the Cambodian health sector (including relevant developments in the wider ASEAN region); and "Smart" health profession regulation practices of possible relevance to Cambodia. We found that the current regulatory system only partially meets Cambodia's needs. A number of key regulatory functions are being performed, but overall, the current system was not designed with Cambodia's specific needs in mind. The existing system is also overly complex, with considerable duplication and

  20. Health and well-being at work: The key role of supervisor support

    Directory of Open Access Journals (Sweden)

    Oliver Hämmig

    2017-12-01

    Full Text Available This study aims to explore whether and in what way social support from different sources and domains makes an additional or different and independent contribution to various health and work-related outcomes. Cross-sectional data were used from an employee survey among the workforces of four service companies from different industries in Switzerland. The study sample covered 5,877 employees of working age. The lack of social support from a spouse, relatives, friends, direct supervisors, closest colleagues at work and other co-workers in case of problems at work and at home were assessed and studied individually and jointly as risk factors with respect to a total number of eight outcomes. Health-related outcomes covered poor self-rated health, musculoskeletal disorders, stress feelings and burnout symptoms. Work-related outcomes included feeling overwhelmed at work, difficulty with switching off after work, job dissatisfaction and intention to turnover. Social support from multiple sources in contrast to only individual sources in both life domains was found to be more frequent in women than in men and proved to be most protective and beneficial with regard to health and well-being at work. However, after mutual adjustment of all single sources of social support from both domains, a lack of supervisor support turned out to be the only or the strongest of the few remaining support measures and statistically significant risk factors for the studied outcomes throughout and by far. Being unable to count on the support of a direct supervisor in case of problems at work and even at home was shown to involve a substantially increased risk of poor health and work-related outcomes (aOR = up to 3.8. Multiple sources of social support, and particularly supervisor support, seem to be important resources of health and well-being at work and need to be considered as key factors in workplace health promotion.

  1. Cessation support for smokers with mental health problems: a survey of resources and training needs.

    Science.gov (United States)

    Simonavicius, Erikas; Robson, Debbie; McEwen, Andy; Brose, Leonie S

    2017-09-01

    Around thirty percent of smokers have a mental health problem. Smoking cessation has been associated with mental health benefits, but smoking prevalence remains high in populations with mental health problems. This study aimed to assess mental health related knowledge, practice, and training needs of practitioners supporting smoking cessation. UK stop smoking practitioners (n=717) recruited via a database of a national provider of smoking cessation training in June 2016 sufficiently completed an online survey about available resources, knowledge, confidence, and training needs related to smoking cessation and mental health. Responses were described and compared between practitioners with a mental health lead and those without such a lead in their service using chi-square statistics and t-tests. A considerable proportion agreed (37%) or were undecided (28.9%) that smoking helped people with mental health problems feel better and agreed (17.2%) or were undecided (30.2%) that cessation would exacerbate mental health symptoms. Only 11.6% said their service had designated funding for smokers with mental health problems and 26.5% were or had a staff member who was a dedicated lead practitioner for mental health work. Practitioners from services that had a dedicated mental health lead were more confident in supporting smokers with different mental health problems and using different pharmacotherapies (all plack of resources. Copyright © 2017. Published by Elsevier Inc.

  2. mHealth Assessment: Conceptualization of a Global Framework.

    Science.gov (United States)

    Bradway, Meghan; Carrion, Carme; Vallespin, Bárbara; Saadatfard, Omid; Puigdomènech, Elisa; Espallargues, Mireia; Kotzeva, Anna

    2017-05-02

    The mass availability and use of mobile health (mHealth) technologies offers the potential for these technologies to support or substitute medical advice. However, it is worrisome that most assessment initiatives are still not able to successfully evaluate all aspects of mHealth solutions. As a result, multiple strategies to assess mHealth solutions are being proposed by medical regulatory bodies and similar organizations. We aim to offer a collective description of a universally applicable description of mHealth assessment initiatives, given their current and, as we see it, potential impact. In doing so, we recommend a common foundation for the development or update of assessment initiatives by addressing the multistakeholder issues that mHealth technology adds to the traditional medical environment. Organized by the Mobile World Capital Barcelona Foundation, we represent a workgroup consisting of patient associations, developers, and health authority representatives, including medical practitioners, within Europe. Contributions from each group's diverse competencies has allowed us to create an overview of the complex yet similar approaches to mHealth evaluation that are being developed today, including common gaps in concepts and perspectives. In response, we summarize commonalities of existing initiatives and exemplify additional characteristics that we believe will strengthen and unify these efforts. As opposed to a universal standard or protocol in evaluating mHealth solutions, assessment frameworks should respect the needs and capacity of each medical system or country. Therefore, we expect that the medical system will specify the content, resources, and workflow of assessment protocols in order to ensure a sustainable plan for mHealth solutions within their respective countries. A common framework for all mHealth initiatives around the world will be useful in order to assess whatever mHealth solution is desirable in different areas, adapting it to the

  3. [Theoretical basis for health system performance assessment].

    Science.gov (United States)

    Sebai, Jihane

    2015-01-01

    In France, the search for improved performance in the public sector, considered to reflect optimization of public services, has undergone various phases since the second World War. Public policy assessment has also considerably developed since the 1990s. The various reforms and resulting programmes have contributed to changing the French public administration from a means-based approach to a results-based approach, an essential step to improve performance according to the New Public Management paradigm. Other theories have also been proposed concerning performance assessment in the public sector, especially the medical care sector. The primary objective of this article is to propose a theoretical framework for the concept of performance and performance assessment in the health sector. The authors also propose a reading grid of the main theories concerning application of performance assessment in the health care sector.

  4. Diabetes self-management education and support delivered by mobile health (m-health) interventions for adults with type 2 diabetes mellitus

    NARCIS (Netherlands)

    Boels, Anne Meike; Vos, Rimke C.; Metzendorf, Maria-Inti; Rutten, Guy E.H.M.

    2017-01-01

    This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To assess the effects of diabetes self-management education and support delivered by mobile health interventions in adults with type 2 diabetes mellitus.

  5. Chemical Mixtures Health Risk Assessment: Overview of Exposure Assessment, Whole Mixtures Assessments; Basic Concepts

    Science.gov (United States)

    This problems-based, half-day, introductory workshop focuses on methods to assess health risks posed by exposures to chemical mixtures in the environment. Chemical mixtures health risk assessment methods continue to be developed and evolve to address concerns over health risks f...

  6. National Built Environment Health Impact Assessment Model ...

    Science.gov (United States)

    Behavioral (activity, diet, social interaction) and exposure (air pollution, traffic injury, and noise) related health impacts of land use and transportation investment decisions are becoming better understood and quantified. Research has shown relationships between density, mix, street connectivity, access to parks, shops, transit, presence of sidewalks and bikeways, and healthy food with physical activity, obesity, cardiovascular disease, type II diabetes, and some mental health outcomes. This session demonstrates successful integration of health impact assessment into multiple scenario planning tool platforms. Detailed evidence on chronic disease and related costs associated with contrasting land use and transportation investments are built into a general-purpose module that can be accessed by multiple platforms. Funders, researchers, and end users of the tool will present a detailed description of the key elements of the approach, how it has been applied, and how will evolve. A critical focus will be placed on equity and social justice inherent within the assessment of health disparities that will be featured in the session. Health impacts of community design have significant cost benefit implications. Recent research is now extending relationships between community design features and chronic disease to health care costs. This session will demonstrate the recent application of this evidence on health impacts to the newly adopted Los Angeles Regional Transpo

  7. Health Information Technology Usability Evaluation Scale (Health-ITUES) for Usability Assessment of Mobile Health Technology: Validation Study.

    Science.gov (United States)

    Schnall, Rebecca; Cho, Hwayoung; Liu, Jianfang

    2018-01-05

    Mobile technology has become a ubiquitous technology and can be particularly useful in the delivery of health interventions. This technology can allow us to deliver interventions to scale, cover broad geographic areas, and deliver technologies in highly tailored ways based on the preferences or characteristics of users. The broad use of mobile technologies supports the need for usability assessments of these tools. Although there have been a number of usability assessment instruments developed, none have been validated for use with mobile technologies. The goal of this work was to validate the Health Information Technology Usability Evaluation Scale (Health-ITUES), a customizable usability assessment instrument in a sample of community-dwelling adults who were testing the use of a new mobile health (mHealth) technology. A sample of 92 community-dwelling adults living with HIV used a new mobile app for symptom self-management and completed the Health-ITUES to assess the usability of the app. They also completed the Post-Study System Usability Questionnaire (PSSUQ), a widely used and well-validated usability assessment tool. Correlations between these scales and each of the subscales were assessed. The subscales of the Health-ITUES showed high internal consistency reliability (Cronbach alpha=.85-.92). Each of the Health-ITUES subscales and the overall scale was moderately to strongly correlated with the PSSUQ scales (r=.46-.70), demonstrating the criterion validity of the Health-ITUES. The Health-ITUES has demonstrated reliability and validity for use in assessing the usability of mHealth technologies in community-dwelling adults living with a chronic illness.

  8. Health Monitoring System Technology Assessments: Cost Benefits Analysis

    Science.gov (United States)

    Kent, Renee M.; Murphy, Dennis A.

    2000-01-01

    The subject of sensor-based structural health monitoring is very diverse and encompasses a wide range of activities including initiatives and innovations involving the development of advanced sensor, signal processing, data analysis, and actuation and control technologies. In addition, it embraces the consideration of the availability of low-cost, high-quality contributing technologies, computational utilities, and hardware and software resources that enable the operational realization of robust health monitoring technologies. This report presents a detailed analysis of the cost benefit and other logistics and operational considerations associated with the implementation and utilization of sensor-based technologies for use in aerospace structure health monitoring. The scope of this volume is to assess the economic impact, from an end-user perspective, implementation health monitoring technologies on three structures. It specifically focuses on evaluating the impact on maintaining and supporting these structures with and without health monitoring capability.

  9. Measurement issues in research on social support and health.

    Science.gov (United States)

    Dean, K; Holst, E; Kreiner, S; Schoenborn, C; Wilson, R

    1994-04-01

    The aims were: (1) to identify methodological problems that may explain the inconsistencies and contradictions in the research evidence on social support and health, and (2) to validate a frequently used measure of social support in order to determine whether or not it could be used in multivariate analyses of population data in research on social support and health. Secondary analysis of data collected in a cross sectional survey of a multistage cluster sample of the population of the United States, designed to study relationships in behavioural, social support and health variables. Statistical models based on item response theory and graph theory were used to validate the measure of social support to be used in subsequent analyses. Data on 1755 men and women aged 20 to 64 years were available for the scale validation. Massive evidence of item bias was found for all items of a group membership subscale. The most serious problems were found in relationship to an item measuring membership in work related groups. Using that item in the social network scale in multivariate analyses would distort findings on the statistical effects of education, employment status, and household income. Evidence of item bias was also found for a sociability subscale. When marital status was included to create what is called an intimate contacts subscale, the confounding grew worse. The composite measure of social network is not valid and would seriously distort the findings of analyses attempting to study relationships between the index and other variables. The findings show that valid measurement is a methodological issue that must be addressed in scientific research on population health.

  10. Toward Predicting Social Support Needs in Online Health Social Networks.

    Science.gov (United States)

    Choi, Min-Je; Kim, Sung-Hee; Lee, Sukwon; Kwon, Bum Chul; Yi, Ji Soo; Choo, Jaegul; Huh, Jina

    2017-08-02

    While online health social networks (OHSNs) serve as an effective platform for patients to fulfill their various social support needs, predicting the needs of users and providing tailored information remains a challenge. The objective of this study was to discriminate important features for identifying users' social support needs based on knowledge gathered from survey data. This study also provides guidelines for a technical framework, which can be used to predict users' social support needs based on raw data collected from OHSNs. We initially conducted a Web-based survey with 184 OHSN users. From this survey data, we extracted 34 features based on 5 categories: (1) demographics, (2) reading behavior, (3) posting behavior, (4) perceived roles in OHSNs, and (5) values sought in OHSNs. Features from the first 4 categories were used as variables for binary classification. For the prediction outcomes, we used features from the last category: the needs for emotional support, experience-based information, unconventional information, and medical facts. We compared 5 binary classifier algorithms: gradient boosting tree, random forest, decision tree, support vector machines, and logistic regression. We then calculated the scores of the area under the receiver operating characteristic (ROC) curve (AUC) to understand the comparative effectiveness of the used features. The best performance was AUC scores of 0.89 for predicting users seeking emotional support, 0.86 for experience-based information, 0.80 for unconventional information, and 0.83 for medical facts. With the gradient boosting tree as our best performing model, we analyzed the strength of individual features in predicting one's social support need. Among other discoveries, we found that users seeking emotional support tend to post more in OHSNs compared with others. We developed an initial framework for automatically predicting social support needs in OHSNs using survey data. Future work should involve nonsurvey

  11. A collaborative approach to improve the assessment of physical health in adult consumers with schizophrenia in Queensland mental health services.

    Science.gov (United States)

    Plever, Sally; McCarthy, Irene; Anzolin, Melissa; Emmerson, Brett; Khatun, Mohsina

    2016-02-01

    The objective of this study was to apply a quality improvement collaborative to increase the number of physical health assessments conducted with consumers diagnosed with schizophrenia in adult community mental health services across Queensland. Sixteen adult mental health service organisations voluntarily took part in the statewide collaborative initiative to increase the number of physical health assessments completed on persons with a diagnosis of schizophrenia spectrum disorders managed through the community mental health service. Improvement in the physical health assessment clinical indicator was demonstrated across the state over a 3-year period with an increase in the number of physical health assessments recorded from 12% to 58%. Significant improvements were made over a 3-year period by all mental health services involved in the collaborative, supporting the application of a quality improvement methodology to drive change across mental health services. © The Royal Australian and New Zealand College of Psychiatrists 2015.

  12. National health management information system: issues of funding and support.

    Science.gov (United States)

    Akinde, A D; Soriyan, H A; Makanjuola, R O

    1997-02-01

    Information Technology has made a substantial inroad into Nigerian society, particularly since the late 1980s. It is, however, already being applied in the health sector. The Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), lle-lfe, Nigeria has adopted a systematic approach to the development of a Health Information System (HIS) for a typical specialist hospital. A review of the existing HIS in OAUIHC is presented, highlighting its attributes, problems, and limitations. In addition, the options of funding HIS on a national scale are identified and discussed. Finally, strategies to ensure ongoing support of a national HIS are presented.

  13. Health Risk Assessment for Organotins in Textiles

    NARCIS (Netherlands)

    Janssen PJCM; Veen MP van; Speijers GJA; CSR; LBM

    2000-01-01

    In January 1998 RIVM was asked to carry out a preliminary risk assessment on organic tin compounds (organotins) in textiles. Measurements carried out by the Dutch Health Protection Inspectorate had shown these potentially toxic compounds to be present in several consumer products, including items of

  14. Quality assessment of occupational health services instruments

    NARCIS (Netherlands)

    van Dijk, F. J.; de Kort, W. L.; Verbeek, J. H.

    1993-01-01

    Interest in the quality of instruments for occupational health services is growing as a result of European legislation on preventive services stressing, for example, risk identification and assessment. The quality of the services can be enhanced when the quality of the applied instruments can be

  15. Assessing Financial Health in Community Colleges

    Science.gov (United States)

    Bers, Trudy H.; Head, Ronald B.

    2014-01-01

    In this age of educational accountability, there is an increasing emphasis on assessment and institutional effectiveness, not only in the academic arena but also in other aspects of community college operation, such as fiscal health and stability, revenue generation, resource allocation, facilities, workforce development, and community enrichment…

  16. 42 CFR 90.11 - Reporting of results of health assessments and health effects studies.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Reporting of results of health assessments and... HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND... assessments and health effects studies. (a) ATSDR shall provide a report of the results of a health assessment...

  17. Assessing Fishers' Support of Striped Bass Management Strategies.

    Directory of Open Access Journals (Sweden)

    Robert D Murphy

    Full Text Available Incorporating the perspectives and insights of stakeholders is an essential component of ecosystem-based fisheries management, such that policy strategies should account for the diverse interests of various groups of anglers to enhance their efficacy. Here we assessed fishing stakeholders' perceptions on the management of Atlantic striped bass (Morone saxatilis and receptiveness to potential future regulations using an online survey of recreational and commercial fishers in Massachusetts and Connecticut (USA. Our results indicate that most fishers harbored adequate to positive perceptions of current striped bass management policies when asked to grade their state's management regime. Yet, subtle differences in perceptions existed between recreational and commercial fishers, as well as across individuals with differing levels of fishing experience, resource dependency, and tournament participation. Recreational fishers in both states were generally supportive or neutral towards potential management actions including slot limits (71% and mandated circle hooks to reduce mortality of released fish (74%, but less supportive of reduced recreational bag limits (51%. Although commercial anglers were typically less supportive of management changes than their recreational counterparts, the majority were still supportive of slot limits (54% and mandated use of circle hooks (56%. Our study suggests that both recreational and commercial fishers are generally supportive of additional management strategies aimed at sustaining healthy striped bass populations and agree on a variety of strategies. However, both stakeholder groups were less supportive of harvest reductions, which is the most direct measure of reducing mortality available to fisheries managers. By revealing factors that influence stakeholders' support or willingness to comply with management strategies, studies such as ours can help managers identify potential stakeholder support for or conflicts

  18. [Study on application of two risk assessment methods in coal dust occupational health risk assessment].

    Science.gov (United States)

    Wu, B; Zhang, Y L; Chen, Y Q

    2017-04-20

    Objective: To evaluate the applicability of quantitative grading method (GBZ/T 229.1-2010) and occupational hazard risk index method in coal dust occupational health risk assessment. Methods: Taking 4 coal mines as the research object of risk assessment and making occupational health field testing and investigation. Based on two risk assessment methods, we analysed the health risk levels of 20 occupations which were exposed to coal dust in workplaces. Results: Coal dust working post had different risk levels in 4 coal mines, the post of higher risk level were mainly concentrated in the underground workplace of coal mine, especially the post of coal mining and tunneling system. The two risk assessment results showed that the risk levels of coal-mining machine drivers and tunneling machine drivers were the highest. The risk levels of coal dust working post used by two risk assessment methods had no significant difference (P>0.05) and were highly correlated (r=0.821, Prisk assessment methods were supported by the field investigation and literatures. Conclusion: The two risk assessment methods can be used in coal dust occupational health risk assessment.

  19. Health Vlogs as Social Support for Chronic Illness Management

    Science.gov (United States)

    HUH, JINA; LIU, LESLIE S.; NEOGI, TINA; INKPEN, KORI; PRATT, WANDA

    2015-01-01

    Studies have shown positive impact of video blogs (vlogs) on patient education. However, we know little on how patient-initiated vlogs shape the relationships among vloggers and viewers. We qualitatively analyzed 72 vlogs on YouTube by users diagnosed with HIV, diabetes, or cancer and 1,274 comments posted to the vlogs to understand viewers’ perspectives on the vlogs. We found that the unique video medium allowed intense and enriched personal and contextual disclosure to the viewers, leading to strong community-building activities and social support among vloggers and commenters, both informationally and emotionally. Furthermore, the unique communication structure of the vlogs allowed ad hoc small groups to form, which showed different group behavior than typical text-based social media, such as online communities. We provide implications to the Health Care Industry (HCI) community on how future technologies for health vlogs could be designed to further support chronic illness management. PMID:26146474

  20. Health Vlogs as Social Support for Chronic Illness Management.

    Science.gov (United States)

    Huh, Jina; Liu, Leslie S; Neogi, Tina; Inkpen, Kori; Pratt, Wanda

    2014-08-01

    Studies have shown positive impact of video blogs (vlogs) on patient education. However, we know little on how patient-initiated vlogs shape the relationships among vloggers and viewers. We qualitatively analyzed 72 vlogs on YouTube by users diagnosed with HIV, diabetes, or cancer and 1,274 comments posted to the vlogs to understand viewers' perspectives on the vlogs. We found that the unique video medium allowed intense and enriched personal and contextual disclosure to the viewers, leading to strong community-building activities and social support among vloggers and commenters, both informationally and emotionally. Furthermore, the unique communication structure of the vlogs allowed ad hoc small groups to form, which showed different group behavior than typical text-based social media, such as online communities. We provide implications to the Health Care Industry (HCI) community on how future technologies for health vlogs could be designed to further support chronic illness management.

  1. 42 CFR 90.8 - Conduct of health assessments and health effects studies.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Conduct of health assessments and health effects... HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES ADMINISTRATIVE FUNCTIONS, PRACTICES, AND PROCEDURES § 90.8 Conduct of health assessments and health effects...

  2. Electronic health information in use: Characteristics that support employee workflow and patient care.

    Science.gov (United States)

    Russ, Alissa L; Saleem, Jason J; Justice, Connie F; Woodward-Hagg, Heather; Woodbridge, Peter A; Doebbeling, Bradley N

    2010-12-01

    The aim of this investigation was to assess helpful and challenging aspects of electronic health information with respect to clinical workflow and identify a set of characteristics that support patient care processes. We conducted 20 semi-structured interviews at a Veterans Affairs Medical Center, with a fully implemented electronic health record (EHR), and elicited positive and negative examples of how information technology (IT) affects the work of healthcare employees. Responses naturally shed light on information characteristics that aid work processes. We performed a secondary analysis on interview data and inductively identified characteristics of electronic information that support healthcare workflow. Participants provided 199 examples of how electronic information affects workflow. Seventeen characteristics emerged along with four primary domains: trustworthy and reliable; ubiquitous; effectively displayed; and adaptable to work demands. Each characteristic may be used to help evaluate health information technology pre- and post-implementation. Results provide several strategies to improve EHR design and implementation to better support healthcare workflow.

  3. Developing a scale to assess health regulatory focus.

    Science.gov (United States)

    Ferrer, Rebecca A; Lipkus, Isaac M; Cerully, Jennifer L; McBride, Colleen M; Shepperd, James A; Klein, William M P

    2017-11-13

    Regulatory focus (i.e., focus on motivation to achieve gains or avoid losses and non-gains) is used to tailor health behavior change interventions, improving efficacy, but is currently assessed by scales that are not health-specific and may capture a version of the construct that is not ideally matched to the rationale for tailoring. We developed and validated a Health Regulatory Focus Scale (HRFS), which assesses tendencies to avoid negative health consequences (prevention focus) or achieve positive health outcomes (promotion focus). Across four studies (and a scale development study in supplementary online materials), we established convergent, discriminant, and predictive validity for the HRFS. In studies examining predictive validity, main outcome measures were health behavior intentions, including intentions to reduce alcohol use, quit smoking, eat a healthy diet, exercise, be screened for cancer, and engage in general cancer preventive behaviors. The promotion and prevention sub-scales performed well in confirmatory factor analyses. Single-factor models had significantly poorer fit than models delineating promotion and prevention. The sub-scales were differentially (and only modestly) correlated with related constructs (anxiety, optimism, information avoidance, ambiguity/fatalism). Higher HRFS-Promotion focus generally corresponded with greater health behavior intentions. Conversely, higher HRFS-Prevention focus corresponded with lower health behavior intentions. Associations were largely maintained even when controlling for established regulatory focus measures, supporting the assertion that the HRFS would predict unique variance in health behavior intentions. The HRFS has the potential to improve the precision with which framed health messages change behavior, as it may assess a version of regulatory focus that is more ideally matched to rationale for tailoring interventions. Copyright © 2017. Published by Elsevier Ltd.

  4. Health information support provided by professional associations in Canada.

    Science.gov (United States)

    Chatterley, Trish; Storie, Dale; Chambers, Thane; Buckingham, Jeanette; Shiri, Ali; Dorgan, Marlene

    2012-09-01

    Healthcare practitioners in Alberta and across Canada have varying levels of access to information resources depending on their institutional and professional affiliations, yet access to current health information is critical for all. To determine what information resources and services are provided by Albertan and Canadian professional health associations to their members. Representatives of professional colleges and associations were interviewed regarding information resources and services offered to members and perceptions of their members' information needs. National-level associations are more likely to provide resources than provincial ones. There is a clear distinction between colleges and associations in terms of information offered: colleges provide regulatory information, while associations are responsible for provision of clinical information resources. Only half of the associations interviewed provide members with access to licensed databases, with cost being a major barrier. There is considerable variation in the number of electronic resources and the levels of information support provided by professional health associations in Alberta and Canada. Access and usage vary among the health professions. National licensing of resources or creation of a portal linking to freely available alternatives are potential options for increasing access and awareness. © 2012 The authors. Health Information and Libraries Journal © 2012 Health Libraries Group.

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

    Science.gov (United States)

    Gabel, Stewart

    2012-12-01

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

  6. Assessment-based health informatics curriculum improvement.

    Science.gov (United States)

    Berner, Eta S; Dorsey, Amanda D; Garrie, Robert L; Qu, Haiyan

    2016-07-01

    Informatics programs need assurance that their curricula prepare students for intended roles as well as ensuring that students have mastered the appropriate competencies. The objective of this study is to describe a method for using assessment data to identify areas for curriculum, student selection, and assessment improvement. A multiple-choice examination covering the content in the Commission for Health Accreditation of Informatics and Information Management Education curricular facets/elements was developed and administered to 2 cohorts of entering students prior to the beginning of the program and to the first cohort after completion of the first year's courses. The reliability of the examination was assessed using Cronbach's alpha. Content validity was assessed by having 2 raters assess the match of the items to the Commission for Health Accreditation of Informatics and Information Management Education requirements. Construct validation included comparison of exam performance of instructed vs uninstructed students. Criterion-related validity was assessed by examining the relationship of background characteristics to exam performance and by comparing examination performance to graduate Grade Point Average (GPA). Reliability of the examination was 0.91 and 0.82 (Cohort 1 pre/post-tests) and 0.43 (Cohort 2 pretest). Both raters judged 76% of the test items as appropriate. There were statistically significant differences between the instructed (Cohort 1 post-test) and uninstructed (Cohort 2 pretest) students (t = 2.95 P Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  7. Imaginary Worlds: The European Network for Health Technology Assessment (EUnetHTA Recommendations for Health Economic Evaluations

    Directory of Open Access Journals (Sweden)

    Paul C Langley

    2016-08-01

    Full Text Available The European Network for Health Technology Assessment (EUnetHTA guidelines for health economic evaluations represent a consolidated view of non-binding recommendations for assessments of the relative effectiveness of pharmaceuticals or other health technologies. EUnetHTA views itself as the scientific and technological backbone of the development of health technology assessment in the European Union and among its member states and other partners. Unfortunately, the standards for health technology assessment proposed by EUnetHTA do not meet the standards of normal science. They do not support credible claims for the clinical and comparative cost-effectiveness of pharmaceuticals. In rejecting the standards of normal science the guidelines put to one side the opportunity not only to re-assess and replicate clinical and cost-effectiveness claims but to provide meaningful feedback on claims assessment to health care decision makers. The purpose of this review is to make the case that, in failing to support standards for experimentation, EUnetHTA is advocating its partners support the creation of modeled or simulated imaginary or false worlds. While EUnetHTA is not alone in recommending the construction of imaginary worlds to support formulary decisions, there is still the opportunity to revisit these recommendations and decide whether or not to encourage a scientifically rigorous approach to health technology assessments - to abandon a commitment to intelligent design in favor of natural selection.  Conflict of Interest None   Type: Commentary  

  8. Finnish Parental Involvement Ethos, Health Support, Health Education Knowledge and Participation: Results from a 2-Year School Health Intervention

    Science.gov (United States)

    Sormunen, Marjorita; Tossavainen, Kerttu; Turunen, Hannele

    2013-01-01

    A 2-year, participatory action research school health study focused on developing components for home-school partnerships to support children's health learning process. Two intervention schools implemented strengthened health and collaboration-orientated activities; two control schools followed the national core curriculum without extracurricular…

  9. Social support protects against the negative effects of partner violence on mental health.

    Science.gov (United States)

    Coker, Ann L; Smith, Paige H; Thompson, Martie P; McKeown, Robert E; Bethea, Lesa; Davis, Keith E

    2002-06-01

    Social support for abused women may reduce the impact of abuse on mental health, yet few studies have addressed this issue. We wish to determine associations between intimate partner violence (IPV) and mental health outcomes and to assess the protective role of abuse disclosure and support on mental health among abused women. A cross-sectional survey was conducted of 1152 women, ages 18-65, recruited from family practice clinics from 1997 through 1999. They were screened for IPV during a brief in-clinic interview, and physical and mental health status was assessed in a follow-up interview. IPV, defined as sexual, physical, or psychological abuse, was associated with poor perceived mental and physical health, substance abuse, symptoms of posttraumatic stress disorder (PTSD), current depression, anxiety, and suicide ideation/actions. Among women experiencing IPV and controlling for IPV frequency, higher social support scores were associated with a significantly reduced risk of poor perceived mental health (adjusted relative risk [aRR] 0.5, 95% confidence interval [CI] 0.3, 0.6) and physical health (aRR 0.6, 95% CI 0.5, 0.8), anxiety (aRR 0.3, 95% CI 0.2, 0.4), current depression (aRR 0.6, 95% CI 0.5, 0.8), PTSD symptoms (aRR 0.5, 95% CI 0.4, 0.8), and suicide attempts (aRR 0.6, 95% CI 0.4, 0.9). Healthcare providers can be instrumental in identifying IPV and helping women develop skills, resources, and support networks to address IPV. Physicians, family, or friends may provide needed social support.

  10. 47 CFR 54.625 - Support for services beyond the maximum supported distance for rural health care providers.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 3 2010-10-01 2010-10-01 false Support for services beyond the maximum supported distance for rural health care providers. 54.625 Section 54.625 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) UNIVERSAL SERVICE Universal Service Support for Health Care Providers § 54.625...

  11. Analysis of suffering at work in Family Health Support Centers.

    Science.gov (United States)

    Nascimento, Débora Dupas Gonçalves do; Oliveira, Maria Amélia de Campos

    2016-01-01

    Analyzing the work process in the Family Health Support Center. An exploratory, descriptive case study using a qualitative approach. Focus groups were conducted with 20 workers of a Family Health Support Center, and the empirical material was subjected to content analysis technique and analyzed in light of Work Psychodynamics. The category of suffering is presented herein as arising from the dialectical contradiction between actual work and prescribed work, from resistance to the Family Health Support Center's proposal and a lack of understanding of their role; due to an immediatist and curative culture of the users and the Family Health Strategy; of the profile, overload and identification with work. The dialectical contradiction between expectations from Family Health Strategy teams and the work in the Family Health Support Center compromises its execution and creates suffering for workers. Analisar o processo de trabalho no Núcleo de Apoio à Saúde da Família. Estudo de caso exploratório, descritivo e de abordagem qualitativa. Grupos focais foram realizados com 20 trabalhadores do Núcleo de Apoio à Saúde da Família, o material empírico foi submetido à técnica de análise de conteúdo e analisado à luz da Psicodinâmica do Trabalho. Apresenta-se aqui a categoria sofrimento que neste estudo decorre da contradição dialética entre o trabalho real e o trabalho prescrito, da resistência à proposta do Núcleo de Apoio à Saúde da Família e da falta de compreensão de seu papel; da cultura imediatista e curativa do usuário e da Estratégia Saúde da Família; do perfil, sobrecarga e identificação com o trabalho. A contradição dialética entre expectativas das equipes da Estratégia Saúde da Família e o trabalho no Núcleo de Apoio à Saúde da Família compromete sua efetivação e gera sofrimento aos trabalhadores.

  12. Untapped potential of health impact assessment.

    Science.gov (United States)

    Winkler, Mirko S; Krieger, Gary R; Divall, Mark J; Cissé, Guéladio; Wielga, Mark; Singer, Burton H; Tanner, Marcel; Utzinger, Jürg

    2013-04-01

    The World Health Organization has promoted health impact assessment (HIA) for over 20 years. At the 2012 United Nations Conference on Sustainable Development (Rio+20), HIA was discussed as a critical method for linking health to "green economy" and "institutional framework" strategies for sustainable development. In countries having a high human development index (HDI), HIA has been added to the overall assessment suite that typically includes potential environmental and social impacts, but it is rarely required as part of the environmental and social impact assessment for large development projects. When they are performed, project-driven HIAs are governed by a combination of project proponent and multilateral lender performance standards rather than host country requirements. Not surprisingly, in low-HDI countries HIA is missing from the programme and policy arena in the absence of an external project driver. Major drivers of global change (e.g. population growth and urbanization, growing pressure on natural resources and climate change) inordinately affect low- and medium-HDI countries; however, in such countries HIA is conspicuously absent. If the cloak of HIA invisibility is to be removed, it must be shown that HIA is useful and beneficial and, hence, an essential component of the 21st century's sustainable development agenda. We analyse where and how HIA can become fully integrated into the impact assessment suite and argue that the impact of HIA must not remain obscure.

  13. Integrated assessment for supporting decision making with multiple criteria

    Science.gov (United States)

    Friedrich, R.

    2015-08-01

    Decisions about the development of the energy system should take all relevant criteria into account, including costs and health, environmental and climate impacts. As usually no decision alternative fulfils all criteria better than all other alternatives, a weighting between the indicators that show the degree of fulfilment of the criteria, is necessary. In the following the "impact pathway approach" is described that supports decisions by using weighting factors that are derived from measuring or observing the preferences of the population. The methodology is applied to rank technologies for generating electricity according to their social costs, which is a summary indicator comprising simultaneously costs, impacts of air pollution on health and biodiversity and climate impacts.

  14. Integrated assessment for supporting decision making with multiple criteria

    Directory of Open Access Journals (Sweden)

    Friedrich R.

    2015-01-01

    Full Text Available Decisions about the development of the energy system should take all relevant criteria into account, including costs and health, environmental and climate impacts. As usually no decision alternative fulfils all criteria better than all other alternatives, a weighting between the indicators that show the degree of fulfilment of the criteria, is necessary. In the following the “impact pathway approach” is described that supports decisions by using weighting factors that are derived from measuring or observing the preferences of the population. The methodology is applied to rank technologies for generating electricity according to their social costs, which is a summary indicator comprising simultaneously costs, impacts of air pollution on health and biodiversity and climate impacts.

  15. Reduction of inequalities in health: assessing evidence-based tools

    Directory of Open Access Journals (Sweden)

    Shea Beverley

    2006-09-01

    Full Text Available Abstract Background The reduction of health inequalities is a focus of many national and international health organisations. The need for pragmatic evidence-based approaches has led to the development of a number of evidence-based equity initiatives. This paper describes a new program that focuses upon evidence- based tools, which are useful for policy initiatives that reduce inequities. Methods This paper is based on a presentation that was given at the "Regional Consultation on Policy Tools: Equity in Population Health Reports," held in Toronto, Canada in June 2002. Results Five assessment tools were presented. 1. A database of systematic reviews on the effects of educational, legal, social, and health interventions to reduce unfair inequalities is being established through the Cochrane and Campbell Collaborations. 2 Decision aids and shared decision making can be facilitated in disadvantaged groups by 'health coaches' to help people become better decision makers, negotiators, and navigators of the health system; a pilot study in Chile has provided proof of this concept. 3. The CIET Cycle: Combining adapted cluster survey techniques with qualitative methods, CIET's population based applications support evidence-based decision making at local and national levels. The CIET map generates maps directly from survey or routine institutional data, to be used as evidence-based decisions aids. Complex data can be displayed attractively, providing an important tool for studying and comparing health indicators among and between different populations. 4. The Ottawa Equity Gauge is applying the Global Equity Gauge Alliance framework to an industrialised country setting. 5 The Needs-Based Health Assessment Toolkit, established to assemble information on which clinical and health policy decisions can be based, is being expanded to ensure a focus on distribution and average health indicators. Conclusion Evidence-based planning tools have much to offer the

  16. Environment, Safety, and Health Risk Assessment Program (ESHRAP)

    Energy Technology Data Exchange (ETDEWEB)

    Eide, Steven Arvid; Thomas Wierman

    2003-12-01

    The Environment, Safety and Health Risk Assessment Program (ESHRAP) models human safety and health risk resulting from waste management and environmental restoration activities. Human safety and health risks include those associated with storing, handling, processing, transporting, and disposing of radionuclides and chemicals. Exposures to these materials, resulting from both accidents and normal, incident-free operation, are modeled. In addition, standard industrial risks (falls, explosions, transportation accidents, etc.) are evaluated. Finally, human safety and health impacts from cleanup of accidental releases of radionuclides and chemicals to the environment are estimated. Unlike environmental impact statements and safety analysis reports, ESHRAP risk predictions are meant to be best estimate, rather than bounding or conservatively high. Typically, ESHRAP studies involve risk predictions covering the entire waste management or environmental restoration program, including such activities as initial storage, handling, processing, interim storage, transportation, and final disposal. ESHRAP can be used to support complex environmental decision-making processes and to track risk reduction as activities progress.

  17. Assessing Metadata Quality of a Federally Sponsored Health Data Repository.

    Science.gov (United States)

    Marc, David T; Beattie, James; Herasevich, Vitaly; Gatewood, Laël; Zhang, Rui

    2016-01-01

    The U.S. Federal Government developed HealthData.gov to disseminate healthcare datasets to the public. Metadata is provided for each datasets and is the sole source of information to find and retrieve data. This study employed automated quality assessments of the HealthData.gov metadata published from 2012 to 2014 to measure completeness, accuracy, and consistency of applying standards. The results demonstrated that metadata published in earlier years had lower completeness, accuracy, and consistency. Also, metadata that underwent modifications following their original creation were of higher quality. HealthData.gov did not uniformly apply Dublin Core Metadata Initiative to the metadata, which is a widely accepted metadata standard. These findings suggested that the HealthData.gov metadata suffered from quality issues, particularly related to information that wasn't frequently updated. The results supported the need for policies to standardize metadata and contributed to the development of automated measures of metadata quality.

  18. Do the supportive staff have enough oral health knowledge? - A study at a teaching health care institution in South India

    OpenAIRE

    Venumbaka Siva Kalyan; A S Kalyana Bhargava; T Madhavi Padma; KVNR Pratap; G Venkateswara Rao; Anitha Akkaloori

    2015-01-01

    Introduction: Oral hygiene plays an imperative role in preventing oral diseases. The assessment of knowledge, attitude and practice in relation to oral hygiene among the supportive staff members would help the professional, to inculcate in their patients the acceptable oral habits to thwart oral diseases as these staff members are a bridge between healthcare professional and the patient. Materials and Methods: A cross-sectional questionnaire-based study was conducted at a teaching health care...

  19. IBM’s Health Analytics and Clinical Decision Support

    Science.gov (United States)

    Sun, J.; Knoop, S.; Shabo, A.; Carmeli, B.; Sow, D.; Syed-Mahmood, T.; Rapp, W.

    2014-01-01

    Summary Objectives This survey explores the role of big data and health analytics developed by IBM in supporting the transformation of healthcare by augmenting evidence-based decision-making. Methods Some problems in healthcare and strategies for change are described. It is argued that change requires better decisions, which, in turn, require better use of the many kinds of healthcare information. Analytic resources that address each of the information challenges are described. Examples of the role of each of the resources are given. Results There are powerful analytic tools that utilize the various kinds of big data in healthcare to help clinicians make more personalized, evidenced-based decisions. Such resources can extract relevant information and provide insights that clinicians can use to make evidence-supported decisions. There are early suggestions that these resources have clinical value. As with all analytic tools, they are limited by the amount and quality of data. Conclusion Big data is an inevitable part of the future of healthcare. There is a compelling need to manage and use big data to make better decisions to support the transformation of healthcare to the personalized, evidence-supported model of the future. Cognitive computing resources are necessary to manage the challenges in employing big data in healthcare. Such tools have been and are being developed. The analytic resources, themselves, do not drive, but support healthcare transformation. PMID:25123736

  20. Comparative Human Health Impact Assessment of Engineered Nanomaterials in the Framework of Life Cycle Assessment.

    Science.gov (United States)

    Fransman, Wouter; Buist, Harrie; Kuijpers, Eelco; Walser, Tobias; Meyer, David; Zondervan-van den Beuken, Esther; Westerhout, Joost; Klein Entink, Rinke H; Brouwer, Derk H

    2017-07-01

    For safe innovation, knowledge on potential human health impacts is essential. Ideally, these impacts are considered within a larger life-cycle-based context to support sustainable development of new applications and products. A methodological framework that accounts for human health impacts caused by inhalation of engineered nanomaterials (ENMs) in an indoor air environment has been previously developed. The objectives of this study are as follows: (i) evaluate the feasibility of applying the CF framework for NP exposure in the workplace based on currently available data; and (ii) supplement any resulting knowledge gaps with methods and data from the life cycle approach and human risk assessment (LICARA) project to develop a modified case-specific version of the framework that will enable near-term inclusion of NP human health impacts in life cycle assessment (LCA) using a case study involving nanoscale titanium dioxide (nanoTiO 2 ). The intent is to enhance typical LCA with elements of regulatory risk assessment, including its more detailed measure of uncertainty. The proof-of-principle demonstration of the framework highlighted the lack of available data for both the workplace emissions and human health effects of ENMs that is needed to calculate generalizable characterization factors using common human health impact assessment practices in LCA. The alternative approach of using intake fractions derived from workplace air concentration measurements and effect factors based on best-available toxicity data supported the current case-by-case approach for assessing the human health life cycle impacts of ENMs. Ultimately, the proposed framework and calculations demonstrate the potential utility of integrating elements of risk assessment with LCA for ENMs once the data are available. © 2016 Society for Risk Analysis.

  1. Foster Care: State Practices for Assessing Health Needs, Facilitating Service Delivery, and Monitoring Children's Care. Report to the Chairman, Subcommittee on Income Security and Family Support, Committee on Ways and Means, House of Representatives. GAO-09-26

    Science.gov (United States)

    Brown, Kay; Bascetta, Cynthia A.

    2009-01-01

    Providing health care services for foster children, who frequently have significant health care needs, can be challenging. The Administration for Children and Families (ACF) oversees foster care, but state child welfare agencies are responsible for ensuring that these children receive health care services, which are often financed by Medicaid. In…

  2. [Nutritional assessment and perioperative nutritional support in gastric cancer patients].

    Science.gov (United States)

    Seo, Kyung Won; Yoon, Ki Young

    2013-04-01

    Weight loss and malnutrition are common in cancer patients. Although weight loss is predominantly due to loss of fat mass, the morbidity risk is given by the decrease in muscle mass. The assessment of nutritional status is essential for a diagnosis of nutritional compromise and required for the multidisciplinary approach. Subjective global assessment (SGA) is made by the patients nutritional symptoms and weight loss. The objective assessment, a significant weight loss (>10%) for 6 months is considered an indicator of nutritional deficiency. The mean body index, body fat mass and body protein mass are decreased as cancer stage increases. The biochemical data of albumin, cholesterol, triglyceride, Zn, transferrin, total lymphocyte count are decreased in advanced cancer stage. Daily energy intake, cabohyderate and Vit B1 intake is decreased according to cancer stage. The patients are divided into three groups according to SGA. The three groups showed a significant difference in body weight, 1 month weight loss%, 6 month weight loss%, body mass index, mid arm circumference, albumin, energy intake, as well as carbohyderate intake protein and energy malnutrition. Nutritional assessment is of great importance because undernutrition has been shown to be associated with increase in stomach cancer associated morbidity and mortality. The authors concluded that nutritional assessment should be done in cancer patients preoperatively, and with adequate nutritional support, the morbidity and mortality would be decreased.

  3. Life cycle assessment in support of sustainable transportation

    Science.gov (United States)

    Eckelman, Matthew J.

    2013-06-01

    In our rapidly urbanizing world, sustainable transportation presents a major challenge. Transportation decisions have considerable direct impacts on urban society, both positive and negative, for example through changes in transit times and economic productivity, urban connectivity, tailpipe emissions and attendant air quality concerns, traffic accidents, and noise pollution. Much research has been dedicated to quantifying these direct impacts for various transportation modes. Transportation planning decisions also result in a variety of indirect environmental and human health impacts, a portion of which can accrue outside of the transit service area and so outside of the local decision-making process. Integrated modeling of direct and indirect impacts over the life cycle of different transportation modes provides decision support that is more comprehensive and less prone to triggering unintended consequences than a sole focus on direct tailpipe emissions. The recent work of Chester et al (2013) in this journal makes important contributions to this research by examining the environmental implications of introducing bus rapid transit and light rail in Los Angeles using life cycle assessment (LCA). Transport in the LA region is dominated by automobile trips, and the authors show that potential shifts to either bus or train modes would reduce energy use and emissions of criteria air pollutants, on an average passenger mile travelled basis. This work compares not just the use of each vehicle, but also upstream impacts from its manufacturing and maintenance, as well as the construction and maintenance of the entire infrastructure required for each mode. Previous work by the lead author (Chester and Horvath 2009), has shown that these non-operational sources and largely non-local can dominate life cycle impacts from transportation, again on an average (or attributional) basis, for example increasing rail-related GHG emissions by >150% over just operational emissions

  4. ECHO: health care performance assessment in several European health systems.

    Science.gov (United States)

    Bernal-Delgado, E; Christiansen, T; Bloor, K; Mateus, C; Yazbeck, A M; Munck, J; Bremner, J

    2015-02-01

    Strengthening health-care effectiveness, increasing accessibility and improving resilience are key goals in the upcoming European Union health-care agenda. European Collaboration for Health-Care Optimization (ECHO), an international research project on health-care performance assessment funded by the seventh framework programme, has provided evidence and methodology to allow the attainment of those goals. This article aims at describing ECHO, analysing its main instruments and discussing some of the ECHO policy implications. Using patient-level administrative data, a series of observational studies (ecological and cross-section with associated time-series analyses) were conducted to analyze population and patients' exposure to health care. Operationally, several performance dimensions such as health-care inequalities, quality, safety and efficiency were analyzed using a set of validated indicators. The main instruments in ECHO were: (i) building a homogeneous data infrastructure; (ii) constructing coding crosswalks to allow comparisons between countries; (iii) making geographical units of analysis comparable; and (iv) allowing comparisons through the use of common benchmarks. ECHO has provided some innovations in international comparisons of health-care performance, mainly derived from the massive pooling of patient-level data and thus: (i) has expanded the usual approach based on average figures, providing insight into within and across country variation at various meaningful policy levels, (ii) the important effort made on data homogenization has increased comparability, increasing stakeholders' reliance on data and improving the acceptance of findings and (iii) has been able to provide more flexible and reliable benchmarking, allowing stakeholders to make critical use of the evidence. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  5. Teaching pediatric health assessment: using Internet capabilities.

    Science.gov (United States)

    Kieckhefer, Gail M; Stevens, Anne; Frkonja, Jeff

    2002-01-01

    Changes brought about by rapidly expanding information technology are affecting many aspects of life, including nursing education. Graduates must be comfortable and flexible with the use of information technology because they will be required to use it in their practice and continuing education activities. In this article, the authors describe their experience in implementing and refining the use of World Wide Web-based technology to teach pediatric health assessment to pediatric and family nurse practitioner students. The article includes reflections on preparation, implementation, and evaluation. The students' level of confidence in their ability to perform pediatric health assessment rose, as did their test scores, and faculty deemed the revision successful and timesaving for them.

  6. Risk assessment of integrated electronic health records.

    Science.gov (United States)

    Bjornsson, Bjarni Thor; Sigurdardottir, Gudlaug; Stefansson, Stefan Orri

    2010-01-01

    The paper describes the security concerns related to Electronic Health Records (EHR) both in registration of data and integration of systems. A description of the current state of EHR systems in Iceland is provided, along with the Ministry of Health's future vision and plans. New legislation provides the opportunity for increased integration of EHRs and further collaboration between institutions. Integration of systems, along with greater availability and access to EHR data, requires increased security awareness since additional risks are introduced. The paper describes the core principles of information security as it applies to EHR systems and data. The concepts of confidentiality, integrity, availability, accountability and traceability are introduced and described. The paper discusses the legal requirements and importance of performing risk assessment for EHR data. Risk assessment methodology according to the ISO/IEC 27001 information security standard is described with examples on how it is applied to EHR systems.

  7. Risk of dependence associated with health, social support, and lifestyle

    Science.gov (United States)

    Alcañiz, Manuela; Brugulat, Pilar; Guillén, Montserrat; Medina-Bustos, Antonia; Mompart-Penina, Anna; Solé-Auró, Aïda

    2015-01-01

    OBJECTIVE To analyze the prevalence of individuals at risk of dependence and its associated factors. METHODS The study was based on data from the Catalan Health Survey, Spain conducted in 2010 and 2011. Logistic regression models from a random sample of 3,842 individuals aged ≥ 15 years were used to classify individuals according to the state of their personal autonomy. Predictive models were proposed to identify indicators that helped distinguish dependent individuals from those at risk of dependence. Variables on health status, social support, and lifestyles were considered. RESULTS We found that 18.6% of the population presented a risk of dependence, especially after age 65. Compared with this group, individuals who reported dependence (11.0%) had difficulties performing activities of daily living and had to receive support to perform them. Habits such as smoking, excessive alcohol consumption, and being sedentary were associated with a higher probability of dependence, particularly for women. CONCLUSIONS Difficulties in carrying out activities of daily living precede the onset of dependence. Preserving personal autonomy and function without receiving support appear to be a preventive factor. Adopting an active and healthy lifestyle helps reduce the risk of dependence. PMID:26018786

  8. Housing, income support and mental health: Points of disconnection

    Directory of Open Access Journals (Sweden)

    Csiernik Rick

    2007-12-01

    Full Text Available Abstract There exists a disconnection between evolving policies in the policy arenas of mental health, housing, and income support in Canada. One of the complexities associated with analysing the intersection of these policies is that federal, provincial, and municipal level policies are involved. Canada is one of the few developed countries without a national mental health policy and because of the federal policy reforms of the 1970s, the provincial governments now oversee the process of deinstitutionalization from the hospital to the community level. During this same period the availability of affordable housing has decreased as responsibility for social housing has been transfered from the federal government to the provincial and/or municipal levels of government. Canada also stands alone in terms of being a developed nation without national housing policy instead what is considered "affordable" housing is partially dependant upon individuals' personal economic resources. As well, over the past decade rates of income supports have also been reduced. Psychiatric survivors have long been identified as being at risk for homelessness, with the disconnection existing between housing, income and mental health policies and the lack of a national policy in any of these policies areas further contributing to this risk.

  9. Housing, income support and mental health: Points of disconnection

    Science.gov (United States)

    Forchuk, Cheryl; Joplin, Libbey; Schofield, Ruth; Csiernik, Rick; Gorlick, Carolyne; Turner, Katherine

    2007-01-01

    There exists a disconnection between evolving policies in the policy arenas of mental health, housing, and income support in Canada. One of the complexities associated with analysing the intersection of these policies is that federal, provincial, and municipal level policies are involved. Canada is one of the few developed countries without a national mental health policy and because of the federal policy reforms of the 1970s, the provincial governments now oversee the process of deinstitutionalization from the hospital to the community level. During this same period the availability of affordable housing has decreased as responsibility for social housing has been transfered from the federal government to the provincial and/or municipal levels of government. Canada also stands alone in terms of being a developed nation without national housing policy instead what is considered "affordable" housing is partially dependant upon individuals' personal economic resources. As well, over the past decade rates of income supports have also been reduced. Psychiatric survivors have long been identified as being at risk for homelessness, with the disconnection existing between housing, income and mental health policies and the lack of a national policy in any of these policies areas further contributing to this risk. PMID:18072980

  10. Smart home technologies for health and social care support.

    Science.gov (United States)

    Martin, Suzanne; Kelly, Greg; Kernohan, W George; McCreight, Bernadette; Nugent, Christopher

    2008-10-08

    The integration of smart home technology to support health and social care is acquiring an increasing global significance. Provision is framed within the context of a rapidly changing population profile, which is impacting on the number of people requiring health and social care, workforce availability and the funding of healthcare systems. To explore the effectiveness of smart home technologies as an intervention for people with physical disability, cognitive impairment or learning disability, who are living at home, and to consider the impact on the individual's health status and on the financial resources of health care. We searched the following databases for primary studies: (a) the Cochrane Effective Practice and Organisation of Care (EPOC) Group Register, (b) the Cochrane Central Register of Controlled Trials (CENTRAL), (The Cochrane Library, issue 1, 2007), and (c) bibliographic databases, including MEDLINE (1966 to March 2007), EMBASE (1980 to March 2007) and CINAHL (1982 to March 2007). We also searched the Database of Abstracts of Reviews of Effectiveness (DARE). We searched the electronic databases using a strategy developed by the EPOC Trials Search Co-ordinator. We included randomised controlled trials (RCTs), quasi-experimental studies, controlled before and after studies (CBAs) and interrupted time series analyses (ITS). Participants included adults over the age of 18, living in their home in a community setting. Participants with a physical disability, dementia or a learning disability were included. The included interventions were social alarms, electronic assistive devices, telecare social alert platforms, environmental control systems, automated home environments and 'ubiquitous homes'. Outcome measures included any objective measure that records an impact on a participant's quality of life, healthcare professional workload, economic outcomes, costs to healthcare provider or costs to participant. We included measures of service satisfaction

  11. Health technology assessment (HTA): ethical aspects.

    Science.gov (United States)

    Sacchini, Dario; Virdis, Andrea; Refolo, Pietro; Pennacchini, Maddalena; de Paula, Ignacio Carrasco

    2009-11-01

    "HTA is a multidisciplinary process that summarizes information about the medical, social, economic and ethical issues related to the use of a health technology in a systematic, transparent, unbiased, robust manner. Its aim is to inform the formulation of safe, effective, health policies that are patient focused, and seek to achieve best value" (EUnetHTA 2007). Even though the assessment of ethical aspects of a health technology is listed as one of the objectives of a HTA process, in practice, the integration of these dimensions into reports remains limited. The article is focused on four points: 1. the HTA concept; 2. the difficult HTA-ethics relationship; 3. the ethical issues in HTA; 4. the methods for integrating ethical analysis into HTA.

  12. Health-related Support Groups on the Internet: Linking Empirical Findings to Social Support and Computer-mediated Communication Theory.

    Science.gov (United States)

    Wright, Kevin B; Bell, Sally B; Wright, Kevin B; Bell, Sally B

    2003-01-01

    This literature review of research on health-related computer-mediated support groups links features of these groups to existing theory from the areas of social support and computer-mediated communication research. The article exams computer-mediated support groups as weak tie networks, focuses on how these support groups facilitate participant similarity and empathic support and identifies changes in supportive communication due to characteristics of the medium.

  13. Teaching health assessment in the virtual classroom.

    Science.gov (United States)

    Lashley, Mary

    2005-08-01

    Health assessment skills are vital to professional nursing practice. Health assessment has traditionally been taught using lecture, teacher-developed tests, practice and live demonstration, and interactive and computer-based learning materials. Rapid advances in information technology during the past decade have greatly expanded distance learning options in higher education. Although much nursing education now uses the Internet, there has been limited use of the Web to teach psychomotor and clinical skills. This article describes how online instruction can be integrated into a health assessment course to teach physical examination skills. The development of instructional videos that can be digitally streamed onto the Web for ready and repeated access can also enhance online learning of technical and clinical skills. Student evaluation of this Web-enhanced course revealed that online assignments enabled them to pace their learning, thereby promoting greater flexibility and independence. Students were able to master the technical skills of working online with minimal difficulty and reported that working online was no more stressful than attending class. The most helpful aspect of the online course was the instructor-developed video that was digitally streamed online.

  14. Use of the community assessment for public health emergency response to conduct community health assessments for public health accreditation.

    Science.gov (United States)

    Conley, Ashley M; Vagi, Sara; Horney, Jennifer A

    2014-01-01

    A community health assessment (CHA) is a collaborative process of collecting and analyzing data to learn about the health status of a community. Community health assessments are also a requirement of public health accreditation for state and local health departments and of the Affordable Care Act for nonprofit hospitals. One element of a CHA is primary data collection. This article describes the use of the Community Assessment for Public Health Emergency Response (CASPER) method for primary data collection to meet public health accreditation requirements in 2 case study communities--Nashua, New Hampshire, and Davidson County, North Carolina; CASPER is a flexible and efficient method for the collection of population-based primary data in an urban or rural setting.

  15. Certified Basic Life Support Instructors Assess Cardiopulmonary Resuscitation Skills Poorly

    DEFF Research Database (Denmark)

    Hansen, Camilla; Rasmussen, Stinne E; Kristensen, Mette Amalie

    2016-01-01

    Introduction: High-quality cardiopulmonary resuscitation (CPR) improves survival from cardiac arrest. During basic life support (BLS) training, instructors assess CPR skills to enhance learning outcome. Emergency department staff and senior residents have been shown to assess chest compression...... out of 3 CPR cycles with 30±2 chest compressions at a depth of 50-60mm and rate of 100-120 min-1. Correct rescue breathing was defined as ≥50% efficient breaths in 3 CPR cycles with visible, but not excessive, manikin’s chest raise (for instructors) or a volume of 500-600 mL (manikin data).Results: We...... of CPR skills may be beneficial to ensure high-quality learning outcome.Author Disclosures: C. Hansen: None. S.E. Rasmussen: None. M.A. Nebsbjerg: None. M. Stærk: None. B. Løfgren: None....

  16. Developing a support system for teaching and assessing clinical competence.

    Science.gov (United States)

    Battles, J B; Sprankell, S J; Carpenter, J L; Bedford, J A; Kirk, L M

    1992-01-01

    Primary care medical school faculty, in partnership with the faculty and staff of a Department of Biomedical Communications (Office of Medical Education) developed a teaching and logistical support system using standardized patients. The patients are used to teach history and physical examination skills to students in an introductory clinical medicine course. Having both clinical assessment team members, who are skilled biomedical communicators, and designated clinic rooms for standardized patients provides the foundation necessary for this growing area in medical education. Improved student performance, as measured by an Objective Structured Clinical Examination (OSCE), and students' positive ratings and comments in the evaluation of the course demonstrated the efficacy of using standardized patients in teaching and assessing clinical performance.

  17. Does One Size Fit All? Assessing the Need for Organizational Second Victim Support Programs.

    Science.gov (United States)

    Edrees, Hanan H; Wu, Albert W

    2017-06-30

    Second victims are health care providers who are emotionally traumatized after experiencing an unanticipated patient's adverse event. To support second victims, organizations can provide a dedicated support program for their workers. The aim of this study was to assess the extent of the second victim problem in acute care hospitals in the state of Maryland, the availability of emotional support services, and the need for organizational support programs. In-depth, semistructured interviews were conducted with 43 patient safety representatives from 38 acute hospitals in Maryland. Data were analyzed using QSR NVivo10 software and a mixed-methods approach to generate codes and extract themes from the interviews. Descriptive statistics were generated for hospital and participant characteristics. The response rate was 83% of hospitals. All participants reported that they and their executives were aware of the second victim problem. Although participants varied in their perceptions of whether a dedicated second victim support program would be helpful for their hospital, all thought that hospitals should offer organizational support programs. Several organizations are attempting to promote a "just culture" in responding to events, and there continues to be stigma associated with speaking up during a root cause analysis, and with accessing support if it were offered. The second victim problem is recognized in all hospitals in Maryland. However, even when support is available, health care providers face stigma and other barriers in accessing it. Future efforts should assess the need for second victim programs from the perspectives of second victims themselves to identify barriers and improve uptake of needed support.

  18. A short mnemonic to support the comprehensive geriatric assessment model.

    Science.gov (United States)

    Han, Brenda; Grant, Cristin

    2016-10-06

    With an increasing number of older people using emergency services, researchers have raised concerns about the quality of care in an environment that is not designed to address older patients' specific needs and conditions. The comprehensive geriatric assessment (CGA) model was developed to address these issues, and to optimise healthcare delivery to older adults. This article introduces a complementary mnemonic, FRAIL, that refers to important elements of health information to consider before initiating care for older patients - falls/functional decline, reactions, altered mental status, illnesses, and living situation. It is not intended to replace the CGA, but can help to quickly identify high-risk older patients who warrant a more in-depth clinical assessment with CGA.

  19. [Health support staff: resources or links for nurses?].

    Science.gov (United States)

    D'Addio, Laura; Lipparini, Letizia

    2003-01-01

    How to open the doors to the new support personnel (OSS)? An enquiry has been elaborate to understand if the nurse were ready to welcome this figure in order to explore the competences and the responsibilities that the nurses attribute to the OSS The limited organizational rationality of the assistance, especially in the public, determines waste of resources and low general effectiveness. In this scenery the challenge for the profession consists of guaranteeing suitable relief levels, despite the serious lack of resources. The nursing profession n, to welcome the OSS needs to analyse and clarify its operatives and the models of collaboration with the other health care professionals.

  20. Building capacity in a health sciences library to support global health projects.

    Science.gov (United States)

    Lackey, Mellanye; Swogger, Susan; McGraw, Kathleen A

    2014-04-01

    This paper describes how a large, academic health sciences library built capacity for supporting global health at its university and discusses related outcomes. Lean budgets require prioritization and organizational strategy. A committee, with leadership responsibilities assigned to one librarian, guided strategic planning and the pursuit of collaborative, global health outreach activities. A website features case studies and videos of user stories to promote how library partnerships successfully contributed to global health projects. Collaborative partnerships were formed through outreach activities and from follow-up to reference questions. The committee and a librarian's dedicated time established the library's commitment to help the university carry out its ambitious global agenda.

  1. Building capacity in a health sciences library to support global health projects*

    Science.gov (United States)

    Lackey, Mellanye; Swogger, Susan; McGraw, Kathleen A.

    2014-01-01

    This paper describes how a large, academic health sciences library built capacity for supporting global health at its university and discusses related outcomes. Lean budgets require prioritization and organizational strategy. A committee, with leadership responsibilities assigned to one librarian, guided strategic planning and the pursuit of collaborative, global health outreach activities. A website features case studies and videos of user stories to promote how library partnerships successfully contributed to global health projects. Collaborative partnerships were formed through outreach activities and from follow-up to reference questions. The committee and a librarian's dedicated time established the library's commitment to help the university carry out its ambitious global agenda. PMID:24860264

  2. Survey of mental health nurses' attitudes towards risk assessment, risk assessment tools and positive risk.

    Science.gov (United States)

    Downes, C; Gill, A; Doyle, L; Morrissey, J; Higgins, A

    2016-04-01

    WHAT IS KNOWN ON THE SUBJECT?: Risk assessment and safety planning are a core aspect of the role of the mental health nurse. Conflicting views exist on the value of risk assessment tools. Few studies have examined mental health nurses' attitudes towards risk, including use of tools and the role of positive risk in recovery. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: Mental health nurses view risk assessment as a core dimension of their role and not merely an exercise to fulfil organizational clinical safety and governance obligations. The majority of nurses hold positive attitudes towards therapeutic or positive risk, and consider creative risk taking as vital to people's recovery. The majority of nurses believe that risk assessment tools facilitate professional decision making, however, some are concerned that tools may negatively impact upon therapeutic relationships. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Ongoing education on the use of risk assessment tools is required to minimize views that their use is incompatible with therapeutic engagement, and to enable nurses to develop confidence to engage with positive risk and to allow service users make decisions and take responsibility. Introduction Risk assessment and safety planning are considered core components of the role of the mental health nurse; however, little is known about nurses' attitudes towards risk assessment, use of tools to assess risk or therapeutic risk taking. Aim This study aimed to explore mental health nurses' attitudes towards completing risk assessments, use of tools as an aid, and therapeutic or positive risk. Method An anonymous survey which included 13 attitudinal statements, rated on a five-point Likert scale, was completed by 381 mental health nurses working in adult services in Ireland. Findings Findings indicate strong support for the practice of risk assessment in mental health practice. The vast majority of nurses believe that risk assessment tools facilitate professional

  3. Relationships among depression during pregnancy, social support and health locus of control among Iranian pregnant women.

    Science.gov (United States)

    Moshki, Mahdi; Cheravi, Khadijeh

    2016-03-01

    Prenatal depression is a significant predictor of postpartum depression and is detrimental to fetal development. To examine whether depression during pregnancy is associated with social support and health locus of control (HLC). Data were collected from a sample of 208 Iranian pregnant women using a demographic questionnaire, the Edinburgh Postnatal Depression Scale, the multidimensional HLC Scale and the social support appraisals. Depression was experienced by 37% of participants. Overall, women reported higher level of family support (6.88 ± 1.15) than other supports (6.87 ± 1.29). Protective supports from other resources (6.87 ± 1.29) were higher than those from friends (5.94 ± 1.5). Internal, powerful others and chance beliefs had the highest mean scores. Social support and chance HLC significantly influenced the proposed mediator (depressive mood) in the linear regression model. Bivariate analysis showed significant associations between social support (friend, family and others) and depressive mood. Internal HLC had a significant association with social support and powerful others HLC. However, Pearson correlation coefficient was not significant between depressive mood and all dimensions of HLC. Clinicians could assess social support and chance HLC to identify and treat women at risk of prenatal depression. By providing support during pregnancy, depression levels in women and its effects on the fetus may be decreased, which could prevent postpartum depression. © The Author(s) 2015.

  4. ARIES: System for Health effects Assessment in industrial risk

    Energy Technology Data Exchange (ETDEWEB)

    Rabago, I.; Vidania, R. de; Inmaculada, S.

    1992-07-01

    In this work we present a general description of ARIES*, a tool designed in order to support the assessment of expected health effects derived from an accidental release of toxic compounds. ARIES includes two sequential and complementary steps. The first one (a quantitative phase) is being developed. for inhalation exposures, using numerical models, empirical correlations, physiological parameters and toxicological index, to estimate short term consequences over the exposed population. Next it will be published a new report were It will be described with detail the procedure designed to the quantitative assessment of the exposure. The system starts the assessment process with values of external concentrations which are processed, together with different exposure values (existing for humans and scaled up irom animals), as inputs for different kinds of models. From these, and other physiological values ARIES calculates the inhaled equivalent doses and the expected associated effects as a function of the exposure limes. Once overcome this first step, ARIES is complemented with an additional system that executes the selection of relevant information from toxicological data bases (qualitative phase). The system works , applying a string of filters and searches that displays selected Information, giving an additional support to the assessment. Both steps, just referred, are integrated into a logical informatics support. The informatics code is developed in dbase language even for the design of the procedure as for the mathematical models linked to the system ( extrapolation, dose inhaled models, etc.) to execute the numerical analysis of the assessment. The system has been designed in order to include progressively new chemicals and the improvements obtained in the development of mathematical models related with dose-effect relationships. At this moment, is programmed a first prototype of ARIES that can be executed in PC's and it can run for several products

  5. Problem structuring in health technology assessment : an argumentative approach to increase its usefulness

    NARCIS (Netherlands)

    Moret-Hartman, Margriet

    2008-01-01

    This thesis addresses the problem of the limited impact of Health Technology Assessment (HTA) research on health policy and clinical practice. HTA is a type of policy research that aims to provide information concerning medical technologies in order to support health care decision making. Although,

  6. 42 CFR 90.3 - Procedures for requesting health assessments.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Procedures for requesting health assessments. 90.3... ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES ADMINISTRATIVE FUNCTIONS, PRACTICES, AND PROCEDURES § 90.3 Procedures for requesting health assessments. (a) ATSDR will...

  7. Lunar Surface Architecture Utilization and Logistics Support Assessment

    Science.gov (United States)

    Bienhoff, Dallas; Findiesen, William; Bayer, Martin; Born, Andrew; McCormick, David

    2008-01-01

    Crew and equipment utilization and logistics support needs for the point of departure lunar outpost as presented by the NASA Lunar Architecture Team (LAT) and alternative surface architectures were assessed for the first ten years of operation. The lunar surface architectures were evaluated and manifests created for each mission. Distances between Lunar Surface Access Module (LSAM) landing sites and emplacement locations were estimated. Physical characteristics were assigned to each surface element and operational characteristics were assigned to each surface mobility element. Stochastic analysis was conducted to assess probable times to deploy surface elements, conduct exploration excursions, and perform defined crew activities. Crew time is divided into Outpost-related, exploration and science, overhead, and personal activities. Outpost-related time includes element deployment, EVA maintenance, IVA maintenance, and logistics resupply. Exploration and science activities include mapping, geological surveys, science experiment deployment, sample analysis and categorizing, and physiological and biological tests in the lunar environment. Personal activities include sleeping, eating, hygiene, exercising, and time off. Overhead activities include precursor or close-out tasks that must be accomplished but don't fit into the other three categories such as: suit donning and doffing, airlock cycle time, suit cleaning, suit maintenance, post-landing safing actions, and pre-departure preparations. Equipment usage time, spares, maintenance actions, and Outpost consumables are also estimated to provide input into logistics support planning. Results are normalized relative to the NASA LAT point of departure lunar surface architecture.

  8. Finnish parental involvement ethos, health support, health education knowledge and participation: results from a 2-year school health intervention.

    Science.gov (United States)

    Sormunen, Marjorita; Tossavainen, Kerttu; Turunen, Hannele

    2013-04-01

    A 2-year, participatory action research school health study focused on developing components for home-school partnerships to support children's health learning process. Two intervention schools implemented strengthened health and collaboration-orientated activities; two control schools followed the national core curriculum without extracurricular activities. The parents of fourth-grade pupils (10-11 years at baseline) completed questionnaires before intervention in spring 2008 (N = 348) and after intervention in spring 2010 (N = 358). A two-way analysis of variance was conducted to determine whether time (2008/2010) and group (intervention/control) influenced parents' perceptions and experiences of parental involvement, health education and health support received from the school. Compared with controls, the intervention schools' parents experienced greater involvement ethos (Cohen's d = 0.57, P < 0.001), increased knowledge of health education (Cohen's d = 0.60, P = 0.02) and health support (Cohen's d = 0.35, P = 0.02). Health education participation among parents increased only partially during the intervention (Cohen's d = -0.12, P = 0.193). School health interventions based on schools' needs may have the potential to influence positively the relationship between home and school and increase the visibility of health education. The study was undertaken within the Schools for Health in Europe program.

  9. Summary of the environmental and indirect human health risk assessment of AquAdvantage salmon

    National Research Council Canada - National Science Library

    Beardall, J; Bradbury, I; Byrne, P; Chaput, G; Devlin, R; Dugan, S; Fraser, D; Hovorka, M; Leggatt, R; MacKinnon, A.-M; MacNair, N; Mandrak, N; Marshall, L; McGowan, C; Meerburg, D; Mills, C; Mimeault, C; Moreau, D; Shahsavarani, A; Situ, D; Stefanov, I; Stephen, S.J; Thorleifson, E

    2013-01-01

    .... DFO conducted environmental and indirect human health risk assessments of AquAdvantage Salmon in order to make recommendations on any necessary risk management measures to EC to support a regulatory...

  10. Human Health Risk Assessment Strategic Research Action Plan 2012-2016

    Science.gov (United States)

    This document outlines the strategic plan for EPA’s Human Health Risk Assessment research efforts, and how they support and are integrated into the overall research portfolio of the Agency’s Office of Research and Development.

  11. Athlete social support, negative social interactions and psychological health across a competitive sport season.

    Science.gov (United States)

    DeFreese, J D; Smith, Alan L

    2014-12-01

    Social support and negative social interactions have implications for athlete psychological health, with potential to influence the links of stress-related experiences with burnout and well-being over time. Using a longitudinal design, perceived social support and negative social interactions were examined as potential moderators of the temporal stress-burnout and burnout-well-being relationships. American collegiate athletes (N = 465) completed reliable and valid online assessments of study variables at four time points during the competitive season. After controlling for dispositional and conceptually important variables, social support and negative social interactions did not moderate the stress-burnout or burnout-well-being relationships, respectively, but did simultaneously contribute to burnout and well-being across the competitive season. The results showcase the importance of sport-related social perceptions to athlete psychological outcomes over time and inform development of socially driven interventions to improve the psychological health of competitive athletes.

  12. [Indirect costs in health technology assessment].

    Science.gov (United States)

    Jakubczyk, Michał; Wrona, Witold; Macioch, Tomasz; Golicki, Dominik; Niewada, Maciej; Hermanowski, Tomasz

    2010-01-01

    In the health technology assessment it is crucial to define the perspective of the analysis. When the societal perspective is chosen it is necessary to include all the costs incurred by the society, also the costs of lost productivity resulting from absence of sick employees from work or their reduced efficiency at work. The aim of this article is to present the notion of indirect costs, their importance in health technology assessment and the methods of calculation. The economic literature has been reviewed for the state of knowledge on indirect costs. Three methods of calculation are described: human capital method, friction cost method or health state valuation. Indirect costs in Western European countries can amount to more than half of total costs attributed to the illness and its treatment. In the literature there is no consensus regarding the proper method of indirect costs calculation. It is necessary to conduct further theoretical and empirical research in the area of indirect costs and enhance discussion among Polish pharmacoeconomists.

  13. Automated assessment of cognitive health using smart home technologies.

    Science.gov (United States)

    Dawadi, Prafulla N; Cook, Diane J; Schmitter-Edgecombe, Maureen; Parsey, Carolyn

    2013-01-01

    The goal of this work is to develop intelligent systems to monitor the wellbeing of individuals in their home environments. This paper introduces a machine learning-based method to automatically predict activity quality in smart homes and automatically assess cognitive health based on activity quality. This paper describes an automated framework to extract set of features from smart home sensors data that reflects the activity performance or ability of an individual to complete an activity which can be input to machine learning algorithms. Output from learning algorithms including principal component analysis, support vector machine, and logistic regression algorithms are used to quantify activity quality for a complex set of smart home activities and predict cognitive health of participants. Smart home activity data was gathered from volunteer participants (n=263) who performed a complex set of activities in our smart home testbed. We compare our automated activity quality prediction and cognitive health prediction with direct observation scores and health assessment obtained from neuropsychologists. With all samples included, we obtained statistically significant correlation (r=0.54) between direct observation scores and predicted activity quality. Similarly, using a support vector machine classifier, we obtained reasonable classification accuracy (area under the ROC curve=0.80, g-mean=0.73) in classifying participants into two different cognitive classes, dementia and cognitive healthy. The results suggest that it is possible to automatically quantify the task quality of smart home activities and perform limited assessment of the cognitive health of individual if smart home activities are properly chosen and learning algorithms are appropriately trained.

  14. Health impact assessment of urban waterway decisions.

    Science.gov (United States)

    Korfmacher, Katrina Smith; Aviles, Katia; Cummings, B J; Daniell, William; Erdmann, Jared; Garrison, Valerie

    2014-12-25

    Health impact assessments (HIA) promote the consideration of health in a wide range of public decisions. Although each HIA is different, common pathways, evidence bases, and strategies for community engagement tend to emerge in certain sectors, such as urban redevelopment, natural resource extraction, or transportation planning. To date, a limited number of HIAs have been conducted on decisions affecting water resources and waterfronts. This review presents four recent HIAs of water-related decisions in the United States and Puerto Rico. Although the four cases are topically and geographically diverse, several common themes emerged from the consideration of health in water-related decisions. Water resource decisions are characterized by multiple competing uses, inter-institutional and inter-jurisdictional complexity, scientific uncertainty, long time scales for environmental change, diverse cultural and historical human values, and tradeoffs between private use and public access. These four case studies reveal challenges and opportunities of examining waterfront decisions through a "health lens". This review analyzes these cases, common themes, and lessons learned for the future practice of HIA in the waterfront zone and beyond.

  15. A Decision support system (DSS) for municipal nurses encountering health deterioration among older people.

    Science.gov (United States)

    Kihlgren, Annica; Svensson, Fredrik; Lövbrand, Conny; Gifford, Mervyn; Adolfsson, Annsofie

    2016-01-01

    This study is part of a larger project called ViSam and includes testing of a decision support system developed and adapted for older people on the basis of M (R) ETTS (Rapid Emergency Triage and Treatment System). The system is designed to allow municipal nurses to determine the optimal level of care for older people whose health has deteriorated. This new system will allow more structured assessment, the patient should receive optimal care and improved data transmission to the next caregiver. This study has an explanatory approach, commencing with quantitative data collection phase followed by qualitative data arising from focus group discussions over the RNs professional experience using the Decision Support system. Focus group discussions were performed to complement the quantitative data to get a more holistic view of the decision support system. Using elements of the decision support system (vital parameters for saturation, pain and affected general health) together with the nurses' decision showed that 94 % of the older persons referred to hospital were ultimately hospitalized. Nurses felt that they worked more systematically, communicated more effectively with others and felt more professional when using the decision support system. The results of this study showed that, with the help of a decision support system, the correct patients are sent to the Emergency Department from municipal home care. Unnecessary referrals of older patients that might lead to poorer health, decreased well-being and confusion can thus be avoided. Using the decision support system means that healthcare co-workers (nurses, ambulance/emergency department/district doctor/SOS alarm) begin to communicate more optimally. There is increased understanding leading to the risk of misinterpretation being reduced and the relationship between healthcare co-workers is improved. However, the decision support system requires more extensive testing in order to enhance the evidence base relating

  16. Miniature Biosensor with Health Risk Assessment Feedback

    Science.gov (United States)

    Hanson, Andrea; Downs, Meghan; Kalogera, Kent; Buxton, Roxanne; Cooper, Tommy; Cooper, Alan; Cooper, Ross

    2016-01-01

    Heart rate (HR) monitoring is a medical requirement during exercise on the International Space Station (ISS), fitness tests, and extravehicular activity (EVA); however, NASA does not currently have the technology to consistently and accurately monitor HR and other physiological data during these activities. Performance of currently available HR monitor technologies is dependent on uninterrupted contact with the torso and are prone to data drop-out and motion artifact. Here, we seek an alternative to the chest strap and electrode based sensors currently in use on ISS today. This project aims to develop a high performance, robust earbud based biosensor with focused efforts on improved HR data quality during exercise or EVA. A health risk assessment algorithm will further advance the goals of autonomous crew health care for exploration missions.

  17. Occupational Health Policies on Risk Assessment in Japan

    Directory of Open Access Journals (Sweden)

    Seichi Horie

    2010-09-01

    Full Text Available Industrial Safety and Health Law (ISH Law of Japan requires abnormalities identifi ed in evaluations of worker health and working environments are reported to occupational physicians, and employers are advised of measures to ensure appropriate accommodations in working environments and work procedures. Since the 1980s, notions of a risk assessment and occupational safety and health management system were expected to further prevent industrial accidents. In 2005, ISH Law stipulated workplace risk assessment using the wording “employers shall endeavor.” Following the amendment, multiple documents and guidelines for risk assessment for different work procedures were developed. They require ISH Laws to be implemented fully and workplaces to plan and execute measures to reduce risks, ranking them from those addressing potential hazards to those requiring workers to wear protective articles. A governmental survey in 2005 found the performance of risk assessment was 20.4% and common reasons for not implementing risk assessments were lack of adequate personnel or knowledge. ISH Law specifi es criminal penalties for both individuals and organizations. Moreover, under the Labor Contract Law promulgated in 2007, employers are obliged to make reasonable efforts to ensure employee health for foreseeable and avoidable risks. Therefore, enterprises neglecting even the non-binding provisions of guidelines are likely to suffer signifi cant business impact if judged to be responsible for industrial accidents or occupational disease. To promote risk assessment, we must strengthen technical, fi nancial, and physical support from public-service organizations, encourage the dissemination of good practices to reduce risks, and consider additional employer incentives, including relaxed mandatory regulations.

  18. An Overview of State Policies Supporting Worksite Health Promotion Programs.

    Science.gov (United States)

    VanderVeur, Jennifer; Gilchrist, Siobhan; Matson-Koffman, Dyann

    2017-05-01

    Worksite health promotion (WHP) programs can reduce the occurrence of cardiovascular disease risk factors. State law can encourage employers and employer-provided insurance companies to offer comprehensive WHP programs. This research examines state law authorizing WHP programs. Quantitative content analysis. Worksites or workplaces. United States (and the District of Columbia). State law in effect in 2013 authorizing WHP programs. Frequency and distribution of states with WHP laws. To determine the content of the laws for analysis and coding, we identified 18 policy elements, 12 from the Centers for Disease Control and Prevention's Worksite Health ScoreCard (HSC) and 6 additional supportive WHP strategies. We used these strategies as key words to search for laws authorizing WHP programs or select WHP elements. We calculated the number and type of WHP elements for each state with WHP laws and selected two case examples from states with comprehensive WHP laws. Twenty-four states authorized onsite WHP programs, 29 authorized WHP through employer-provided insurance plans, and 18 authorized both. Seven states had a comprehensive WHP strategy, addressing 8 or more of 12 HSC elements. The most common HSC elements were weight management, tobacco cessation, and physical activity. Most states had laws encouraging the adoption of WHP programs. Massachusetts and Maine are implementing comprehensive WHP laws but studies evaluating their health impact are needed.

  19. A global health partnership's use of time-limited support to catalyze health practice change: the case of GAVI's Injection Safety Support.

    Directory of Open Access Journals (Sweden)

    Ann Levin

    Full Text Available This paper presents the findings of a study to assess the effectiveness and sustainability of a GAVI (Global Alliance of Vaccines and Immunization sponsored, time-limited Injection Safety (INS support. The support came in two forms: 1 in-kind, in the form of AD syringes and safety boxes, and 2 in cash, for those countries that already had a secure, multi-year source of AD syringes and safety boxes, but proposed to use INS support to strengthen their injection safety activities. In total, GAVI gave INS support for a three-year period to 58 countries: 46 with commodities and 12 with cash support. To identify variables that might be associated with financial sustainability, frequencies and cross-tabulations were run against various programmatic and socio-economic variables in the 58 countries. All but two of the 46 commodity-recipient countries were able to replace and sustain the use of AD syringes and safety boxes after the end of their GAVI INS support despite the fact that standard disposable syringes are less costly than ADs (10-15 percent differential. In addition, all 12 cash-recipient countries continued to use AD syringes and safety boxes in their immunization programs in the years following GAVI INS assistance. At the same time, countries were often not prepared for the increased waste management requirements associated with the use of the syringes, suggesting the importance of anticipating challenges with the introduction of new technologies. The sustained use of AD syringes in countries receiving injection safety support from GAVI, in a majority of cases through government financing, following the completion of three years of time-limited support, represents an early indication of how GHPs can contribute to improved health outcomes in immunization safety in the world's poorest countries in a sustainable way.

  20. A Global Health Partnership's Use of Time-Limited Support to Catalyze Health Practice Change: The Case of GAVI's Injection Safety Support

    Science.gov (United States)

    Levin, Ann; Fang, Arnold; Hansen, Peter M.; Pyle, David; Dia, Ousmane; Schwalbe, Nina

    2010-01-01

    This paper presents the findings of a study to assess the effectiveness and sustainability of a GAVI (Global Alliance of Vaccines and Immunization) sponsored, time-limited Injection Safety (INS) support. The support came in two forms: 1) in-kind, in the form of AD syringes and safety boxes, and 2) in cash, for those countries that already had a secure, multi-year source of AD syringes and safety boxes, but proposed to use INS support to strengthen their injection safety activities. In total, GAVI gave INS support for a three-year period to 58 countries: 46 with commodities and 12 with cash support. To identify variables that might be associated with financial sustainability, frequencies and cross-tabulations were run against various programmatic and socio-economic variables in the 58 countries. All but two of the 46 commodity-recipient countries were able to replace and sustain the use of AD syringes and safety boxes after the end of their GAVI INS support despite the fact that standard disposable syringes are less costly than ADs (10–15 percent differential). In addition, all 12 cash-recipient countries continued to use AD syringes and safety boxes in their immunization programs in the years following GAVI INS assistance. At the same time, countries were often not prepared for the increased waste management requirements associated with the use of the syringes, suggesting the importance of anticipating challenges with the introduction of new technologies. The sustained use of AD syringes in countries receiving injection safety support from GAVI, in a majority of cases through government financing, following the completion of three years of time-limited support, represents an early indication of how GHPs can contribute to improved health outcomes in immunization safety in the world's poorest countries in a sustainable way. PMID:20885995

  1. COMPREHENSIVE ASSESSMENT OF COMPLEX TECHNOLOGIES: INTEGRATING VARIOUS ASPECTS IN HEALTH TECHNOLOGY ASSESSMENT.

    Science.gov (United States)

    Lysdahl, Kristin Bakke; Mozygemba, Kati; Burns, Jacob; Brönneke, Jan Benedikt; Chilcott, James B; Ward, Sue; Hofmann, Bjørn

    2017-08-07

    Despite recent development of health technology assessment (HTA) methods, there are still methodological gaps for the assessment of complex health technologies. The INTEGRATE-HTA guidance for effectiveness, economic, ethical, socio-cultural, and legal aspects, deals with challenges when assessing complex technologies, such as heterogeneous study designs, multiple stakeholder perspectives, and unpredictable outcomes. The objective of this article is to outline this guidance and describe the added value of integrating these assessment aspects. Different methods were used to develop the various parts of the guidance, but all draw on existing, published knowledge and were supported by stakeholder involvement. The guidance was modified after application in a case study and in response to feedback from internal and external reviewers. The guidance consists of five parts, addressing five core aspects of HTA, all presenting stepwise approaches based on the assessment of complexity, context, and stakeholder involvement. The guidance on effectiveness, health economics and ethics aspects focus on helping users choose appropriate, or further develop, existing methods. The recommendations are based on existing methods' applicability for dealing with problems arising with complex interventions. The guidance offers new frameworks to identify socio-cultural and legal issues, along with overviews of relevant methods and sources. The INTEGRATE-HTA guidance outlines a wide range of methods and facilitates appropriate choices among them. The guidance enables understanding of how complexity matters for HTA and brings together assessments from disciplines, such as epidemiology, economics, ethics, law, and social theory. This indicates relevance for a broad range of technologies.

  2. Inspiring health worker motivation with supportive supervision: a survey of lady health supervisor motivating factors in rural Pakistan.

    Science.gov (United States)

    Rabbani, Fauziah; Shipton, Leah; Aftab, Wafa; Sangrasi, Kashif; Perveen, Shagufta; Zahidie, Aysha

    2016-08-17

    Community health worker motivation is an important consideration for improving performance and addressing maternal, newborn, and child health in low and middle-income countries. Therefore, identifying health system interventions that address motivating factors in resource-strained settings is essential. This study is part of a larger implementation research project called Nigraan, which is intervening on supportive supervision in the Lady Health Worker Programme to improve community case management of pneumonia and diarrhea in rural Pakistan. This study explored the motivation of Lady Health Supervisors, a cadre of community health workers, with particular attention to their views on supportive supervision. Twenty-nine lady health supervisors enrolled in Nigraan completed open-ended structured surveys with questions exploring factors that affect their motivation. Thematic analysis was conducted using a conceptual framework categorizing motivating factors at individual, community, and health system levels. Supportive supervision, recognition, training, logistics, and salaries are community and health system motivating factors for lady health supervisors. Lady health supervisors are motivated by both their role in providing supportive supervision to lady health workers and by the supervisory support received from their coordinators and managers. Family support, autonomy, and altruism are individual level motivating factors. Health system factors, including supportive supervision, are crucial to improving lady health supervisor motivation. As health worker motivation influences their performance, evaluating the impact of health system interventions on community health worker motivation is important to improving the effectiveness of community health worker programs.

  3. Mobile technology for mental health assessment.

    Science.gov (United States)

    Areàn, Patricia A; Hoa Ly, Kien; Andersson, Gerhard

    2016-06-01

    Assessment and outcome monitoring are critical for the effective detection and treatment of mental illness. Traditional methods of capturing social, functional, and behavioral data are limited to the information that patients report back to their health care provider at selected points in time. As a result, these data are not accurate accounts of day-to-day functioning, as they are often influenced by biases in self-report. Mobile technology (mobile applications on smartphones, activity bracelets) has the potential to overcome such problems with traditional assessment and provide information about patient symptoms, behavior, and functioning in real time. Although the use of sensors and apps are widespread, several questions remain in the field regarding the reliability of off-the-shelf apps and sensors, use of these tools by consumers, and provider use of these data in clinical decision-making.

  4. Assessing the impact of workshops promoting concepts of psychosocial support for emergency events.

    Science.gov (United States)

    Johal, Sarb

    2012-09-17

    BACKGROUND Psychosocial support is a widely accepted term referring to activities designed to promote social and psychological recovery in disasters, and is a crucial concept in the organisation and management of preparedness, response and recovery systems. The New Zealand Ministry of Health recognised the importance of a common framework of understanding this concept, and commissioned a series of workshops to promote the understanding and implementation of psychosocial support concepts in disasters. METHODS Two hundred and eighty-eight people participated in 9 educational workshops across New Zealand - before the recent Canterbury earthquakes - designed to educate people about the key concepts and delivery models of psychosocial support during and after emergency events. Participants were also asked to note down three key ideas concerning what psychosocial support meant to them both before and after participating in the workshop. FINDINGS The level of satisfaction reported both for the workshop presentations (4.5 out of 5) and the resources provided (4.6 out of 5) suggested that participants were highly engaged with the presented material, and that this may be a useful training resource tool for education about psychosocial support in emergency events. Although the general concepts of support and recovery remained important both before and after the workshops, there was a shift to expressing attitudes acknowledging the importance of the management and organisation of psychosocial support activities. CONCLUSIONS Overall, the findings suggest that participants' attitudes about psychosocial support in disasters changed after attending the workshop, from a consideration of the experience of the individual in a disaster to more structured ideas about how supportive interventions might be organised and implemented. Although care should be taken to reinforce the core actions of psychosocial support for practitioners, the workshops seem to offer a promising approach for

  5. Assessing Social Support, Companionship, and Distress: NIH Toolbox Adult Social Relationship Scales

    Science.gov (United States)

    Cyranowski, Jill M.; Zill, Nicholas; Bode, Rita; Butt, Zeeshan; Kelly, Morgen A. R.; Pilkonis, Paul A.; Salsman, John M.; Cella, David

    2013-01-01

    Objective The quality of our daily social interactions – including perceptions of support, feelings of loneliness, and distress stemming from negative social exchanges – influence physical health and well-being. Despite the importance of social relationships, brief yet precise, unidimensional scales that assess key aspects of social relationship quality are lacking. As part of the NIH Toolbox for the Assessment of Neurological and Behavioral Function, we developed brief self-report scales designed to assess aspects of social support, companionship, and social distress across age cohorts. This report details the development and psychometric testing of the adult NIH Toolbox Social Relationship scales. Methods Social relationship concepts were selected, and item sets were developed and revised based on expert feedback and literature review. Items were then tested across a community-dwelling U.S. internet panel sample of adults aged 18 and above (N=692) using traditional (classic) psychometric methods and item response theory (IRT) approaches to identify items for inclusion in 5–8 item unidimensional scales. Finally, concurrent validity of the newly-developed scales was evaluated with respect to their inter-relationships with classic social relationship validation instruments. Results Results provide support for the internal reliability and concurrent validity of resulting self-report scales assessing Emotional Support, Instrumental Support, Friendship, Loneliness, Perceived Rejection, and Perceived Hostility. Conclusion These brief social relationship scales provide the pragmatic utility and enhanced precision needed to promote future epidemiological and social neuroscience research on the impact of social relationships on physical and emotional health outcomes. PMID:23437856

  6. Health Social Networks as Online Life Support Groups for Patients With Cardiovascular Diseases

    Energy Technology Data Exchange (ETDEWEB)

    Medina, Edhelmira Lima, E-mail: edhyly@ic.uff.br; Loques, Orlando Filho [Instituto de Computação - Universidade Federal Fluminense, Niterói, RJ (Brazil); Mesquita, Cláudio Tinoco [Hospital Universitário Antônio Pedro - Universidade Federal Fluminense, Niterói, RJ (Brazil)

    2013-08-15

    The number of patients who use the internet in search for information that might improve their health conditions has increased. Among them, those looking for virtual environments to share experiences, doubts, opinions, and emotions, and to foster relationships aimed at giving and getting support stand out. Therefore, there is an increasing need to assess how those environments can affect the patients' health. This study was aimed at identifying scientific studies on the proliferation and impact of virtual communities, known as health social networks or online support groups, directed to cardiovascular diseases, which might be useful to patients with certain conditions, providing them with information and emotional support. A systematic review of the literature was conducted with articles published from 2007 to 2012, related to cardiovascular diseases and collected from the following databases: PubMed; Association for Computing Machinery(ACM); and Institute of Electrical and Electronics Engineers (IEEE). Four articles meeting the inclusion criteria were selected. The results were interesting and relevant from the health viewpoint, identifying therapeutic benefits, such as provision of emotional support, greater compliance to treatment, and information sharing on diseases and on life experiences.

  7. Social support as moderator of the stress on unemployed people’s health

    Directory of Open Access Journals (Sweden)

    Leticia Rosaria Guarino

    2011-09-01

    Full Text Available The aim of this research was to assess moderating role of two indexes of social support in the relationship between the length of unemployment and the physical and mental health of Venezuelan unemployed. Self-report measures were administered to a sample of 328 unemployed residents in Caracas, Venezuela. Results indicated that perceived social support acted as moderator in predicting better general health and lower somatization in the unemployed, acting as buffer of longer periods of unemployment over these health indexes. On the other side, the fear of disclosure did not show moderator effects as expected, but showed direct effects over the majority health indexes, acting as a risk factor for the unemployed. These results support previous findings regarding the significance of perceived social support as a buffer factor in front of stressful experiences in different populations.At the same time, results showed the negative impact of the individual´s inability to reveal and express his/her emotions and distress, when under the experience of unemployment.

  8. Making electronic health records support quality management: A narrative review.

    Science.gov (United States)

    Triantafillou, Peter

    2017-08-01

    Since the 1990s many hospitals in the OECD countries have introduced electronic health record (EHR) systems. A number of studies have examined the factors impinging on EHR implementation. Others have studied the clinical efficacy of EHR. However, only few studies have explored the (intermediary) factors that make EHR systems conducive to quality management (QM). Undertake a narrative review of existing studies in order to identify and discuss the factors conducive to making EHR support three dimensions of QM: clinical outcomes, managerial monitoring and cost-effectiveness. A narrative review of Web of Science, Cochrane, EBSCO, ProQuest, Scopus and three Nordic research databases. most studies do not specify the type of EHR examined. 39 studies were identified for analysis. 10 factors were found to be conducive to make EHR support QM. However, the contribution of EHR to the three specific dimensions of QM varied substantially. Most studies (29) included clinical outcomes. However, only half of these reported EHR to have a positive impact. Almost all the studies (36) dealt with the ability of EHR to enhance managerial monitoring of clinical activities, the far majority of which showed a positive relationship. Finally, only five dealt with cost-effectiveness of which two found positive effects. The findings resonates well with previous reviews, though two factors making EHR support QM seem new, namely: political goals and strategies, and integration of guidelines for clinical conduct. Lacking EHR type specification and diversity in study method imply that there is a strong need for further research on the factors that may make EHR may support QM. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Assessing the effectiveness of policies to support renewable energy

    DEFF Research Database (Denmark)

    Close to 80% of the world’s energy supply could be generated through renewables by mid-century with the right enabling public policies. Policies can play a fundamental role in promoting a sustainable energy-mix and it is key to measure their effectiveness in the medium and long run. What...... is the most effective way to measure and monitor this effectiveness? What can we learn from Brazil, one of the first emerging countries to refocus its national energy strategies toward renewable energy? And from South Africa, which committed to develop 42% of additional capacity in renewable by 2030......? These are some of the questions addressed in the report commissioned by UNEP DTIE: Assessing the effectiveness of policies to support renewable energy. The report demonstrates the importance of monitoring policy effectiveness by using the Policy Effectiveness Indicator (PEI) approach.i While there is no one...

  10. Assessment 100% Supported by ICT: Possibilities Offered and Risks

    Directory of Open Access Journals (Sweden)

    Plinio del Carmen Teherán Sermeño

    2010-09-01

    Full Text Available After the launching of a Fundamentals of Physics course offered for different campuses of the National University of Colombia in blended learning mode, various experiences were collected in a virtual assessment that were supported 100% by ICT. We implemented an evaluation system that consists of different categories ranging from traditional examinations, partial examinations, final examinations, workshops, quizzes, attendance, and duties and forums, all evaluated online. In particular, random blocks of questions were used for examinations taken from large databases, built especially for this purpose, on the order of 100 per chapter. We comment on the results achieved with the implementation of the evaluation system proposed, in addition to the possibilities offered and the risks they present.

  11. Environmental assessment strategies in support of the Nonproliferation alternative systems assessment program (NASAP)

    Energy Technology Data Exchange (ETDEWEB)

    Emery, R.M.; Warner, M.L.; Meyer, H.R.; Little, C.A.; Till, J.E.

    1977-10-01

    The U.S. Department of Energy (DOE) is currently conducting a Nonproliferation Alternative Systems Assessment Program (NASAP) to identify nuclear fuel cycle options that pose inherently low risks of nuclear weapons proliferation while retaining the major benefits of nuclear energy. During FY 1978, the desirability and effectiveness of alternative nuclear fuel cycles will be examined in terms of the cycles' proliferation risk, technical feasibility, economic feasibility, and potential environmental and health effects. Final recommendations based on these several assessments may be made late in FY 1978. Carefully planned, highly efficient research strategies will be required to complete the necessary assessments within the anticipated time frame. The purpose of this report is to identify and evaluate alternative strategies for organizing the environmental and health (E and H) effects assessment. Following a brief review of the range of alternative nuclear fuel cycles under consideration, the report consists of three major sections. A discussion of what presently appear to be the most significant environmental and health issues associated with alternative fuel cycles is presented in Section 2. Major choice points in developing an effective assessment strategy, and the range of options available at each, are identified and evaluated in Section 3. Section 4 summarizes conclusions and recommends courses of action for proceeding with the detailed NASAP environmental assessment.

  12. Family Health Strategy: assessment and reasons for searching of health service by users

    Directory of Open Access Journals (Sweden)

    Loeste de Arruda-Barbosa

    2011-12-01

    Full Text Available Objective: To assess the evaluation of the users regarding the family health services and identify the main reasons that led them to seek such services. Methods: A descriptive study with qualitative approach, carried out in 5 Family Health Units with 25 users of theFamily Health Strategy (FHS of the city of Crato-CE, Brazil. The study took place from March to April 2009. Semi-structured interview was applied and recorded. We used thetechnique of thematic content analysis. Results: We found that the users of the FHS have great dissatisfaction, especially on the organization and access to health services, evaluating the family health as inefficient, although bringing care closer to the population, primarily through home visits. It was clear also that there is a search to the service mainly supported by curative vision and the acquisition of medicines. Conclusions: The subjects evaluate the organization and access to healthcare services as unsatisfactory, but value the actions, when there is a bond with the health team. However, there is still demand for health services, based on the search for medicines and medical consultation. Thus, it is necessary to improve services of the Family Health Strategy in Crato, with a view to ensure quality, accessibilityand greater resolution of health services.

  13. Disrupting the Pathways of Social Determinants of Health: Doula Support during Pregnancy and Childbirth.

    Science.gov (United States)

    Kozhimannil, Katy B; Vogelsang, Carrie A; Hardeman, Rachel R; Prasad, Shailendra

    2016-01-01

    The goal of this study was to assess perspectives of racially/ethnically diverse, low-income pregnant women on how doula services (nonmedical maternal support) may influence the outcomes of pregnancy and childbirth. We conducted 4 in-depth focus group discussions with low-income pregnant women. We used a selective coding scheme based on 5 themes (agency, personal security, connectedness, respect, and knowledge) identified in the Good Birth framework, and we analyzed salient themes in the context of the Gelberg-Anderson behavioral model and the social determinants of health. Participants identified the role doulas played in mitigating the effects of social determinants. The 5 themes of the Good Birth framework characterized the means by which nonmedical support from doulas influenced the pathways between social determinants of health and birth outcomes. By addressing health literacy and social support needs, pregnant women noted that doulas affect access to and the quality of health care services received during pregnancy and birth. Access to doula services for pregnant women who are at risk of poor birth outcomes may help to disrupt the pervasive influence of social determinants as predisposing factors for health during pregnancy and childbirth. © Copyright 2016 by the American Board of Family Medicine.

  14. Support for learning in the perspective of patient safety in primary health care

    Directory of Open Access Journals (Sweden)

    Thatianny Tanferri de Brito Paranaguá

    Full Text Available ABSTRACT Objective: to analyze the support for learning, in the perspective of patient safety, offered in the work environment, according to health professionals working in primary care. Method: a transversal study, held with 86 health professionals working in primary care. A validated instrument was used, applied via the Internet. Descriptive statistical analysis was undertaken with a presentation of median, mean, standard deviation and coefficient of variation. Results: points which are favorable to supporting learning were evidenced, such as mutual respect, autonomy for organizing the work and valorization of new ideas, which obtained means above 7.0. The variables which hinder the process of learning in the work environment, perceived by the professionals, were: resistance to changes, and excess of work impeding reflection on how to improve the work, with means above 6.0. Conclusion: the study found evidence of indicators related to the process of staff development in the area of health and indicates the influence of support for learning for the improvement of the work processes and of patient safety. It is necessary that a culture involving the systematic assessment of educational interventions in health should be established, the aim being to diagnose actions which are more incisive for changing health professionals' attitude and, therefore, clinical practice.

  15. Associations between supportive leadership and employees self-rated health in an occupational sample.

    Science.gov (United States)

    Schmidt, Burkhard; Loerbroks, Adrian; Herr, Raphael M; Wilson, Mark G; Jarczok, Marc N; Litaker, David; Mauss, Daniel; Bosch, Jos A; Fischer, Joachim E

    2014-01-01

    Protecting the health of the work force has become an important issue in public health research. This study aims to explore potential associations between supportive leadership style (SLS), an aspect of leadership behavior, and self-rated health (SRH) among employees. We drew on cross-sectional data from a cohort of industrial workers (n = 3,331), collected in 2009. We assessed employees' ratings of supportive, employee-oriented leadership behavior at their job, their SRH, and work stress as measured by the effort-reward model and scales measuring demands, control, and social support. Logistic regression estimated odds ratios (ORs) and corresponding 95 % confidence intervals (CIs) for the association between the perception of poor SLS and poor SRH controlling for work-related stress and other confounders. Sensitivity analyses stratified models by sex, age, and managerial position to test the robustness of associations. Perception of poor SLS was associated with poor SRH [OR 2.39 (95 % CI 1.95-2.92)]. Although attenuated following adjustment for measures of work-related stress and other confounders [OR 1.60 (95 % CI 1.26-2.04)], the magnitude, direction, and significance of this association remained robust in stratified models in most subgroups. SLS appears to be relevant to health in the workplace. Leadership behavior may represent a promising area for future research with potential for promoting better health in a large segment of the adult population.

  16. Impacts Assessment of Dynamic Speed Harmonization with Queue Warning : Task 3, Impacts Assessment Report. [supporting datasets

    Science.gov (United States)

    2015-05-31

    The datasets in the .pdf and .zip attached to this record are in support of Intelligent Transportation Systems Joint Program Office (ITS JPO) report FHWA-JPO-15-222, "Impacts Assessment of Dynamic Speed Harmonization with Queue Warning : Task 3, Impa...

  17. A joint urban planning and public health framework: contributions to health impact assessment.

    Science.gov (United States)

    Northridge, Mary E; Sclar, Elliott

    2003-01-01

    A joint urban planning and public health perspective is articulated here for use, in health impact assessment. Absent a blueprint for a coherent and supportive structure on which to test our thinking, we are bound to fall flat. Such a perspective is made necessary by the sheer number of people living in cities throughout the world, the need for explicit attention to land use and transportation systems as determinants of population health, and the dearth of useful indicators of the built environment for monitoring progress. If explicit attention is not paid to the overarching goals of equality and democracy, they have little if any chance of being realized in projects, programs, and policies that shape the built environment and therefore the public's health.

  18. A Joint Urban Planning and Public Health Framework: Contributions to Health Impact Assessment

    Science.gov (United States)

    Northridge, Mary E.; Sclar, Elliott

    2003-01-01

    A joint urban planning and public health perspective is articulated here for use, in health impact assessment. Absent a blueprint for a coherent and supportive structure on which to test our thinking, we are bound to fall flat. Such a perspective is made necessary by the sheer number of people living in cities throughout the world, the need for explicit attention to land use and transportation systems as determinants of population health, and the dearth of useful indicators of the built environment for monitoring progress. If explicit attention is not paid to the overarching goals of equality and democracy, they have little if any chance of being realized in projects, programs, and policies that shape the built environment and therefore the public’s health. PMID:12511400

  19. Dealing with Health and Health Care System Challenges in China: assessing health determinants and health care reforms

    NARCIS (Netherlands)

    H. Zhang (Hao)

    2017-01-01

    markdownabstractThis dissertation investigates the challenges faced by China around 2010 in two domains – population health and the health care system. Specifically, chapters 2 and 3 are devoted to health challenges, explaining the female health disadvantage in later life and assessing the effect

  20. Using rangeland health assessment to inform successional management

    Science.gov (United States)

    Rangeland health assessment provides qualitative information on ecosystem attributes. Successional management is a conceptual framework that allows managers to link information gathered in rangeland health assessment to ecological processes that need to be repaired to allow vegetation to change in ...

  1. Managing Air Quality - Human Health, Environmental and Economic Assessments

    Science.gov (United States)

    Human health and environmental assessments characterize health and environmental risks associated with exposure to pollution. Economic assessments evaluate the cost and economic impact of a policy or regulation & can estimate economic benefits.

  2. Developing public sociology through health impact assessment.

    Science.gov (United States)

    Elliott, Eva; Williams, Gareth

    2008-11-01

    The renewed interest in 'public sociology' has sparked debate and discussion about forms of sociological work and their relationship to the State and civil society. Medical sociologists are accustomed to engaging with a range of publics and audiences inside and outside universities and are in a position to make an informed contribution to this debate. This paper describes how some of the debates about sociological work are played out through a 'health impact assessment' of a proposed housing renewal in a former coal mining community. We explore the dynamics of the health impact assessment process and relate it to wider debates, current in the social sciences, on the 'new knowledge spaces' within which contentious public issues are now being discussed, and the nature of different forms of expertise. The role of the 'public sociologist' in mediating the relationships between the accounts and interpretations of lay participants and the published 'evidence' is described as a process of mutual learning between publics, professionals and social scientists. It is argued that the continued existence and development of any meaningful 'professional sociology' requires an openness to a 'public sociology' which recognises and responds to new spaces of knowledge production.

  3. Influence of perceived social support on health and socio-economic differences in social support in adolescents

    NARCIS (Netherlands)

    Gecková, A.; Pudelsky, M.; van Dijk, J.P.

    2001-01-01

    The influence of perceived social support on health and socio-economic differences in social support were investigated in sample of adolescents (n = 2616, including 1370 boys, mean age 15 years). The perceived social support was studied in five spheres: school, interpersonal relations, serious

  4. New trends in high-technology health care support services.

    Science.gov (United States)

    Blumberg, D F

    1998-01-01

    To understand clearly the economic dynamics of high-technology service and support in hospitals, the author used results of recent studies carried out by D. F. Blumberg & Associates, utilizing a variety of sources, to identify existing cost components of the typical 300- to 400-bed general hospital located in a major metropolitan area in the United States. The largest single functional component of cost is direct labor and benefits. Other major cost items include direct overhead administration and infrastructure costs and outside material equipment and supply purchases. This evaluation, based on extensive benchmarking comparison and market estimates, suggests that the issues of make, buy, or outsource are neither trivial nor easy to resolve in the health care field.

  5. Mentoring a health technology assessment initiative in Kazakhstan.

    Science.gov (United States)

    Muratov, Sergei; Hailey, David; Foerster, Vicki; Brady, Bruce; Juzwishin, Don; la Fleur, Philip; McGowan, Jessie

    2014-04-01

    The aim of this study was to assist in the development of a health technology assessment (HTA) program for the Ministry of Health (MOH) of the Republic of Kazakhstan Mentoring of an initial HTA program in Kazakhstan was provided by the Canadian Society for International Health (CSIH) by means of a partnership with the Kazakhstan MOH. HTA materials, courses, and one-on-one support for the preparation of a series of initial HTA reports by MOH HTA staff were provided by a seven-member CSIH team over a 2.5-year project. Guidance documents on HTA and institutional strengthening were prepared in response to an extensive set of deliverables developed by the MOH and the World Bank. Introductory and train-the-trainer workshops in HTA and economic evaluation were provided for MOH staff members, experts from Kazakhstan research institutes and physicians. Five short HTA reports were successfully developed by staff in the Ministry's HTA Unit with assistance from the CSIH team. Challenges that may be relevant to other emerging HTA programs included lack of familiarity with some essential underlying concepts, organization culture, and limited time for MOH staff to do HTA work. The project helped to define the need for HTA and mentored MOH staff in taking the first steps to establish a program to support health policy decision making in Kazakhstan. This experience offers practical lessons for other emerging HTA programs, although these should be tailored to the specific context.

  6. [Epidemiological study in mental health: health services use and perception of social support].

    Science.gov (United States)

    Muñoz-Rodríguez, Mariela; Basco, María E

    2016-04-01

    Objective The general aim of this non-probabilistic epidemiologic study is to detect the levels of mental health symptoms and social support for the residents of two neighborhoods in the General Belgrano district in Guaymallén, Mendoza Province, Argentina. Methods A random sample of 62 adults was selected, in which the proportionality of age and sex were conserved in each quota. Each person was interviewed in his/her house using the Cuestionario Epidemiológico de Sintomatología Mental [Epidemiological Questionnaire on Mental Health Symptoms] (CESIM) and the Cuestionario de Apoyo Social Comunitario Percibido [Questionnaire on Perceived Community Social Support]. In addition, participants were asked about sociodemographic factors, self-rated mental health symptoms andv visits to services specializing in this area. Results The results show that unemployment, a low educational level and a marital status of separation or divorce were related to high symptoms in the mental health area. In groups with high symptoms, few visits to health services were identified. Conclusions No relationship was found between the social support indicators and the level of symptoms.

  7. Moving on: How depressive symptoms, social support, and health behaviors predict residential mobility.

    Science.gov (United States)

    Airaksinen, Jaakko; Hakulinen, Christian; Elovainio, Marko; Pulkki-Råback, Laura; Lehtimäki, Terho; Raitakari, Olli T; Keltikangas-Järvinen, Liisa; Jokela, Markus

    2016-06-01

    There are major health inequalities between residential areas. However, it remains unclear whether these inequalities are due to social causation or selective residential mobility, because little is known about the associations between health-related factors and selective residential mobility. This study examined how depressive symptoms, social support, and health behaviors are associated with subsequent residential mobility, as measured by frequency, distance, and direction of moves. Participants were selected from the Young Finns prospective cohort study (N = 3017) with four study waves in 1992, 1997, 2001, and 2007. Complete residential mobility history was gathered for each participant from registry data. Residential mobility was assessed over three-year periods following each study wave. The direction of mobility was measured as changes in residential location's population density, health index, mortality index, and unemployment. Area characteristics were used as covariates together with the participants' age, sex, and education. Individuals reporting higher social support from friends were more likely to move (b = 0.20; 95% confidence interval (CI): 0.08, 0.37) and move more frequently (b = 0.08; 95% CI: 0.01, 0.14), whereas individuals reporting higher social support from their family members were less likely to move (b = -0.08; 95% CI: -0.14, -0.02). Better health behaviors were associated with longer moving distances (b = 0.14; 95% CI: 0.06, -0.23). None of the individual characteristics were associated with the direction of moves as measured by changes in municipality characteristics. CONCLUSIONS SOME OF THE HEALTH-RELATED CHARACTERISTICS ARE ASSOCIATED WITH RESIDENTIAL MOBILITY IN FINLAND HOWEVER, THESE INDIVIDUAL CHARACTERISTICS DO NOT SEEM TO PREDICT SYSTEMATIC SELECTIVE RESIDENTIAL MOBILITY ACROSS MUNICIPALITIES WITH DIFFERENT REGIONAL HEALTH PROFILES. © 2015 the Nordic Societies of Public Health.

  8. A critical review of population health literacy assessment.

    Science.gov (United States)

    Guzys, Diana; Kenny, Amanda; Dickson-Swift, Virginia; Threlkeld, Guinever

    2015-03-04

    Defining health literacy from a public health perspective places greater emphasis on the knowledge and skills required to prevent disease and for promoting health in everyday life. Addressing health literacy at the community level provides great potential for improving health knowledge, skills and behaviours resulting in better health outcomes. Yet there is a notable absence of discussion in the literature of what a health literate population looks like, or how this is best assessed. The emphasis in assessing health literacy has predominantly focused on the functional health literacy of individuals in clinical settings. This review examines currently available health literacy assessment tools to identify how well suited they are in addressing health literacy beyond clinical care settings and beyond the individual. Although public health literature appears to place greater emphasis on conceptualizing critical health literacy, the focus continues to remain on assessing individuals, rather than on health literacy within the context of families, communities and population groups. When a population approach is adopted, an aggregate of individual health literacy assessment is generally used. Aggregation of individual health literacy fails to capture the dynamic and often synergistic relationships within communities, and fails to reflect societal influences on health knowledge, beliefs and behaviours. We hypothesise that a different assessment framework is required to adequately address the complexities of community health literacy. We assert that a public health approach, founded on health promotion theories provides a useful scaffold to assess the critical health literacy of population groups. It is proposed that inclusion of community members in the research process is a necessary requirement to coproduce such an appropriate assessment framework. We contend that health literacy assessment and potential interventions need to shift to promoting the knowledge and skills

  9. Assessing Psychological Health: The Contribution of Psychological Strengths

    Science.gov (United States)

    Macaskill, Ann; Denovan, Andrew

    2014-01-01

    Balanced assessment of mental health involves assessing well-being and strengths as well as psychopathology. The character strengths of curiosity, gratitude, hope, optimism and forgiveness are assessed in 214 new undergraduates and their relationships to mental health, subjective well-being and self-esteem explored. Scoring the mental health scale…

  10. 75 FR 82382 - Beaches Environmental Assessment and Coastal Health Act

    Science.gov (United States)

    2010-12-30

    ... AGENCY Beaches Environmental Assessment and Coastal Health Act AGENCY: Environmental Protection Agency... Water Act (CWA) as amended by the Beaches Environmental Assessment and Coastal Health (BEACH) Act... Environmental Assessment and Coastal Health (BEACH) Act of 2000 amends the Clean Water Act to better protect...

  11. 75 FR 70009 - Development of Health Risk Assessment Guidance

    Science.gov (United States)

    2010-11-16

    ... HUMAN SERVICES Centers for Disease Control and Prevention Development of Health Risk Assessment Guidance... guidance concerning Health Risk Assessment (HRAs). Section 4103 of the Affordable Care Act (ACA) (Pub. L. 111-148) requires that a health risk assessment be included in the annual wellness visit benefit...

  12. 75 FR 1373 - Beaches Environmental Assessment and Coastal Health Act

    Science.gov (United States)

    2010-01-11

    ... AGENCY Beaches Environmental Assessment and Coastal Health Act AGENCY: Environmental Protection Agency... Water Act (CWA) as amended by the Beaches Environmental Assessment and Coastal Health (BEACH) Act... Environmental Assessment and Coastal Health (BEACH) Act of 2000 amends the Clean Water Act to better protect...

  13. [Use of spreadsheets as decision support systems in health care].

    Science.gov (United States)

    Sabanović, Z; Masic, I

    1995-01-01

    During the last decade the spreadsheets take very important place in many different kind of theoretical and practical applications. In recent years the PC-Windows Operating System allowed us to use and develop many sorts of specialised software packages, as well as expert packages, applicable in medicine. The relationship or communication between man and computer has been improved using new hardware configuration based on fast and intelligent processors, software modification and audio-visual technology. The facts mentioned above have instantly produced circumstances for more powerful spreadsheet software. According to powerful spreadsheet features we can utilise calculation and maximise HIGM requirement for our software configuration. The investigation within large area of Tuzla-Podrinje Kanton shows us that small number of people are using spreadsheet in medical application. Very small percentage of people have limited number of applications on calculation like, subtraction, addition, multiplication, division and percentage. They have often used spreadsheet as an integral part of the following software packages, EXCEL ver. 5.0 and very little Lotus 1-2-3 because Lotus is in these days behind. The aim of this paper is to highlight application of the spreadsheet USING EXCEL software package. Apart from simple calculation and graphic presentation in "DSS-Decision making support system" can be used for model simulation, generator configuration, management monitoring, support and decision making in health care.

  14. Community Health Worker Support for Disadvantaged Patients With Multiple Chronic Diseases: A Randomized Clinical Trial.

    Science.gov (United States)

    Kangovi, Shreya; Mitra, Nandita; Grande, David; Huo, Hairong; Smith, Robyn A; Long, Judith A

    2017-10-01

    To determine whether a community health worker (CHW) intervention improved outcomes in a low-income population with multiple chronic conditions. We conducted a single-blind, randomized clinical trial in Philadelphia, Pennsylvania (2013-2014). Participants (n = 302) were high-poverty neighborhood residents, uninsured or publicly insured, and diagnosed with 2 or more chronic diseases (diabetes, obesity, tobacco dependence, hypertension). All patients set a disease-management goal. Patients randomly assigned to CHWs also received 6 months of support tailored to their goals and preferences. Support from CHWs (vs goal-setting alone) led to improvements in several chronic diseases (changes in glycosylated hemoglobin: -0.4 vs 0.0; body mass index: -0.3 vs -0.1; cigarettes per day: -5.5 vs -1.3; systolic blood pressure: -1.8 vs -11.2; overall P = .08), self-rated mental health (12-item Short Form survey; 2.3 vs -0.2; P = .008), and quality of care (Consumer Assessment of Healthcare Providers and Systems; 62.9% vs 38%; P < .001), while reducing hospitalization at 1 year by 28% (P = .11). There were no differences in patient activation or self-rated physical health. A standardized CHW intervention improved chronic disease control, mental health, quality of care, and hospitalizations and could be a useful population health management tool for health care systems. clinicaltrials.gov identifier: NCT01900470.

  15. Creating and supporting a mixed methods health services research team.

    Science.gov (United States)

    Bowers, Barbara; Cohen, Lauren W; Elliot, Amy E; Grabowski, David C; Fishman, Nancy W; Sharkey, Siobhan S; Zimmerman, Sheryl; Horn, Susan D; Kemper, Peter

    2013-12-01

    To use the experience from a health services research evaluation to provide guidance in team development for mixed methods research. The Research Initiative Valuing Eldercare (THRIVE) team was organized by the Robert Wood Johnson Foundation to evaluate The Green House nursing home culture change program. This article describes the development of the research team and provides insights into how funders might engage with mixed methods research teams to maximize the value of the team. Like many mixed methods collaborations, the THRIVE team consisted of researchers from diverse disciplines, embracing diverse methodologies, and operating under a framework of nonhierarchical, shared leadership that required new collaborations, engagement, and commitment in the context of finite resources. Strategies to overcome these potential obstacles and achieve success included implementation of a Coordinating Center, dedicated time for planning and collaborating across researchers and methodologies, funded support for in-person meetings, and creative optimization of resources. Challenges are inevitably present in the formation and operation of effective mixed methods research teams. However, funders and research teams can implement strategies to promote success. © Health Research and Educational Trust.

  16. Assessment of implementation of the health management ...

    African Journals Online (AJOL)

    management information system at the district level ... Despite Malawi's introduction of a health management information system (HMIS) in 1999, the country's health sector still lacks accurate, reliable .... CHIP = Committee for Health Information Policy; HIMTC = Health Information Management Technical Committee; DHO =.

  17. The Second Victim Experience and Support Tool: Validation of an Organizational Resource for Assessing Second Victim Effects and the Quality of Support Resources.

    Science.gov (United States)

    Burlison, Jonathan D; Scott, Susan D; Browne, Emily K; Thompson, Sierra G; Hoffman, James M

    2017-06-01

    Medical errors and unanticipated negative patient outcomes can damage the well-being of health care providers. These affected individuals, referred to as "second victims," can experience various psychological and physical symptoms. Support resources provided by health care organizations to prevent and reduce second victim-related harm are often inadequate. In this study, we present the development and psychometric evaluation of the Second Victim Experience and Support Tool (SVEST), a survey instrument that can assist health care organizations to implement and track the performance of second victim support resources. The SVEST (29 items representing 7 dimensions and 2 outcome variables) was completed by 303 health care providers involved in direct patient care. The survey collected responses on second victim-related psychological and physical symptoms and the quality of support resources. Desirability of possible support resources was also measured. The SVEST was assessed for content validity, internal consistency, and construct validity with confirmatory factor analysis. Confirmatory factor analysis results suggested good model fit for the survey. Cronbach α reliability scores for the survey dimensions ranged from 0.61 to 0.89. The most desired second victim support option was "A respected peer to discuss the details of what happened." The SVEST can be used by health care organizations to evaluate second victim experiences of their staff and the quality of existing support resources. It can also provide health care organization leaders with information on second victim-related support resources most preferred by their staff. The SVEST can be administered before and after implementing new second victim resources to measure perceptions of effectiveness.

  18. Hospital Adoption of Health Information Technology to Support Public Health Infrastructure.

    Science.gov (United States)

    Walker, Daniel M; Diana, Mark L

    2016-01-01

    Health information technology (IT) has the potential to improve the nation's public health infrastructure. In support of this belief, meaningful use incentives include criteria for hospitals to electronically report to immunization registries, as well as to public health agencies for reportable laboratory results and syndromic surveillance. Electronic reporting can facilitate faster and more appropriate public health response. However, it remains unclear the extent that hospitals have adopted IT for public health efforts. To examine hospital adoption of IT for public health and to compare hospitals capable of using and not using public health IT. Cross-sectional design with data from the 2012 American Hospital Association annual survey matched with data from the 2013 American Hospital Association Information Technology Supplement. Multivariate logistic regression was used to compare hospital characteristics. Inverse probability weights were applied to adjust for selection bias because of survey nonresponse. All acute care general hospitals in the United States that matched across the surveys and had complete data available were included in the analytic sample. Three separate outcome measures were used: whether the hospital could electronically report to immunization registries, whether the hospital could send electronic laboratory results, and whether the hospital can participate in syndromic surveillance. A total of 2841 hospitals met the inclusion criteria. Weighted results show that of these hospitals, 62.7% can electronically submit to immunization registries, 56.6% can electronically report laboratory results, and 54.4% can electronically report syndromic surveillance. Adjusted and weighted results from the multivariate analyses show that small, rural hospitals and hospitals without electronic health record systems lag in the adoption of public health IT capabilities. While a majority of hospitals are using public health IT, the infrastructure still has

  19. Adolescent views on comprehensive health risk assessment and counseling: assessing gender differences.

    Science.gov (United States)

    Kadivar, Hajar; Thompson, Lindsay; Wegman, Martin; Chisholm, TaJuana; Khan, Maryum; Eddleton, Katie; Muszynski, Michael; Shenkman, Elizabeth

    2014-07-01

    Adolescence is an important time for the detection of health risk behaviors and factors with subsequent counseling and intervention. Limited research has examined adolescent perceptions of comprehensive health risk assessments (HRAs) and counseling with an assessment of gender differences. Participants were identified using Florida's Medicaid and State Children's Health Insurance Program databases. A total of 35 low-income, racially/ethnically diverse adolescents (ages 14-18 years) participated in eight focus groups stratified by gender. Adolescents completed an internet-based, tablet-administered, comprehensive HRA and then participated in a semi-structured interview. Discussions were recorded, transcribed, and analyzed using a multi-step, team-based approach applying grounded theory to determine major themes. Male adolescents desired less parental involvement, had less understanding of the protections of clinical confidentiality and the need for comprehensive HRA, and placed greater emphasis on the importance of professional appearance. In contrast, more females valued face-to-face interactions and stressed the importance of concern from the health risk assessor. Overall, adolescents placed importance on their relationship with the health risk assessor, and on valuing trust, confidentiality, and nonjudgmental care. Adolescents preferred to complete HRAs in clinical, private, and professional settings, and reported that tablet technology supported their confidentially in completing the HRA. Furthermore, they stressed the importance of autonomy and learning about the health risk outcomes for risk reduction. Gender differences exist in adolescent perceptions of comprehensive HRAs. Adolescent perceptions of HRAs support their use in confidential primary care settings using modalities that emphasize nonjudgmental, private care, and the use of communication techniques that respect adolescents' autonomy to change health risks. Copyright © 2014. Published by Elsevier

  20. Health system support for childbirth care in Southern Tanzania: results from a health facility census.

    Science.gov (United States)

    Hanson, Claudia; Ronsmans, Carine; Penfold, Suzanne; Maokola, Werner; Manzi, Fatuma; Jaribu, Jenny; Mbaruku, Godfrey; Mshinda, Hassan; Tanner, Marcel; Schellenberg, Joanna

    2013-10-30

    Progress towards reaching Millennium Development Goals four (child health) and five (maternal health) is lagging behind, particularly in sub-Saharan Africa, despite increasing efforts to scale up high impact interventions. Increasing the proportion of birth attended by a skilled attendant is a main indicator of progress, but not much is known about the quality of childbirth care delivered by these skilled attendants. With a view to reducing maternal mortality through health systems improvement we describe the care routinely offered in childbirth at dispensaries, health centres and hospitals in five districts in rural Southern Tanzania. We use data from a health facility census assessing 159 facilities in five districts in early 2009. A structural and operational assessment was undertaken based on staff reports using a modular questionnaire assessing staffing, work load, equipment and supplies as well as interventions routinely implemented during childbirth. Health centres and dispensaries attended a median of eight and four deliveries every month respectively. Dispensaries had a median of 2.5 (IQR 2-3) health workers including auxiliary staff instead of the recommended four clinical officer and certified nurses. Only 28% of first-line facilities (dispensaries and health centres) reported offering active management in the third stage of labour (AMTSL). Essential childbirth care comprising eight interventions including AMTSL, infection prevention, partograph use including foetal monitoring and newborn care including early breastfeeding, thermal care at birth and prevention of ophthalmia neonatorum was offered by 5% of dispensaries, 38% of health centres and 50% of hospitals consistently. No first-line facility had provided all signal functions for emergency obstetric complications in the previous six months. Essential interventions for childbirth care are not routinely implemented in first-line facilities or hospitals. Dispensaries have both low staffing and low

  1. The Tennessee Department of Health WORKshops on Use of Secondary Data for Community Health Assessment, 2012

    OpenAIRE

    Behringer, Bruce A.; Omohundro, Ellen; Boswell, Derrick; Evans, Dwayne; Ferranti, Lori B.

    2014-01-01

    Community health assessment is a core function of public health departments, a standard for accreditation of public health departments, and a core competency for public health professionals. The Tennessee Department of Health developed a statewide initiative to improve the processes for engaging county health departments in assessing their community’s health status through the collection and analysis of secondary data. One aim of the Tennessee Department of Health was to position county publi...

  2. Changing roles in community health care: Delegation of insulin injections to health care support workers.

    Science.gov (United States)

    Dutton, Julie; McCaskill, Kelly; Alton, Sarah; Levesley, Maria; Hemingway, Cath; Farndon, Lisa

    2018-01-02

    Diabetes is a common long-term condition affecting many people many of whom require support with their insulin injections at home. These injections are often carried out by community nurses if individuals are unable to self-manage their condition. This paper describes a pilot project where health care support workers were trained to administer insulin at home for suitable patients. Four patients took part in the pilot study and two support workers were trained to give the insulin injections. The project was evaluated well by all those who took part. It freed up 80 hours of nursing time while also providing the support workers with an extended scope of practice and associated increased in job satisfaction. No untoward medication errors were reported as a result of this initiative. This project will now be rolled out to the wider nursing teams with a staggered approach to the delivery of the training to ensure there is not a detrimental effect on patient care.

  3. A Study to Develop a Decision Support Model for the Assessment of Needs and Prioritization of Recruitment/Selection Activities Under the Military- Civilian Health Services Partnership Program at Bayne-Jones Army Community Hospital

    Science.gov (United States)

    1989-07-01

    at least one beneficiary category m received a direct financial benefit through use of the Joint HealthM 0 C Benefits Delivery Program. Dependents of...Lester C. "Medicine versus Economics." The New England Journal of Medicine." 1985. 313(10)s 611-14. U.S. Department of Defense. Department of Defense...professional and scientific journals . 6. It is understood that no care rendered pursuant to this agreement will be a part of a study, research grant, or other

  4. Family violence exposure and health outcomes among older African American women: do spirituality and social support play protective roles?

    Science.gov (United States)

    Paranjape, Anuradha; Kaslow, Nadine

    2010-10-01

    Family violence (FV), spirituality, and social support are salient psychosocial determinants of health. FV is associated with poor health among older African American women. The effect of spirituality and social support levels on the health of older African American women is unknown. To assess the role of spirituality and social support as culturally relevant determinants of health status for older African American women independent of FV levels, we used a cross-sectional observational study. Two hundred twelve African American women, aged ≥ 50, were interviewed in two urban primary care practices. The measures used were (1) Family Violence Against Older Women (FVOW) scale, (2) Physical and Mental Composite Scores of the Short-Form 8® scale, (3) Medical Outcomes of Social Support survey (MOSS), and (4) Spiritual Well-Being Scale (SWBS). Spearman correlation coefficients estimated to test associations among lifetime FV exposure, spirituality, social support, and health status outcomes and multivariate regression models were used to examine the independent effect of spirituality and social support on physical and mental health status, controlling for FV and significant demographic variables. Mean participant age was 63.9 years. Higher spirituality levels were significantly associated with better physical health status after adjusting for FV levels and demographic factors (F = 6.17, p = 0.0001). Similarly, higher levels of spirituality and social support both significantly correlated with better mental health status in the multivariate model (F = 13.45, p Spirituality and social support are two potentially modifiable determinants of health for older African American women. Culturally appropriate mechanisms to enhance social support and spirituality levels need to be explored as potential inteventions to improve the health of those African American women who have been exposed to FV.

  5. Does social support modify the effect of disability acquisition on mental health? A longitudinal study of Australian adults.

    Science.gov (United States)

    Aitken, Zoe; Krnjacki, Lauren; Kavanagh, Anne Marie; LaMontagne, Anthony Daniel; Milner, Allison

    2017-10-01

    Disability acquisition in adulthood is associated with deterioration in mental health. Social support may act as a "buffer" against poor mental health following disability acquisition. We tested the hypothesis that women and men with low social support experienced larger declines in mental health on acquisition of a disability compared to women and men with high social support. We assessed whether social support, measured both prior and subsequent to disability acquisition, modified the association between disability acquisition and mental health using 14 annual waves of data from the Household, Income and Labour Dynamics in Australia Survey. Participants reported at least two consecutive waves of disability preceded by at least two consecutive waves without disability (2200 participants, 15,724 observations). Fixed-effects linear regression models were used to estimate average differences in mental health between waves with and without disability, for women and men separately. We tested for effect measure modification of the association by social support, including a three-way interaction between disability and social support prior and subsequent to disability acquisition. Though the effects of disability acquisition on mental health were much larger for women, for both women and men there was a consistent pattern of association with social support. There was evidence that social support modified the association between disability acquisition and mental health, with the largest effects for those experiencing a change from high to low social support subsequent to disability and for people with consistently low social support. These findings highlight the importance of developing new policy and practice strategies to improve the mental health of people with disabilities, including interventions to promote social support at the time of disability acquisition.

  6. Development and validation of an instrument to assess perceived social influence on health behaviors.

    Science.gov (United States)

    Holt, Cheryl L; Clark, Eddie M; Roth, David L; Crowther, Martha; Kohler, Connie; Fouad, Mona; Foushee, Rusty; Lee, Patricia A; Southward, Penny L

    2010-11-01

    Assessment of social influence on health behavior is often approached through a situational context. The current study adapted an existing, theory-based instrument from another content domain to assess Perceived Social Influence on Health Behavior (PSI-HB) among African Americans, using an individual difference approach. The adapted instrument was found to have high internal reliability (α = .81-.84) and acceptable test-retest reliability (r = .68-.85). A measurement model revealed a three-factor structure and supported the theoretical underpinnings. Scores were predictive of health behaviors, particularly among women. Future research using the new instrument may have applied value assessing social influence in the context of health interventions.

  7. Development and validation of an instrument to assess perceived social influence on health behaviors

    Science.gov (United States)

    HOLT, CHERYL L.; CLARK, EDDIE M.; ROTH, DAVID L.; CROWTHER, MARTHA; KOHLER, CONNIE; FOUAD, MONA; FOUSHEE, RUSTY; LEE, PATRICIA A.; SOUTHWARD, PENNY L.

    2012-01-01

    Assessment of social influence on health behavior is often approached through a situational context. The current study adapted an existing, theory-based instrument from another content domain to assess Perceived Social Influence on Health Behavior (PSI-HB) among African Americans, using an individual difference approach. The adapted instrument was found to have high internal reliability (α = .81–.84) and acceptable testretest reliability (r = .68–.85). A measurement model revealed a three-factor structure and supported the theoretical underpinnings. Scores were predictive of health behaviors, particularly among women. Future research using the new instrument may have applied value assessing social influence in the context of health interventions. PMID:20522506

  8. Life after Genocide: Mental Health, Education, and Social Support of Orphaned Survivors.

    Science.gov (United States)

    Ng, Lauren C; Ahishakiye, Naphtal; Miller, Donald E; Meyerowitz, Beth E

    Thousands of orphaned survivors of the 1994 Rwandan Genocide against the Tutsi were not only exposed to extraordinarily severe forms of violence, but also many of these children took on the responsibility of caring and providing for other child survivors. This study describes the poverty, educational attainment, social support and mental health of orphaned heads of household (OHH) fourteen years after the genocide, and analyzes how violence exposure during the genocide and post-genocide stressors contributed to symptoms of posttraumatic stress disorder (PTSD) and distress. Participants were 61 members of an OHH community organization who were interviewed in 2002 about their genocide experiences and who provided a follow-up assessment of post-genocide risk factors and PTSD and distress symptoms in 2008. Almost all of the OHH in this study reported low social support, high levels of poverty, and high rates of PTSD and distress symptoms. Lower educational attainment predicted PTSD symptoms and partially mediated the association between exposure to genocide violence and PTSD. Distress was predicted by lack of social support and witnessing family members harmed during the genocide. Results suggest that public health and community efforts to improve educational outcomes and to strengthen and expand social support networks may improve mental health outcomes of OHH.

  9. Stress, social support and health-related behavior: a study of smoking, alcohol consumption and physical exercise.

    Science.gov (United States)

    Steptoe, A; Wardle, J; Pollard, T M; Canaan, L; Davies, G J

    1996-08-01

    The effects of academic examination stress on health behavior was assessed in university students. It was hypothesized that the anticipation of examinations would lead to increases in cigarette smoking and alcohol consumption, and to decreases in physical activity, and that effects would be particularly salient in students with low social supports. One hundred eighty students were divided into exam-stress (51 women, 64 men) and control (49 women, 16 men) groups, and were assessed at baseline and then within 2 weeks of exams, or an equivalent point for the control group. Perceived stress, emotional well-being and health behaviors were assessed by questionnaire and interview. The exam-stress group reported significant increases in perceived stress and emotional distress between baseline and exam sessions, but responses were not affected by social support availability. The controls showed no systematic changes in health behaviors. In the exam-stress group, smoking increased by an average of 54.7% between sessions in women with few social supports, but remained stable in men. There was a decrease in alcohol consumption of 17.5% in students with high social support between sessions, while those with low social supports showed an average increase of 18.5%. Physical activity decreased between baseline and exam sessions in the exam-stress group, but was not affected by social support. The results are discussed in relation to the effects of naturally occurring episodic stress on health behaviors, and the role of social support in moderating responses.

  10. Assessing clinical competency in the health sciences

    Science.gov (United States)

    Panzarella, Karen Joanne

    To test the success of integrated curricula in schools of health sciences, meaningful measurements of student performance are required to assess clinical competency. This research project analyzed a new performance assessment tool, the Integrated Standardized Patient Examination (ISPE), for assessing clinical competency: specifically, to assess Doctor of Physical Therapy (DPT) students' clinical competence as the ability to integrate basic science knowledge with clinical communication skills. Thirty-four DPT students performed two ISPE cases, one of a patient who sustained a stroke and the other a patient with a herniated lumbar disc. Cases were portrayed by standardized patients (SPs) in a simulated clinical setting. Each case was scored by an expert evaluator in the exam room and then by one investigator and the students themselves via videotape. The SPs scored each student on an overall encounter rubric. Written feedback was obtained from all participants in the study. Acceptable reliability was demonstrated via inter-rater agreement as well as inter-rater correlations on items that used a dichotomous scale, whereas the items requiring the use of the 4-point rubric were somewhat less reliable. For the entire scale both cases had a significant correlation between the Expert-Investigator pair of raters, for the CVA case r = .547, p < .05 and for the HD case r = .700, p < .01. The SPs scored students higher than the other raters. Students' self-assessments were most closely aligned with the investigator. Effects were apparent due to case. Content validity was gathered in the process of developing cases and patient scenarios that were used in this study. Construct validity was obtained from the survey results analyzed from the experts and students. Future studies should examine the effect of rater training upon the reliability. Criterion or predictive validity could be further studied by comparing students' performances on the ISPE with other independent estimates

  11. Exploring Health Impact Assessment in Europe

    Directory of Open Access Journals (Sweden)

    Matthias Wismar

    2007-09-01

    Full Text Available

    Background: Health impact assessment (HIA prospectively judges the potential health impacts of pending decisions and feeds the assessment back into the decision making process. HIA is considered as a key tool for intersectoral collaboration. This article presents selected results of a mapping exercise on HIA in Europe. The mapping exercise is complemented by the presentation of a conceptual framework on the effectiveness of HIA and illustrative examples.

    Method: Two methodologies are employed in this article: First, the use of HIA across Europe is based on a survey conducted by 21 teams in 19 countries. A semi standardized questionnaire was employed, using a wide variety of sources. Second, for the discussion on the effectiveness of HIA, a conceptual framework using four types of effectiveness was employed. Results: HIA is a common practice only in a handful of European countries. In most of Europe, HIA is at an early developmental stage. The mapping exercise, however, provides evidence that HIA can work across all sectors and at all political level, although there is currently a focus on the local level. HIA is conducted in different countries by different sets of actors and organizations, reflecting the existing setup. The evidence on the effectiveness of HIA is still inconclusive. However, single case studies and upcoming evidence suggests that HIA has the capacity to inform and influence the decision making process.

    Conclusions: HIA can work and deliver. The variations in context across European countries have resulted in different forms of implementation and different dynamics of developing HIA.

  12. Trial of an electronic decision support system to facilitate shared decision making in community mental health.

    Science.gov (United States)

    Woltmann, Emily M; Wilkniss, Sandra M; Teachout, Alexandra; McHugo, Gregory J; Drake, Robert E

    2011-01-01

    Involvement of community mental health consumers in mental health decision making has been consistently associated with improvements in health outcomes. Electronic decision support systems (EDSSs) that support both consumer and provider decision making may be a sustainable way to improve dyadic communication in a field with approximately 50% workforce turnover per year. This study examined the feasibility of such a system and investigated proximal outcomes of the system's performance. A cluster randomized design was used to evaluate an EDSS at three urban community mental health sites. Case managers (N=20) were randomly assigned to the EDSS-supported planning group or to the usual care planning group. Consumers (N=80) were assigned to the same group as their case managers. User satisfaction with the care planning process was assessed for consumers and case managers (possible scores range from 1 to 5, with higher summary scores indicating more satisfaction). Recall of the care plan was assessed for consumers. Linear regression with adjustment for grouping by worker was used to assess satisfaction scores. A Wilcoxon rank-sum test was used to examine knowledge of the care plan. Compared with case managers in the control group, those in the intervention group were significantly more satisfied with the care planning process (mean ± SD score=4.0 ± .5 versus 3.3 ± .5; adjusted p=.01). Compared with consumers in the control group, those in the intervention group had significantly greater recall of their care plans three days after the planning session (mean proportion of plan goals recalled=75% ± 28% versus 57% ± 32%; p=.02). There were no differences between the clients in the intervention and control groups regarding satisfaction. This study demonstrated that clients can build their own care plans and negotiate and revise them with their case managers using an EDSS.

  13. Environmental assessment in health care organizations.

    Science.gov (United States)

    Romero, Isabel; Carnero, María Carmen

    2017-12-22

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

  14. Assessing the Mediating Role of Social Support in Childhood Maltreatment and Psychopathology Among College Students in Northern Ireland.

    Science.gov (United States)

    Lagdon, Susan; Ross, Jana; Robinson, Martin; Contractor, Ateka A; Charak, Ruby; Armour, Cherie

    2018-02-01

    The detrimental impact of early trauma, particularly childhood maltreatment, on mental health is well documented. Although it is understood that social support can act as a protective factor toward mental health for children who experience such adversity, few studies have addressed the experience of childhood maltreatment and the important function of social support in adulthood. The current study aimed to assess the mediating role of social support in the relationship between childhood experiences of maltreatment and mental health outcomes including anxiety, depression, posttraumatic stress disorder (PTSD), and problematic alcohol use in a sample of university students ( N = 640) from Northern Ireland. Results of binary logistic regression analyses indicated that those reporting experiences of childhood maltreatment were at increased odds of mental health outcomes of PTSD, anxiety, and depression, but not alcohol use. Those reporting greater social support were significantly less likely to report on these mental health outcomes. In addition, the indirect paths from childhood maltreatment through social support to PTSD, depression, and anxiety were all significant, suggesting that social support, particularly family support, is a significant mediator of these relationships. Such findings have important implications for the social care response to children experiencing maltreatment and future support for such children as they transition to adolescence and adulthood.

  15. Supporting analysis and assessments quality metrics: Utility market sector

    Energy Technology Data Exchange (ETDEWEB)

    Ohi, J. [National Renewable Energy Lab., Golden, CO (United States)

    1996-10-01

    In FY96, NREL was asked to coordinate all analysis tasks so that in FY97 these tasks will be part of an integrated analysis agenda that will begin to define a 5-15 year R&D roadmap and portfolio for the DOE Hydrogen Program. The purpose of the Supporting Analysis and Assessments task at NREL is to provide this coordination and conduct specific analysis tasks. One of these tasks is to prepare the Quality Metrics (QM) for the Program as part of the overall QM effort at DOE/EERE. The Hydrogen Program one of 39 program planning units conducting QM, a process begun in FY94 to assess benefits/costs of DOE/EERE programs. The purpose of QM is to inform decisionmaking during budget formulation process by describing the expected outcomes of programs during the budget request process. QM is expected to establish first step toward merit-based budget formulation and allow DOE/EERE to get {open_quotes}most bang for its (R&D) buck.{close_quotes} In FY96. NREL coordinated a QM team that prepared a preliminary QM for the utility market sector. In the electricity supply sector, the QM analysis shows hydrogen fuel cells capturing 5% (or 22 GW) of the total market of 390 GW of new capacity additions through 2020. Hydrogen consumption in the utility sector increases from 0.009 Quads in 2005 to 0.4 Quads in 2020. Hydrogen fuel cells are projected to displace over 0.6 Quads of primary energy in 2020. In future work, NREL will assess the market for decentralized, on-site generation, develop cost credits for distributed generation benefits (such as deferral of transmission and distribution investments, uninterruptible power service), cost credits for by-products such as heat and potable water, cost credits for environmental benefits (reduction of criteria air pollutants and greenhouse gas emissions), compete different fuel cell technologies against each other for market share, and begin to address economic benefits, especially employment.

  16. Health Technology Assessment and vaccine: new needs and opportunities?

    Directory of Open Access Journals (Sweden)

    Giuseppe La Torre

    2007-03-01

    Full Text Available Health Technology Assessment (HTA can represent an innovative and effective approach to supply decisionmakers with a valid instrument to improve the allocation of resources in the field of vaccines. We proposed a HTA approach for considering the introduction of a new vaccine that could potentially have a great impact on the population’s health, using as an example the vaccine against Human Papilloma Virus (HPV. This approach could be of great interest when the decision making process involves choices regarding new vaccines. We developed a HTA approach for assessing all of the aspects involved in the introduction of vaccines against HPV in Italy, considering the following issues: - epidemiological evaluation of HPV infection and related pathologies through the consultation of data banks and the scientific literature; - evaluation of health care resources utilisation by people suffering from the infection/ related diseases, through the consultation of hospital archives; - systematic review and meta-analysis of randomised clinical trials on HPV vaccination effectiveness and safety; - mathematical modelling and economic evaluation of the vaccination using a cost-effectiveness analysis; - evaluation of the impact of vaccination on the Health System [organisational aspects, vaccine surveillance, relationship between different decisional levels (national, regional]; - analysis of the ethical, social (acceptability, availability, accessibility, information and legislative aspects of vaccination. A HTA report on the new vaccine could represent an new important tool to support the choice of decision makers in order to better inform the allocation of economic resources and maximize healthcare services, since it takes into account not only the burden and the epidemiology of the disease, and the economic evaluation of different scenarios, but also the social, legal and bioethical aspects. For HTA to support the introduction of new technologies, and new

  17. The Influence of Religious Coping and Religious Social Support on Health Behaviour, Health Status and Health Attitudes in a British Christian Sample.

    Science.gov (United States)

    Brewer, Gayle; Robinson, Sarita; Sumra, Altaf; Tatsi, Erini; Gire, Nadeem

    2015-12-01

    Previous research has established a relationship between religion and health. However, the specific aspects of religion which may influence health are not fully understood. The present study investigates the effect of religious social support and religious coping on health behaviours, health status and attitudes to health whilst controlling for age and non-religious social support. The results indicate religious coping and religious social support positively impact on self-reported current health status, depression, health outlook and resistance susceptibility. However, negative religious coping was predictive of increased alcohol consumption. Overall congregational support and negative religious coping had the greatest impact on health.

  18. Sugar Price Supports and Taxation: A Public Health Policy Paradox.

    Science.gov (United States)

    Dilk, Abby; Savaiano, Dennis A

    2017-05-01

    Domestic US sugar production has been protected by government policy for the past 82 years, resulting in elevated domestic prices and an estimated annual (2013) $1.4 billion dollar "tax" on consumers. These elevated prices and the simultaneous federal support for domestic corn production have ensured a strong market for high-fructose corn syrup. Americans have dramatically increased their consumption of caloric sweeteners during the same period. Consumption of "empty" calories (ie, foods with low-nutrient/high-caloric density)-sugar and high-fructose corn syrup being the primary sources-is considered by most public health experts to be a key contributing factor to the rise in obesity. There have been substantial efforts to tax sugar-sweetened beverages (SSBs) to both reduce consumption and provide a source of funds for nutrition education, thereby emulating the tobacco tax model. Volume-based SSB taxes levy the tax rate per ounce of liquid, where some are only imposed on beverages with added sugar content exceeding a set threshold. Nonetheless, volume-based taxes have significant limitations in encouraging consumers to reduce their caloric intake due to a lack of transparency at the point of purchase. Thus, it is hypothesized that point-of-purchase, nutrient-specific excise taxes on SSBs would be more effective at reducing sugar consumption. However, all SSB taxes are limited by the possibility that consumers may compensate their decreased intake from SSBs with other high-calorie junk foods. Furthermore, there are no existing studies to provide evidence on how SSB taxes will impact obesity rates in the long term. The paradox of sugar prices is that Americans have paid higher prices for sugar to protect domestic production for more than 80 years, and now, Americans are being asked to pay even more to promote public health. The effective use of sugar taxes should be considered based on their merits in reducing sugar consumption and making available a new source of

  19. Electronic health records and support for primary care teamwork

    Science.gov (United States)

    Draper, Kevin; Gourevitch, Rebecca; Cross, Dori A.; Scholle, Sarah Hudson

    2015-01-01

    Objective Consensus that enhanced teamwork is necessary for efficient and effective primary care delivery is growing. We sought to identify how electronic health records (EHRs) facilitate and pose challenges to primary care teams as well as how practices are overcoming these challenges. Methods Practices in this qualitative study were selected from those recognized as patient-centered medical homes via the National Committee for Quality Assurance 2011 tool, which included a section on practice teamwork. We interviewed 63 respondents, ranging from physicians to front-desk staff, from 27 primary care practices ranging in size, type, geography, and population size. Results EHRs were found to facilitate communication and task delegation in primary care teams through instant messaging, task management software, and the ability to create evidence-based templates for symptom-specific data collection from patients by medical assistants and nurses (which can offload work from physicians). Areas where respondents felt that electronic medical record EHR functionalities were weakest and posed challenges to teamwork included the lack of integrated care manager software and care plans in EHRs, poor practice registry functionality and interoperability, and inadequate ease of tracking patient data in the EHR over time. Discussion Practices developed solutions for some of the challenges they faced when attempting to use EHRs to support teamwork but wanted more permanent vendor and policy solutions for other challenges. Conclusions EHR vendors in the United States need to work alongside practicing primary care teams to create more clinically useful EHRs that support dynamic care plans, integrated care management software, more functional and interoperable practice registries, and greater ease of data tracking over time. PMID:25627278

  20. Electronic health records and support for primary care teamwork.

    Science.gov (United States)

    O'Malley, Ann S; Draper, Kevin; Gourevitch, Rebecca; Cross, Dori A; Scholle, Sarah Hudson

    2015-03-01

    Consensus that enhanced teamwork is necessary for efficient and effective primary care delivery is growing. We sought to identify how electronic health records (EHRs) facilitate and pose challenges to primary care teams as well as how practices are overcoming these challenges. Practices in this qualitative study were selected from those recognized as patient-centered medical homes via the National Committee for Quality Assurance 2011 tool, which included a section on practice teamwork. We interviewed 63 respondents, ranging from physicians to front-desk staff, from 27 primary care practices ranging in size, type, geography, and population size. EHRs were found to facilitate communication and task delegation in primary care teams through instant messaging, task management software, and the ability to create evidence-based templates for symptom-specific data collection from patients by medical assistants and nurses (which can offload work from physicians). Areas where respondents felt that electronic medical record EHR functionalities were weakest and posed challenges to teamwork included the lack of integrated care manager software and care plans in EHRs, poor practice registry functionality and interoperability, and inadequate ease of tracking patient data in the EHR over time. Practices developed solutions for some of the challenges they faced when attempting to use EHRs to support teamwork but wanted more permanent vendor and policy solutions for other challenges. EHR vendors in the United States need to work alongside practicing primary care teams to create more clinically useful EHRs that support dynamic care plans, integrated care management software, more functional and interoperable practice registries, and greater ease of data tracking over time. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association.

  1. Health impact assessment in a network of European cities.

    Science.gov (United States)

    Ison, Erica

    2013-10-01

    The methodology of health impact assessment (HIA) was introduced as one of four core themes for Phase IV (2003-2008) of the World Health Organization European Healthy Cities Network (WHO-EHCN). Four objectives for HIA were set at the beginning of the phase. We report on the results of the evaluation of introducing and implementing this methodology in cities from countries across Europe with widely differing economies and sociopolitical contexts. Two main sources of data were used: a general questionnaire designed for the Phase IV evaluation and the annual reporting template for 2007-2008. Sources of bias included the proportion of non-responders and the requirement to communicate in English. Main barriers to the introduction and implementation of HIA were a lack of skill, knowledge and experience of HIA, the newness of the concept, the lack of a legal basis for implementation and a lack of political support. Main facilitating factors were political support, training in HIA, collaboration with an academic/public health institution or local health agency, a pre-existing culture of intersectoral working, a supportive national policy context, access to WHO materials about or expertise in HIA and membership of the WHO-EHCN, HIA Sub-Network or a National Network. The majority of respondents did not feel that they had had the resources, knowledge or experience to achieve all of the objectives set for HIA in Phase IV. The cities that appear to have been most successful at introducing and implementing HIA had pre-existing experience of HIA, came from a country with a history of applying HIA, were HIA Sub-Network members or had made a commitment to implementing HIA during successive years of Phase IV. Although HIA was recognised as an important component of Healthy Cities' work, the experience in the WHO-EHCN underscores the need for political buy-in, capacity building and adequate resourcing for the introduction and implementation of HIA to be successful.

  2. Participatory design of an integrated information system design to support public health nurses and nurse managers.

    Science.gov (United States)

    Reeder, Blaine; Hills, Rebecca A; Turner, Anne M; Demiris, George

    2014-01-01

    The objectives of the study were to use persona-driven and scenario-based design methods to create a conceptual information system design to support public health nursing. We enrolled 19 participants from two local health departments to conduct an information needs assessment, create a conceptual design, and conduct a preliminary design validation. Interviews and thematic analysis were used to characterize information needs and solicit design recommendations from participants. Personas were constructed from participant background information, and scenario-based design was used to create a conceptual information system design. Two focus groups were conducted as a first iteration validation of information needs, personas, and scenarios. Eighty-nine information needs were identified. Two personas and 89 scenarios were created. Public health nurses and nurse managers confirmed the accuracy of information needs, personas, scenarios, and the perceived usefulness of proposed features of the conceptual design. Design artifacts were modified based on focus group results. Persona-driven design and scenario-based design are feasible methods to design for common work activities in different local health departments. Public health nurses and nurse managers should be engaged in the design of systems that support their work. © 2013 Wiley Periodicals, Inc.

  3. 76 FR 55673 - Vulnerability Assessments in Support of the Climate Ready Estuaries Program: A Novel Approach...

    Science.gov (United States)

    2011-09-08

    ... AGENCY Vulnerability Assessments in Support of the Climate Ready Estuaries Program: A Novel Approach... period for the draft documents titled, Vulnerability Assessments in Support of the Climate Ready... Partnership (EPA/600/R-11/ 058a) and Vulnerability Assessments in Support of the Climate Ready Estuaries...

  4. Health Literacy Assessment: Feasibility in a Breast Surgical Oncology Clinic
.

    Science.gov (United States)

    Keim-Malpass, Jessica; Doede, Aubrey; Kennedy, Christine; Showalter, Shayna L

    2017-06-01

    Health literacy is recognized as an integral component of high-quality health care. However, health literacy has been understudied in the context of cancer care delivery and surgical decision making. The goal of this article is to outline a process for implementation of a health literacy screening assessment within the routine practices of an academic breast surgical oncology clinic. The self-reported health literacy assessment is feasible, particularly with integration of the health literacy screen in the electronic health record. The authors' estimated clinic prevalence of low health literacy was 22%, which has numerous implications for communication and shared decision-making processes.
.

  5. Advancing human health risk assessment: integrating recent advisory committee recommendations.

    Science.gov (United States)

    Dourson, Michael; Becker, Richard A; Haber, Lynne T; Pottenger, Lynn H; Bredfeldt, Tiffany; Fenner-Crisp, Penelope A

    2013-07-01

    Over the last dozen years, many national and international expert groups have considered specific improvements to risk assessment. Many of their stated recommendations are mutually supportive, but others appear conflicting, at least in an initial assessment. This review identifies areas of consensus and difference and recommends a practical, biology-centric course forward, which includes: (1) incorporating a clear problem formulation at the outset of the assessment with a level of complexity that is appropriate for informing the relevant risk management decision; (2) using toxicokinetics and toxicodynamic information to develop Chemical Specific Adjustment Factors (CSAF); (3) using mode of action (MOA) information and an understanding of the relevant biology as the key, central organizing principle for the risk assessment; (4) integrating MOA information into dose-response assessments using existing guidelines for non-cancer and cancer assessments; (5) using a tiered, iterative approach developed by the World Health Organization/International Programme on Chemical Safety (WHO/IPCS) as a scientifically robust, fit-for-purpose approach for risk assessment of combined exposures (chemical mixtures); and (6) applying all of this knowledge to enable interpretation of human biomonitoring data in a risk context. While scientifically based defaults will remain important and useful when data on CSAF or MOA to refine an assessment are absent or insufficient, assessments should always strive to use these data. The use of available 21st century knowledge of biological processes, clinical findings, chemical interactions, and dose-response at the molecular, cellular, organ and organism levels will minimize the need for extrapolation and reliance on default approaches.

  6. Community Health Needs Assessments: Expanding the Boundaries of Nursing Education in Population Health.

    Science.gov (United States)

    Evans-Agnew, Robin; Reyes, David; Primomo, Janet; Meyer, Karen; Matlock-Hightower, Corrie

    2017-01-01

    Conducting federally mandated community health needs assessments through academic-practice partnerships provides new opportunities for developing population health nursing competencies. The purpose of this article was to describe how a baccalaureate practicum experience within such an assessment process, involving health care system partners, re-affirms the importance of community and population health assessment in the development of future nursing leaders. Student evaluations indicated an emerging appreciation for the social determinants of health, the power of partnerships, and the importance of diversity. Integrating health care and public health system perspectives on assessment meets both public health and nursing accreditation standards and extends student leadership experiences. Such integration also improves regional capacity for improving population health. Federal mandates for community health needs assessments provide opportunities to advance leadership roles for nursing graduates throughout the health care system, and for confirming the importance of community assessment as an essential nursing competency. © 2016 Wiley Periodicals, Inc.

  7. Mothers' and health visitors' perceptions of the support provided to mothers who have experienced domestic violence: A systematic review.

    Science.gov (United States)

    Eynon, Julia; Carrier, Judith; Rees, Sally; Cartwright, Annie

    2012-01-01

    Domestic violence has been described as a public health epidemic, with victims of domestic violence encountered in all health care settings. Within the United Kingdom the role of the health visitor (specialist community public health nurse) is to promote health in the whole community; every family with a child under five years has a named health visitor. Preparation for the health visitor role is unique to the United Kingdom. Health visitors are particularly well placed to identify and support mothers who are experiencing domestic violence. The objective of this review was to synthesise the best available evidence relating to support provided by UK health visitors for mothers who have experienced domestic violence, from both the mothers and the health visitors' perspectives. The participants of interest were mothers who have experienced domestic violence and health visitors who offer support to those mothers.The self reported experiences of health visitor support provided to mothers who have experienced domestic violence, from the perspective of both the mothers and the health visitors providing the support.This review considered studies that focus on qualitative data including, but not limited to, designs such as ethnography, phenomenology, grounded theory, action research and feminist research. Studies published up to April 2011 were included in the review. The search was restricted to English language studies. The databases searched were: Medline, CINAHL, PsycINFO, PsycARTICLES, EMBASE, British Nursing Index and Archive, ASSIA and TRIP. Studies were assessed for methodological quality using the standardised critical appraisal instruments from the Joanna Briggs Institute. Data were extracted using standardised data extraction tools from the Joanna Briggs Institute. Data synthesis used the Joanna Briggs Institute approach for meta-synthesis by meta-aggregation. Findings were synthesised into categories, which were aggregated into synthesised findings. Four

  8. An assessment of counselling and support services for people living ...

    African Journals Online (AJOL)

    An increasing body of literature shows that HIV/AIDS and mental health issues are closely related. In spite of this, the mental health correlates of HIV and AIDS remain largely unacknowledged and under-researched in sub-Saharan Africa. Furthermore, despite guidelines by the World Health Organization insisting that ...

  9. A rural local health department-hospital collaborative for a countywide community health assessment.

    Science.gov (United States)

    Sampson, Gretchen; Miner Gearin, Kim J; Boe, Mary

    2015-01-01

    In mid-2012, the Polk County Health Department initiated a community health needs assessment process with the 3 medical centers serving this rural Wisconsin county of 45 000 residents. The collaborative process drew on primary and secondary data, including clinical data pooled from health care organizations, to assess population health. Community health assessment ultimately engaged more than 1800 county residents through coordinated surveys and community forums. Although the Polk County Health Department has a long history of collaboration with the local health care community, the Patient Protection and Affordable Care Act, coupled with meaningful use requirements for health care providers, sharply increased engagement, contributed to shared priorities, and brought this relationship to a new level. Partners have now convened community-based workgroups around the top 3 health focus areas selected from the assessment process. Community health assessment emphasized the social determinants of health as a step toward a more "upstream" orientation to population health goals.

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

    Science.gov (United States)

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

    2013-09-01

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

  11. A systematic review of peer-supported interventions for health promotion and disease prevention.

    Science.gov (United States)

    Ramchand, Rajeev; Ahluwalia, Sangeeta C; Xenakis, Lea; Apaydin, Eric; Raaen, Laura; Grimm, Geoffrey

    2017-08-01

    Prior research has examined peer programs with respect to specific peer roles (e.g.; peer support) or specific health/wellness domains (e.g.; exercise/diet), or have aggregated effects across roles and domains. We sought to conduct a systematic review that categorizes and assesses the effects of peer interventions to promote health and wellness by peer role, intervention type, and outcomes. We use evidence mapping to visually catalog and synthesize the existing research. We searched PubMed and WorldCat databases (2005 to 2015) and New York Academy of Medicine Grey Literature Report (1999 to 2016) for English-language randomized control trials. We extracted study design, study participants, type of intervention(s), peer role(s), outcomes assessed and measures used, and effects from 116 randomized controlled trials. Maps were created to provide a visual display of the evidence by intervention type, peer role, outcome type, and significant vs null or negative effects. There are more null than positive effects across peer interventions, with notable exceptions: group-based interventions that use peers as educators or group facilitators commonly improve knowledge, attitudes, beliefs, and perceptions; peer educators also commonly improved social health/connectedness and engagement. Dyadic peer support influenced behavior change and peer counseling shows promising effects on physical health outcomes. Programs seeking to use peers in public health campaigns can use evidence maps to identify interventions that have previously demonstrated beneficial effects. Those seeking to produce health outcomes may benefit from identifying the mechanisms by which they expect their program to produce these effects and associated proximal outcomes for future evaluations. Although we attempted to register our protocol with PROSPERO, we did not meet eligibility criteria because we were past the data collection phase. The full PROSPERO-aligned protocol is available from the authors

  12. A Peer-Support and Mindfulness Program to Improve the Mental Health of Medical Students.

    Science.gov (United States)

    Moir, Fiona; Henning, Marcus; Hassed, Craig; Moyes, Simon A; Elley, C Raina

    2016-01-01

    There is evidence that peer-support programs can improve mental health indices and help-seeking behavior among students in some secondary school and university settings and that mindfulness can improve mental health in medical students. Peer-led programs have not been formally assessed in a medical student population, where psychological issues exist and where it has been shown that students approach peers for help in preference to staff members or professional services. Medical students elected peer leaders who underwent training and then provided the intervention. The peer leaders provided support to students in the intervention group, as well as offering teaching in mindfulness meditation. An exploratory study was conducted with 2nd- and 3rd-year medical students at 1 medical school in New Zealand randomized into 2 groups. In addition to existing mental health resources, intervention participants received a program including peer support and peer-taught mindfulness practice. Study participants not offered the intervention participants could use existing mental health resources. Primary measures included depression (PHQ-9) and anxiety (GAD-7) scores. Secondary measures were quality of life, resilience (15-item resilience scale), academic self-concept, and motivation to learn, assessed at baseline and 6 months. Of the 402 students eligible, 275 (68%) participated and 232 (58%) completed the study. At baseline, 53% were female and mean age was 21 years (SD = 3)-PHQ-9 score (M = 5.2, SD = 3.7) and GAD-7 score (M = 4.5, SD = 3.4). Twelve peer leaders were elected. There was good participation in the intervention. One fourth of intervention students used the face-to-face peer support and more than 50% attended a peer social event and/or participated in the mindfulness program. Although improvements in mental health were seen in the intervention group, the difference between the intervention and nonintervention groups did not reach statistical significance. Although

  13. Computer-assisted health impact assessment for intersectoral health policy

    NARCIS (Netherlands)

    Mooy, J. M.; Gunning-Schepers, L. J.

    2001-01-01

    Intersectoral health policy implies negotiations with politicians outside the health sector. Health politicians have a stronger position if they can quantify health impact. In this Dutch case-study we used a computer simulation approach to answer the following questions: Which anti-tobacco

  14. Information support for health information management in regional Sri Lanka: health managers' perspectives.

    Science.gov (United States)

    Ranasinghe, Kaduruwane Indika; Chan, Taizan; Yaralagadda, Prasad

    2012-01-01

    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

  15. Ethnic and Nativity Differences in the Social Support-Physical Health Association Among Black Americans.

    Science.gov (United States)

    Erving, Christy L

    2018-02-01

    Despite an abundant literature on social support and health, relatively less is known about how support and its impact on physical health vary within the Black population. Using the National Survey of American Life (NSAL), this paper examines which sources and types of support are associated with physical health among African Americans, U.S.-born Caribbean Blacks and foreign-born Caribbean Blacks. The results showed that for U.S.-born Caribbean Blacks, being married was especially beneficial to health. Closeness to family was associated with better health while negative interactions with family members was associated with worse health for African Americans and foreign-born Caribbean Blacks. Different sources of instrumental support affected all three groups. Overall, the findings reveal that, among Black Americans, the association between social support and physical health is contingent upon ethnicity, nativity, and the ways in which social support and health are operationalized.

  16. Transportation Matters: A Health Impact Assessment in Rural New Mexico

    Directory of Open Access Journals (Sweden)

    Michelle Del Rio

    2017-06-01

    Full Text Available This Health Impact Assessment (HIA informed the decision of expanding public transportation services to rural, low income communities of southern Doña Ana County, New Mexico on the U.S./Mexico border. The HIA focused on impacts of access to health care services, education, and economic development opportunities. Qualitative and quantitative data were collected from surveys of community members, key informant interviews, a focus group with community health workers, and passenger surveys during an initial introduction of the transit system. Results from the survey showed that a high percentage of respondents would use the bus system to access the following: (1 84% for health services; (2 83% for formal and informal education opportunities; and (3 81% for economic opportunities. Results from interviews and the focus group supported the benefits of access to services but many were concerned with the high costs of providing bus service in a rural area. We conclude that implementing the bus system would have major impacts on resident’s health through improved access to: (1 health services, and fresh foods, especially for older adults; (2 education opportunities, such as community colleges, universities, and adult learning, especially for young adults; and (3 economic opportunities, especially jobs, job training, and consumer goods and services. We highlight the challenges associated with public transportation in rural areas where there are: (1 long distances to travel; (2 difficulties in scheduling to meet all needs; and (3 poor road and walking conditions for bus stops. The results are applicable to low income and fairly disconnected rural areas, where access to health, education, and economic opportunities are limited.

  17. Transportation Matters: A Health Impact Assessment in Rural New Mexico.

    Science.gov (United States)

    Del Rio, Michelle; Hargrove, William L; Tomaka, Joe; Korc, Marcelo

    2017-06-13

    This Health Impact Assessment (HIA) informed the decision of expanding public transportation services to rural, low income communities of southern Doña Ana County, New Mexico on the U.S./Mexico border. The HIA focused on impacts of access to health care services, education, and economic development opportunities. Qualitative and quantitative data were collected from surveys of community members, key informant interviews, a focus group with community health workers, and passenger surveys during an initial introduction of the transit system. Results from the survey showed that a high percentage of respondents would use the bus system to access the following: (1) 84% for health services; (2) 83% for formal and informal education opportunities; and (3) 81% for economic opportunities. Results from interviews and the focus group supported the benefits of access to services but many were concerned with the high costs of providing bus service in a rural area. We conclude that implementing the bus system would have major impacts on resident's health through improved access to: (1) health services, and fresh foods, especially for older adults; (2) education opportunities, such as community colleges, universities, and adult learning, especially for young adults; and (3) economic opportunities, especially jobs, job training, and consumer goods and services. We highlight the challenges associated with public transportation in rural areas where there are: (1) long distances to travel; (2) difficulties in scheduling to meet all needs; and (3) poor road and walking conditions for bus stops. The results are applicable to low income and fairly disconnected rural areas, where access to health, education, and economic opportunities are limited.

  18. A health equity impact assessment umbrella program (AAPRISS) to tackle social inequalities in health: program description.

    Science.gov (United States)

    Lang, Thierry; Bidault, Elsa; Villeval, Mélanie; Alias, François; Gandouet, Benjamin; Servat, Martine; Theis, Ivan; Breton, Eric; Haschar-Noé, Nadine; Grosclaude, Pascale

    2016-09-01

    The failure to simultaneously address two objectives (increasing the average health of the population and reducing health inequalities) may have led to what has been observed in France so far: an overall decrease in mortality and increase in inequality. The Apprendre et Agir pour Réduire les Inégalités Sociales de Santé (AAPRISS) methodology is to analyze and modify interventions that are already underway in terms of their potential impact on health inequalities. It relies on partnership between researchers and actors in the health field, as well as policy makers. In this paper, we describe the program and discuss its feasibility and acceptability. This program is not a single intervention, but a process aiming at assessing and reshaping existing health programs, therefore acting as a kind of meta-intervention. The program develops scientific and methodological support stemming from co-construction methods aimed at increasing equity within the programs. Stakeholders from prevention policy-making and the health care system, as well as researchers, collaborate in defining interventions, monitoring their progress, and choosing indicators, methods and evaluation procedures. The target population is mainly the population of the greater Toulouse area. The steps of the process are described: (1) establishment of AAPRISS governance and partnerships; (2) inclusion of projects; and (3) the projects' process. Many partners have rallied around this program, which has been shown to be feasible and acceptable by partners and health actors. A major challenge is understanding each partner's expectations in terms of temporality of interventions, expected outcomes, assessment methods and indicators. Analyzing the projects has been quite feasible, and some modifications have been implemented in them in order to take inequalities in health into account. © The Author(s) 2015.

  19. Rapid Assessment Medical Support (RAMS) for active shooter incidents.

    Science.gov (United States)

    Mechem, C Crawford; Bossert, Richard; Baldini, Christopher

    2015-01-01

    This country has witnessed a steady increase in the number of active shooter incidents in recent years. The traditional emergency medical services (EMS) response to such incidents has been to stage at a safe distance until the scene has been secured by law enforcement. Such an approach may lead to unnecessary delays in medical care and potentially needless loss of life. To address this issue locally, the Philadelphia Fire Department (PFD) and the Philadelphia Police Department (PPD) collaborated to develop the Rapid Assessment Medical Support (RAMS) program. All PFD paramedics have been equipped and trained to move with PPD officers into a scene that has been cleared by police but not yet secured in order to initiate emergency care, with an emphasis on hemorrhage control. Patients are then extracted to awaiting EMS resources in the cold zone. The history behind the program and the challenges and obstacles that had to be addressed in its development are described. These included initial and ongoing training and funding sources; buy-in from risk management, labor, and the individual providers; whether only paramedics should be included in the RAMS program or if the PFD's firefighter-EMTs should be included as well; the potential for mission creep as police recognized the value of this asset and its potential application to other scenarios; and how to involve the many nonmunicipal ambulance services that are not involved in the routine operation of Philadelphia's 9-1-1 system. To date, RAMS teams have been activated on multiple occasions, but fortunately the incidents were resolved without injury or loss of life. However, the program provides another valuable tool with which the City of Philadelphia can respond should another active shooter incident occur.

  20. Health effects assessment of chemical exposures: ARIES methodology

    Energy Technology Data Exchange (ETDEWEB)

    Sierra, L; Montero, M.; Rabago, I.; Vidania, R.

    1995-07-01

    In this work, we present ARIES* update: a system designed in order to facilitate the human health effects assessment produced by accidental release of toxic chemicals. The first version of ARIES was developed in relation to 82/501/EEC Directive about mayor accidents in the chemical industry. So, the first aim was the support of the effects assessment derived for the chemicals included into this directive. From this establishment, it was considered acute exposures for high concentrations. In this report, we present the actual methodology for considering other type of exposures, such as environmental and occupational. Likewise other versions, the methodology comprises two approaches: quantitative and qualitative assessments. Quantitative assessment incorporates the mathematical algorithms useful to evaluate the effects produced by the most important routes of exposure: inhalation, ingestion, eye contact and skin absorption, in a short, medium and long term. It has been included models that realizes an accurate quantification of doses, effects,... and so on, such as simple approaches when the available information is not enough. Qualitative assessment, designed in order to complement or replace the previous one, is incorporated into an informatics system, developed in Clipper. It executes and displays outstanding and important toxicological information of about 100 chemicals. This information comes from ECDIN (Environmental Chemicals Data and Information Network) database through a collaboration with JRC-ISPRA working group. (Author) 24 refs.

  1. The history of health technology assessment in Australia.

    Science.gov (United States)

    Hailey, David

    2009-07-01

    To describe the development and application of health technology assessment (HTA) in Australia. Review of relevant literature and other documents related to HTA in Australia. Most HTA activity in Australia has been associated with provision of advice for the two national subsidy programs, Medicare, and the Pharmaceutical Benefits Scheme (PBS). National advisory bodies established by the federal government have had a prominent role. Assessments from the advisory bodies have had a major influence on decisions related to Medicare and the PBS, and in some other areas. Technologies without links to the national subsidy schemes, and those that are widely distributed, have been less well covered by HTA. To some extent these are addressed by evaluations supported by state governments, but details of approaches taken are not readily available. HTA in Australia now has a long history and is well established as a source of advice to health decision makers. Challenges remain in extending the scope of assessments, developing more transparent approaches in some areas, and consistently applying appropriate standards.

  2. Clarifying Associations between Childhood Adversity, Social Support, Behavioral Factors, and Mental Health, Health, and Well-Being in Adulthood: A Population-Based Study.

    Science.gov (United States)

    Sheikh, Mashhood A; Abelsen, Birgit; Olsen, Jan A

    2016-01-01

    Previous studies have shown that socio-demographic factors, childhood socioeconomic status (CSES), childhood traumatic experiences (CTEs), social support and behavioral factors are associated with health and well-being in adulthood. However, the relative importance of these factors for mental health, health, and well-being has not been studied. Moreover, the mechanisms by which CTEs affect mental health, health, and well-being in adulthood are not clear. Using data from a representative sample (n = 12,981) of the adult population in Tromsø, Norway, this study examines (i) the relative contribution of structural conditions (gender, age, CSES, psychological abuse, physical abuse, and substance abuse distress) to social support and behavioral factors in adulthood; (ii) the relative contribution of socio-demographic factors, CSES, CTEs, social support, and behavioral factors to three multi-item instruments of mental health (SCL-10), health (EQ-5D), and subjective well-being (SWLS) in adulthood; (iii) the impact of CTEs on mental health, health, and well-being in adulthood, and; (iv) the mediating role of adult social support and behavioral factors in these associations. Instrumental support (24.16%, p mental health, while gender (21.32%, p health, and emotional support (23.34%, p mental health (12.13%), health (7.01%), and well-being (9.09%), as compared to physical abuse, and substance abuse distress. The subjective assessment of childhood financial conditions was relatively more important for mental health (6.02%), health (10.60%), and well-being (20.60%), as compared to mother's and father's education. CTEs were relatively more important for mental health, while, CSES was relatively more important for health and well-being. Respondents exposed to all three types of CTEs had a more than two-fold increased risk of being mentally unhealthy (RR Total Effect = 2.75, 95% CI: 2.19-3.10), an 89% increased risk of being unhealthy (RR Total Effect = 1.89, 95% CI: 1

  3. Clarifying associations between childhood adversity, social support, behavioral factors, and mental health, health, and well-being in adulthood: A population-based study

    Directory of Open Access Journals (Sweden)

    Mashhood Ahmed Sheikh

    2016-05-01

    Full Text Available Previous studies have shown that socio-demographic factors, childhood socioeconomic status (CSES, childhood traumatic experiences (CTEs, social support and behavioural factors are associated with health and well-being in adulthood. However, the relative importance of these factors for mental health, health, and well-being has not been studied. Moreover, the mechanisms by which CTEs affect mental health, health, and well-being in adulthood are not clear. Using data from a representative sample (n=12,981 of the adult population in Tromsø, Norway, this study examines (i the relative contribution of structural conditions (gender, age, CSES, psychological abuse, physical abuse, and substance abuse distress to social support and behavioural factors in adulthood ; (ii the relative contribution of socio-demographic factors, CSES, CTEs, social support, and behavioural factors to three multi-item instruments of mental health (SCL-10, health (EQ-5D, and subjective well-being (SWLS in adulthood; (iii the impact of CTEs on mental health, health, and well-being in adulthood, and; (iv the mediating role of adult social support and behavioural factors in these associations. Instrumental support (24.16%, p<0.001 explained most of the variation in mental health, while gender (21.32%, p<0.001 explained most of the variation in health, and emotional support (23.34%, p<0.001 explained most of the variation in well-being. Psychological abuse was relatively more important for mental health (12.13%, health (7.01%, and well-being (9.09%, as compared to physical abuse, and substance abuse distress. The subjective assessment of childhood financial conditions was relatively more important for mental health (6.02%, health (10.60%, and well-being (20.60%, as compared to mother’s and father’s education. CTEs were relatively more important for mental health, while, CSES was relatively more important for health and well-being. Respondents exposed to all three types of CTEs

  4. Associations of social support and stress with postpartum maternal mental health symptoms: Main effects, moderation, and mediation.

    Science.gov (United States)

    Schwab-Reese, Laura M; Schafer, Ellen J; Ashida, Sato

    2017-07-01

    Poor maternal mental health during the postpartum period can have significant effects on the health of mothers, infants, and families. The findings from cross-sectional studies suggest that stress and social support are related to maternal mental health. This study contributes to the literature through the use of longitudinal data, and examines moderation and mediation among these factors. In 2012-2013, mothers completed surveys assessing stress, social support, and depressive and anxiety symptoms following birth (n = 125), and 3 months (n = 110) and 6 months (n = 99) after birth. The authors examined temporal associations, moderation, and mediation of social support on the relationship between stress and postpartum depressive and anxiety symptoms using modified Poisson regression models and the counterfactual approach to mediation. Current levels of stress and social support were associated with depressive and anxiety symptoms, both independently and when considered together at multiple time points. Social support did not strongly moderate or mediate the relationships between stress and maternal mental health. Interventions to reduce current perceptions of stress and increase social support for mothers during the postpartum period may help improve maternal mental health symptoms. Efforts are needed to assess the current needs of mothers continuously.

  5. The role of health impact assessment in promoting population health and health equity.

    Science.gov (United States)

    Wise, Marilyn; Harris, Patrick; Harris-Roxas, Ben; Harris, Elizabeth

    2009-12-01

    Within the discipline of health promotion there has been long-standing understanding of the social determinants of health and life expectancy.1-3 There is also long-standing evidence of the unfair, unjust distribution of these resources within and among societies. It has proven difficult to translate this evidence of the need for the fairer distribution of socially-distributed resources into powerful action by the range of sectors through whose policies and programs/services much of this inequitable distribution is created.4 Health promotion has proven effective in contributing to significant improvements in the health of populations. It is, now, based on well-developed theory and a comprehensive body of evidence. However, health promotion in particular and the health sector in general have found it difficult to work with other sectors to influence public policy to create the social, economic, environmental and cultural conditions necessary for health equity. Health Impact Assessment (HIA) is outlined as an approach that offers the health sector a structured, transparent method and process to work with other sectors to predict the impact of policy proposals on the health of populations (and on the determinants of health), and to predict the distribution of these impacts in advance of adoption and implementation of the policy. Based on Australian experience of conducting HIAs, the paper outlines contributions that HIA can make to formulating and implementing of healthy public policy. It describes the steps in HIA and illustrates the use of these in practice.

  6. Oral Histories as Critical Qualitative Inquiry in Community Health Assessment

    Science.gov (United States)

    Hernandez, Sarah Gabriella; Genkova, Ana; Castañeda, Yvette; Alexander, Simone; Hebert-Beirne, Jennifer

    2017-01-01

    Qualitative methods such as focus groups and interviews are common methodologies employed in participatory approaches to community health assessment to develop effective community health improvement plans. Oral histories are a rarely used form of qualitative inquiry that can enhance community health assessment in multiple ways. Oral histories…

  7. 78 FR 20523 - Community Health Needs Assessments for Charitable Hospitals

    Science.gov (United States)

    2013-04-05

    ... Internal Revenue Service 26 CFR Parts 1 and 53 RIN 1545-BL30 Community Health Needs Assessments for... organizations on the community health needs assessment (CHNA) requirements, and related excise tax and reporting... hospital organization to conduct a CHNA and adopt an implementation strategy to meet the community health...

  8. Internal and External Factors Affecting Teachers' Adoption of Formative Assessment to Support Learning

    Science.gov (United States)

    Izci, Kemal

    2016-01-01

    Assessment forms an important part of instruction. Assessment that aims to support learning is known as formative assessment and it contributes student's learning gain and motivation. However, teachers rarely use assessment formatively to aid their students' learning. Thus reviewing the factors that limit or support teachers' practices of…

  9. Redesigning community mental health services for urban children: Supporting schooling to promote mental health.

    Science.gov (United States)

    Atkins, Marc S; Shernoff, Elisa S; Frazier, Stacy L; Schoenwald, Sonja K; Cappella, Elise; Marinez-Lora, Ane; Mehta, Tara G; Lakind, Davielle; Cua, Grace; Bhaumik, Runa; Bhaumik, Dulal

    2015-10-01

    This study examined a school- and home-based mental health service model, Links to Learning, focused on empirical predictors of learning as primary goals for services in high-poverty urban communities. Teacher key opinion leaders were identified through sociometric surveys and trained, with mental health providers and parent advocates, on evidence-based practices to enhance children's learning. Teacher key opinion leaders and mental health providers cofacilitated professional development sessions for classroom teachers to disseminate 2 universal (Good Behavior Game, peer-assisted learning) and 2 targeted (Good News Notes, Daily Report Card) interventions. Group-based and home-based family education and support were delivered by mental health providers and parent advocates for children in kindergarten through 4th grade diagnosed with 1 or more disruptive behavior disorders. Services were Medicaid-funded through 4 social service agencies (N = 17 providers) in 7 schools (N = 136 teachers, 171 children) in a 2 (Links to Learning vs. services as usual) × 6 (pre- and posttests for 3 years) longitudinal design with random assignment of schools to conditions. Services as usual consisted of supported referral to a nearby social service agency. Mixed effects regression models indicated significant positive effects of Links to Learning on mental health service use, classroom observations of academic engagement, teacher report of academic competence and social skills, and parent report of social skills. Nonsignificant between-groups effects were found on teacher and parent report of problem behaviors, daily hassles, and curriculum-based measures. Effects were strongest for young children, girls, and children with fewer symptoms. Community mental health services targeting empirical predictors of learning can improve school and home behavior for children living in high-poverty urban communities. (c) 2015 APA, all rights reserved).

  10. A clinical decision support needs assessment of community-based physicians.

    Science.gov (United States)

    Richardson, Joshua E; Ash, Joan S

    2011-12-01

    To conduct a grounded needs assessment to elicit community-based physicians' current views on clinical decision support (CDS) and its desired capabilities that may assist future CDS design and development for community-based practices. To gain insight into community-based physicians' goals, environments, tasks, and desired support tools, we used a human-computer interaction model that was based in grounded theory. We conducted 30 recorded interviews with, and 25 observations of, primary care providers within 15 urban and rural community-based clinics across Oregon. Participants were members of three healthcare organizations with different commercial electronic health record systems. We used a grounded theory approach to analyze data and develop a user-centered definition of CDS and themes related to desired CDS functionalities. Physicians viewed CDS as a set of software tools that provide alerts, prompts, and reference tools, but not tools to support patient management, clinical operations, or workflow, which they would like. They want CDS to enhance physician-patient relationships, redirect work among staff, and provide time-saving tools. Participants were generally dissatisfied with current CDS capabilities and overall electronic health record usability. Physicians identified different aspects of decision-making in need of support: clinical decision-making such as medication administration and treatment, and cognitive decision-making that enhances relationships and interactions with patients and staff. Physicians expressed a need for decision support that extended beyond their own current definitions. To meet this requirement, decision support tools must integrate functions that align time and resources in ways that assist providers in a broad range of decisions.

  11. Enabling health care decisionmaking through clinical decision support and knowledge management.

    Science.gov (United States)

    Lobach, David; Sanders, Gillian D; Bright, Tiffani J; Wong, Anthony; Dhurjati, Ravi; Bristow, Erin; Bastian, Lori; Coeytaux, Remy; Samsa, Gregory; Hasselblad, Vic; Williams, John W; Wing, Liz; Musty, Michael; Kendrick, Amy S

    2012-04-01

    To catalogue study designs used to assess the clinical effectiveness of CDSSs and KMSs, to identify features that impact the success of CDSSs/KMSs, to document the impact of CDSSs/KMSs on outcomes, and to identify knowledge types that can be integrated into CDSSs/KMSs. MEDLINE(®), CINAHL(®), PsycINFO(®), and Web of Science(®). We included studies published in English from January 1976 through December 2010. After screening titles and abstracts, full-text versions of articles were reviewed by two independent reviewers. Included articles were abstracted to evidence tables by two reviewers. Meta-analyses were performed for seven domains in which sufficient studies with common outcomes were included. We identified 15,176 articles, from which 323 articles describing 311 unique studies including 160 reports on 148 randomized control trials (RCTs) were selected for inclusion. RCTs comprised 47.5 percent of the comparative studies on CDSSs/KMSs. Both commercially and locally developed CDSSs effectively improved health care process measures related to performing preventive services (n = 25; OR 1.42, 95% confidence interval [CI] 1.27 to 1.58), ordering clinical studies (n = 20; OR 1.72, 95% CI 1.47 to 2.00), and prescribing therapies (n = 46; OR 1.57, 95% CI 1.35 to 1.82). Fourteen CDSS/KMS features were assessed for correlation with success of CDSSs/KMSs across all endpoints. Meta-analyses identified six new success features: Integration with charting or order entry system. Promotion of action rather than inaction. No need for additional clinician data entry. Justification of decision support via research evidence. Local user involvement. Provision of decision support results to patients as well as providers. Three previously identified success features were confirmed: Automatic provision of decision support as part of clinician workflow. Provision of decision support at time and location of decisionmaking. Provision of a recommendation, not just an assessment. Only 29

  12. Geriatric Assessment Units and Rural Health System Viability.

    Science.gov (United States)

    Lassey, William R.; Lassey, Marie L.

    The Geriatric Assessment Unit (GAU), which has proven successful in urban areas, may be a viable system for providing health care to the elderly in rural areas. GAUs engage in assessment, follow-up response to findings, education, and research. The assessment component includes, at minimum, physical health, functional ability in activities of…

  13. Quantitative health impact assessment: current practice and future directions

    NARCIS (Netherlands)

    J.L. Veerman (Lennert); J.J.M. Barendregt (Jan); J.P. Mackenbach (Johan)

    2005-01-01

    textabstractSTUDY OBJECTIVE: To assess what methods are used in quantitative health impact assessment (HIA), and to identify areas for future research and development. DESIGN: HIA reports were assessed for (1) methods used to quantify effects of policy on determinants of health

  14. Caries risk assessment tool and prevention protocol for public health nurses in mother and child health centers, Israel.

    Science.gov (United States)

    Natapov, Lena; Dekel-Markovich, Dan; Granit-Palmon, Hadas; Aflalo, Efrat; Zusman, Shlomo Paul

    2018-01-01

    Dental caries is the most prevalent chronic disease in children. Caries risk assessment tools enable the dentists, physicians, and nondental health care providers to assess the individual's risk. Intervention by nurses in primary care settings can contribute to the establishment of oral health habits and prevention of dental disease. In Israel, Mother and Child Health Centers provide free preventive services for pregnant women and children by public health nurses. A caries prevention program in health centers started in 2015. Nurses underwent special training regarding caries prevention. A customized Caries Risk Assessment tool and Prevention Protocol for nurses, based on the AAPD tool, was introduced. A two-step evaluation was conducted which included a questionnaire and in-depth phone interviews. Twenty-eight (out of 46) health centers returned a completed questionnaire. Most nurses believed that oral health preventive services should be incorporated into their daily work. In the in-depth phone interviews, nurses stated that the integration of the program into their busy daily schedule was realistic and appropriate. The lack of specific dental module for computer program was mentioned as an implementation difficulty. The wide use of our tool by nurses supports its simplicity and feasibility which enables quick calculation and informed decision making. The nurses readily embraced the tool and it became an integral part of their toolkit. We provide public health nurses with a caries risk assessment tool and prevention protocol thus integrating oral health into general health of infants and toddlers. © 2017 Wiley Periodicals, Inc.

  15. Capturing health literacy assessment in the electronic health record through evidence-based concept creation: A review of the literature and recommendations for action.

    Science.gov (United States)

    Wetta, Ruth E; Severin, Roberta D; Gruhler, Heidi; Lewis, Nate

    2017-11-01

    Health literacy is the capacity to understand and act upon health-related information and navigate the healthcare system. Published evidence demonstrates a relationship between health literacy and health status. Because of this, there are increasingly calls for a health literacy assessment to be collected and stored in the electronic health record for use by the healthcare team. This article describes the results of a literature review of health literacy assessment instruments with the goal of formulating semantically interoperable concepts that may be used to store the interpretation of the health literacy assessment in the electronic health record. The majority of health literacy instruments could be stored in the electronic health record using a three-concept solution of inadequate, marginal and adequate health literacy. This three-concept solution fully supports semantic interoperability needs across the patient care spectrum.

  16. Robot-supported assessment of balance in standing and walking

    NARCIS (Netherlands)

    Shirota, Camila; Van Asseldonk, Edwin; Matjačić, Zlatko; Vallery, Heike; Barralon, Pierre; Maggioni, Serena; Buurke, Jaap H.; Veneman, Jan F.

    2017-01-01

    Clinically useful and efficient assessment of balance during standing and walking is especially challenging in patients with neurological disorders. However, rehabilitation robots could facilitate assessment procedures and improve their clinical value. We present a short overview of balance

  17. Alternative Assessment Methods Based on Categorizations, Supporting Technologies, and a Model for Betterment

    Science.gov (United States)

    Ben-Jacob, Marion G.; Ben-Jacob, Tyler E.

    2014-01-01

    This paper explores alternative assessment methods from the perspective of categorizations. It addresses the technologies that support assessment. It discusses initial, formative, and summative assessment, as well as objective and subjective assessment, and formal and informal assessment. It approaches each category of assessment from the…

  18. Fostering SMART partnerships to develop an effective continuum of behavioral health services and supports in schools.

    Science.gov (United States)

    Bruns, Eric J; Duong, Mylien T; Lyon, Aaron R; Pullmann, Michael D; Cook, Clayton R; Cheney, Douglas; McCauley, Elizabeth

    2016-03-01

    The education sector offers compelling opportunities to address the shortcomings of traditional mental health delivery systems and to prevent and treat youth mental, emotional, and behavioral (MEB) problems. Recognizing that social and emotional wellness is intrinsically related to academic success, schools are moving to adopt multi-tier frameworks based on the public health model that provide a continuum of services to all children, including services to address both academic and MEB problems. In this article, we review the potential value of multi-tier frameworks in facilitating access to, and increasing the effectiveness of, mental health services in schools, and review the empirical support for school-based mental health interventions by tier. We go on to describe a community-academic partnership between the Seattle Public Schools and the University of Washington School Mental Health Assessment, Research, and Training (SMART) Center that exemplifies how multi-tier educational frameworks, research and evidence, and purposeful collaboration can combine to improve development and implementation of a range of school-based strategies focused on MEB needs of students. Finally, we present a set of 10 recommendations that may help guide other research and practice improvement efforts to address MEB problems in youth through effective school mental health programming. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  19. A Randomized Trial Examining Three Strategies for Supporting Health Insurance Decisions among the Uninsured.

    Science.gov (United States)

    Politi, Mary C; Kaphingst, Kimberly A; Liu, Jingxia Esther; Perkins, Hannah; Furtado, Karishma; Kreuter, Matthew W; Shacham, Enbal; McBride, Timothy

    2016-10-01

    The Affordable Care Act allows uninsured individuals to select health insurance from numerous private plans, a challenging decision-making process. This study examined the effectiveness of strategies to support health insurance decisions among the uninsured. Participants (N = 343) from urban, suburban, and rural areas were randomized to 1 of 3 conditions: 1) a plain language table; 2) a visual condition where participants chose what information to view and in what order; and 3) a narrative condition. We administered measures assessing knowledge (true/false responses about key features of health insurance), confidence in choices (uncertainty subscale of the Decisional Conflict Scale), satisfaction (items from the Health Information National Trends Survey), preferences for insurance features (measured on a Likert scale from not at all important to very important), and plan choice. Although we did not find significant differences in knowledge, confidence in choice, or satisfaction across condition, participants across conditions made value-consistent choices, selecting plans that aligned with their preferences for key insurance features. In addition, those with adequate health literacy skills as measured by the Rapid Estimate of Adult Literacy in Medicine-Short Form (REALM-SF) had higher knowledge overall ([Formula: see text] = 6.1 v. 4.8, P < 0.001) and preferred the plain language table to the visual (P = 0.04) and visual to narrative (P = 0.0002) conditions, while those with inadequate health literacy skills showed no preference for study condition. A similar pattern was seen for those with higher subjective numeracy skills and higher versus lower education with regard to health insurance knowledge. Individuals with higher income felt less confident in their choices ([Formula: see text] = 28.7 v. 10.0, where higher numbers indicate less confidence/more uncertainty; P = 0.004). Those developing materials about the health insurance marketplace to support health

  20. Environmental, health, and safety assessment of photovoltaics

    Energy Technology Data Exchange (ETDEWEB)

    Rose, E.C.

    1983-10-15

    Potential enviornmental, health, and safety (E,H and S) concerns associated with all phases of the photovoltaic (PV) energy system life cycle are identified and assessed. E,H and S concerns affecting the achievement of National PV Program goals or the viability of specific PV technologies are emphasized. The report is limited to near-term manufacturing process alternatives for crystalline silicon PV materials, addresses flat-plate and concentrator collector designs, and reviews system deployment in grid-connected, roof-mounted, residential and ground-mounted central-station applications. The PV life-cycle phases examined include silicon refinement and manufacture of PV collectors, system deployment, and decommissioning. The primary E,H and S concerns that arise during collector fabrication are associated with occupational exposure to materials of undetermined toxicity or to materials that are known to be hazardous, but for which process control technology may be inadequate. Stricter exposure standards are anticipated for some materials and may indicate a need for further control technology development. Minimizing electric shock hazards is a significant concern during system construction, operation and maintenance, and decommissioning.

  1. Robot-supported assessment of balance in standing and walking.

    Science.gov (United States)

    Shirota, Camila; van Asseldonk, Edwin; Matjačić, Zlatko; Vallery, Heike; Barralon, Pierre; Maggioni, Serena; Buurke, Jaap H; Veneman, Jan F

    2017-08-14

    Clinically useful and efficient assessment of balance during standing and walking is especially challenging in patients with neurological disorders. However, rehabilitation robots could facilitate assessment procedures and improve their clinical value. We present a short overview of balance assessment in clinical practice and in posturography. Based on this overview, we evaluate the potential use of robotic tools for such assessment. The novelty and assumed main benefits of using robots for assessment are their ability to assess 'severely affected' patients by providing assistance-as-needed, as well as to provide consistent perturbations during standing and walking while measuring the patient's reactions. We provide a classification of robotic devices on three aspects relevant to their potential application for balance assessment: 1) how the device interacts with the body, 2) in what sense the device is mobile, and 3) on what surface the person stands or walks when using the device. As examples, nine types of robotic devices are described, classified and evaluated for their suitability for balance assessment. Two example cases of robotic assessments based on perturbations during walking are presented. We conclude that robotic devices are promising and can become useful and relevant tools for assessment of balance in patients with neurological disorders, both in research and in clinical use. Robotic assessment holds the promise to provide increasingly detailed assessment that allows to individually tailor rehabilitation training, which may eventually improve training effectiveness.

  2. Social support network structure in older people: underlying dimensions and association with psychological and physical health.

    Science.gov (United States)

    Golden, Jeannette; Conroy, Ronán M; Lawlor, Brian A

    2009-05-01

    Social networks have been associated with a wide variety of health outcomes in older people. We examined the dimensions underlying the Wenger social support network type assessment to identify dimensions associated with mental and physical health. We interviewed 1334 community-dwelling participants aged 65+. The Geriatric Mental State automated geriatric examination for computer-assisted taxonomy interview was used to rate psychiatric symptoms and quality of life. Cognitive impairment was defined as a score of social support network domains: family (distance from and contact with relatives) and social engagement. Social engagement was associated with a lower age- and sex-adjusted prevalence of depression (odds ratio for a one-tertile increase 0.48), generalised anxiety disorder (OR 0.60), cognitive impairment (OR 0.68) and physical disability (OR 0.62) all p social engagement domain was also associated with better quality of life (OR 1.5) self-rated happiness (OR 1.3) and rating life as worth living (OR 1.4). The family domain, on the other hand, was not significantly associated with any health outcome. The results suggest that elective relationships and social engagement are the 'active ingredients' of social networks which promote health in later life.

  3. Mobile Apps to Support and Assess Foreign Language Learning

    Science.gov (United States)

    Berns, Anke; Palomo-Duarte, Manuel; Dodero, Juan Manuel; Ruiz-Ladrón, Juan Miguel; Márquez, Andrea Calderón

    2015-01-01

    In the last two decades there have been many attempts to integrate all kinds of mobile devices and apps to support formal as well as informal learning processes. However, most of the available apps still support mainly individual learning, using mobile devices to deliver content rather than providing learners with the opportunity to interact with…

  4. An Assessment of the Emerging Networks of Support for Street ...

    African Journals Online (AJOL)

    Nigeria, being asignatory to the Convention on the Rights of the Child (UNCRC, 1989) promulgated the Child Rights Act 2003, which aimed at ameliorating the condition of street children in Nigeria. In line with this, there are emerging networks of support for street children. The extent to which these support networks are ...

  5. Telephone based self-management support by 'lay health workers' and 'peer support workers' to prevent and manage vascular diseases: a systematic review and meta-analysis.

    Science.gov (United States)

    Small, Nicola; Blickem, Christian; Blakeman, Tom; Panagioti, Maria; Chew-Graham, Carolyn A; Bower, Peter

    2013-12-27

    Improved prevention and management of vascular disease is a global priority. Non-health care professionals (such as, 'lay health workers' and 'peer support workers') are increasingly being used to offer telephone support alongside that offered by conventional services, to reach disadvantaged populations and to provide more efficient delivery of care. However, questions remain over the impact of such interventions, particularly on a wider range of vascular related conditions (such as, chronic kidney disease), and it is unclear how different types of telephone support impact on outcome. This study assessed the evidence on the effectiveness and cost-effectiveness of telephone self-management interventions led by 'lay health workers' and 'peer support workers' for patients with vascular disease and long-term conditions associated with vascular disease. Systematic review of randomised controlled trials. Three electronic databases were searched. Two authors independently extracted data according to the Cochrane risk of bias tool. Random effects meta-analysis was used to pool outcome measures. Ten studies were included, primarily based in community settings in the United States; with participants who had diabetes; and used 'peer support workers' that shared characteristics with patients. The included studies were generally rated at risk of bias, as many methodological criteria were rated as 'unclear' because of a lack of information.Overall, peer telephone support was associated with small but significant improvements in self-management behaviour (SMD = 0.19, 95% CI 0.05 to 0.33, I2 = 20.4%) and significant reductions in HbA1c level (SMD = -0.26, 95% CI -0.41 to -0.11, I2 = 47.6%). There was no significant effect on mental health quality of life (SMD = 0.03, 95% CI -0.12 to 0.18, I2 = 0%). Data on health care utilisation were very limited and no studies reported cost effectiveness analyses. Positive effects were found for telephone self-management interventions via 'lay

  6. [Preventive health care and health promotion: Which models for supporting the evolution of clinical practice in primary health care?].

    Science.gov (United States)

    Vanmeerbeek, Marc; Mathonet, Julien; Miermans, Marie-Christine; Lenoir, Anne-Laure; Vandoorne, Chantal

    2015-06-01

    Published operating models about preventive health care and health promotion in primary care were sought with the aim of (1) compiling a functional inventory; and (2) to formulate working hypotheses for the improvement of clinical practice towards more efficiency and more equity. Narrative literature review, using keywords related to the various prevention classes, health promotion, primary care, practice models and health care delivery. The diversity of models led to a multi-criteria analysis. Twelve models were selected. Their characteristics were unevenly distributed. The models, whose authors announce that they apply to prevention, mainly describe approaches that focus on individuals within physician-patient relationship, and take into account practice organization. Some socio-ecological and systems models illustrate health promotion: educational practice, group- or population-based targets, community environment and social determinants of health. There is little room for patients in elaborating the models, as they have little role in health care systems. The definitions of prevention, health promotion and patient education greatly differ from one model to another. Little is known about practical implementation of the models; assessment data are scarce. Some elements valued by health promotion could be integrated to health care: empowerment of citizens, addressing community environment; increased involvement in local health professionals' networks; integration of individual and collective approaches within the same health care facilities to address simultaneously individual customization, efficiency and equity objectives. These developments may call for adaptation in vocational training and continuous professional development: communication skills, awareness to public health concepts, and early and longitudinal exposure to community-based learning experiences for students. Copyright © 2015. Published by Elsevier Masson SAS.

  7. Religion-based emotional social support mediates the relationship between intrinsic religiosity and mental health.

    Science.gov (United States)

    Hovey, Joseph D; Hurtado, Gabriela; Morales, Lori R A; Seligman, Laura D

    2014-01-01

    Although previous research suggests that increased religiosity is associated with better mental health and many authors have conjectured that religion-based social support may help explain this connection, scant research has directly examined whether religion-based support mediates religiosity and mental health. The present study examined whether various dimensions of religion-based support (social interaction, instrumental, and emotional) mediated the relationship between religiosity and mental health in college students in the Midwest United States. As expected, of the support dimensions, perceived emotional support was the strongest predictor of decreased hopelessness, depression, and suicide behaviors; and the relationships among intrinsic religiosity and the mental health variables were fully mediated by emotional support. These findings provide strong support to the notion that the relationship between religiosity and mental health can be reduced to mediators such as social support. Research and theoretical implications are discussed.

  8. Building Canadian Support for Global Health Research - Phase III ...

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

    2008. Key activities will include mobilizing Canadian investment in global health research, building global health research capacity in Canada and LMICs, translating research into action, nurturing partnerships between researchers in Canada ...

  9. Main and interactive effects of social support in predicting mental health symptoms in men and women following military stressor exposure.

    Science.gov (United States)

    Smith, Brian N; Vaughn, Rachel A; Vogt, Dawne; King, Daniel W; King, Lynda A; Shipherd, Jillian C

    2013-01-01

    Evidence across a multitude of contexts indicates that social support is associated with reduced risk for mental health symptoms. More information is needed on the effectiveness of different sources of support, as well as sex differences in support. Associations between social support from two sources - the military unit and friends and family - and mental health symptoms were examined in a study of 1571 Marine recruits assessed at the beginning and end of a highly stressful 13-week training program. Military social support buffered the stressor exposure-posttraumatic stress symptomatology (PTSS) relationship, whereas the relationship between stressor exposure and PTSS was highest when civilian social support was high. Further inspection of the interactions revealed that military support was most important at high levels of stressor exposure. Sex differences in the relationship between social support and symptoms were found, such that support from military peers was associated with lower levels of PTSS for men, whereas civilian support was associated with lower PTSS for women. While civilian social support was associated with lower levels of depression symptom severity in both women and men, the relationship was stronger for women. Reviewed implications focus on the importance of considering the recipient, source, and context of social support.

  10. Health Impact Assessment as a Student Service Learning Experience

    Science.gov (United States)

    Stone, Cynthia; Greene, Marion S.

    2012-01-01

    Health Impact Assessments (HIAs) incorporate a combination of tools, methods, and procedures to evaluate the potential health effects of a proposed program, project, or policy. The university public health department, in collaboration with the county health department, and the local planning organization, developed a curriculum for a…

  11. Reciprocal Effects Between Health and Social Support in Older Adults' Relationships With Their Children and Friends.

    Science.gov (United States)

    Ha, Jung-Hwa; Kahng, Sang Kyoung; Choi, Namkee

    2015-10-16

    This study examined the longitudinal reciprocal effects between health and social support in older adults' relationships with their children and friends. Data are from the 2006 and 2010 waves of the Health and Retirement Study (N = 3,760). We focused on three specific aspects of social support: frequency of contact, positive interactions, and negative interactions. We used autoregressive cross-lagged models to examine the bidirectional effects between social support and health. When the bidirectional effects between health and social support were simultaneously examined, the longitudinal effect of social support on health was not significant. In contrast, older adults' poor health was associated with decreased contact and decreased positive interactions with friends as well as with increased negative interactions with their adult children and friends. The findings suggest that older adults' poor health has a negative impact on their social relationships and that such effect surpasses the impact of social relationships on health. © The Author(s) 2015.

  12. Medical students' subjective ratings of stress levels and awareness of student support services about mental health.

    Science.gov (United States)

    Walter, Garry; Soh, Nerissa Li-Wey; Norgren Jaconelli, Sanna; Lampe, Lisa; Malhi, Gin S; Hunt, Glenn

    2013-06-01

    To descriptively assess medical students' concerns for their mental and emotional state, perceived need to conceal mental problems, perceived level of support at university, knowledge and use of student support services, and experience of stresses of daily life. From March to September 2011, medical students at an Australian university were invited to complete an anonymous online survey. 475 responses were received. Students rated study and examinations (48.9%), financial concerns (38.1%), isolation (19.4%) and relationship concerns (19.2%) as very or extremely stressful issues. Knowledge of available support services was high, with 90.8% indicating they were aware of the university's medical centre. Treatment rates were modest (31.7%). Students' concerns about their mental state were generally low, but one in five strongly felt they needed to conceal their emotional problems. Despite widespread awareness of appropriate support services, a large proportion of students felt they needed to conceal mental and emotional problems. Overall treatment rates for students who were greatly concerned about their mental and emotional state appeared modest, and, although comparable with those of similarly aged community populations, may reflect undertreatment. It would be appropriate for universities to address stressors identified by students. Strategies for encouraging distressed students to obtain appropriate assessment and treatment should also be explored. Those students who do seek healthcare are most likely to see a primary care physician, suggesting an important screening role for these health professionals.

  13. Worksite Health Promotion, Labor Unions and Social Support.

    Science.gov (United States)

    Feldman, Robert H. L.

    1989-01-01

    By working with labor unions, health educators have the opportunity to reach worker groups that have been ignored by many worksite health promotion programs. A union-based smoking cessation program is described, and general guidelines for worksite health promotion are given. (IAH)

  14. Rangeland health assessment - The key to understanding and assessing rangeland soil health in the Northern Great Plains

    Science.gov (United States)

    As the science related to soil and rangeland health evolves, so do their protocols and assessment methodologies. Rangeland health assessments consist of evaluating how well ecological processes such as the water cycle, energy flow and nutrient cycling are functioning at a site. Soil health is the ca...

  15. 47 CFR 54.613 - Limitations on supported services for rural health care providers.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 3 2010-10-01 2010-10-01 false Limitations on supported services for rural health care providers. 54.613 Section 54.613 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) UNIVERSAL SERVICE Universal Service Support for Health Care Providers § 54.613 Limitations on supported...

  16. Health risk assessment in the occupational health nurse’s practice

    OpenAIRE

    2012-01-01

    M.Cur. Occupational health nurses are qualified registered nurses with a post-graduate qualification in occupational health nursing as a specialised discipline, and provide the basic healthcare aspect of the occupational health programme. Their most important activity is to identify and assess the health hazard risks in the workplace. Health risk assessments are conducted by occupational health nurses to determine all the stresses, e.g. hazardous chemicals, vibration, insufficient lighting...

  17. Ozone Health Risk Assessment for Selected Urban Areas

    Science.gov (United States)

    The health risk assessment described in this report estimated various health effects associated with O3 exposures as well as the reduced risks for one O3 season associated with just meeting the current O3 NAAQS.

  18. Computational Exposure Science: An Emerging Discipline to Support 21st-Century Risk Assessment.

    Science.gov (United States)

    Egeghy, Peter P; Sheldon, Linda S; Isaacs, Kristin K; Özkaynak, Halûk; Goldsmith, Michael-Rock; Wambaugh, John F; Judson, Richard S; Buckley, Timothy J

    2016-06-01

    Computational exposure science represents a frontier of environmental science that is emerging and quickly evolving. In this commentary, we define this burgeoning discipline, describe a framework for implementation, and review some key ongoing research elements that are advancing the science with respect to exposure to chemicals in consumer products. The fundamental elements of computational exposure science include the development of reliable, computationally efficient predictive exposure models; the identification, acquisition, and application of data to support and evaluate these models; and generation of improved methods for extrapolating across chemicals. We describe our efforts in each of these areas and provide examples that demonstrate both progress and potential. Computational exposure science, linked with comparable efforts in toxicology, is ushering in a new era of risk assessment that greatly expands our ability to evaluate chemical safety and sustainability and to protect public health. Egeghy PP, Sheldon LS, Isaacs KK, Özkaynak H, Goldsmith M-R, Wambaugh JF, Judson RS, Buckley TJ. 2016. Computational exposure science: an emerging discipline to support 21st-century risk assessment. Environ Health Perspect 124:697-702; http://dx.doi.org/10.1289/ehp.1509748.

  19. An electronic health record to support patients and institutions of the health care system

    Directory of Open Access Journals (Sweden)

    Ückert, Frank

    2004-08-01

    Full Text Available The department of Medical Informatics of the University Hospital Münster and the Gesakon GmbH (an university offspring initiated the cooperative development of an electronic health record (EHR called "akteonline.de" in 2000. From 2001 onwards several clinics of the university hospital have already offered this EHR (within pilot projects as an additional service to selected subsets of their patients. Based on the experiences of those pilot projects the system architecture and the basic data model underwent several evolutionary enhancements, e.g. implementations of electronic interfaces to other clinical systems (considering for example data interchange methods like the Clinical Document Architecture - standardized within the HL7 group - and also interfacing architectures of German GP systems, such as VCS and D2D. "akteonline.de" in its current structure supports patients as well as health care professionals and aims at providing a collaborative health information system which perfectly supports the clinical workflow even across institutional boundaries and including the patient himself. Since such an EHR needs to strictly fulfill high data security and data protection requirements, a complex authorization and access control component has been included. Furthermore the EHR data are encrypted within the database itself and during their transfer across the internet.

  20. An electronic health record to support patients and institutions of the health care system.

    Science.gov (United States)

    Uckert, Frank; Müller, Marcel Lucas; Bürkle, Thomas; Prokosch, Hans-Ulrich

    2004-08-24

    The department of Medical Informatics of the University Hospital Münster and the Gesakon GmbH (an university offspring) initiated the cooperative development of an electronic health record (EHR) called "akteonline.de" in 2000. From 2001 onwards several clinics of the university hospital have already offered this EHR (within pilot projects) as an additional service to selected subsets of their patients. Based on the experiences of those pilot projects the system architecture and the basic data model underwent several evolutionary enhancements, e.g. implementations of electronic interfaces to other clinical systems (considering for example data interchange methods like the Clinical Document Architecture - standardized within the HL7 group - and also interfacing architectures of German GP systems, such as VCS and D2D). "akteonline.de" in its current structure supports patients as well as health care professionals and aims at providing a collaborative health information system which perfectly supports the clinical workflow even across institutional boundaries and including the patient himself. Since such an EHR needs to strictly fulfill high data security and data protection requirements, a complex authorization and access control component has been included. Furthermore the EHR data are encrypted within the database itself and during their transfer across the internet.

  1. Mental health and psychological support in UK armed forces personnel deployed to Afghanistan in 2010 and 2011.

    Science.gov (United States)

    Jones, Norman; Mitchell, Paul; Clack, John; Fertout, Mohammed; Fear, Nicola T; Wessely, Simon; Greenberg, Neil

    2014-02-01

    Most accounts of deployment mental health in UK armed forces personnel rely on retrospective assessments. We present data relating to the burden of mental ill health and the effect of support measures including operational, family, welfare and medical support obtained on two occasions some 18 months apart. A total of 2794 personnel completed a survey while deployed to Afghanistan; 1363 in 2011 and 1431 in 2010. Their responses were compared and contrasted. The prevalence of self-report mental health disorder was low and not significantly different between the surveys; the rates of probable post-traumatic stress disorder (PTSD) were 2.8% in 2010 and 1.8% in 2011; for common mental health disorders the rates were 17.0% and 16.0% respectively. Remembering receiving predeployment psychoeducation, perceptions of good leadership and good family support were all significantly associated with better mental health. Seeking support from non-medical sources and reporting sick for medical reasons were both significantly associated with poorer mental health. Over a period of 18 months, deployment mental health symptoms in UK armed forces personnel were fewer than those obtained from a military population sample despite continuing deployment in a high-threat context and were associated with perceptions of support.

  2. Policy processes and health technology assessment

    NARCIS (Netherlands)

    Palmhøj Nielsen, Camilla; Sarriá Santamera, Antonio; Vondeling, Hindrik

    2008-01-01

    Decision-makers throughout Europe have a common goal of raising health standards in order to improve the health status of the European population. Health service delivery is carried out under conditions of growing political and economic complexity – rapid technological change puts pressure on

  3. Assessment of implementation of the health management ...

    African Journals Online (AJOL)

    Background Despite Malawi's introduction of a health management information system (HMIS) in 1999, the country's health sector still lacks accurate, reliable, complete, consistent and timely health data to inform effective planning and resource management. Methods A cross-sectional survey was conducted wherein ...

  4. Assessing the quality of care in a new nation: South Sudan's first national health facility assessment.

    Science.gov (United States)

    Berendes, Sima; Lako, Richard L; Whitson, Donald; Gould, Simon; Valadez, Joseph J

    2014-10-01

    We adapted a rapid quality of care monitoring method to a fragile state with two aims: to assess the delivery of child health services in South Sudan at the time of independence and to strengthen local capacity to perform regular rapid health facility assessments. Using a two-stage lot quality assurance sampling (LQAS) design, we conducted a national cross-sectional survey among 156 randomly selected health facilities in 10 states. In each of these facilities, we obtained information on a range of access, input, process and performance indicators during structured interviews and observations. Quality of care was poor with all states failing to achieve the 80% target for 14 of 19 indicators. For example, only 12% of facilities were classified as acceptable for their adequate utilisation by the population for sick-child consultations, 16% for staffing, 3% for having infection control supplies available and 0% for having all child care guidelines. Health worker performance was categorised as acceptable in only 6% of cases related to sick-child assessments, 38% related to medical treatment for the given diagnosis and 33% related to patient counselling on how to administer the prescribed drugs. Best performance was recorded for availability of in-service training and supervision, for seven and ten states, respectively. Despite ongoing instability, the Ministry of Health developed capacity to use LQAS for measuring quality of care nationally and state-by-state, which will support efficient and equitable resource allocation. Overall, our data revealed a desperate need for improving the quality of care in all states. © 2014 John Wiley & Sons Ltd.

  5. The role of social support in the association between gambling, poor health and health risk-taking.

    Science.gov (United States)

    Räsänen, Tiina; Lintonen, Tomi; Tolvanen, Asko; Konu, Anne

    2016-08-01

    Studies have shown that gambling is associated with poor health and health risk-taking behaviour. However, little is known about those factors that can influence the association between gambling, health risk-taking and health. Using a population-based School Health Promotion Study of eighth- and ninth-grade Finnish boys and girls (N = 62,956), we investigated the relationships between gambling frequency, health risk-taking and poor health as well as whether social support from parents, friends and school staff could mediate these associations. Path analysis was used to discover direct and indirect effects of health, health risk-taking and gambling. Social support from parents and school staff decreased gambling among boys and girls, whereas among boys support from friends increased gambling. However, the role of social support as a mediator was very weak. Overall poor health and health risk-taking were associated with increased gambling. CONCLUSIONS GAMBLING SHOULD BE CONSIDERED AN IMPORTANT PUBLIC HEALTH ISSUE BECAUSE IT CLUSTERS WITH OTHER UNHEALTHY BEHAVIOUR PATTERNS INTERVENTIONS CONCERNING ADOLESCENT GAMBLING SHOULD ALSO TAKE OTHER SIMULTANEOUS RISK-TAKING INTO CONSIDERATION ALSO SOCIAL SUPPORT FROM PARENTS AND SCHOOL SHOULD BE NOTED WHEN TRYING TO DECREASE ADOLESCENTS' GAMBLING. © 2016 the Nordic Societies of Public Health.

  6. Health literacy assessment and patient satisfaction in surgical practice.

    Science.gov (United States)

    Komenaka, Ian K; Nodora, Jesse N; Machado, Lorenzo; Hsu, Chiu-Hsieh; Klemens, Anne E; Martinez, Maria Elena; Bouton, Marcia E; Wilhelmson, Krista L; Weiss, Barry D

    2014-03-01

    Individuals with limited health literacy have barriers to patient-physician communication. Problems in communication are known to contribute to malpractice litigation. Concern exists, however, about the feasibility and patient acceptance of a health literacy assessment. This study was performed to determine the feasibility of health literacy assessment in surgical practice and its effect on patient satisfaction. Every patient seen in a Breast Surgery Clinic during a 2-year period was asked to undergo a health literacy assessment with the Newest Vital Sign (NVS) as part of the routine history and physical examination. During the year before routine NVS assessments and during the 2-year study period, all patients were asked to rate their "overall satisfaction with clinic visit" on a 5-point scale. A total of 2,026 of 2,097 patients (96.6%) seen during the study were eligible for the health literacy assessment. Of those, no patients refused assessment, and only one patient was missed. Therefore, 2,025 of 2,026 eligible patients (99.9%) underwent the assessment. The average time for NVS assessment was 2:02 minutes. Only 19% of patients had adequate health literacy. Patient satisfaction ratings were slightly greater during the first year of the health literacy assessment (3.8 vs 3.7, P = .049) compared with the year prior to health literacy assessment and greater during the second year of health literacy assessment (4.1 vs 3.7, P < .0001). Routine health literacy assessment is feasible in surgical practice and results in no decrease in patient satisfaction. In fact, satisfaction was greater during the years when health literacy assessments were performed. Copyright © 2014 Mosby, Inc. All rights reserved.

  7. The role of autonomy and social support in the relation between psychosocial safety climate and stress in health care workers

    NARCIS (Netherlands)

    Havermans, B.M.; Boot, C.R.L.; Houtman, I.L.D.; Brouwers, E.P.M.; Anema, J.R.; Beek, A.J. van der

    2017-01-01

    BACKGROUND: Health care workers are exposed to psychosocial work factors. Autonomy and social support are psychosocial work factors that are related to stress, and are argued to largely result from the psychosocial safety climate within organisations. This study aimed to assess to what extent the

  8. The role of autonomy and social support in the relation between psychosocial safety climate and stress in health care workers

    NARCIS (Netherlands)

    Havermans, B.M.; Boot, C.R.L.; Houtman, I.L.D.; Brouwers, E.P.M.; Anema, J.R.; van der Beek, A.J.

    2017-01-01

    Background Health care workers are exposed to psychosocial work factors. Autonomy and social support are psychosocial work factors that are related to stress, and are argued to largely result from the psychosocial safety climate within organisations. This study aimed to assess to what extent the

  9. Health System Decision Makers' Feedback on Summaries and Tools Supporting the Use of Systematic Reviews: A Qualitative Study

    Science.gov (United States)

    Ellen, Moriah E.; Lavis, John N.; Wilson, Michael G.; Grimshaw, Jeremy; Haynes, R. Brian; Ouimet, Mathieu; Raina, Parminder; Gruen, Russell

    2014-01-01

    Health system managers and policy makers need timely access to high quality, policy-relevant systematic reviews. Our objectives were to obtain managers' and policy makers' feedback about user-friendly summaries of systematic reviews and about tools related to supporting or assessing their use. Our interviews identified that participants prefer key…

  10. Assessment of mercury health risks to adults from coal combustion

    Energy Technology Data Exchange (ETDEWEB)

    Lipfert, F.W.; Moskowitz, P.D.; Fthenakis, V.M.; DePhillips, M.P.; Viren, J.; Saroff, L.

    1994-05-01

    The U.S. Environmental Protection Agency (EPA) is preparing, for the U.S. Congress, a report evaluating the need to regulate mercury (Hg) emissions from electric utilities. This study, to be completed in 1995, will have important health and economic implications. In support of these efforts, the U.S. Department of Energy, Office of Fossil Energy, sponsored a risk assessment project at Brookhaven National Laboratory (BNL) to evaluate methylmercury (MeHg) hazards independently. In the BNL study, health risks to adults resulting from Hg emissions from a hypothetical 1000 MW{sub e} coal-fired power plant were estimated using probabilistic risk assessment techniques. The approach draws on the extant knowledge in each of the important steps in the calculation chain from emissions to health effects. Estimated results at key points in the chain were compared with actual measurements to help validate the modeled estimates. Two cases were considered: the baseline case (no local impacts), and the impact case (maximum local power-plant impact). The BNL study showed that the effects of emissions of a single power plant may double the background exposures to MeHg resulting from consuming fish obtained from a localized area near the power plant. Many implicit and explicit sources of uncertainty exist in this analysis. Those that appear to be most in need of improvement include data on doses and responses for potentially sensitive subpopulations (e.g., fetal exposures). Rather than considering hypothetical situations, it would also be preferable to assess the risks associated with actual coal-fired power plants and the nearby sensitive water bodies and susceptible subpopulations. Finally, annual total Hg emissions from coal burning and from other anthropogenic sources are still uncertain; this makes it difficult to estimate the effects of U.S. coal burning on global Hg concentration levels, especially over the long term.

  11. Effectiveness of computerized risk assessment system on enhancing workers' occupational health and attitudes towards occupational health.

    Science.gov (United States)

    Ho, Wan-Yi; Sung, Connie Y Y; Yu, Qiu-Hua; Chan, Chetwyn C H

    2014-01-01

    Efforts have been paid to lower the health risks associated with use of computers at the workplace. Computerized risk assessment systems are available in the market for adoption by companies. The Display Screen Equipment Risk Assessment and Management System was designed for conducting risk assessment and providing intelligent-driven solutions for DSE-related occupational health problems. This report summarizes two consecutive research work conducted on evaluating its effect in reducing body discomfort and mental fatigue, and enhancing sedentary workers' occupational health. Convenience sampling was adopted to recruit participants (111 participants for Study 1 and 75 participants for Study 2 who were randomly assigned to an immediate or a delayed intervention group. The intervention was using DSE RAM System to perform a risk assessment followed by an immediate modification of participant's workstation based on the recommendations generated by the System. Face to face interview was conducted and participants completed three sets of questionnaires right before the assessment and two weeks after the intervention. The results of Study 1 revealed that the DSE RAM System was effective for alleviating the discomfort and fatigue levels by rectifying the workstation-worker match. These mismatches were identified to be the heights of monitor, keyboard and chair with the workers. The results of Study 2 indicate that the System was specific for promoting participants to take more frequent rest breaks (OR: 3.65) and pay more attention to occupational safety and health information (OR: 3.90). In particular, the take frequent rest breaks behavior was found to predict decrease in discomfort in the eyes and mental fatigue (lack of energy). Nevertheless, there was no strong evidence on the use of the System can lead to immediate attitudinal changes towards occupational health and safety. The findings support the notion that workers' participation and integration of ergonomics into

  12. The role of autonomy and social support in the relation between psychosocial safety climate and stress in health care workers.

    Science.gov (United States)

    Havermans, Bo M; Boot, Cécile R L; Houtman, Irene L D; Brouwers, Evelien P M; Anema, Johannes R; van der Beek, Allard J

    2017-06-08

    Health care workers are exposed to psychosocial work factors. Autonomy and social support are psychosocial work factors that are related to stress, and are argued to largely result from the psychosocial safety climate within organisations. This study aimed to assess to what extent the relation between psychosocial safety climate and stress in health care workers can be explained by autonomy and social support. In a cross-sectional study, psychosocial safety climate, stress, autonomy, co-worker support, and supervisor support were assessed using questionnaires, in a sample of health care workers (N = 277). Linear mixed models analyses were performed to assess to what extent social support and autonomy explained the relation between psychosocial safety climate and stress. A lower psychosocial safety climate score was associated with significantly higher stress (B = -0.21, 95% CI = -0.27 - -0.14). Neither co-worker support, supervisor support, nor autonomy explained the relation between psychosocial safety climate and stress. Taken together, autonomy and both social support measures diminished the relation between psychosocial safety climate and stress by 12% (full model: B = -0.18, 95% CI = -0.25 - -0.11). Autonomy and social support together seemed to bring about a small decrease in the relation between psychosocial safety climate and stress in health care workers. Future research should discern whether other psychosocial work factors explain a larger portion of this relation. This study was registered in the Netherlands National Trial Register, trial code: NTR5527 .

  13. Using Assessment to Support Employability Awareness\\ud and Development

    OpenAIRE

    Wilson-Medhurst, Sarah

    2005-01-01

    This paper examines a teaching and learning approach to support employability awareness and development within a pilot employability module on the second year of an undergraduate degree (at London Metropolitan University). The module, QB212 ‘Professional Systems in Systems Development’, resides within the computing and information systems subject area (IT sector).\\ud \\ud The view of employability taken on this module, and the courses it supports, is that whether or not a student is employable...

  14. Guidance on DSTO Analysis Support to ADF Campaign Assessment

    Science.gov (United States)

    2013-10-01

    support was later formalised under Operational Science and Technology Support Request (OPSTSR) 132. UNCLASSIFIED DSTO-TN-1233 UNCLASSIFIED 8...evaluation is integrated into the CA process. The LARF has been trialled on a variety of campaign planning and CA phases, and may be formalised as part of CA...some form of formalised initiation of each cycle from HQJOC to Commander of the deployed HQ is required. This could eliminate potential

  15. Associations among stress, gender, sources of social support, and health in emerging adults.

    Science.gov (United States)

    Lee, Chih-Yuan Steven; Dik, Bryan J

    2017-10-01

    This study aimed to examine how sources of social support intersect with stress and health by testing two theoretical models. Three relationship-specific sources of social support (family, friends, and romantic partners) and two health indicators (self-rated physical health and depressive symptoms) were investigated. The sample consisted of 636 emerging adults attending college (age range: 18-25). Results suggest that only support from family was a stress-buffer, in that it buffered the adverse association between stress and depressive symptoms. Holding stress constant, only support from family was related to self-rated physical health and only support from friends or romantic partners was associated with depressive symptoms. There were no gender differences in the mean levels of self-rated physical health and depressive symptoms. However, gender moderations were found, in that the positive relationship between friends support and physical health was observed only in women, that the association between friends support and depressive symptoms was greater in men than in women, and that family support buffered the negative relationship between stress and physical health only in men. Findings of this study suggest that the associations among stress, social support, and health vary by the sources of support, the health outcome, and gender. Copyright © 2016 John Wiley & Sons, Ltd.

  16. Social Networks and Social Support in Health Promotion Programmes

    OpenAIRE

    Donev, Doncho; Pavlekovic, Gordana; Zaletel Kragelj, Lijana

    2008-01-01

    Social networks and social support are general terms to describe different aspects of social relationships, including those mechanisms, which may protect the individual from the negative effects of stress. The social support is offered by the part of the social network, the people around us, that are ready to help us, and on whose help we can always count. Those enjoying strong social ties appear to be at low risk of psychosocial and physical impairment, whereas a lack of social support has b...

  17. Integrated Science Assessment (ISA) for Nitrogen Dioxide (Health Criteria)

    Science.gov (United States)

    Information, history and background on the development and maintenance of nitrogen dioxide (health criteria) assessments. There is a separate site that has combined NOx/SOx ecological criteria assessment.

  18. Human Health Toxicity Values in Superfund Risk Assessments

    Science.gov (United States)

    This memorandum revises the hierarchy of human health toxicity values generally recommended for use inr isk assessments, originally presented in Risk Assessment Guidance for Superfund Volume I, Part A.

  19. Using Health Impact Assessment as an Interdisciplinary Teaching Tool.

    Science.gov (United States)

    Chinchilla, Melissa; Arcaya, Mariana C

    2017-07-08

    Health Impact Assessment (HIA) courses are teaching public health and urban planning students how to assess the likely health effects of proposed policies, plans, and projects. We suggest that public health and urban planning have complimentary frameworks for training practitioners to address the living conditions that affect health. Planning perspectives emphasize practical skills for impacting community change, while public health stresses professional purpose and ethics. Frameworks from both disciplines can enhance the HIA learning experience by helping students tackle questions related to community impact, engagement, social justice, and ethics. We also propose that HIA community engagement processes can be enriched through an empathetic practice that focuses on greater personal introspection.

  20. A health examination system integrated with clinical decision support system.

    Science.gov (United States)

    Kuo, Kuan-Liang; Fuh, Chiou-Shann

    2010-10-01

    Health examinations play a key role in preventive medicine. We propose a health examination system named Health Examination Automatic Logic System (HEALS) to assist clinical workers in improving the total quality of health examinations. Quality of automated inference is confirmed by the zero inference error where during 6 months and 14,773 cases. Automated inference time is less than one second per case in contrast to 2 to 5 min for physicians. The most significant result of efficiency evaluation is that 3,494 of 4,356 (80.2%) cases take less than 3 min per case for producing a report summary. In the evaluation of effectiveness, novice physicians got 18% improvement in making decisions with the assistance of our system. We conclude that a health examination system with a clinical decision system can greatly reduce the mundane burden on clinical workers and markedly improve the quality and efficiency of health examination tasks.

  1. Re-Designing Community Mental Health Services for Urban Children: Supporting Schooling to Promote Mental Health

    Science.gov (United States)

    Atkins, Marc S.; Shernoff, Elisa S.; Frazier, Stacy L.; Schoenwald, Sonja K.; Cappella, Elise; Marinez-Lora, Ane; Mehta, Tara G.; Lakind, Davielle; Cua, Grace; Bhaumik, Runa; Bhaumik, Dulal

    2015-01-01

    Objective This study examined a school- and home-based mental health service model, Links to Learning (L2L), focused on empirical predictors of learning as primary goals for services in high poverty urban communities. Method Teacher key opinion leaders (KOLs) were identified through sociometric surveys and trained, with mental health providers (MHPs) and parent advocates (PAs), on evidence-based practices to enhance children’s learning. KOLs and MHPs co-facilitated professional development sessions for classroom teachers to disseminate two universal (Good Behavior Game, Peer Assisted Learning) and two targeted (Good News Notes, Daily Report Card) interventions. Group-based and home-based family education and support were delivered by MHPs and PAs for K-4th grade children diagnosed with one or more disruptive behavior disorder. Services were Medicaid-funded through four social service agencies (N = 17 providers) in seven schools (N = 136 teachers, 171 children) in a two (L2L vs. services-as-usual SAU]) by six (pre- and post-tests for three years) longitudinal design with random assignment of schools to conditions. SAU consisted of supported referral to a nearby social service agency. Results Mixed effects regression models indicated significant positive effects of L2L on mental health service use, classroom observations of academic engagement, teacher report of academic competence and social skills, and parent report of social skills. Nonsignificant between-group effects were found on teacher and parent report of problem behaviors, daily hassles, and curriculum based measures. Effects were strongest for young children, girls, and children with fewer symptoms. Conclusions Community mental health services targeting empirical predictors of learning can improve school and home behavior for children living in high poverty urban communities. PMID:26302252

  2. METHODOLOGICAL APPROACHES TO ASSESSMENTS OF HEALTH RISKS IN HYGIENIC RESEARCH

    Directory of Open Access Journals (Sweden)

    A. M. Biblin

    2013-01-01

    Full Text Available This review of publications presents the analysis of national scientific publications and methodological documents on health risks assessments under unfavorable external impacts. In available research publications, the hygienic risks assessment is most often considered in situations of chemicals impact, and such assessment has sufficient methodological providing. Comparison of publications and methodological documents allows determination of the possibility of methodological unity for health risk assessment in conditions of chemical and radiation impacts.

  3. Peer educator vs. respiratory therapist support: which form of support better maintains health and functional outcomes following pulmonary rehabilitation?

    Science.gov (United States)

    Wong, Eric Y; Jennings, Cally A; Rodgers, Wendy M; Selzler, Anne-Marie; Simmonds, Lindsay G; Hamir, Rashida; Stickland, Michael K

    2014-04-01

    This study examined if ongoing support delivered by telephone following pulmonary rehabilitation (PR) assisted chronic obstructive pulmonary disease (COPD) patients to maintain health outcomes. Phase one (n=79) compared post-rehabilitation telephone-based support delivered by peers compared to usual care (UC). The second phase (n=168) compared post-rehabilitation support from peer educators, respiratory therapists (RT), or UC. Primary outcome variables were St. George's Respiratory Questionnaire (SGRQ) total score and the six minute walk test (6MWT). Measures were obtained at baseline, immediately following PR, and six-months post PR. Six-month follow-up data for phase one was collected for 66 COPD patients (n=35 peer support, n=31 UC) and 142 for phase two (n=42 peer support, n=52 RT support, n=48 UC). Per-protocol and intention to treat (ITT) analysis in both phases found no significant group by time differences for SGRQ or 6MWT. Providing peer or RT support via telephone following PR was not more effective than UC for maintaining health outcomes. There are concerns with using peers to provide ongoing support to COPD patients. Additionally, COPD patients require a higher level of care than telephone support can provide. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  4. Health Impact Assessment Practice and Potential for Integration within Environmental Impact and Strategic Environmental Assessments in Italy

    Science.gov (United States)

    Linzalone, Nunzia; Assennato, Giorgio; Ballarini, Adele; Cadum, Ennio; Cirillo, Mario; Cori, Liliana; De Maio, Francesca; Musmeci, Loredana; Natali, Marinella; Rieti, Sabrina; Soggiu, Maria Eleonora; Bianchi, Fabrizio

    2014-01-01

    Avoiding or minimizing potential environmental impact is the driving idea behind protecting a population’s health via Environmental Impact Assessments (EIAs) and Strategic Environmental Assessments (SEAs). However, both are often carried out without any systematic approach. This paper describes the findings of a review of HIA, EIA and SEA experiences carried out by the authors, who act as institutional competent subjects at the national and regional levels in Italy. The analysis of how health is tackled in EIA and SEA procedures could support the definition of a protocol for the integration of HIA with EIA and SEA. Although EIA and SEA approaches include the aim of protecting health, significant technical and methodological gaps are present when assessing health systematically, and their basic principles regarding assessment are unsatisfactory for promoting and addressing healthcare concepts stated by the WHO. HIA is still poorly integrated into the decision-making process, screening and monitoring phases are only occasionally implemented, and operational details are not well-defined. The collaborative approach of institutions involved in environment and health is a core element in a systematic advancement toward supporting effective decisions and effective protection of the environment and health. At the Italian national level, the definition of guidelines and tools for HIA, also in relation with EIA and SEA, is of great interest. PMID:25493391

  5. Health Impact Assessment practice and potential for integration within Environmental Impact and Strategic Environmental Assessments in Italy.

    Science.gov (United States)

    Linzalone, Nunzia; Assennato, Giorgio; Ballarini, Adele; Cadum, Ennio; Cirillo, Mario; Cori, Liliana; De Maio, Francesca; Musmeci, Loredana; Natali, Marinella; Rieti, Sabrina; Soggiu, Maria Eleonora; Bianchi, Fabrizio

    2014-12-01

    Avoiding or minimizing potential environmental impact is the driving idea behind protecting a population's health via Environmental Impact Assessments (EIAs) and Strategic Environmental Assessments (SEAs). However, both are often carried out without any systematic approach. This paper describes the findings of a review of HIA, EIA andSEA experiences carried out by the authors, who act as institutional competent subjects at the national and regional levels in Italy. The analysis of how health is tackled in EIA and SEA procedures could support the definition of a protocol for the integration of HIA with EIA and SEA. Although EIA and SEA approaches include the aim of protecting health,significant technical and methodological gaps are present when assessing health systematically, and their basic principles regarding assessment are unsatisfactory for promoting and addressing healthcare concepts stated by the WHO. HIA is still poorly integrated into the decision-making process, screening and monitoring phases are only occasionally implemented, and operational details are not well-defined. The collaborative approach of institutions involved in environment and health is a core element in a systematic advancement toward supporting effective decisions and effective protection ofthe environment and health. At the Italian national level, the definition of guidelines and tools for HIA, also in relation with EIA and SEA, is of great interest.

  6. Using Community Health Assessment to Teach and Explore Health Status Disparities

    Science.gov (United States)

    Sullivan, Marianne; Levine, Jack

    2014-01-01

    Introduction: Community health assessment (CHA) is a useful tool for identifying health status disparities at the community level. Developing the skills of master's level public health students to conduct CHA addresses a number of the Association of Schools of Public Health Core competencies for graduate public health education. Teaching…

  7. Equity-focused health impact assessment of Portuguese tobacco control legislation.

    Science.gov (United States)

    Costa, A; Cortes, M; Sena, C; Nunes, E; Nogueira, P; Shivaji, T

    2016-10-02

    The World Health Organization recommend the Equity-Focused Health Impact Assessment (HIA) as a means to assess the impact of social and economic policies on the health of populations, and acknowledges their contribution to health inequality. We describe the application of the Equity-focused Impact Assessment methodology on the Portuguese law on Smoking Prevention and Tobacco Control (Law No. 37/2007). A rapid assessment was carried out to issue recommendations which could be incorporated into the law during a revision in 2014. Quantitative (consumption and health status indicators; equity analysis) and qualitative (Focus Group) approaches were taken to evaluate the impact of the law and formulate recommendations. Young people, men and women of low socioeconomic status, and pregnant women were identified as requiring specific and appropriate interventions to prevent smoking and support smoking cessation. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  8. Relationships between Academic Stress, Social Support, Mental Health and Academic Performance in Venezuelan University Students

    OpenAIRE

    LYA FELDMAN; LILA GONCALVES; GRACE CHACÓN-PUIGNAU; JOANMIR ZARAGOZA; NURI BAGÉS; JOAN DE PABLO

    2008-01-01

    The objective of the present study was to evaluate academic stress, social support and their relationships with mental health and academic performance in university students. Three hundred and twenty one students from a technological university in Caracas, Venezuela, responded instruments on academic stress, social support and mental health during the most academically stressful period. The results indicate that favorable conditions of mental health were associated to more social support and ...

  9. The correlation of social support with mental health: A meta-analysis

    OpenAIRE

    Harandi, Tayebeh Fasihi; Taghinasab, Maryam Mohammad; Nayeri, Tayebeh Dehghan

    2017-01-01

    Background and aim Social support is an important factor that can affect mental health. In recent decades, many studies have been done on the impact of social support on mental health. The purpose of the present study is to investigate the effect size of the relationship between social support and mental health in studies in Iran. Methods This meta-analysis was carried out in studies that were performed from 1996 through 2015. Databases included SID and Magiran, the comprehensive portal of hu...

  10. Assessing Cancer Health Literacy among Spanish-Speaking Latinos.

    Science.gov (United States)

    Echeverri, Margarita; Anderson, David; Nápoles, Anna María

    2017-07-24

    Health literacy is a dynamic construct that changes with specific health conditions; thus, new disease-specific health literacy tools are needed. Since cancer is the leading cause of death among Latinos, the largest and fastest-growing minority population in the nation, there is a need to develop tools to assess cancer health literacy (CHL) among the Spanish-speaking population. The Cancer Health Literacy Test, Spanish version (CHLT-30-DKspa) was applied to identify Spanish-speaking individuals with low CHL and ascertain which items in the tool best discriminate between CHL level groups. Cross-sectional field test of the CHLT-30-DKspa among Spanish-speaking Latinos. Latent class analysis (LCA) identified participants with varying CHL levels. Probability of correct answers, odds ratios, and standardized errors were used to identify the items that allow the classification of individuals among the latent classes. LCA resulted in a three-latent-class model predicting 39.4% of participants to be in the HIGH class, 43.3% in the MEDIUM class, and 17.3% in the LOW class. Eleven items (the CHLT-11-DKspa) meet the criteria to clearly separate participants with HIGH and LOW classes of CHL. Although the best model fit was a three-class solution, results showed a clear separation of individuals from HIGH versus LOW levels of CHL, but separation of those in the MEDIUM level was not as clear. The CHLT-11-DKspa is a shorter measure that may be relatively easy to use in a clinical encounter to identify Spanish-speaking patients with the poorest levels of CHL who may require additional support to understand medical instructions and care plans.

  11. Theorizing about social support and health communication in a prostate cancer support group.

    Science.gov (United States)

    Arrington, Michael Irvin

    2010-01-01

    This article inquires into whether and how uncertainty reduction theory and problematic integration theory, two theories relevant to social support as enacted within a chapter of the Man-to-Man prostate cancer support group, inform us of how such groups can assist group members most effectively. Interview data from members of a prostate cancer support group shed light on theoretical assumptions about uncertainty. Although the group applies elements of both theories, prostate cancer survivors likely would benefit from a more comprehensive and flexible treatment of social support theory.

  12. Assessment of the Health Impacts of Climate Change in Kiribati

    OpenAIRE

    Lachlan McIver; Alistair Woodward; Seren Davies; Tebikau Tibwe; Steven Iddings

    2014-01-01

    Kiribati—a low-lying, resource-poor Pacific atoll nation—is one of the most vulnerable countries in the World to the impacts of climate change, including the likely detrimental effects on human health. We describe the preparation of a climate change and health adaptation plan for Kiribati carried out by the World Health Organization and the Kiribati Ministry of Health and Medical Services, including an assessment of risks to health, sources of vulnerability and suggestions for highest prior...

  13. Questioning reliability assessments of health information on social media

    OpenAIRE

    Nicole K. Dalmer, BSc, MLIS, PhD Candidate

    2017-01-01

    This narrative review examines assessments of the reliability of online health information retrieved through social media to ascertain whether health information accessed or disseminated through social media should be evaluated differently than other online health information. Several medical, library and information science, and interdisciplinary databases were searched using terms relating to social media, reliability, and health information. While social media?s increasing role in health i...

  14. Health Impact Assessment Impact Characterization Table

    Science.gov (United States)

    The potential health impacts of the proposed decision should be characterized based on the following criteria: Direction, Likelihood, Magnitude, Distribution, Severity, Permanence, Strength of Evidence.

  15. Health financing reform in Kenya- assessing the social health ...

    African Journals Online (AJOL)

    For economic, social, political and organisational reasons a transition period will be necessary, which is likely to last more than a decade. However, important objectives such as access to health care and avoiding impoverishment due to direct health care payments should be recognised from the start so that steady progress ...

  16. Assessing support packs from an occupational hygiene perspective

    CSIR Research Space (South Africa)

    Pretorius, Cecilia J

    2017-07-01

    Full Text Available Support packs in the mining industry are used to support the hangingwall from imminent collapse where the rock and/or soil have been excavated in mining activities. Mines generally use explosives to move the rock face while following the reef... fraction CS is a problem to employees and users of the products only once the bulk material becomes airborne. The Metrology Working Group of the Industrial Minerals Association in Europe (IMA-EU) has developed the Size-Weighted Poten- tial Respirable...

  17. Mapping the terrain: A conceptual schema for a mental health medication support service in community pharmacy

    National Research Council Canada - National Science Library

    Scahill, Shane; Fowler, Jane L; Hattingh, H Laetitia; Kelly, Fiona; Wheeler, Amanda J

    2015-01-01

    .... To best inform the design of a community pharmacy medication support intervention for mental health consumers, the literature was reported as a conceptual schema and subsequent recommendations...

  18. Agriculture for Improved Nutrition and Health: Support to the ...

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

    ... Africa and 33% in South Asia are undernourished. Agricultural practices, interventions, and policies need to be better adapted and redesigned in order to maximize health and nutrition benefits and reduce health risks for the poor. Much agricultural research funding is spent on the "big three" grains: rice, maize and wheat.

  19. Evaluation of a Reproductive Health Program to Support Married ...

    African Journals Online (AJOL)

    Few reproductive health programs are targeted to married adolescent girls. This study measures changes associated with a program for married adolescent girls and a parallel husbands' program, in rural Ethiopia. The married girls' program provided information on communication, self-esteem, reproductive health and ...

  20. Rationale and scientific support for health claims on foods

    African Journals Online (AJOL)

    Nicky

    The role of diet and physical activity in health has been increasingly documented and pinpointed as a major ... development and normal physiological functions of the body; (ii) other function claims – previously referred to .... Draft guidelines for use of nutrition and health claims. ALINORM 04/27/22 APPENDIX III, 2004. 9.

  1. Agriculture for Improved Nutrition and Health: Support to the ...

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

    The Food and Agriculture Organization estimates that 28% of the population in sub-Saharan Africa and 33% in South Asia are undernourished. Agricultural practices, interventions, and policies need to be better adapted and redesigned in order to maximize health and nutrition benefits and reduce health risks for the poor.

  2. GPs' opinions of health assessment instruments for people with intellectual disabilities: a qualitative study.

    Science.gov (United States)

    Bakker-van Gijssel, Esther J; Olde Hartman, Tim C; Lucassen, Peter Lbj; van den Driessen Mareeuw, Francine; Dees, Marianne K; Assendelft, Willem Jj; van Schrojenstein Lantman-de Valk, Henny Mj

    2017-01-01

    GPs provide health care to people with intellectual disabilities (ID). People with ID find it difficult to express themselves concerning health-related matters. Applying health assessments is an effective method to reveal health needs, and can play a role in prevention and health promotion. The aim of this qualitative study was to explore GPs' considerations about applying a health assessment for people with ID. This focus group study was conducted among a selection of Dutch GPs. An interview guide was developed. All discussions were audiorecorded and transcribed. Analysis was performed using the framework analysis approach. Two researchers independently applied open coding and identified a thematic framework. This framework and the summaries of views per theme were discussed in the research team. After four focus groups, with 23 GPs, saturation was reached. Three main themes evolved: health assessments in relation to GPs' responsibility; the usefulness and necessity of health assessments; and barriers to using health assessments on people with ID. A health assessment instrument for people with ID can help GPs to focus on certain issues that are not so common in the general population. GPs are motivated to use such a tool if it is scientifically tested, and results in significant health gains. However, GPs identify barriers at the level of GP, patient, and organisation. Most GPs in the focus groups consider providing medical care to people with ID their responsibility and indicate that a health assessment instrument could be a valuable tool. In order to deliver good care, they need education and support. Many barriers need to be overcome before a health assessment instrument can be implemented. © British Journal of General Practice 2017.

  3. The impact of perceived stress, social support, and home-based physical activity on mental health among older adults.

    Science.gov (United States)

    Kwag, Kyung Hwa; Martin, Peter; Russell, Daniel; Franke, Warren; Kohut, Marian

    2011-01-01

    This study investigated how perceived stress, social support, and home-based physical activity affected older adults' fatigue, loneliness, and depression. We also explored whether social support and physical activity mediated the relationships between stress and mental health problems. The data of 163 older participants were analyzed in this study. Structural equation modeling using LISREL 8.71 was performed to assess the effects of stress, support, and physical activity on mental health. The findings indicate that perceived stress predicted higher levels of depression, social support predicted lower levels of loneliness and fatigue, and physical activity predicted lower levels of fatigue among older adults. Social support and physical activity mediated the relationships between stress and mental health, except depression. In conclusion, the relative impacts of perceived stress, social support, and physical activity on types of mental health (e.g., fatigue, loneliness, and depression) were different. Furthermore, stress had direct and indirect effects on each construct of mental health (e.g., fatigue, loneliness, and depression).

  4. Pharmaceutical expenditure forecast model to support health policy decision making.

    Science.gov (United States)

    Rémuzat, Cécile; Urbinati, Duccio; Kornfeld, Åsa; Vataire, Anne-Lise; Cetinsoy, Laurent; Aballéa, Samuel; Mzoughi, Olfa; Toumi, Mondher

    2014-01-01

    With constant incentives for healthcare payers to contain their pharmaceutical budgets, modelling policy decision impact became critical. The objective of this project was to test the impact of various policy decisions on pharmaceutical budget (developed for the European Commission for the project 'European Union (EU) Pharmaceutical expenditure forecast' - http://ec.europa.eu/health/healthcare/key_documents/index_en.htm). A model was built to assess policy scenarios' impact on the pharmaceutical budgets of seven member states of the EU, namely France, Germany, Greece, Hungary, Poland, Portugal, and the United Kingdom. The following scenarios were tested: expanding the UK policies to EU, changing time to market access, modifying generic price and penetration, shifting the distribution chain of biosimilars (retail/hospital). Applying the UK policy resulted in dramatic savings for Germany (10 times the base case forecast) and substantial additional savings for France and Portugal (2 and 4 times the base case forecast, respectively). Delaying time to market was found be to a very powerful tool to reduce pharmaceutical expenditure. Applying the EU transparency directive (6-month process for pricing and reimbursement) increased pharmaceutical expenditure for all countries (from 1.1 to 4 times the base case forecast), except in Germany (additional savings). Decreasing the price of generics and boosting the penetration rate, as well as shifting distribution of biosimilars through hospital chain were also key methods to reduce pharmaceutical expenditure. Change in the level of reimbursement rate to 100% in all countries led to an important increase in the pharmaceutical budget. Forecasting pharmaceutical expenditure is a critical exercise to inform policy decision makers. The most important leverages identified by the model on pharmaceutical budget were driven by generic and biosimilar prices, penetration rate, and distribution. Reducing, even slightly, the prices of

  5. Perceived support from a caregiver's social ties predicts subsequent care-recipient health.

    Science.gov (United States)

    Kelley, Dannielle E; Lewis, Megan A; Southwell, Brian G

    2017-12-01

    Most social support research has examined support from an individual patient perspective and does not model the broader social context of support felt by caregivers. Understanding how social support networks may complement healthcare services is critical, considering the aging population, as social support networks may be a valuable resource to offset some of the demands placed on the healthcare system. We sought to identify how caregivers' perceived organizational and interpersonal support from their social support network influences care-recipient health. We created a dyadic dataset of care-recipient and caregivers from the first two rounds of the National Health and Aging Trends survey (2011, 2012) and the first round of the associated National Study of Caregivers survey (2011). Using structural equation modeling, we explored how caregivers' perceived social support is associated with caregiver confidence to provide care, and is associated with care-recipient health outcomes at two time points. All data were analyzed in 2016. Social engagement with members from caregivers' social support networks was positively associated with caregiver confidence, and social engagement and confidence were positively associated with care-recipient health at time 1. Social engagement positively predicted patient health at time 2 controlling for time 1. Conversely, use of organizational support negatively predicted care-recipient health at time 2. Care-recipients experience better health outcomes when caregivers are able to be more engaged with members of their social support network.

  6. The Informatics Collaboratory: building an online community to support health care informatics students.

    Science.gov (United States)

    Skiba, Diane J; Barton, Amy J; Howard, Audrey; Fields, Leeann; McCullar, Wendy

    2004-01-01

    For the past decade, the School of Nursing has examined the role of computer mediated communication and virtual environments in both health care and educational systems. This recent project, the I-Collaboratory, draws upon previous work and builds on recent studies examining the role of social presence in learning communities. The I-Collaboratory creates a virtual infrastructure to support a collaborative learning environment for Master level students in a web-based health care informatics program. This innovative and supportive environment allows students to learn through collaborative inter-actions and have access to a cadre of professionals associated with nursing, informatics and health care. This paper provides an introduction to the concept of a collaboratory and describes the set of principles derived from the literature that serve as a foundation. The process of selecting a web-based platform and the development of the online community based on the results of a need assessment is also detailed. The paper concludes with an outline of the online community components and the plans for evaluation.

  7. Support Process Development for Assessing Green Infrastructure in Omaha, NE

    Science.gov (United States)

    Evaluates Omaha’s current process for assessing green infrastructure projects and recommends improvements for comparing green and gray infrastructure. Compares Omaha’s design criteria to other cities. Reviews other US programs with rights-of-way criteria.

  8. The power of social connection and support in improving health: lessons from social support interventions with childbearing women

    Directory of Open Access Journals (Sweden)

    Small Rhonda

    2011-11-01

    Full Text Available Abstract Background and objective Social support interventions have a somewhat chequered history. Despite evidence that social connection is associated with good health, efforts to implement interventions designed to increase social support have produced mixed results. The aim of this paper is to reflect on the relationship between social connectedness and good health, by examining social support interventions with mothers of young children and analysing how support was conceptualised, enacted and valued, in order to advance what we know about providing support to improve health. Context and approach First, we provide a brief recent history of social support interventions for mothers with young children and we critically examine what was intended by ‘social support’, who provided it and for which groups of mothers, how support was enacted and what was valued by women. Second, we examine the challenges and promise of lay social support approaches focused explicitly on companionship, and draw on experiences in two cluster randomised trials which aimed to improve the wellbeing of mothers. One trial involved a universal approach, providing befriending opportunities for all mothers in the first year after birth, and the other a targeted approach offering support from a ‘mentor mother’ to childbearing women experiencing intimate partner violence. Results Interventions providing social support to mothers have most often been directed to women seen as disadvantaged, or ‘at risk’. They have also most often been enacted by health professionals and have included strong elements of health education and/or information, almost always with a focus on improving parenting skills for better child health outcomes. Fewer have involved non-professional ‘supporters’, and only some have aimed explicitly to provide companionship or a listening ear, despite these aspects being what mothers receiving support have said they valued most. Our trial

  9. [Quality of health care, accreditation, and health technology assessment in Croatia: role of agency for quality and accreditation in health].

    Science.gov (United States)

    Mittermayer, Renato; Huić, Mirjana; Mestrović, Josipa

    2010-12-01

    standards, and providing other services in the field of healthcare quality assurance, improvement, promotion and monitoring, according to the Act. Formal activities of the Agency in the field of HTA actually began in summer 2009. In the field of quality and accreditation, the plan and program of healthcare quality assurance, improvement, promotion and monitoring was finished and published in October 2010; preparation of the healthcare quality standards as well as the accreditation standards is still in process, with the aim to start accreditation process at 10 hospitals in 2011. Education in the field of healthcare quality assurance, improvement and promotion has been established as a continuous process from the beginning. The Agency is member of the International Society for Quality in Health Care (ISQua) and participates in the work of the European Accreditation Network (EAN). In the field of HTA, the Agency has established international collaboration and support, which resulted in its appointment and participation in the European network for Health Technology Assessment (EUnetHTA) Joint Action Project as a EUnetHTA Partner, as well as its membership in the international society, HTAi. TAIEX project has been approved as a two-day workshop in December 2010. The Croatian HTA Guidelines have been issued with the aim to start the HTA process and reports that should serve as recommendations, as a support to policy-makers at the national level, in particular the Croatian Ministry of Health and Social Welfare, and Croatian Institute of Health Insurance, in making evidence-informed decisions on the strategic planning, investment, management and implementation of technologies in health care, on funding (reimbursement) and coverage of health technologies, and at hospital level on the request from hospital directors and policy teams. In conclusion, establishment of all these measures in Croatia is by no means an easy and quick process, however, we do believe that it is feasible

  10. Vulnerability Assessments in Support of the Climate Ready ...

    Science.gov (United States)

    As part of the Climate Ready Estuaries (CRE) program, the Global Change Research Program (GCRP) in the National Center for Environmental Assessment, Office of Research and Development at the U.S. Environmental Protection Agency has prepared this draft report exploring a new methodology for climate change vulnerability assessments using San Francisco Bay’s salt marsh and mudflat ecosystems as a demonstration. N/A

  11. Assessment of Transport Projects: Risk Analysis and Decision Support

    DEFF Research Database (Denmark)

    Salling, Kim Bang

    2008-01-01

    . Even though vast amounts of money are spent upon preliminary models, environmental investigations, public hearings, etc., the resulting outcome is given by point estimates, i.e. in terms of net present values or benefit-cost rates. This thesis highlights the perspective of risks when assessing...... choosing probability distributions and performing real term data fits. The perspective of this Ph.D. study presents newer and better understanding of assigning risks within assessment of transport projects....

  12. Air Quality Modeling Technical Support Document for the 2015 Ozone NAAQS Preliminary Interstate Transport Assessment

    Science.gov (United States)

    In this technical support document (TSD) EPA describes the air quality modeling performed to support the 2015 ozone National Ambient Air Quality Standards (NAAQS) preliminary interstate transport assessment Notice of Data Availability (NODA).

  13. Revisiting Health System Performance Assessment in Africa

    NARCIS (Netherlands)

    Achoki, Tom

    2016-01-01

    Health systems in Africa have long faced a huge burden of disease, amidst pressing resource constraints. However, despite the constraints, the last three decades have seen the region make progress in tackling some of the most critical health challenges. Notably, many countries have registered

  14. An Assessment of the Emerging Networks of Support for Street ...

    African Journals Online (AJOL)

    Nekky Umera

    by the homeless adults on the street is most preferred (μ=3.26) while the government agencies were least on this ranking scale (μ=1.78).The study concluded that, despite the global shift from eradication of street children to providing support for them right on the streets, this paradigm shift has very weak roots in Nigeria.

  15. Assessment of nutritional status of soil supporting coconut ( Cocus ...

    African Journals Online (AJOL)

    Coconut cultivation and information on the nutritional status of soils and fertilizers recommendations for its cultivation are limited in Nigeria. Since a high yield of coconut is related to the fertility status of the soil, a study was conducted to evaluate the status of soils supporting coconut cultivation. The evaluation of the surface ...

  16. Impact Assessment of UN Peacebuilding Support in Central Africa ...

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

    ... to help consolidate peace and national reconciliation, strengthen democratic institutions to promote the rule of law, and mobilize international political support and resources for national reconstruction and economic recovery. It also promotes public awareness of human rights and the strengthening of civil society capacity.

  17. Assessment of nutritional status of soil supporting coconut (Cocus ...

    African Journals Online (AJOL)

    AJB SERVER

    2007-02-05

    Feb 5, 2007 ... Coconut cultivation and information on the nutritional status of soils and fertilizers recommendations for its cultivation are limited in Nigeria. Since a high yield of coconut is related to the fertility status of the soil, a study was conducted to evaluate the status of soils supporting coconut cultivation. The.

  18. Ergonomic Assessment of a Seat Back Support (Spine Fit

    Directory of Open Access Journals (Sweden)

    Zeinab Kazemi1

    2014-04-01

    Full Text Available Background & Objectives : In case of inappropriateness of the dimensions of chairs or when users feel pain and pressure in their lumbar region due to poor posture, damage to the spine can be prevented using some additional supports. The aim of this study was ergonomic evaluation of one of these supportive products named “Spine Fit”. Methods : In this descriptive and cross-sectional study, in the first stage, five ergonomists evaluated the product regarding its dimension, adjustability, material, conformity, and manufacturer claims. Then, three groups of workers including office workers, office workers with low back pain, and bus drivers filled out a self-administered questionnaire after using Spine Fit . Results : For the first stage, an acceptable adjustability and dimension was found. Conformity for different kinds of office and bus seats was mostly fair. Findings from the second stage revealed that the subjects in three groups were satisfied regarding seats comfort and ease of use. Concerning the conformity of Spine Fit, it was in good level among office workers, while different levels of conformity were observed by drivers of different models of bus . Conclusion : Spine Fit supports back region based on its supportive role in pelvis, lumbar vertebrae column and thoracic spine. Moreover, Spine Fit features that reduce sweating can improve individuals’ convenience.

  19. Assessment and Placement: Supporting Student Success in College Gateway Courses

    Science.gov (United States)

    Vandal, Bruce

    2014-01-01

    Evidence is mounting that the vast majority of students who are currently placed into prerequisite remedial education could be successful in gateway college-­level courses if they receive additional academic support as a corequisite. Recent research on college placement exams reveals that the exams are unreliable at predicting college success, and…

  20. Experiences of health professionals with nutritional support of critically ill patients in tertiary hospitals in Malawi.

    Science.gov (United States)

    Bunyani, A; Mtimuni, B; Kalimbira, A; Kamalo, P

    2015-03-01

    Nutritional support is a recognized determinant of outcome in critically ill patients. Development of critical care services in low-income countries has not been accompanied by certain appropriate ancillary services and interventions, such as adequate nutritional support. This study was designed to investigate the experiences of health professionals who have provided nutritional supportive care to critically ill patients admitted to two major central hospitals in Malawi, with the aim of identifying the common practices in nutritional support in these settings. A cross-sectional study in which 50 health professionals working in intensive care and high dependency units, admitting both adult and pediatric patients, were interviewed using a semi-structured questionnaire. Data were coded and then analyzed using SPSS version 16.0. Responses between the two hospitals were compared using Fisher's exact test. There was no difference in the composition of respondents from the two hospitals. About 60% of respondents had had experience with nutritional supplementation in their patients-mainly enteral. The most commonly used formulations were the "ready-to-use therapeutic feeds," followed by modified milk. A high percentage of respondents (40%) reported having used dextrose solution as the sole nutritional supplement. Lack of in-service training, nonexistent nutrition protocols pertaining to acutely and critically ill patients, and a lack of clinical nutritionists were the major challenges identified. Knowledge of nutrient supplementation was poor among the respondents. The use of ready-to-use therapeutic feeds was quite common, although there is no evidence of its effectiveness in care of acutely critically ill patients. There is a need to establish nutritional support teams in these tertiary hospitals. Clinical nutritionists would ideally help train and play leadership roles in such teams, who would be responsible for assessing patients for their nutritional needs, and

  1. Pathway to Support the Sustainable National Health Information System

    Science.gov (United States)

    Sahavechaphan, Naiyana; Phengsuwan, Jedsada; U-Ruekolan, Suriya; Aroonrua, Kamron; Ponhan, Jukrapong; Harnsamut, Nattapon; Vannarat, Sornthep

    Heath information across geographically distributed healthcare centers has been recognized as an essential resource that drives an efficient national health-care plan. There is thus a need for the National Health Information System (NHIS) that provides the transparent and secure access to health information from different healthcare centers both on demand and in a time efficient manner. As healthiness is the ultimate goal of people and nation, we believe that the NHIS should be sustainable by taking the healthcare center and information consumer perspectives into account. Several issues in particular must be resolved altogether: (i) the diversity of health information structures among healthcare centers; (ii) the availability of health information sharing from healthcare centers; (iii) the efficient information access to various healthcare centers; and (iv) the privacy and privilege of heath information. To achieve the sustainable NHIS, this paper details our work which is divided into 3 main phases. Essentially, the first phase focuses on the application of metadata standard to enable the interoperability and usability of health information across healthcare centers. The second phase moves forward to make information sharing possible and to provide an efficient information access to a large number of healthcare centers. Finally, in the third phase, the privacy and privilege of health information is promoted with respect to access rights of information consumers.

  2. Assessment of the Health IT Usability Evaluation Model (Health-ITUEM) for evaluating mobile health (mHealth) technology.

    Science.gov (United States)

    Brown, William; Yen, Po-Yin; Rojas, Marlene; Schnall, Rebecca

    2013-12-01

    Over two decades of research has been conducted using mobile devices for health related behaviors yet many of these studies lack rigor. There are few evaluation frameworks for assessing the usability of mHealth, which is critical as the use of this technology proliferates. As the development of interventions using mobile technology increase, future work in this domain necessitates the use of a rigorous usability evaluation framework. We used two exemplars to assess the appropriateness of the Health IT Usability Evaluation Model (Health-ITUEM) for evaluating the usability of mHealth technology. In the first exemplar, we conducted 6 focus group sessions to explore adolescents' use of mobile technology for meeting their health Information needs. In the second exemplar, we conducted 4 focus group sessions following an Ecological Momentary Assessment study in which 60 adolescents were given a smartphone with pre-installed health-related applications (apps). We coded the focus group data using the 9 concepts of the Health-ITUEM: Error prevention, Completeness, Memorability, Information needs, Flexibility/Customizability, Learnability, Performance speed, Competency, Other outcomes. To develop a finer granularity of analysis, the nine concepts were broken into positive, negative, and neutral codes. A total of 27 codes were created. Two raters (R1 and R2) initially coded all text and a third rater (R3) reconciled coding discordance between raters R1 and R2. A total of 133 codes were applied to Exemplar 1. In Exemplar 2 there were a total of 286 codes applied to 195 excerpts. Performance speed, Other outcomes, and Information needs were among the most frequently occurring codes. Our two exemplars demonstrated the appropriateness and usefulness of the Health-ITUEM in evaluating mobile health technology. Further assessment of this framework with other study populations should consider whether Memorability and Error prevention are necessary to include when evaluating mHealth

  3. Risk Assessment Methodology for Software Supportability (RAMSS): User’s Handbook.

    Science.gov (United States)

    1986-04-14

    287 THE RON CORPORATION 1801 Randolph Road. S E. Albuquerque, NM 87106 0 505) 848-5000 Risk Assessment Methodology for Software Supportability ( RAMSS ...S.E., Albuquerque, NM 87106 * (505) 848-5000 RISK ASSESSMENT METHODOLOGY FOR SOFTWARE SUPPORTABILITY ( RAMSS ) USER’S HANDBOOK April 14, 1986 BDM/A.-85...NThe Risk Assessment Methodology for Software Supportability ( RAMSS ) was developed for the Air Force Operational Test and Evaluation Center (AFOTEC) to

  4. Health Assessment and the Right to Health in Sweden: Asylum Seekers' Perspectives.

    Science.gov (United States)

    Lobo Pacheco, Lubin; Jonzon, Robert; Hurtig, Anna-Karin

    2016-01-01

    Swedish law entitles asylum seekers to a voluntary health assessment and to "health care that cannot be postponed". The last expression suggests, however, restrictions on the entitlement, and what it may or may not include remains ultimately a decision for health professionals in the specific case. Indeed, the health assessment constitutes the sole active effort from Swedish authorities to fulfill this right. This study was therefore aimed at assessing how the information, procedures and services related to the health assessment are accessible and acceptable to fulfill the right to health of asylum seekers, from their own perspective. The study has a cross-sectional design. A questionnaire was administrated in 16 language schools for immigrants, in four counties of Sweden. Three hundred eighty-six individuals fulfilled the inclusion criteria. The frequency of their answers was tabulated to estimate how the information, procedures and services related to the health assessment correspond to the criteria for accessibility and acceptability regarding the right to health. Forty-eight (12.4%) respondents did not undergo the health assessment. Thirty-one of them did not even receive the invitation letter. They said they lost the opportunity to know their health status, to obtain treatment for or advice about their health problems. Additionally, 55.2% of those who attended the health assessment indicated that their needs were overlooked, particularly when these were of a psychological nature. Two in three participants also considered the health assessment to be a communicable disease control, rather than an effort to take care of their health needs. Nevertheless, the respondents had a positive attitude towards the health assessment as such. Although being an important contribution, the health assessment does not suffice to fulfill the right to health of asylum seekers because there are shortcomings regarding the accessibility and acceptability of the information

  5. Health Assessment and the Right to Health in Sweden: Asylum Seekers' Perspectives.

    Directory of Open Access Journals (Sweden)

    Lubin Lobo Pacheco

    Full Text Available Swedish law entitles asylum seekers to a voluntary health assessment and to "health care that cannot be postponed". The last expression suggests, however, restrictions on the entitlement, and what it may or may not include remains ultimately a decision for health professionals in the specific case. Indeed, the health assessment constitutes the sole active effort from Swedish authorities to fulfill this right. This study was therefore aimed at assessing how the information, procedures and services related to the health assessment are accessible and acceptable to fulfill the right to health of asylum seekers, from their own perspective.The study has a cross-sectional design. A questionnaire was administrated in 16 language schools for immigrants, in four counties of Sweden. Three hundred eighty-six individuals fulfilled the inclusion criteria. The frequency of their answers was tabulated to estimate how the information, procedures and services related to the health assessment correspond to the criteria for accessibility and acceptability regarding the right to health.Forty-eight (12.4% respondents did not undergo the health assessment. Thirty-one of them did not even receive the invitation letter. They said they lost the opportunity to know their health status, to obtain treatment for or advice about their health problems. Additionally, 55.2% of those who attended the health assessment indicated that their needs were overlooked, particularly when these were of a psychological nature. Two in three participants also considered the health assessment to be a communicable disease control, rather than an effort to take care of their health needs. Nevertheless, the respondents had a positive attitude towards the health assessment as such.Although being an important contribution, the health assessment does not suffice to fulfill the right to health of asylum seekers because there are shortcomings regarding the accessibility and acceptability of the

  6. The Development of a Secondary School Health Assessment Model

    Science.gov (United States)

    Sriring, Srinual; Erawan, Prawit; Sriwarom, Monoon

    2015-01-01

    The objective of this research was to: 1) involved a survey of information relating to secondary school health, 2) involved the construction of a model of health assessment and a handbook for using the model in secondary school, 3) develop an assessment model for secondary school. The research included 3 phases. (1) involved a survey of…

  7. Urban ecosystem health assessment: perspectives and Chinese practice.

    Science.gov (United States)

    Su, Meirong; Zhang, Yan; Liu, Gengyuan; Xu, Linyu; Zhang, Lixiao; Yang, Zhifeng

    2013-11-06

    The concept of ecosystem health is a way to assess the holistic operations and development potential of urban ecosystems. Accelerated by the practical need for integrated ecosystem management, assessment of urban ecosystem health has been greatly developed and extensively applied in urban planning and management. Development is aimed at comprehensively evaluating the performance of urban ecosystems, identifying the limiting factors, and providing suggestions for urban regulation. The time has come for reviewing and establishing an instructional framework for urban ecosystem health assessment to shed light on certain essential issues of urban ecosystem health. Based on literature reviews and series of practice, a holistic framework of urban ecosystem health assessment is proposed. The framework covers the essential elements of urban ecosystem health and integrates three dimensions: theoretical foundation, assessment method, and practical application. Concrete assessment methods are also established, focusing on both external performance and internal metabolic processes. The practice of urban ecosystem health assessment in China is illustrated to briefly demonstrate the application of the established framework and methods. Some prospects are discussed for urban ecosystem health assessment and its application in urban planning and management.

  8. Supporting Risk Assessment: Accounting for Indirect Risk to Ecosystem Components.

    Directory of Open Access Journals (Sweden)

    Cathryn Clarke Murray

    Full Text Available The multi-scalar complexity of social-ecological systems makes it challenging to quantify impacts from human activities on ecosystems, inspiring risk-based approaches to assessments of potential effects of human activities on valued ecosystem components. Risk assessments do not commonly include the risk from indirect effects as mediated via habitat and prey. In this case study from British Columbia, Canada, we illustrate how such "indirect risks" can be incorporated into risk assessments for seventeen ecosystem components. We ask whether (i the addition of indirect risk changes the at-risk ranking of the seventeen ecosystem components and if (ii risk scores correlate with trophic prey and habitat linkages in the food web. Even with conservative assumptions about the transfer of impacts or risks from prey species and habitats, the addition of indirect risks in the cumulative risk score changes the ranking of priorities for management. In particular, resident orca, Steller sea lion, and Pacific herring all increase in relative risk, more closely aligning these species with their "at-risk status" designations. Risk assessments are not a replacement for impact assessments, but-by considering the potential for indirect risks as we demonstrate here-they offer a crucial complementary perspective for the management of ecosystems and the organisms within.

  9. Quantitative health impact assessment: taking stock and moving forward.

    Science.gov (United States)

    Fehr, Rainer; Hurley, Fintan; Mekel, Odile Cecile; Mackenbach, Johan P

    2012-12-01

    Over the past years, application of health impact assessment has increased substantially, and there has been a strong growth of tools that allow quantification of health impacts for a range of health relevant policies. We review these developments, and conclude that further tool development is no longer a main priority, although several aspects need to be further developed, such as methods to assess impacts on health inequalities and to assess uncertainties. The main new challenges are, first, to conduct a comparative evaluation of different tools, and, second, to ensure the maintenance and continued availability of the toolkits including their data contents.

  10. A Digital Feedback System to Support Implementation of Measurement-Based Care by School-Based Mental Health Clinicians.

    Science.gov (United States)

    Lyon, Aaron R; Pullmann, Michael D; Whitaker, Kelly; Ludwig, Kristy; Wasse, Jessica Knaster; McCauley, Elizabeth

    2017-03-02

    Evidence supports the utility of measurement-based care (MBC) to improve youth mental health outcomes, but clinicians rarely engage in MBC practices. Digital measurement feedback systems (MFS) may reflect a feasible strategy to support MBC adoption and sustainment. This pilot study was initiated to evaluate the impact of a MFS and brief consultation supports to facilitate MBC uptake and sustainment among mental health clinicians in the education sector, the most common mental health service delivery setting for youth. Following an initial training in MBC, 14 clinicians were randomized to either a digital MFS and brief consultation supports or control. Baseline ratings of MBC attitudes, skill, and use were collected. In addition, daily assessment ratings tracked 2 core MBC practices (i.e., assessment tool administration, provision of feedback) over a 6-month follow-up period. Clinicians in the MFS condition demonstrated rapid increases in both MBC practices, whereas the control group did not significantly change. For clinicians in the MFS group, consultation effects were significant for feedback and approached significance for administration. Over the follow-up period, average decreases in the current study were moderate with only 1 of the 2 outcome variables (administration) decreasing significantly. Inspection of individual clinician trajectories revealed substantial within-group trend variation. MFS may represent an effective MBC implementation strategy beyond initial training, although individual clinician response is variable. Identifying feasible and impactful implementation strategies is critical given the ability of MBC to support precision health care.

  11. Development of an online information and support resource for adolescent idiopathic scoliosis patients considering surgery: perspectives of health care providers

    Directory of Open Access Journals (Sweden)

    Nicholas David

    2010-06-01

    Full Text Available Abstract Background Adolescents with idiopathic scoliosis who are considering spinal surgery face a major decision that requires access to in-depth information and support. Unfortunately, most online resources provide incomplete and inconsistent information and minimal social support. The aim of this study was to develop an online information and support resource for adolescent idiopathic scoliosis (AIS patients considering spinal surgery. Prior to website development, a user-based needs assessment was conducted. The needs assessment involved a total of six focus groups with three stakeholder groups: (1 post-operative AIS patients or surgical candidates (10-18 years (n = 11, (2 their parents (n = 6 and (3 health care providers (n = 11. This paper reports on the findings from focus groups with health care providers. Methods Focus group methodology was used to invite a range of perspectives and stimulate discussion. During audio-recorded focus groups, an emergent table of website content was presented to participants for assessment of relevance, viability and comprehensiveness in targeting global domains of need. Specifically, effective presentation of content, desired aspects of information and support, and discussions about the value of peer support and the role of health professionals were addressed. Focus group transcripts were then subject to content analysis through a constant comparative review and analysis. Results Two focus groups were held with health care providers, consisting of 5 and 6 members respectively. Clinicians provided their perceptions of the information and support needs of surgical patients and their families and how this information and support should be delivered using internet technology. Health care providers proposed four key suggestions to consider in the development of this online resource: (1 create the website with the target audience in mind; (2 clearly state the purpose of the website and organize website content

  12. Development of an online information and support resource for adolescent idiopathic scoliosis patients considering surgery: perspectives of health care providers.

    Science.gov (United States)

    Macculloch, Radha; Nyhof-Young, Joyce; Nicholas, David; Donaldson, Sandra; Wright, James G

    2010-06-29

    Adolescents with idiopathic scoliosis who are considering spinal surgery face a major decision that requires access to in-depth information and support. Unfortunately, most online resources provide incomplete and inconsistent information and minimal social support. The aim of this study was to develop an online information and support resource for adolescent idiopathic scoliosis (AIS) patients c