Jinks, Annette M; Lawson, Valerie; Daniels, Ruth
Developing strategies to address the health needs of the National Health Services (NHS) workforce are of concern to many health care managers. Focal to the development of such strategies are of being in receipt of baseline information about employees expressed health needs and concerns. This article addresses obtaining such baseline information and presents the findings of a health needs survey of acute hospital staff in a trust in North Wales. The total population of trust employees were surveyed (n = 2300) and a 44% (n = 1021) response rate was achieved. A number of positive findings are given. Included are that the majority of those surveyed stated that their current health status is good, are motivated to improve their health further, do not smoke and their alcohol consumption is within recommended levels. There appears, however, to be a number of areas where trust managers can help its staff improve their health. Included are trust initiatives that focus on weight control and taking more exercise. In addition, there appears to be a reported lack of knowledge and positive health behaviour amongst the male respondents surveyed that would imply the trust needs to be more effective in promoting well man type issues. Finally there appears to be a general lack of pride in working for the trust and a pervasive feeling that the trust does not care about its employees that needs to be addressed. It is concluded that the findings of this survey have implications for management practices in the trust where the survey was conducted and also wider applicability to the management of health care professionals. For example, addressing work-related psychological and physical problems of employees are of importance to all health care managers. This is especially so when considering recruitment and retention issues.
Windsor, Timothy D; Rodgers, Bryan; Butterworth, Peter; Anstey, Kaarin J; Jorm, Anthony F
The effects of using different approaches to scoring the SF-12 summary scales of physical and mental health were examined with a view to informing the design and interpretation of community-based survey research. Data from a population-based study of 7485 participants in three cohorts aged 20-24, 40-44 and 60-64 years were used to examine relationships among measures of physical and mental health calculated from the same items using the SF-12 and RAND-12 approaches to scoring, and other measures of chronic physical conditions and psychological distress. A measure of physical health constructed using the RAND-12 scoring showed a monotonic negative association with psychological distress as measured by the Goldberg depression and anxiety scales. However, a non-monotonic association was evident in the relationship between SF-12 physical health scores and distress, with very high SF-12 physical health scores corresponding with high levels of distress. These relationships highlight difficulties in interpretation that can arise when using the SF-12 summary scales in some analytical contexts. It is recommended that community surveys that measure physical and mental functioning using the SF-12 items generate summary scores using the RAND-12 protocol in addition to the SF-12 approach. In general, researchers should be wary of using factor scores based on orthogonal rotation, which assumes that measures are uncorrelated, to represent constructs that have an actual association.
Kreps, G L; Ruben, B D; Baker, M W; Rosenthal, S R
Increasing emphasis in recent years has been placed on health promotion, prevention, and the self-management of health care. These strategies presume the public has sufficient levels of relevant health information, as well as necessary attitudes and skills for the effective use of this information in the management of their own health care. This study tests this assumption as it relates to the level of public knowledge of digestive health and disease, a major health concern affecting an estim...
Bradford, Judith; And Others
Findings from national survey of approximately 1,925 U lesbians revealed that over 50% had considered suicide and 18% had attempted suicide; 37% had been physically abused; 32% had been raped/sexually attacked; and 19% had been in incestuous relationships. Almost one-third used tobacco daily, and about 30% drank alcohol more than once a week.…
McCaughey, Deirdre; McGhan, Gwen; Kim, Jungyoon; Brannon, Diane; Leroy, Hannes; Jablonski, Rita
Purpose of study: The direct care workforce continues to rank as one of the most frequently injured employee groups in North America. Occupational health and safety studies have shown that workplace injuries translate into negative outcomes for workers and their employers. The National Institute for Occupational Safety and Health (NIOSH)…
Anderson, Britta L; Juliano, Laura M; Schulkin, Jay
Caffeine has relevance for women's health and pregnancy, including significant associations with spontaneous abortion and low birth weight. According to scientific data, pregnant women and women of reproductive age should be advised to limit their caffeine consumption. This article reviews the implications of caffeine for women's psychological and physical health, and presents data on obstetrician-gynecologists' (ob-gyns) knowledge and practices pertaining to caffeine. Ob-gyns (N = 386) who are members of the American College of Obstetricians and Gynecologists' Collaborative Ambulatory Research Network responded to a 21-item survey about caffeine. Although most knew that caffeine is passed through breast milk, only 24.8% were aware that caffeine metabolism significantly slows as pregnancy progresses. Many respondents were not aware of the caffeine content of commonly used products, such as espresso and Diet Coke, with 14.3% and 57.8% indicating amounts within an accurate range, respectively. Furthermore, ob-gyns did not take into account large differences in caffeine content across different caffeinated beverages with most recommending one to two servings of coffee or tea or soft drinks per day. There was substantial inconsistency in what was considered to be "high levels" of maternal caffeine consumption, with only 31.6% providing a response. When asked to indicate the risk that high levels of caffeine have on various pregnancy outcomes, responses were not consistent with scientific data. For example, respondents overestimated the relative risk of stillbirths and underestimated the relative risk of spontaneous abortion. There was great variability in assessment and advice practices pertaining to caffeine. More than half advise their pregnant patients to consume caffeine under certain circumstances, most commonly to alleviate headache and caffeine withdrawal. The data suggest that ob-gyns could benefit from information about caffeine and its relevance to their
Hong, Y Alicia; Zhou, Zi; Fang, Ya; Shi, Leiyu
The digital divide persists despite broad accessibility of mobile tools. The relationship between the digital divide and health disparities reflects social status in terms of access to resources and health outcomes; however, data on this relationship are limited from developing countries such as China. The aim of this study was to examine the current rates of access to mobile tools (Internet use and mobile phone ownership) among older Chinese individuals (aged ≥45 years), the predictors of access at individual and community levels, and the relationship between access to mobile tools and health outcomes. We drew cross-sectional data from a national representative survey, the China Health and Retirement Longitudinal Study (CHARLS), which focused on the older population (aged ≥45 years). We used two-level mixed logistic regression models, controlling for unobserved heterogeneity at the community and individual levels for data analysis. In addition to individual-level socioeconomic status (SES), we included community-level resources such as neighborhood amenities, health care facilities, and community organizations. Health outcomes were measured by self-reported health and absence of disability based on validated scales. Among the 18,215 participants, 6.51% had used the Internet in the past month, and 83% owned a mobile phone. In the multivariate models, Internet use was strongly associated with SES, rural or urban residence, neighborhood amenities, community resources, and geographic region. Mobile phone ownership was strongly associated with SES and rural/urban residence but not so much with neighborhood amenities and community resources. Internet use was a significant predictor of self-reported health status, and mobile phone ownership was significantly associated with having disability even after controlling for potential confounders at the individual and community levels. This study is one of the first to examine digital divide and its relationship with health
Bleakley, Amy; Jordan, Amy; Ellithorpe, Morgan E; Lazovich, DeAnn; Grossman, Sara; Glanz, Karen
Indoor tanning is a risk factor for melanoma among young white women. Health communications can be an effective way of reaching this population and promoting behavior change. The purpose of this study was (i) to investigate the associations between intention to quit indoor tanning and attitudes, normative pressure, and efficacy about quitting, and (ii) to identify beliefs about quitting indoor tanning that can be used to design effective health communication messages to reduce skin cancer risk. A national online survey was conducted with 279 non-Hispanic white women ages 18-25 in the USA who are indoor tanners. The survey, based on the reasoned action approach, assessed intention, attitudes, norms, and efficacy and their corresponding underlying beliefs related to quitting indoor tanning, along with other known covariates. Data were collected in November/December 2015. Intention to quit indoor tanning was significantly associated with attitudes, specifically with the beliefs that it would "reduce damage to skin" (increased intention) and "make me less happy" (decreased intention). While self-efficacy was not related to intention to quit indoor tanning, injunctive normative beliefs were with key referent groups including mothers, friends, and romantic partners. Messages aimed at discouraging indoor tanning among young, non-Hispanic, white women should highlight the salient belief that quitting indoor tanning will reduce skin damage, counter the belief that it will make them less happy, and highlight key people who would approve of them quitting indoor tanning.
Nugrahedi, P.Y.; Hantoro, I.; Verkerk, R.; Dekker, M.; Steenbekkers, L.P.A.
Food preparation practices are known to have large nutritional implications on the final product. This article describes survey data on preparation practices of Brassica vegetables and the translation of these data into technological and nutritional implications using knowledge on the mechanisms of
Unruh, D H; King, J E; Eaton, R D; Allen, J R
A total of 959 faecal samples were obtained from dogs in 12 native communities in Northern Saskatchewan, Central and Northern Alberta and the Northwest Territories. All samples were examined using a flotation technique. Samples from an area of endemic human amoebic infections were also examined by a formol-ether sedimentation method. Eighteen necropsies were performed. Entamoeba histolytica cysts were recovered from dog faeces at Loon Lake, Saskatchewan. Toxocara canis had low incidence in Saskatchewan and Central Alberta, and appeared to be almost non-existent further North. Toxascaris leonina was found in all areas surveyed. Canine hookworm infections were plentiful in all areas, the highest incidence being recorded from Northern Alberta and Northwest Territories. Many Taenia (or Echinococcus) infections were found consistently in all areas. Only one infection with Dipylidium caninum was discovered.Metorchis conjunctus infections were found to be common in the Saskatchewan reserves. Infections with Diphyllobothrium sp. were found in all communities with access to good fishing. One specimen of Dioctophyma renale was recovered at necropsy. Infections with parasites of no known zoonotic importance such as Trichuris, Alaria and Isospora species were also recorded.
Rowell, Candace; Kuiper, Nora; Al-Saad, Khalid; Nriagu, Jerome; Shomar, Basem
Qatar is dependent on importation of rice, its staple dish, and is therefore susceptible to compromises of food quality in the global market. This market basket study assesses potential health risks of As exposure from rice consumption in Qatar and examines its contribution to the recommended nutritional intakes (RNI) for Zn and Se. Fifty-six rice types and 12 products sold in Qatar were analyzed by ICP/MS. Mean concentrations and ranges were 96.2±54.1μg/kg (9.76-258μg/kg) for As; 12.5±5.35mg/kg (2.79-29.9mg/kg) for Zn and 103±113μg/kg (Qatar is not a significant route of As exposure but can contribute up to 100% and 50% of the RNI for Se and Zn, respectively. Results indicate that children in Qatar may be at elevated risk of arsenic exposure from rice-based infant cereals but more data is needed to obtain a definitive assessment. Copyright © 2014 Elsevier Ltd. All rights reserved.
Millennium Challenge Corporation — The main objective of the 2011 Health Facility Survey (HFS) was to establish a baseline for informing the Health Project performance indicators on health facilities,...
U.S. Department of Health & Human Services — The National Health Interview Survey (NHIS) is the principal source of information on the health of the civilian noninstitutionalized population of the United States...
Leonard, Tammy; Xuan, Lei; Amory, Richard; Higashi, Robin T.; Nguyen, Oanh Kieu; Pezzia, Carla; Swales, Stephanie
Introduction Food insecurity is negatively associated with health; however, health needs may differ among people participating in food assistance programs. Our objectives were to characterize differences in health among people receiving different types of food assistance and summarize strategies for targeted recruitment and outreach of various food insecure populations. Methods We examined health status, behaviors, and health care access associated with food insecurity and receipt of food assistance among US adults aged 20 years or older using data from participants (N = 16,934) of the National Health and Nutrition Examination Survey from 2005 through 2010. Results Food insecurity affected 19.3% of US adults (95% confidence interval, 17.9%–20.7%). People who were food insecure reported poorer health and less health care access than those who were food secure (P food insecure, 58.0% received no assistance, 20.3% received only Supplemental Nutrition Assistance Program (SNAP) benefits, 9.7% received only food bank assistance, and 12.0% received both SNAP and food bank assistance. We observed an inverse relationship between receipt of food assistance and health and health behaviors among the food insecure. Receipt of both (SNAP and food bank assistance) was associated with the poorest health; receiving no assistance was associated with the best health. For example, functional limitations were twice as prevalent among people receiving both types of food assistance than among those receiving none. Conclusion Receipt of food assistance is an overlooked factor associated with health and has the potential to shape future chronic disease prevention efforts among the food insecure. PMID:27736055
David L Nordstrom
Full Text Available The aim of this paper is to introduce novice researchers to surveys as a method of data collection. It starts with the definition of a survey, its major purposes and types as well as changes in the goals surveys have helped to achieve over time. Advantages and disadvantages of surveys over population censuses and medical examinations are discussed. Approaches to questionnaire construction are introduced along with properties that questionnaires are evaluated for. Modes of administration, sample size issues, and data analysis approaches are also introduced. The primer is illustrated with examples of surveys conducted in different countries with various public health purposes.
Kornfeld, Julie; Sznol, Joshua; Lee, David
Public health financial competencies are often overlooked or underrepresented in public health training programs. These skills are important for public health workforce members who are involved in managing resources and strategic planning and have been defined as key competencies by several national entities. To characterize business skills among state health agency employees and examine self-reported skill levels and their association with job satisfaction, worksite training and development opportunities, and annual salary. A cross-sectional survey, the Public Health Workforce Interests and Needs Survey (PH WINS), of state health agency central office employees was conducted in 2014. Multivariable logistic regression analyses, controlling for job classification, supervisory status, years of public health practice, annual compensation, educational attainment, geographic region, and sociodemographic status, were used to assess the relationship between business skills and training environment and job satisfaction. Linear regression was used to correlate business skills and annual compensation. A total of 10,246 state health agency staff completed a Web-based survey. Self-reported proficiency in business skills, job satisfaction, opportunities for training, and annual salary. The workforce reported high levels of proficiency in applying quality improvement concepts and managing change (67.5% and 69.2%, respectively). Half of the respondents reported proficiency in budget skills (49.3%). Participants who were proficient in applying quality improvement concepts were significantly more likely to report job satisfaction (OR = 1.27). A supportive training environment was significantly associated with business competencies (range of OR = 1.08-1.11). Managing change (β = .15) and budget skill proficiency (β = .37) were significantly associated with increased yearly compensation. Public health workers who self-report proficiency with business skills report increased job
This podcast gives an overview of the health survey ATSDR is conducting of more than 300,000 people who lived or worked at Camp Lejeune or Camp Pendleton in the 1970s and 1980s. Created: 8/30/2011 by Agency for Toxic Substances and Disease Registry (ATSDR). Date Released: 8/30/2011.
Moon, Ji Hyun; Kong, Mi Hee; Kim, Hyeon Ju
Previous studies have demonstrated a positive association between obesity and decreased lung function. However, the effect of muscle and fat has not been fully assessed, especially in a healthy elderly population. In this study, we evaluated the impact of low muscle mass (LMM) and LMM with obesity on pulmonary impairment in healthy elderly subjects. Our study used data from the Korea National Health and Nutrition Examination Survey from 2008 to 2011. Men and women aged 65 yr or older were included. Muscle mass was measured by dual-energy X-ray absorptiometry. LMM was defined as two standard deviations below the sex-specific mean for young healthy adults. Obesity was defined as body mass index ≥ 25 kg/m(2). The prevalence of LMM in individuals aged over 65 was 11.9%. LMM and pulmonary function (forced vital capacity and forced expiratory volume in 1 second) were independently associated after adjusting for age, sex, body mass index, smoking status, alcohol consumption, and frequency of exercise. LMM with obesity was also related to a decrease in pulmonary function. This study revealed that LMM is an independent risk factor of decreased pulmonary function in healthy Korean men and women over 65 yr of age.
"Strategic Implications of Global Health" responds to a request from the Undersecretary of State for Democratization and Global Affairs for an intelligence assessment on the connections between health and U.S. national interests...
Maina, William K; Kim, Andrea A; Rutherford, George W; Harper, Malayah; K'Oyugi, Boniface O; Sharif, Shahnaaz; Kichamu, George; Muraguri, Nicholas M; Akhwale, Willis; De Cock, Kevin M
AIDS Indicator Surveys are standardized surveillance tools used by countries with generalized HIV epidemics to provide, in a timely fashion, indicators for effective monitoring of HIV. Such data should guide responses to the HIV epidemic, meet program reporting requirements, and ensure comparability of findings across countries and over time. Kenya has conducted 2 AIDS Indicator Surveys, in 2007 (KAIS 2007) and 2012-2013 (KAIS 2012). These nationally representative surveys have provided essential epidemiologic, sociodemographic, behavioral, and biologic data on HIV and related indicators to evaluate the national HIV response and inform policies for prevention and treatment of the disease. We present a summary of findings from KAIS 2007 and KAIS 2012 and the impact that these data have had on changing HIV policies and practice.
David L Nordstrom; David L Nordstrom
The aim of this paper is to introduce novice researchers to surveys as a method of data collection. It starts with the definition of a survey, its major purposes and types as well as changes in the goals surveys have helped to achieve over time. Advantages and disadvantages of surveys over population censuses and medical examinations are discussed. Approaches to questionnaire construction are introduced along with properties that questionnaires are evaluated for. Modes of administration, sam...
This report provides general guidelines for national public health and environmental authorities. It does not provide detailed technical data, but instead broadly surveys the whole field, indicating the present position as assessed by members of the Working Group. The Working Group considered three major facets: physiological, toxicological and dosimetric aspects of the transuranium elements; the application of occupational health control, including health physics; and environmental behaviour together with public health implications associated with the transuranium elements. The intention was to cover all aspects relevant to health, with respect both to those who are occupationally engaged in work with such elements and to the general public who might be affected as the result of such operations. Consideration was also given to routine and emergency situations
World Fertility Survey, London (England).
A survey was conducted in 42 developing countries and in 20 developed countries to determine fertility practices and trends. Both individual and household questionnaires were used by interviewers to gather data. Findings concerning marriage patterns, contraception, reproductive motivation, childspacing, breastfeeding, maternal and child health,…
Rainwater, Kimberly L; Marchese, Krysten; Slavinski, Sally; Humberg, Lee A; Dubovi, Edward J; Jarvis, Jodie A; McAloose, Denise; Calle, Paul P
We conducted health assessments on 113 free-ranging raccoons ( Procyon lotor ) in Central Park, New York City, US, in February 2010, September 2010, and November 2011 in conjunction with a trap-vaccinate-release program to control a raccoon rabies epizootic. Five individuals were sampled at two time points for 118 raccoon examinations in total. We tested 13 of 13 and 8 of 13 euthanized raccoons for rabies and canine distemper virus (CDV), respectively, by antigen testing on brain tissue; all were negative for both viruses. Endoparasitism was the most common necropsy finding, with definitive identification of Baylisascaris procyonis in six of eight (75%) necropsied raccoons. Multiple intestinal parasites were detected in feces of living raccoons, including ascarid-type ova in 25 of 80 (31%) raccoons, with B. procyonis confirmed in one sample. Median blood lead level was 7.3 μg/dL (n=104). Rabies virus neutralizing antibody titer was ≥0.5 IU/mL in 9 of 88 (10%) raccoons naive to rabies vaccination and in 13 of 20 (65%) previously vaccinated raccoons. The majority of raccoons we tested were seropositive for canine parvovirus-2 (54/59, 92%) and Toxoplasma gondii (39/60, 65%). Fewer were seropositive for Rickettsia rickettsii (3/30, 10%). None were seropositive for CDV (n=108), canine adenovirus-1 (n=60), or Borrelia burgdorferi (n=30). Ectoparasites found during 16 of 118 (13.6%) physical examinations included Ixodes texanus ticks (15/118, 12.7%) and Trichodectes octomaculatus lice (1/118, 0.8%). We detected Campylobacter jejuni in 5 of 79 (6%) fecal samples. We detected 11 Salmonella enterica serotypes in 70 of 111 (63.1%) enteric cultures, the most common of which were Salmonella Newport (20/70, 29%) and Salmonella Oranienburg (20/70, 29%). These results indicate that raccoons in Central Park likely are involved in the environmental occurrence and potential disease transmission of a variety of infectious and noninfectious diseases of concern for human, wildlife
Hydropower development had been neglected in many countries during the past few decades, but the situation dramatically changed during the 1970s owing to the constantly increasing costs of electricity generation by fossil-fuel and nuclear power plants. Currently, hydroelectric generation accounts for approximately 23% of total global electricity supply. Much of the hydropower potential in developing countries of Africa, Asia and Latin America still remains to be exploited. Like any other source of energy, hydropower development has several health impacts. Conceptually, health implications of hydropower development can be divided into two broad categories: short-term and long-term problems. Short-term health impacts occur during the planning, construction and immediate post-construction phases, whereas long-term impacts stem from the presence of large man-made lakes, development of extensive canal systems, alteration of the ecosystem of the area, and changing socio-economic conditions. Longer-term impacts are further classified into two categories: introduction of new diseases and/or intensification of existing ones due to the improvements of the habitats of disease-carrying vectors, and health problems arising from resettlement of the people whose homes and land-holdings are inundated by the reservoirs. All these impacts are discussed in detail. Health impacts of hydropower developments have not yet been studied extensively. It is often implicitly assumed that health impacts of major dams are minor compared with other social and environmental impacts. Future studies could possibly reverse this assumption. (author)
Tanner, R. J.; Bartlett, D. T.; Hager, I. G.; Jones, I. N.; Molinos, C.; Roberts, N. J.; Taylor, G. C.; Thomas, D. J.
Improvements have been made to the Monte Carlo modelling used to calculate the response of the neutron survey instruments most commonly used in the UK, for neutron energies up to 20 MeV. The improved modelling of the devices includes the electronics and battery pack, allowing better calculations of both the energy and angle dependence of response. These data are used to calculate the response of the instruments in rotationally and fully isotropic, as well as unidirectional fields. Experimental measurements with radionuclide sources and monoenergetic neutron fields have been, and continue to be made, to test the calculated response characteristics. The enhancements to the calculations have involved simulation of the sensitivity of the response to variations in instrument manufacture, and will include the influence of the user and floor during measurements. The practical implications of the energy and angle dependence of response, variations in manufacture, and the influence of the user are assessed by folding the response characteristics with workplace energy and direction distributions. (authors)
Joshi, Manisha; Childress, Saltanat
Attitudes toward intimate partner violence (IPV) can affect the prevalence of IPV, response of victims' to IPV (e.g., whether to seek help), and the response of professionals (e.g., police, social workers, health care professionals) to IPV. Knowledge about IPV-related attitudes is essential for developing effective social work and violence-related programs. Using data from the 2005-2006 Multiple Indicator Cluster Surveys, this study examines attitudes toward IPV and socio-demographic predictors of these attitudes among married women in Kazakhstan, Kyrgyzstan, and Tajikistan. Women were asked whether they approved of a husband beating his wife: if she goes out without telling him, neglects their children, argues, refuses to have sex, and burns food. The prevalence of IPV acceptance for at least one of the five reasons varied from 12.3% in Kazakhstan to 45.3% in Kyrgyzstan and 74.5% in Tajikistan. Women who were less educated, members of Asian ethnic groups, resided in middle-class urban areas, and lived in specific regions were more likely to accept IPV. Few age differences that emerged indicated that young women were more approving of IPV. Proactive efforts are needed to confront attitudes about gender roles and IPV in Tajikistan and Kyrgyzstan.
U.S. Department of Health & Human Services — 1999-2000 forward. The National Health and Nutrition Examination Survey (NHANES) is a program of studies designed to assess the health and nutritional status of...
Dukić, Nikolina; Arbula Blecich, Andrea; Cerović, Ljerka
The main goal of this paper is to elaborate the importance of health literacy in cost-effective utilization of health care services which influence the efficiency of the entire health care sector. In order to complement the theoretical framework of the economic implications and the circular influence of health literacy on the economy, an empirical analysis was carried out using S–TOFHLA. The results suggest that the patients’ personal characteristics and the accessibil...
The NHIS collects data on a broad range of health topics through personal household interviews. The results of NHIS provide data to track health status, health care access, and progress toward achieving national health objectives.
Noffsinger, Dana L
The role of acute care nurse practitioners (ACNPs) in trauma care has evolved over time. A survey was performed with the aim of describing the role across the United States. There were 68 respondents who depicted the typical trauma ACNP as being a 42-year-old woman who works full-time at a level I American College of Surgeons verified trauma center. Trauma ACNPs typically practice with 80% of their time for clinical care and are based on a trauma and acute care surgery service. They are acute care certified and hold several advanced certifications to supplement their nursing license.
U.S. Department of Health & Human Services — The Medicare Health Outcomes Survey (HOS) identifiable data files are comprised of the entire national sample for a given 2-year cohort (including both respondents...
U.S. Department of Health & Human Services — The Medicare Health Outcomes Survey (HOS) limited data sets (LDS) are comprised of the entire national sample for a given 2-year cohort (including both respondents...
Breitenstein, Donna; Ewert, Alan
This article reviews literature related to the positive effects of outdoor education. The following dimensions of health, and the benefits associated with each, are discussed: emotional, social, physical, intellectual, and spiritual. A model of health benefits derived from outdoor recreation is presented, and implications for health education are…
Chigozie Damian Ezeonyejiaku; Maximilian Obinna Obiakor
Background. Elevated arsenic and trace metal contamination of the terrestrial food chain represents one of the most significant environmental risk exposures for human populations in developing countries. Metalloid and metal contamination in horticultural crop produce such as fruit is a public health concern in Nigeria. Local fruits are cheap sources of vitamins and minerals for the resident population and pose an important dietary threat of metal(loid) toxicity through consumption. Objecti...
The National Employer Health Insurance Survey (NEHIS) was developed to produce estimates on employer-sponsored health insurance data in the United States. The NEHIS was the first Federal survey to represent all employers in the United States by State and obtain information on all...
.... This study diverges from that paper, however, in that it expands the field of inquiry to fully encompass all aspects of global health, including maternal mortality, malnutrition, chronic diseases...
Richards, Tiffany A
Freedom is arguably the most cherished right in the United States. But each year, approximately 14,500 to 17,500 women, men and children are trafficked into the United States for the purposes of forced labor or sexual exploitation. Human trafficking has significant effects on both physical and mental health. This article describes the features of human trafficking, its physical and mental health effects and the vital role nurses can play in providing care to this vulnerable population. © 2014 AWHONN.
the late 1980s, it now accounts for seven out of every ten new cases in the region, with Rio de Janeiro municipality in particular recording ever...health-care costs. The health effects of industrial pollution are an increasing source of discontent in China, while the recent outcry over contaminated...governments and populations. Success is possible even in very poor settings with hard to reach populations. Cases: Guinea worm and river
Michel, Laurent; Trouiller, Philippe; Chollet, Aude; Molinier, Marie; Duchesne, Lucie; Jauffret-Roustide, Marie
The aims of this study were to describe the prevalences of injection practices and needle/syringe sharing in people who use drugs in French prisons, and to investigate associated factors. Using the ANRS-Coquelicot survey (2011-2013), a random sample of 1718 people who used drugs in free society was included. Information regarding a history of incarceration, drug-injection practices inside prison and needle/syringe sharing was collected during interviews. In our sample, 65.5% reported a history of injection and 57.4% had been incarcerated at least once. Among those who reported both of these conditions, 14% reported injection practices inside prison, 40.5% of whom had shared needles/syringes. In the multivariable model, the following variables were associated with injection practices inside prison: being a Russian-speaking detainee, having spent more time in prison, and having started to inject before 1996 and especially before 1987. Being Russian speaking was also associated with needle/syringe sharing in prison. The prevalences of injection practices and needle/syringe sharing in prisons are alarmingly high. Effective interventions to prevent the transmission of infectious diseases among people who use drugs in the prison setting are essential. The implementation of international recommendations on the principle of equivalence between prisons and the community is still very limited in most countries, and should be complemented with tailored interventions for the most vulnerable prison populations, especially Russian-speaking detainees. © 2017 Australasian Professional Society on Alcohol and other Drugs.
Green, Joseph S.; And Others
Attitudes of health practitioners and others toward death and dying and their emotional reactions to dying patients were surveyed both before and after a Veterans Administration workshop. Some attitude changes were noted, with implications for future workshops. (MF)
Mr A. O. Akinpelu
HEALTH IMPLICATIONS OF CASSAVA PRODUCTION AND CONSUMPTION. AKINPELU, A.O. ... huge potential for the export market (Egesi et al., 2007). In urban areas ... farmer's/ household income and economic growth. Stakeholders in ..... dissertation submitted to the school of graduate studies in partial fulfilment of the.
Mycobacterial Species Identification and Public Health Implications of Tuberculosis Among Nomadic Pastoralists in Three Local Governments of Plateau State, North ... Bovine and human tuberculosis is endemic in Nigeria, and apart from meat inspection at the abattoir, which is not very effective, no control measures are ...
Bennett, Rachel E.; Boulos, David; Garber, Bryan G.; Jetly, Rakesh; Sareen, Jitender
Objective: The 2013 Canadian Forces Mental Health Survey (CFMHS) collected detailed information on mental health problems, their impacts, occupational and nonoccupational determinants of mental health, and the use of mental health services from a random sample of 8200 serving personnel. The objective of this article is to provide a firm scientific foundation for understanding and interpreting the CFMHS findings. Methods: This narrative review first provides a snapshot of the Canadian Armed Forces (CAF), focusing on 2 key determinants of mental health: the deployment of more than 40,000 personnel in support of the mission in Afghanistan and the extensive renewal of the CAF mental health system. The findings of recent population-based CAF mental health research are reviewed, with a focus on findings from the very similar mental health survey done in 2002. Finally, key aspects of the methods of the 2013 CFMHS are presented. Results: The findings of 20 peer-reviewed publications using the 2002 mental health survey data are reviewed, along with those of 25 publications from other major CAF mental health research projects executed over the past decade. Conclusions: More than a decade of population-based mental health research in the CAF has provided a detailed picture of its mental health and use of mental health services. This knowledge base and the homology of the 2013 survey with the 2002 CAF survey and general population surveys in 2002 and 2012 will provide an unusual opportunity to use the CFMHS to situate mental health in the CAF in a historical and societal perspective. PMID:27270738
Karras, Bryant T.; Tufano, James T.
This paper describes the development process of an evaluation framework for describing and comparing web survey tools. We believe that this approach will help shape the design, development, deployment, and evaluation of population-based health interventions. A conceptual framework for describing and evaluating web survey systems will enable the…
We want to learn from university students about your experiences and perspectives on mental health and well-being in the context of being a student. Your input can help us develop evidence-based intervention programs that can help address the mental health needs of students. This survey should take 15-20 minutes to complete.
This document covers papers presented to the Institute of Petroleum's conference ''Automotive Fuels: Environmental and Health Implications'' held on the 9th October 1991. This wide ranging title meant that topics covered included the biochemistry, pathology and epidemiology of automotive fuel use, combustion science, environmental chemistry and atmospheric modelling. Also discussed are the technology of fuel and engine manufacture, limiting and containing emissions and social and political aspects relating to the use of automotive fuels. (UK)
Meslin, F X; Stöhr, K; Heymann, D
Many new, emerging and re-emerging diseases of humans are caused by pathogens which originate from animals or products of animal origin. A wide variety of animal species, both domestic and wild, act as reservoirs for these pathogens, which may be viruses, bacteria or parasites. Given the extensive distribution of the animal species affected, the effective surveillance, prevention and control of zoonotic diseases pose a significant challenge. The authors describe the direct and indirect implications for public health of emerging zoonoses. Direct implications are defined as the consequences for human health in terms of morbidity and mortality. Indirect implications are defined as the effect of the influence of emerging zoonotic disease on two groups of people, namely: health professionals and the general public. Professional assessment of the importance of these diseases influences public health practices and structures, the identification of themes for research and allocation of resources at both national and international levels. The perception of the general public regarding the risks involved considerably influences policy-making in the health field. Extensive outbreaks of zoonotic disease are not uncommon, especially as the disease is often not recognised as zoonotic at the outset and may spread undetected for some time. However, in many instances, the direct impact on health of these new, emerging or re-emerging zoonoses has been small compared to that of other infectious diseases affecting humans. To illustrate the tremendous indirect impact of emerging zoonotic diseases on public health policy and structures and on public perception of health risks, the authors provide a number of examples, including that of the Ebola virus, avian influenza, monkeypox and bovine spongiform encephalopathy. Recent epidemics of these diseases have served as a reminder of the existence of infectious diseases and of the capacity of these diseases to occur unexpectedly in new
Full Text Available In the age of digital technology, as teens seem to be constantly connected online, via social media, and through mobile applications, it is no surprise that they increasingly turn to digital media to answer their health questions. This study is the first of its kind to survey a large, nationally-representative sample of teens to investigate how they use the newest digital technologies, including mobile apps, social networking sites, electronic gaming and wearable devices, to explore health topics. The survey covered the types of health topics teens most frequently search for, which technologies they are most likely to use and how they use them, and whether they report having changed their behaviors due to digital health information. In addition, this survey explores how the digital divide continues to impact adolescents. Results of this study indicate that teens are concerned about many health issues, ranging from fitness, sexual activity, drugs, hygiene as well as mental health and stress. As teens virtually always have a digital device at their fingertips, it is clear that public health interventions and informational campaigns must be tailored to reflect the ways that teens currently navigate digital health information and the health challenges that concern them most.
Stokes, Laura B; Rogers, Joseph W; Hertig, John B; Weber, Robert J
Big Data refers to datasets that are so large and complex that traditional methods and hardware for collecting, sharing, and analyzing them are not possible. Big Data that is accurate leads to more confident decision making, improved operational efficiency, and reduced costs. The rapid growth of health care information results in Big Data around health services, treatments, and outcomes, and Big Data can be used to analyze the benefit of health system pharmacy services. The goal of this article is to provide a perspective on how Big Data can be applied to health system pharmacy. It will define Big Data, describe the impact of Big Data on population health, review specific implications of Big Data in health system pharmacy, and describe an approach for pharmacy leaders to effectively use Big Data. A few strategies involved in managing Big Data in health system pharmacy include identifying potential opportunities for Big Data, prioritizing those opportunities, protecting privacy concerns, promoting data transparency, and communicating outcomes. As health care information expands in its content and becomes more integrated, Big Data can enhance the development of patient-centered pharmacy services.
Rozek, Laura S; Dolinoy, Dana C; Sartor, Maureen A; Omenn, Gilbert S
Improved understanding of the multilayer regulation of the human genome has led to a greater appreciation of environmental, nutritional, and epigenetic risk factors for human disease. Chromatin remodeling, histone tail modifications, and DNA methylation are dynamic epigenetic changes responsive to external stimuli. Careful interpretation can provide insights for actionable public health through collaboration between population and basic scientists and through integration of multiple data sources. We review key findings in environmental epigenetics both in human population studies and in animal models, and discuss the implications of these results for risk assessment and public health protection. To ultimately succeed in identifying epigenetic mechanisms leading to complex phenotypes and disease, researchers must integrate the various animal models, human clinical approaches, and human population approaches while paying attention to life-stage sensitivity, to generate effective prescriptions for human health evaluation and disease prevention.
Jones, Peter; Sopina, Liza Elizaveta; Ashton, Toni
Background The Shorter Stays in Emergency Departments health target was introduced in New Zealand in 2009. District Health Boards (DHBs) are expected to meet the target with no additional funding or incentives. The costs of implementing such targets have not previously been studied. Method A survey.......03), whereas expenditure in the hospital was not (r = 0.08, P = 0.75). Conclusion The fact that estimated expenditure on the target was over $50 million without additional funding suggests that DHBs were able to make savings through improved efficiencies and/or that funds were reallocated from other services...
Ellen Wartella; Vicky Rideout; Heather Montague; Leanne Beaudoin-Ryan; Alexis Lauricella
In the age of digital technology, as teens seem to be constantly connected online, via social media, and through mobile applications, it is no surprise that they increasingly turn to digital media to answer their health questions. This study is the first of its kind to survey a large, nationally-representative sample of teens to investigate how they use the newest digital technologies, including mobile apps, social networking sites, electronic gaming and wearable devices, to explore health...
Spencer, N J; Penlington, E
Community child health medical audit is established in most districts surveyed. A minority have integrated audit with hospital paediatric units. Very few districts use an external auditor. Subject audit is preferred to individual performance audit and school health services were the most common services subjected to medical audit. The need for integrated audit and audit forms suitable for use in the community services is discussed.
Singh, R.K.; Syam, P.V.S.
Due to the build up of green house gases in atmosphere, less heat escapes through the atmosphere promoting global warming. This may result in world wide droughts, sea-level rise inundating islands and coastal countries, cataclysmic hurricanes etc. Human health as a result of these changes, will be affected both physiologically and psychologically. Physiological effects may be more pronounced in cases occurring due to changes in rainfall and temperature patterns, food production amounts, water availability, etc. Psychological impact may be more in cases of catastrophes like floods, hurricanes or famine. In this paper, an attempt has been made to highlight the implications of global warming on human health due to temperature change. Food production changes and ultra-violet radiation effects and cataclysmic disaster effects. (author)
Oak Ridge Institute for Science and Education
This annual survey collects 2006 data on the number of health physics degrees awarded as well as the number of students enrolled in health physics academic programs. Thirty universities offer health physics degrees; all responded to the survey
With the recent passage of the National Defense Authorization Act for Fiscal Year 2017, Congress has triggered groundbreaking Military Health System organizational restructuring with the Defense Health Agency assuming responsibility for managing all hospitals and clinics owned by the Army, Navy, and Air Force. This is a major shift toward a modern value-based managed care system, which will require much greater military-civilian health care delivery integration to be in place by October 2018. Just before the National Defense Authorization Act for Fiscal Year 2017 passage, the Department of Defense had already begun a seismic shift and awarded a contract for the new Military Health System-wide electronic health record system. In this perspective, we discuss the implications of the intersection of two large-scope and large-scale initiatives, health system transformation, and information technology modernization, being rolled out in the largest and most complex federal agency and potential risk mitigating steps. The Military Health System will require an expanded unified clinical leadership to spearhead short-term transformation; furthermore, developing, organizing, and growing a cadre of informatics expertise to expand the use and diffusion of novel solutions such as health information exchanges, data analytics, and others to transcend organizational barriers are still needed to achieve the long-term aim of health system reform as envisioned by the National Defense Authorization Act for Fiscal Year 2017.
Watson, Robert T.; Patz, Jonathan; Gubler, Duane J.; Parson, Edward A.; Vincent, James H.
This paper reviews the background that has led to the now almost-universally held opinion in the scientific community that global climate change is occurring and is inescapably linked with anthropogenic activity. The potential implications to human health are considerable and very diverse. These include, for example, the increased direct impacts of heat and of rises in sea level, exacerbated air and water-borne harmful agents, and - associated with all the preceding - the emergence of environmental refugees. Vector-borne diseases, in particular those associated with blood-sucking arthropods such as mosquitoes, may be significantly impacted, including redistribution of some of those diseases to areas not previously affected. Responses to possible impending environmental and public health crises must involve political and socio-economic considerations, adding even greater complexity to what is already a difficult challenge. In some areas, adjustments to national and international public health practices and policies may be effective, at least in the short and medium terms. But in others, more drastic measures will be required. Environmental monitoring, in its widest sense, will play a significant role in the future management of the problem. (Author)
Ernstsen, Vibeke; Ladenberger, Anna; Wragg, Joanna; Gulan, Aleksandra
The GEMAS Project resulted in a large coherent data set displaying baseline levels of elements in agricultural and grazing land soil, which has a wide variety of applications. Medical geology is an emerging new discipline providing a link between geoscience and medicine by interpreting natural geological factors in relation to human and animal health and their geographical distribution. Medical geology shows not only problems related to harmful health effects of natural geological materials and processes, but also deals with their beneficial aspects. Since the GEMAS project demonstrates the importance of geological factors in geochemical patterns in European soil, this data set can be used in improving our understanding of how the geological processes may affect human health in Europe. The main potential health problems are related to deficiency of nutrients in soil and toxic effects of potentially harmful elements. Deficiency in macro- (e.g., K, Fe, Mg, P) and micro-nutrients (e.g., Se, Zn, Cl) can be responsible for a reduction in crop productivity and certain health issues for livestock and humans. On the other hand, bioavailability of crucial elements depends on soil parameters, e.g., pH; namely, low pH in soil (in northern Europe) makes more micronutrients bioavailable, with the exception of Mo, P and Ca. Rocks underlying the soil layer have a major impact on soil composition, and soil parent material can be a main source of toxic metals, for instance, soil developed on black shale (e.g., Oslo region) shows potentially toxic levels of metals, such as As, Cd, U, Zn and Pb. High content of organic matter is another factor amplifying the toxic levels of metals in soil. Several important topics with health implications can be then addressed using the GEMAS data set, namely, soil properties and element bioavailability, arsenic toxicity, selenium deficiency, potential health effects of liming, uranium in European soil, influence of recent and historical volcanic
This article is a review of the PhD Thesis of Malin Eriksson, entitled ‘Social capital, health and community action – implications for health promotion.’ The article presents a theoretical overview of social capital and its relation to health, reviews empirical findings of the links between social capital and (self-rated) health, and discusses the usefulness of social capital in health promotion interventions at individual and community levels. Social capital, conceptualized as an individual characteristic, can contribute to the field of health promotion by adding new knowledge on how social network interventions may best be designed to meet the needs of the target group. The distinction of different forms of social capital, i.e. bonding, bridging, and linking, can be useful in mapping the kinds of networks that are available and health-enhancing (or damaging) and for whom. Further, social capital can advance social network interventions by acknowledging the risk for unequal distribution of investments and returns from social network involvement. Social capital, conceptualized as characterizing whole communities, provides a useful framework for what constitutes health-supporting environments and guidance on how to achieve them. Mapping and mobilization of social capital in local communities may be one way of achieving community action for health promotion. Social capital is context-bound by necessity. Thus, from a global perspective, it cannot be used as a ‘cookbook’ on how to achieve supportive environments and community action smoothly. However, social capital can provide new ideas on the processes that influence human interactions, cooperation, and community action for health promotion in various contexts. PMID:21311607
This article is a review of the PhD Thesis of Malin Eriksson, entitled 'Social capital, health and community action - implications for health promotion.' The article presents a theoretical overview of social capital and its relation to health, reviews empirical findings of the links between social capital and (self-rated) health, and discusses the usefulness of social capital in health promotion interventions at individual and community levels. Social capital, conceptualized as an individual characteristic, can contribute to the field of health promotion by adding new knowledge on how social network interventions may best be designed to meet the needs of the target group. The distinction of different forms of social capital, i.e. bonding, bridging, and linking, can be useful in mapping the kinds of networks that are available and health-enhancing (or damaging) and for whom. Further, social capital can advance social network interventions by acknowledging the risk for unequal distribution of investments and returns from social network involvement. Social capital, conceptualized as characterizing whole communities, provides a useful framework for what constitutes health-supporting environments and guidance on how to achieve them. Mapping and mobilization of social capital in local communities may be one way of achieving community action for health promotion. Social capital is context-bound by necessity. Thus, from a global perspective, it cannot be used as a 'cookbook' on how to achieve supportive environments and community action smoothly. However, social capital can provide new ideas on the processes that influence human interactions, cooperation, and community action for health promotion in various contexts. © 2011 Malin Eriksson.
Full Text Available This article is a review of the PhD Thesis of Malin Eriksson, entitled ‘Social capital, health and community action – implications for health promotion.’ The article presents a theoretical overview of social capital and its relation to health, reviews empirical findings of the links between social capital and (self-rated health, and discusses the usefulness of social capital in health promotion interventions at individual and community levels. Social capital, conceptualized as an individual characteristic, can contribute to the field of health promotion by adding new knowledge on how social network interventions may best be designed to meet the needs of the target group. The distinction of different forms of social capital, i.e. bonding, bridging, and linking, can be useful in mapping the kinds of networks that are available and health-enhancing (or damaging and for whom. Further, social capital can advance social network interventions by acknowledging the risk for unequal distribution of investments and returns from social network involvement. Social capital, conceptualized as characterizing whole communities, provides a useful framework for what constitutes health-supporting environments and guidance on how to achieve them. Mapping and mobilization of social capital in local communities may be one way of achieving community action for health promotion. Social capital is context-bound by necessity. Thus, from a global perspective, it cannot be used as a ‘cookbook’ on how to achieve supportive environments and community action smoothly. However, social capital can provide new ideas on the processes that influence human interactions, cooperation, and community action for health promotion in various contexts.This article has been commented on by Catherine Campbell. Please follow this link http://www.globalhealthaction.net/index.php/gha/article/view/5964 – to read her Commentary.
Tveten, U.; Garder, K.
This report was originally written as a chapter of a report entitled 'Air pollution effects of electric power generation, a literature survey', written jointly by the Norwegian Institute for Air Research (NILU) and the Institutt for Atomenergi (IFA). (INIS RN242406). A survey is presented of the health effects of radiation. It has not, however, been the intention of the authors to make a complete list of all the literature relevant to this subject. The NILU/IFA report was meant as a first step towards a method of comparing the health effects of electric power generation by fission, gas and oil. Consequently information relevant to quantification of the health effects on humans has been selected. It is pointed out that quantitative information on the health effects of low radiation and dose rates, as are relevant to routine releases, does not exist for humans. The convention of linear extrapolation from higher doses and dose rates is used worldwide, but it is felt by most that the estimates are conservative. As an example of the use of the current best estimates, a calculation of normal release radiation doses is performed. (Auth.)
Full Text Available Global health's goal of reducing low-and-middle-income country versus high-income country health disparities faces complex challenges. Although there have been discussions of barriers, there has not been a broad-based, quantitative survey of such barriers.432 global health professionals were invited via email to participate in an online survey, with 268 (62% participating. The survey assessed participants' (A demographic and global health background, (B perceptions regarding 66 barriers' seriousness, (C detailed ratings of barriers designated most serious, (D potential solutions.Thirty-four (of 66 barriers were seen as moderately or more serious, highlighting the widespread, significant challenges global health development faces. Perceived barrier seriousness differed significantly across domains: Resource Limitations mean = 2.47 (0-4 Likert scale, Priority Selection mean = 2.20, Corruption, Lack of Competence mean = 1.87, Social and Cultural Barriers mean = 1.68. Some system-level predictors showed significant but relatively limited relations. For instance, for Global Health Domain, HIV and Mental Health had higher levels of perceived Social and Cultural Barriers than other GH Domains. Individual-level global health experience predictors had small but significant effects, with seriousness of (a Corruption, Lack of Competence, and (b Priority Selection barriers positively correlated with respondents' level of LMIC-oriented (e.g., weeks/year spent in LMIC but Academic Global Health Achievement (e.g., number of global health publications negatively correlated with overall barrier seriousness.That comparatively few system-level predictors (e.g., Organization Type were significant suggests these barriers may be relatively fundamental at the system-level. Individual-level and system-level effects do have policy implications; e.g., Priority Selection barriers were among the most serious, yet effects on seriousness of how LMIC-oriented a professional
Child Rearing Practices in Nigeria: Implications for Mental Health. ... over time are important, especially as this region is undergoing rapid transformation. ... Through policy and aggressive health education, traditional child rearing practices in ...
U.S. Department of Health & Human Services — The National Mental Health Services Survey (N-MHSS) is an annual survey designed to collect statistical information on the numbers and characteristics of all known...
U.S. Department of Health & Human Services — The National Survey on Drug Use and Health (NSDUH) series (formerly titled National Household Survey on Drug Abuse) primarily measures the prevalence and correlates...
U.S. Department of Health & Human Services — The National Survey on Drug Use and Health (NSDUH) series (formerly titled National Household Survey on Drug Abuse) measures the prevalence and correlates of drug...
U.S. Department of Health & Human Services — The National Survey on Drug Use and Health (NSDUH) series (formerly titled National Household Survey on Drug Abuse) primarily measures the prevalence and correlates...
U.S. Department of Health & Human Services — The National Survey on Drug Use and Health (NSDUH) series (formerly titled National Household Survey on Drug Abuse) primarily measures the prevalence and correlates...
U.S. Department of Health & Human Services — The National Survey on Drug Use and Health (NSDUH) series (formerly titled National Household Survey on Drug Abuse) measures the prevalence and correlates of drug...
U.S. Department of Health & Human Services — The National Survey on Drug Use and Health (NSDUH) series (formerly titled National Household Survey on Drug Abuse) measures the prevalence and correlates of drug...
Arrivillaga, Marcela; Aristizabal, Juan Carlos; Pérez, Mauricio; Estrada, Victoria Eugenia
The aim of this study was to design and validate a health services access survey for households in Colombia to provide a methodological tool that allows the country to accumulate evidence of real-life access conditions experienced by the Colombian population. A validation study with experts and a pilot study were performed. It was conducted in the municipality of Jamundi, located in the department of Valle del Cauca, Colombia. Probabilistic, multistage and stratified cluster sampling was carried out. The final sample was 215 households. The survey was composed of 63 questions divided into five modules: socio-demographic profile of the head of the household or adult informant, household socioeconomic profile, access to preventive services, access to curative and rehabilitative services and household out of pocket expenditure. In descriptive terms, the promotion of preventive services only reached 44%; the use of these services was always highest among children younger than one year old and up to the age of ten. The perceived need for emergency medical care and hospitalisation was between 82% and 85%, but 36% perceived the quality of care to be low or very low. Delays were experienced in medical visits with GPs and specialists. The designed survey is valid, relevant and representative of access to health services in Colombia. Empirically, the pilot showed institutional weaknesses in a municipality of the country, indicating that health coverage does not in practice mean real and effective access to health services. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.
Kessler, Ronald C; Haro, Josep Maria; Heeringa, Steven G; Pennell, Beth-Ellen; Ustün, T Bedirhan
To present an overview of the World Health Organization World Mental Health (WMH) Survey Initiative. The discussion draws on knowledge gleaned from the authors' participation as principals in WMH. WMH has carried out community epidemiological surveys in more than two dozen countries with more than 200,000 completed interviews. Additional surveys are in progress. Clinical reappraisal studies embedded in WMH surveys have been used to develop imputation rules to adjust prevalence estimates for within- and between-country variation in accuracy. WMH interviews include detailed information about sub-threshold manifestations to address the problem of rigid categorical diagnoses not applying equally to all countries. Investigations are now underway of targeted substantive issues. Despite inevitable limitations imposed by existing diagnostic systems and variable expertise in participating countries, WMH has produced an unprecedented amount of high-quality data on the general population cross-national epidemiology of mental disorders. WMH collaborators are in thoughtful and subtle investigations of cross-national variation in validity of diagnostic assessments and a wide range of important substantive topics. Recognizing that WMH is not definitive, finally, insights from this round of surveys are being used to carry out methodological studies aimed at improving the quality of future investigations.
U.S. Department of Health & Human Services — 2001 forward. The National Health Interview Survey (NHIS) has monitored the health of the nation since 1957. NHIS data on a broad range of health topics are...
Bousquet, Jean; Bousquet, Philippe J; Godard, Philippe; Daures, Jean-Pierre
Asthma is a very common chronic disease that occurs in all age groups and is the focus of various clinical and public health interventions. Both morbidity and mortality from asthma are significant. The number of disability-adjusted life years (DALYs) lost due to asthma worldwide is similar to that for diabetes, liver cirrhosis and schizophrenia. Asthma management plans have, however, reduced mortality and severity in countries where they have been applied. Several barriers reduce the availability, affordability, dissemination and efficacy of optimal asthma management plans in both developed and developing countries. The workplace environment contributes significantly to the general burden of asthma. Patients with occupational asthma have higher rates of hospitalization and mortality than healthy workers. The surveillance of asthma as part of a global WHO programme is essential. The economic cost of asthma is considerable both in terms of direct medical costs (such as hospital admissions and the cost of pharmaceuticals) and indirect medical costs (such as time lost from work and premature death). Direct costs are significant in most countries. In order to reduce costs and improve quality of care, employers and health plans are exploring more precisely targeted ways of controlling rapidly rising health costs. Poor control of asthma symptoms is a major issue that can result in adverse clinical and economic outcomes. A model of asthma costs is needed to aid attempts to reduce them while permitting optimal management of the disease. This paper presents a discussion of the burden of asthma and its socioeconomic implications and proposes a model to predict the costs incurred by the disease.
Meekers, D; Ogada, E A
Reproductive health programmes often need exit surveys and population-based surveys for monitoring and evaluation. This study investigates why such studies produce discrepant estimates of condom use, sexual behaviour and condom brand knowledge, and discusses the implications for future use of exit surveys for programme monitoring. Logistic regression is used to explain differences between a household survey of 1295 persons and an exit survey among a random sample of 2550 consumers at retail outlets in RWANDA: Discrepancies in ever use of condoms and risky sexual behaviours are due to differences in socioeconomic status of the two samples. After controls, exit surveys at most outlet types have the same results as the household survey. Only exit surveys at bars, nightclubs and hotels yield significantly different estimates. However, the above-average knowledge of Prudence Plus condoms in the exit interviews is not attributable to socioeconomic or demographic variables, most likely because respondents have seen the product at the outlets. Information about condom use and sexual behaviour obtained from exit surveys appears as accurate as that obtained through household surveys. Nevertheless, exit surveys must be used cautiously. Because exit surveys may include wealthier and better-educated respondents, they are not representative of the general population. The composition of exit survey samples should be validated through existing household surveys. Comparisons across survey types are generally unadvisable, unless they control for sample differences. When generalizing to the population at large is not needed (e.g. for studies aimed at identifying the characteristics and behaviour of users of particular products or services), exit surveys can provide an appropriate alternative to household surveys.
Willoughby, Jessica Fitts; L'Engle, Kelly Ladin; Jackson, Kennon; Brickman, Jared
Text message programs for sexual health are becoming increasingly popular as practitioners aim to meet youth on media they use frequently. Two-way mobile health (mHealth) interventions allow for feedback solicitation from participants. This study explores the use of a text message survey to assess demographics and program feedback from users of an adolescent sexual health text message question-and-answer service. Development and feasibility of the short-message service survey are discussed. The text message survey achieved a 43.9% response rate, which is comparable to response rates of surveys conducted via other methods. When compared to respondents who used the service and completed an online in-school questionnaire, text survey respondents were more likely to be female and older. They also reported higher service satisfaction. Results have implications for text message service providers and researchers. This article examines a community application of a new intervention strategy and research methodology.
Arulananthan, C.; Hanifa, Sabibullah Mohamed
Healthcare is an imperative key field of research, where individuals or groups can be engaged in the self-tracking of any kind of biological, physical, behavioral, or environmental information. In a massive health care data, the valuable information is hidden. The quantity of the available unstructured data has been expanding on an exponential scale. The newly developing Disruptive Technologies can handle many challenges that face data analysis and ability to extract valuable information via data analytics. Connected Wellness in Healthcare would retrieve patient’s physiological, pathological and behavioral parameters through sensors to perform inner workings of human body analysis. Disruptive technologies can take us from a reactive illness-driven to a proactive wellness-driven system in health care. It is need to be strive and create a smart health system towards wellness-driven instead of being illness-driven, today’s biggest problem in health care. Wellness-driven-analytics application help to promote healthiest living environment called “Smart Health”, deliver empower based quality of living. The contributions of this survey reveals and opens (touches uncovered areas) the possible doors in the line of research on smart health and its computing technologies.
Mothersill, Carmel; Seymour, Colin
Recent insights into the mechanisms underlying the biological effects of low dose effects of ionising radiation have revealed that similar mechanisms can be induced by chemical stressors in the environment. This means that interactions between radiation and chemicals are likely and that the outcomes following mixed exposures to radiation and chemicals may not be predictable for human health, by consideration of single agent effects. Our understanding of the biological effects of low dose exposure has undergone a major paradigm shift. We now possess technologies which can detect very subtle changes in cells due to small exposures to radiation or other pollutants. We also understand much more now about cell communication, systems biology and the need to consider effects of low dose exposure at different hierarchical levels of organisation from molecules up to and including ecosystems. Furthermore we understand, at least in part, some of the mechanisms which drive low dose effects and which perpetuate these not only in the exposed organism but also in its progeny and in certain cases, its kin. This means that previously held views about safe doses or lack of harmful effects cannot be sustained. The International Commission on Radiological Protection (ICRP) and all national radiation and environmental protection organisations have always accepted a theoretical risk and have applied the precautionary principle and the LNT (linear-non-threshold) model which basically says that there is no safe dose of radiation. Therefore even in the absence of visible effects, exposure of people to radiation is strictly limited. This review will consider the historical context and the new discoveries and will focus on evidence for emergent effects after mixed exposures to combined stressors which include ionising radiation. The implications for regulation of low dose exposures to protect human health and environmental security will be discussed.
The past few decades have witnessed a dramatic increase in consumers seeking health information online. However, the quality of such information remains questionable, and the trustworthiness of online health information has become a hot topic, whereas little attention has been paid to how consumers evaluate online health information credibility. This study builds on theoretical perspectives of trust such as personal-capital-based, social-capital-based, and transfer-based, and it examines various correlates of consumer trust in online health information. The author analyzed the 2007 Health Information National Trends Survey data (N = 7,674). Results showed that consumer trust in online health information did not correlate with personal capital such as income, education, and health status. Social capital indicated by visiting social networking Web sites was not associated with trust in online health information either. Nevertheless, trust in online health information transferred from traditional mass media and government health agencies to the Internet, and it varied by such information features as easiness to locate and to understand. Age appeared to be a key factor in understanding the correlates of trust in online health information. Theoretical and empirical implications of the results are discussed.
Timothy J.J. Inglis
Full Text Available Melioidosis, which is caused by the bacterium Burkholderia pseudomallei, is a potentially fatal tropical infection, little known outside its main endemic zone of Southeast Asia and northern Australia. Though it has received more attention in recent years on account of its claimed suitability as a biological weapon agent, the principal threat from melioidosis is a result of naturally occurring events. Occasional case clusters, sporadic cases outside the known endemic zone and infections in unusual demographic groups highlight a changing epidemiology. As melioidosis is the result of an environmental encounter and not person-to-person transmission, subtle changes in its epidemiology indicate a role environmental factors, such as man-made disturbances of soil and surface water. These have implications for travel, occupational and tropical medicine and in particular for risk assessment and prevention. Practical problems with definitive laboratory diagnosis, antibiotic treatment and the current lack of a vaccine underline the need for prevention through exposure avoidance and other environmental health measures. It is likely that the increasing population burden of the tropical zone and extraction of resources from the humid tropics will increase the prevalence of melioidosis. Climate change-driven extreme weather events will both increase the prevalence of infection and gradually extend its main endemic zone.
Canta, Chiara; Dubois, Pierre
This paper studies spousal peer effects on the smoking behaviour and their implication for the health of children through passive smoking. Smoking decisions are modeled as equilibrium strategies of an incomplete information game within the couple. Using data from the French Health Survey 2002-2003, we identify two distinct effects linked to spousal behaviour: a smoking enhancing effect of smoking partners and a smoking deterring effect of non smoking partners. On the one hand, ...
U.S. Department of Health & Human Services — The National Health and Nutrition Examination Survey (NHANES) is a program of studies designed to assess the health and nutritional status of adults and children in...
Hupkens, C L; van den Berg, J; van der Zee, J
In order to study the value of national health interview surveys for national and international research and policy activities, this paper examines the existence and content of recent and future health interview surveys in the 15 member states of the European Union (EU), Norway, Iceland and Switzerland. National health interview surveys are performed in most countries, but not in Greece (only regional surveys), Luxembourg, Ireland and Iceland (only multi-purpose surveys). The health interview surveys in the other 14 countries provide regular data on the main health topics. Of the 14 health topics that are examined in this inventory seven are measured in all countries. Questions on health status (e.g. self-assessed health, long-term physical disability, and height and weight) and medical consumption (e.g. consultations with the general practitioner, GP) are often included. Lifestyle topics are less often included, except smoking habits, information about which is sought in all countries. Topics like diet and drugs/narcotics are more often included in special surveys than in general health interview surveys. Despite differences in the content, frequency and methodology of national health interview surveys in different countries, these surveys are a valuable source of information on the health of Europeans.
This article sets out to outline the tenets of neoliberalism and globalization, prior to the identification of the implications of neoliberalism for the British health system since 1979. The article then focuses on the applications and implications of neoliberalism for the British mental health system in terms of service organization and management, and the impact these changes in direction had on the three existing service sectors: users, carers and professionals. The discussion and the conclusion highlight the significance of these developments in the mental health system in the rather hybrid context of health, mental health, and social care policy and practice in the United Kingdom.
Lenihan, I. M.A. [Western Regional Hospital Board, Glasgow (United Kingdom); Smith, H. [University of Glasgow, Glasgow (United Kingdom)
The technique of activation analysis has useful and distinctive applications, not yet fully recognized or exploited, in public health. Three areas of usefulness may be recognized. 1. Industrial hygiene. Activation analysis offers a simple and efficient method for assessing and controlling occupational hazards associated with the handling of toxic materials, such as compounds of arsenic and of mercury. Examination of hair and nail samples, taken at six-monthly intervals, will yield a surprising amount of information regarding the influence on occupational exposure of individual variation in working habits, and inadequacy or non-observance of hygienic rules and other prescribed safety measures. 2. Epidemiology. The advantage conferred by activation analysis lies in the possibility of rapid and accurate estimation of trace element concentrations in small samples of tissue or other materials, such as can readily be obtained from population groups large enough to be statistically significant. Surveys of this kind have interesting potentialities in relation to dental caries, cancer, cirrhosis of the liver and heart disease. 3. Recognition of essential trace elements. Surveys of trace element concentrations suggest that the variability of tissue levels among members of a population is smaller for essential trace elements than for non-essential elements. It is possible also that tissue levels show a normal distribution for essential elements and a log-normal distribution for non-essential elements. (author)
... hence proxy measure of health services were utilised in the paper and this might blur the expected impacts. The implication of the paper is for African countries to adequately participate in GATS as it involves trade in health services. Key Words: Liberalisation, health system, mortality, services supply modes, WTO, general ...
Concentration and Health Implication of Heavy Metals in Drinking Water from Urban ... water is not mentioned by WHO, but all the samples analyzed were found to ... Key words: Drinking water quality, Heavy metals, Maximum admissible limit, ...
Bowen, M; Lyons, K J; Young, B E
The health care system is undergoing profound changes. Cost containment efforts and restructuring have resulted in cutbacks in registered nurse (RN) positions. These changes are often related to the increased market penetration by managed care companies. To determine how RN graduates perceive these changes and their impact on the delivery of patient care, Healthcare Environment Surveys were mailed to graduates of the classes of 1986 and 1991. Using the Survey's 5-point Likert Scale, we measured the graduates' satisfaction with their salary, quality of supervision they received, opportunities for advancement, recognition for their job, working conditions, the overall job and the changes in their careers over the previous five year period. Our study suggests that the changes in the health care system are having an impact on how health care is being delivered and the way nurses view their jobs. Respondents reported that insurance companies are exerting increased control over patient care and perceive that the quality of patient care is declining. Increased workloads and an increase in the amount of paperwork were reported. Participants perceived that there were fewer jobs available and that job security was decreasing. The percentage of nurses who see job satisfaction as remaining the same or increasing are a majority. However, the relatively high percent of nurses who see job satisfaction as declining should provide a note of warning. The major implications of this study are that the professional nursing curriculum must be modified to include content on communication, organization, legislative/policy skills, and leadership. The nation's health care system is undergoing profound changes. There are numerous forces at work that are effecting the delivery of care and, consequently, the work of health professionals. These forces include significant efforts at cost containment, restructuring and downsizing of hospitals, and the movement of health care delivery out of acute
Okorafor, Okore Apia
A recent health reform proposal in South Africa proposes universal access to a comprehensive package of healthcare services in the public sector, through the implementation of a national health insurance (NHI) scheme. Implementation of the scheme is likely to involve the introduction of a payroll tax. It is implied that the introduction of the payroll tax will significantly reduce the size of the private health insurance market. The objective of this study was to estimate the impact of an NHI payroll tax on the demand for private health insurance in South Africa, and to explore the broader implications for health policy. The study applies probit regression analysis on household survey data to estimate the change in demand for private health insurance as a result of income shocks arising from the proposed NHI. The introduction of payroll taxes for the proposed NHI was estimated to result in a reduction to private health insurance membership of 0.73%. This suggests inelasticity in the demand for private health insurance. In the literature on the subject, this inelasticity is usually due to quality differences between alternatives. In the South African context, there may be other factors at play. An NHI tax may have a very small impact on the demand for private health insurance. Although additional financial resources will be raised through a payroll tax under the proposed NHI reform, systemic problems within the South African health system can adversely affect the ability of the NHI to translate additional finances into better quality healthcare. If these systemic challenges are not adequately addressed, the introduction of a payroll tax could introduce inefficiencies within the South African health system.
Boice, J.D. Jr.; Mandel, J.S.; Doody, M.M.; Yoder, R.C.; McGowan, R.
A health survey of more than 143,000 radiologic technologists is described. The population was identified from the 1982 computerized files of the American Registry of Radiologic Technologists, which was established in 1926. Inactive members were traced to obtain current addresses or death notifications. More than 6000 technologists were reported to have died. For all registrants who were alive when located, a detailed 16-page questionnaire was sent, covering occupational histories, medical conditions, and other personal and lifestyle characteristics. Nonrespondents were contacted by telephone to complete an abbreviated questionnaire. More than 104,000 responses were obtained. Most technologists were female (76%), white (93%), and employed for an average of 12 years; 37% attended college, and approximately 50% never smoked cigarettes. Radiation exposure information was sought from employer records and commercial dosimetry companies. Technologists employed for the longest times had the highest estimated cumulative exposures, with approximately 9% with exposures greater than 5 cGy. There was a high correlation between cumulative occupational exposure and personal exposure to medical radiographs, related, in part, to the association of both factors with attained age. It is interesting that 10% of all technologists allowed others to practice taking radiographs on them during their training. Nearly 4% of the respondents reported having some type of cancer, mainly of the skin (1517), breast (665), and cervix (726). Prospective surveys will monitor cancer mortality rates through use of the National Death Index and cancer incidence through periodic mailings of questionnaires. This is the only occupational study of radiation employees who are primarily women and should provide new information on the possible risks associated with relatively low levels of exposure
Cheng, Scott; Tsai, Kai-ya; Nascimento, Lori M; Cousineau, Michael R
To determine whether enrollment events may serve as a venue to identify eligible individuals, enroll them into health insurance programs, and educate them about the changes the Patient Protection and Affordable Care Act will bring about. More than 2900 surveys were administered to attendees of 7 public health insurance enrollment events in California. Surveys were used to identify whether participants had any change in understanding of health reform after participating in the event. More than half of attendees at nearly all events had no knowledge about health reform before attending the event. On average, more than 80% of attendees knew more about health reform following the event and more than 80% believed that the law would benefit their families. Enrollment events can serve as an effective method to educate the public on health reform. Further research is recommended to explore in greater detail the impact community enrollment events can have on expanding public understanding of health reform.
Andrew Liebhold; Michael. Wingfield
Consideration of forest health is central to the sustainable management of forests. While many definitions of forest health have been proposed, the most widely adopted concept refers to the sustained functioning of desired forest ecosystem processes (Kolb et al., 1994). Legitimate complaints have been raised about the human-centric usage of the term "Forest Health...
Ekholm, Ola; Gundgaard, Jens; Rasmussen, Niels K R
AIMS: To investigate the relationship between potential explanatory factors (socio-economic factors and health) and non-response in two general population health interview surveys (face-to-face and telephone), and to compare the effects of the two interview modes on non-response patterns. METHODS...... in health interview surveys, but the non-response rate is higher in lower socio-economic groups. Analyses of non-response should be performed to understand the implications of survey findings.......: Data derives from The Danish Health Interview Survey 2000 (face-to-face interview) and The Funen County Health Survey 2000/2001 (telephone interview). Data on all invited individuals were obtained from administrative registers and linked to survey data at individual level. Multiple logistic regression...
Sekhri, Neelam; Savedoff, William
Private health insurance is playing an increasing role in both high- and low-income countries, yet is poorly understood by researchers and policy-makers. This paper shows that the distinction between private and public health insurance is often exaggerated since well regulated private insurance markets share many features with public insurance systems. It notes that private health insurance preceded many modern social insurance systems in western Europe, allowing these countries to develop the mechanisms, institutions and capacities that subsequently made it possible to provide universal access to health care. We also review international experiences with private insurance, demonstrating that its role is not restricted to any particular region or level of national income. The seven countries that finance more than 20% of their health care via private health insurance are Brazil, Chile, Namibia, South Africa, the United States, Uruguay and Zimbabwe. In each case, private health insurance provides primary financial protection for workers and their families while public health-care funds are targeted to programmes covering poor and vulnerable populations. We make recommendations for policy in developing countries, arguing that private health insurance cannot be ignored. Instead, it can be harnessed to serve the public interest if governments implement effective regulations and focus public funds on programmes for those who are poor and vulnerable. It can also be used as a transitional form of health insurance to develop experience with insurance institutions while the public sector increases its own capacity to manage and finance health-care coverage.
U.S. Department of Health & Human Services — A list of VHA hospitals with inpatient experience of care survey data. The VA SHEP uses the same questions as the Hospital Consumer Assessment of Health Providers...
Patten, Scott B; Adair, Carol E; Williams, Jeanne Va; Brant, Rollin; Wang, Jian Li; Casebeer, Ann; Beauséjour, Pierre
Mental health is an emerging priority for health surveillance. It has not been determined that the existing data sources can adequately meet surveillance needs. The objective of this project was to explore the use of telephone surveys as a means of collecting supplementary surveillance information. A computer-assisted telephone interview was administered to 5,400 subjects in Alberta. The interview included a set of brief, validated measures for evaluating mental disorder prevalence and related variables. The individual subject response rate was 78 percent, but a substantial number of refusals occurred at the initial household contact. The age and sex distribution of the study sample differed from that of the provincial population prior to weighting. Prevalence proportions did not vary substantially across administrative health regions. There is a potential role for telephone data collection in mental health surveillance, but these results highlight some associated methodological challenges. They also draw into question the importance of regional variation in mental disorder prevalence--which might otherwise have been a key advantage of telephone survey methodologies.
Although intersectionality is now recognized in the context of women's health, men's health, and gender and health, its full implications for research, policy, and practice have not yet been interrogated. This paper investigates, from an intersectionality perspective, the common struggles within each field to confront the complex interplay of factors that shape health inequities. Drawing on developments within intersectionality scholarship and various sources of research and policy evidence (including examples from the field of HIV/AIDS), the paper demonstrates the methodological feasibility of intersectionality and in particular, the wide-ranging benefits of de-centering gender through intersectional analyses. Copyright © 2012 Elsevier Ltd. All rights reserved.
Cress, Eileen McKenna
Vitamin D deficiency is considered to be a pandemic with implications for compromised bone health and other chronic diseases. Few studies have examined vitamin D status in college-aged individuals where prevention of future health consequences is still possible. Serum vitamin D 25(OH)D status and vitamin D intake were examined in 98 college…
Lurati, Ann Regina
Computers and other digital devices are commonly used both in the workplace and during leisure time. Computer vision syndrome (CVS) is a new health-related condition that negatively affects workers. This article reviews the pathology of and interventions for CVS with implications for the occupational health nurse.
Topics related to the radioactivity or radiation are presented. The importance of protection and security measures that are required both for public health, occupational health and the medical radiation is analyzed. In addition, it emphasizes the risks faced by professionals who work with radioactivity. Issues that confront the serious environmental implications of such activities are also showed [es
Dahlen, Carl R.; Hadrich, Joleen C.; Lardy, Gregory P.
A portion of the North Dakota Beef Industry Survey was developed to determine how educational programs can evolve to meet future needs of North Dakota beef producers. Of the 2,500 surveys mailed out to beef producers, 527 responses were completed and returned. Results highlight the level of education of North Dakota beef producers, anticipated use…
Moffat, Susan M; Coates, Dawn E
To obtain background information on the Oral Health (OH) students at Auckland University of Technology (AUT) and the University of Otago in order to aid in the recruitment of students; to determine the extent of the students' professional knowledge; and to determine their future employment preferences. Cross-sectional survey of all OH students at AUT and the University of Otago in 2008. A questionnaire was given to all 165 OH students at both Universities, and the response rate was 100%. Most students came from Cities. Prior to commencing their OH course, they had been engaged in full-time work, in tertiary education or at school. Their main sources of information about the courses were websites, the Universities, friends and dental practitioners. The students' professional knowledge improved significantly as they progressed through the OH courses. Students were likely to want to return to work in the type of community that they had come from. Most (90.3%) would consider working in private practice, while 56.4% would consider working for the School Dental Service (SDS). Overall, 49.7% of students would consider working in both environments. This study provides information on recruitment of students into OH courses, and the OH students' preferences for employment after graduation. The findings have implications for OH education and workforce planning in New Zealand.
Bariola, Emily; Lyons, Anthony; Leonard, William
Lesbians and gay men are exposed to unique minority stressors. We examined the health implications of one type of distal minority stressor (victimisation) and one type of proximal minority stressor (sexual identity concealment due to anticipated stigma) among lesbians and gay men. Gender-specific health implications were assessed. Data were collected via an online survey involving an Australian sample of 1,470 gay men and 1,264 lesbians. Survey questions assessed demographics, experiences of different forms of sexual identity-related victimisation and sexual identity concealment in a variety of contexts. Health outcomes included self-reported general health, illicit drug use, frequency of alcohol consumption, smoking status, and weight status. Gay men reported higher rates of victimisation and identity concealment than lesbians. Controlling for demographic differences, experiences of victimisation were associated with poorer self-rated health, illicit drug use, and smoking among both gay men and lesbians. In contrast, identity concealment was linked with poorer health outcomes among lesbians only. Our findings offer new insights into the potential antecedents of the health inequalities that have previously been reported for these populations. © 2016 Public Health Association of Australia.
Hupkens, C.L.H.; Berg, J. van den; Zee, J. van der
In order to study the value of national health interview surveys for national and international research and policy activities, this paper examines the existence and content of recent and future health interview surveys in the 15 member states of the European Union (EU), Norway, Iceland and
Westert, G.P.; Schellevis, F.G.
Aim: To compare prevalence of conditions and health inequalities in one study population using two methods of data collection: health interview survey and GP registration of consultations. Methods: Data is from the Second Dutch Survey of General Practice, using a multistage sampling design with
Full Text Available Effective infectious disease control requires early diagnosis and treatment initiation. Point-of-care testing offers rapid turn-around-times, facilitating same day clinical management decisions. To maximize the benefits of such POC testing programs, we need to understand how rapid tests are used in everyday clinical practice.In this cross-sectional survey study, 400 primary healthcare providers in two cities in South Africa were interviewed on their use of rapid tests in general, and tuberculosis diagnostic practices, between September 2012 and June 2013. Public healthcare facilities were selected using probability-sampling techniques and private healthcare providers were randomly selected from the Health Professional Council of South Africa list. To ascertain differences between the two healthcare sectors 2-sample z-tests were used to compare sample proportions.The numbers of providers interviewed were equally distributed between the public (n = 200 and private sector (n = 200. The most frequently reported tests in the private sector include blood pressure (99.5%, glucose finger prick (89.5% and urine dipstick (38.5%; and in the public sector were pregnancy (100%, urine dipstick (100%, blood pressure (100%, glucose finger prick (99% and HIV rapid test (98%. The majority of TB testing occurs in the public sector, where significantly more providers prefer Xpert MTB/RIF assay, the designated clinical TB diagnostic tool by the national TB program, as compared to the private sector (87% versus 71%, p-value >0.0001. Challenges with regard to TB diagnosis included the long laboratory turn-around-time, difficulty in obtaining sputum samples and lost results. All providers indicated that a new POC test for TB should be rapid and cheap, have good sensitivity and specificity, ease of sample acquisition, detect drug-resistance and work in HIV-infected persons.The existing centralized laboratory services, poor quality assurance, and lack of staff capacity
The professionalization of psychology yielded many advantages, but also led to a main focus on psychopathology in mental health care. This thesis investigated an additional positive approach to mental health, focusing on positive feelings and life satisfaction (emotional well-being) and optimal
Hiott, Ann E.; Grzywacz, Joseph G.; Davis, Stephen W.; Quandt, Sara A.; Arcury, Thomas A.
Context: The number of Latinos in rural regions of the United States is increasing. Little is known about factors that undermine the mental health of this segment of the rural population. Purpose: The goal of this study is to determine which stressors inherent in farmwork and the farmworker lifestyle contribute to poor mental health. Methods: An…
The 2014 survey includes degrees granted between September 1, 2013 and August 31, 2014. Enrollment information refers to the fall term 2014. Twenty-two academic programs were included in the survey universe, with all 22 programs providing data. Since 2009, data for two health physics programs located in engineering departments are also included in the nuclear engineering survey. The enrollments and degrees data includes students majoring in health physics or in an option program equivalent to a major.
This article uses survey data to investigate health effects of racialization in Canada. The operative sample was comprised of 91,123 Canadians aged 25 and older who completed the 2003 Canadian Community Health Survey. A "racial and cultural background" survey question contributed a variable that differentiated respondents who identified with Aboriginal, Black, Chinese, Filipino, Latin American, South Asian, White, or jointly Aboriginal and White racial/cultural backgrounds. Indicators of diabetes, hypertension and self-rated health were used to assess health. The healthy immigrant effect suppressed some disparity in risk for diabetes by racial/cultural identification. In logistic regression models also containing gender, age, and immigrant status, no racial/cultural identifications corresponded with significantly better health outcomes than those reported by survey respondents identifying as White. Subsequent models indicated that residential locale did little to explain the associations between racial/cultural background and health and that socioeconomic status was only implicated in relatively poor health outcomes for respondents identifying as Aboriginal or Aboriginal/White. Sizable and statistically significant relative risks for poor health for respondents identifying as Aboriginal, Aboriginal/White, Black, Chinese, or South Asian remained unexplained by the models, suggesting that other explanations for health disparities by racialized identity in Canada - perhaps pertaining to experiences with institutional racism and/or the wear and tear of experiences of racism and discrimination in everyday life - also deserve empirical investigation in this context.
Savinainen, Minna; Oksa, Panu
In Finland, workplace surveys are used to identify and assess health risks and problems caused by work and make suggestions for continuous improvement of the work environment. With the aid of the workplace survey, occupational health services can be tailored to a company. The aims of this study were to determine how occupational health professionals gather data via the workplace survey and the effect survey results have on companies. A total of 259 occupational health nurses and 108 occupational health physicians responded to the questionnaire: 84.2% were women and 15.8% were men. The mean age of the respondents was 48.8 years (range, 26 to 65 years). Usually occupational health nurses and foremen and sometimes occupational health physicians and occupational safety and health representatives initiate the workplace survey. More than 90% of the surveys were followed by action proposals, and about 50% of these were implemented. The proposals implemented most often concerned personal protective equipment and less often leadership. Survey respondents should have both the opportunity and the authority to affect resources, the work environment, work arrangements, and tools. Teamwork among occupational health and safety professionals, management, and employees is vital for cost-effectively solving today's complex problems at workplaces around the globe. Copyright 2011, SLACK Incorporated.
Among other things, researchers will assess: - what influence these have over health scientists; - which groups ... in the alcohol industry, focusing on the main alcohol companies in each country; - conduct a stakeholder survey; ... Site internet.
Radon is a colorless, odorless gas formed by radioactive decay of radium and uranium, which are naturally present in the earth's crust. When concentrated indoors, this invisible gas becomes a potential health hazard. The Environmental Protection Agency estimates that up to 20,000 lung cancer deaths annually can be attributed to prolonged radon exposure. Radon is an important health issue that should be understood by all health care professionals. This paper discusses some of the important issues regarding radon, such as the incidences of lung cancer believed to be attributable to radon, the high-risk areas in the United States, federal safety guidelines, and public apathy. These issues and their impact on the health care required by professionals, especially nurse practitioners, are discussed
Houser, Shannon H; Tesch, Linde; Hart-Hester, Susan; Dixon-Lee, Claire
Health information technology initiatives created the framework for a national health information infrastructure that concomitantly fostered a need to build intellectual capacity within our current and future health information management (HIM) work force. Results from the 2008 HIM Educator Survey are discussed. Developed for voluntary electronic participation, the survey comprised a series of questions about educators' professional interests and responsibilities. Summary data from the 402 respondents are provided and highlight areas such as academic rank, teaching status, salary range, levels of interest in various issues, and use of virtual learning tools. Data from this survey provide insights into the concerns and challenges many HIM educators face in today's training institutions and suggest implications for future directions in work force training and professional development within the HIM field.
Golub, M.S.; Collman, G.W.; Foster, P.M.
for chemicals. Recent US legislation has mandated improved chemical testing approaches for protecting children's health and screening for endocrine-disrupting agents, which has led to changes in the US Environmental Protection Agency's risk assessment and toxicity testing guidelines to include puberty...
Petersen, Robert C.
Summarizes what is known about the effects of marijuana use on health. The topics included are its chemistry and the metabolism; the effects of acute intoxication on learning, memory, intellectual performance, driving, and other skilled performances; and effects on lungs, brain, heart, and other systems. (SA)
Minimally invasive surgery is one of the great innovations of health care in the 20th century. It promises to revolutionise surgery by allowing many more operations to be performed with minimal hospitalisation. Pressure from patients has caused many techniques to spread rapidly before they have been
Suskind, Anne M; Clemens, J Quentin
The US healthcare system is undergoing fundamental changes in an effort to improve access to care, curtail healthcare spending, and improve quality of care. These efforts largely focused on Medicare, and therefore, will have a fundamental impact on the care of geriatric patients. This article reviews contemporary health policy issues, with a focus on how these issues may impact the care of geriatric urology patients. The Affordable Care Act has broadened the scope of Medicare coverage. Future Medicare reimbursement will be increasingly tied to care coordination, quality reporting, and demonstration of appropriate outcomes. Additional research is needed to better define the comparative effectiveness of urologic therapies in geriatric patients. Workforce projections indicate that there is a shortage of urologists in many areas of the country, and that this shortage will worsen over time unless a new funding model is instituted for graduate medical education. Medicare spending drives many health policy decisions. Therefore, few health policy topics are unique to geriatrics or geriatric urology. However, certain health policy topics (e.g., care coordination and risk-stratification) are particularly germaine to the elderly patients. Urologists with a particular interest in geriatric urology should be familiar with these issues.
Harbit, Maryanne Drake; Willis, Dawn
Lyme disease may be one of the most commonly misdiagnosed diseases of this decade. Health educators should be knowledgeable about this new disease and be able to share with the public information about prevention, early signs and symptoms, and treatment of the disease (Author/IAH)
Shahnazi, Hossein; Daniali, Seyede Shahrbanoo; Sharifirad, Gholamreza
Background: Due to the importance of health care organizations with significant responsibility for prevention and care, assessment of job satisfaction among health care staff is essential. Quality of health services will be decreased provided they are not satisfied. Materials and Methods: This study was a cross-sectional analysis of health care staff in Khomeinishahr (centers, buildings, and networks) If they had at least 6 months work experience, they could enter the study. Data included a t...
Bousquet, Jean; Bousquet, Philippe J.; Godard, Philippe; Daures, Jean-Pierre
Asthma is a very common chronic disease that occurs in all age groups and is the focus of various clinical and public health interventions. Both morbidity and mortality from asthma are significant. The number of disability-adjusted life years (DALYs) lost due to asthma worldwide is similar to that for diabetes, liver cirrhosis and schizophrenia. Asthma management plans have, however, reduced mortality and severity in countries where they have been applied. Several barriers reduce the availabi...
Sage, Cindy; Carpenter, David O
Global exposures to emerging wireless technologies from applications including mobile phones, cordless phones, DECT phones, WI-FI, WLAN, WiMAX, wireless internet, baby monitors, and others may present serious public health consequences. Evidence supporting a public health risk is documented in the BioInitiative Report. New, biologically based public exposure standards for chronic exposure to low-intensity exposures are warranted. Existing safety standards are obsolete because they are based solely on thermal effects from acute exposures. The rapidly expanding development of new wireless technologies and the long latency for the development of such serious diseases as brain cancers means that failure to take immediate action to reduce risks may result in an epidemic of potentially fatal diseases in the future. Regardless of whether or not the associations are causal, the strengths of the associations are sufficiently strong that in the opinion of the authors, taking action to reduce exposures is imperative, especially for the fetus and children. Such action is fully compatible with the precautionary principle, as enunciated by the Rio Declaration, the European Constitution Principle on Health (Section 3.1) and the European Union Treaties Article 174.
Miglioretti, Massimo; Velasco, Veronica; Celata, Corrado; Vecchio, Luca
Objectives: The study explores the relationships among teachers' health representations, their ideas about health promotion, their working conditions and their involvement in health-promotion activities at school. Methods: A questionnaire was administered to 107 teachers in 86 schools in Milan (Italy). The questionnaire was structured in four…
McCoyd, Judith L M
Identifying common patient dynamics is useful for developing social work practice sensitivity in health social work. This article draws on findings from a study of women who terminated desired pregnancies because of fetal anomalies and identifies dynamics that may be applicable to many health settings. Data suggest that women have expectations that submission to medical care, particularly high-tech medical care, should ensure a positive outcome--in this case a healthy baby. Analysis of data reveals the presence of an implicit contract that the women hold with the medical system,"Mother Nature," or society. The analysis carries an implication that health social work should help patients develop realistic expectations about health care. The presence of implicit contracts may have further implications for liability and litigation. Social work roles and interventions are addressed.
Wysocki, Susan; Kingsberg, Sheryl; Krychman, Michael
Vulvar and vaginal atrophy (VVA) is a chronic and progressive medical condition common in postmenopausal women. Symptoms of VVA such as dyspareunia, vaginal dryness, irritation, and itching can negatively impact sexual function and quality of life. The REVIVE (REal Women's VIews of Treatment Options for Menopausal Vaginal ChangEs) survey assessed knowledge about VVA and recorded attitudes about interactions with healthcare providers (HCPs) and available treatment options for VVA. The REVIVE survey identified unmet needs of women with VVA symptoms such as poor understanding of the condition, poor communication with HCPs despite the presence of vaginal symptoms, and concerns about the safety, convenience, and efficacy of available VVA treatments. HCPs can address these unmet needs by proactively identifying patients with VVA and educating them about the condition as well as discussing treatment preferences and available therapies for VVA.
Full Text Available Students were surveyed regarding usage of ebooks. Findings demonstrate that their propensity to using Ebooks increases as costs decrease, Tecnological advancements have led to ebooks being more than a written text displayed in digital format as web sites provide more up to date information. Also, licensing changes such as Creative Commons allow for more data to be accessible for students allowing for more student research opportunity.
Bovine tuberculosis (TB) is a neglected zoonosis of cattle that is prevalent but under-investigated in Cameroon. Based on epidemiological data of the disease, this study was designed to assess the risks and public health implications for zoonotic M. bovis infection in cattle and humans in the highlands of Cameroon.
Pratt, Charlotte A.; Pratt, Cornelius B.
Examines the "Ladies' Home Journal" and two popular consumer magazines that target blacks to determine the proportions of food and beverage advertisements, nutrition advertisements and their promotional messages, and the health implications they reveal. Findings reveal these magazines had a significantly higher number of alcohol ads,…
The physiology and function of the bone is looked at as to the role in housing bone marrow. The bone marrow and particularly the red bone marrow is discussed. Sources of radiation are discussed and the health implications highlighted for caution and for study or evaluation. Key Words: Bone marrow, Irradiation, Radiation, ...
Chng, Chwee Lye
Many males still perceive contraception as a woman's responsibility. This paper describes male contraceptives and their effectiveness and draws implications for school and community health education professionals. More equitable sharing of the responsibility for contraception might result in more effective contraception. (PP)
The larval habitats of mosquitoes were investigated in Abeokuta, Nigeria in order to determine the breeding sites of the existing mosquito fauna and its possible public health implications on the residents of the City. The habitats were sampled between August 2005 and July 2006 using plastic dippers and a pipette.
Cryptosporidium species and cattle: Implication for public health and water - Short Communication. VA Pam, COE Onwuliri, DA Dakul, ICJ Omalu. Abstract. This paper presents a brief summary of the ecology of Cryptosporidium species in Calves and humans and the existing scientific evidence that addresses the claim that ...
The public health implications of pathogens in polluted aquatic ecosystems: a review. ... Pathogen contamination in water sources and related diseases constitute ... of public water supply and most importantly, increased rate of human mortality. ... illnesses related to respiratory, gastrointestinal and dermatological systems, ...
Sanders, Alison P; Messier, Kyle P; Shehee, Mina; Rudo, Kenneth; Serre, Marc L; Fry, Rebecca C
Arsenic is a known human carcinogen and relevant environmental contaminant in drinking water systems. We set out to comprehensively examine statewide arsenic trends and identify areas of public health concern. Specifically, arsenic trends in North Carolina private wells were evaluated over an eleven-year period using the North Carolina Department of Health and Human Services database for private domestic well waters. We geocoded over 63,000 domestic well measurements by applying a novel geocoding algorithm and error validation scheme. Arsenic measurements and geographical coordinates for database entries were mapped using Geographic Information System techniques. Furthermore, we employed a Bayesian Maximum Entropy (BME) geostatistical framework, which accounts for geocoding error to better estimate arsenic values across the state and identify trends for unmonitored locations. Of the approximately 63,000 monitored wells, 7712 showed detectable arsenic concentrations that ranged between 1 and 806μg/L. Additionally, 1436 well samples exceeded the EPA drinking water standard. We reveal counties of concern and demonstrate a historical pattern of elevated arsenic in some counties, particularly those located along the Carolina terrane (Carolina slate belt). We analyzed these data in the context of populations using private well water and identify counties for targeted monitoring, such as Stanly and Union Counties. By spatiotemporally mapping these data, our BME estimate revealed arsenic trends at unmonitored locations within counties and better predicted well concentrations when compared to the classical kriging method. This study reveals relevant information on the location of arsenic-contaminated private domestic wells in North Carolina and indicates potential areas at increased risk for adverse health outcomes. Copyright © 2011 Elsevier Ltd. All rights reserved.
Jaffee, Kim D; Shires, Deirdre A; Stroumsa, Daphna
The transgender community experiences health care discrimination and approximately 1 in 4 transgender people were denied equal treatment in health care settings. Discrimination is one of the many factors significantly associated with health care utilization and delayed care. We assessed factors associated with delayed medical care due to discrimination among transgender patients, and evaluated the relationship between perceived provider knowledge and delayed care using Anderson's behavioral model of health services utilization. Multivariable logistic regression analysis was used to test whether predisposing, enabling, and health system factors were associated with delaying needed care for transgender women and transgender men. A sample of 3486 transgender participants who took part in the National Transgender Discrimination Survey in 2008 and 2009. Predisposing, enabling, and health system environment factors, and delayed needed health care. Overall, 30.8% of transgender participants delayed or did not seek needed health care due to discrimination. Respondents who had to teach health care providers about transgender people were 4 times more likely to delay needed health care due to discrimination. Transgender patients who need to teach their providers about transgender people are significantly more likely to postpone or not seek needed care. Systemic changes in provider education and training, along with health care system adaptations to ensure appropriate, safe, and respectful care, are necessary to close the knowledge and treatment gaps and prevent delayed care with its ensuing long-term health implications.
Younger, David S
A network of family-based community-oriented primary health programs, or Programa Agentes Communita˙rios de Saúde, and family health programs, or Programa Saúde da Família, introduced almost 2 decades ago were the Brazilian government's health care models to restructure primary care under the Unified Health System, or Sistema Único de Saúde. The latter offers comprehensive coverage to all, although it is used by those of lower income, and despite achievement in the last quarter century, access to health services and gradients of health status continue to persist along income, educational background, racial, and religious lines. Copyright © 2016 Elsevier Inc. All rights reserved.
Petrochuk, M A; Javalgi, R G
Health care reform has become the dominant domestic policy issue in the United States. President Clinton, and the Democratic leaders in the House and Senate have all proposed legislation to reform the system. Regardless of the plan which is ultimately enacted, health care delivery will be radically changed. Health care marketers, given their perspective, have a unique opportunity to ensure their own institutions' success. Organizational, managerial, and marketing strategies can be employed to deal with the changes which will occur. Marketers can utilize personal strategies to remain proactive and successful during an era of health care reform. As outlined in this article, responding to the health care reform changes requires strategic urgency and action. However, the strategies proposed are practical regardless of the version of health care reform legislation which is ultimately enacted.
Kruk, Margaret E
Globalisation is a defining economic and social trend of the past several decades. Globalisation affects health directly and indirectly and creates economic and health disparities within and across countries. The political response to address these disparities, exemplified by the Millennium Development Goals, has put pressure on the global community to redress massive inequities in health and other determinants of human capability across countries. This, in turn, has accelerated a transformation in the architecture of global health governance. The entrance of new actors, such as private foundations and multi-stakeholder initiatives, contributed to a doubling of funds for global health between 2000 and 2010. Today the governance of public health is in flux, with diminished leadership from multilateral institutions, such as the WHO, and poor coherence in policy and programming that undermines the potential for sustainable health gains. These trends pose new challenges and opportunities for global public health, which is centrally concerned with identifying and addressing threats to the health of vulnerable populations worldwide.
Francis, Joshua R; McCall, Bradley J; Hutchinson, Penny; Powell, Jodie; Vaska, Vikram L; Nourse, Clare
Australian bat lyssavirus (ABLV) infection in humans is rare but fatal, with no proven effective therapy. ABLV infection can be prevented by administration of a post-exposure prophylaxis regimen of human rabies immunoglobulin and rabies vaccine. All Australian bats (flying foxes and microbats) should be considered to be carrying ABLV unless proven otherwise. Any bat-related injury (bite, scratch or mucosal exposure to bat saliva or neural tissue) should be notified immediately to the relevant public health unit - no matter how small the injury or how long ago it occurred. Human-to-human transmission of ABLV has not been reported but is theoretically possible. Standard infection control precautions should be employed when managing patients with suspected or confirmed ABLV infection.
Online Learning for Mobile Technology Applications in Health Surveys. In light of ... to develop a globally accessible asynchronous Internet-based training packaged backed by a real-time coaching service. Project ID. 105932. Project status.
Yasumura, Seiji; Hosoya, Mitsuaki; Yamashita, Shunichi; Kamiya, Kenji; Abe, Masafumi; Akashi, Makoto; Kodama, Kazunori; Ozasa, Kotaro
The accidents that occurred at the Fukushima Daiichi Nuclear Power Plant after the Great East Japan Earthquake on 11 March 2011 have resulted in long-term, ongoing anxiety among the residents of Fukushima, Japan. Soon after the disaster, Fukushima Prefecture launched the Fukushima Health Management Survey to investigate long-term low-dose radiation exposure caused by the accident. Fukushima Medical University took the lead in planning and implementing this survey. The primary purposes of this survey are to monitor the long-term health of residents, promote their future well-being, and confirm whether long-term low-dose radiation exposure has health effects. This report describes the rationale and implementation of the Fukushima Health Management Survey. This cohort study enrolled all people living in Fukushima Prefecture after the earthquake and comprises a basic survey and 4 detailed surveys. The basic survey is to estimate levels of external radiation exposure among all 2.05 million residents. It should be noted that internal radiation levels were estimated by Fukushima Prefecture using whole-body counters. The detailed surveys comprise a thyroid ultrasound examination for all Fukushima children aged 18 years or younger, a comprehensive health check for all residents from the evacuation zones, an assessment of mental health and lifestyles of all residents from the evacuation zones, and recording of all pregnancies and births among all women in the prefecture who were pregnant on 11 March. All data have been entered into a database and will be used to support the residents and analyze the health effects of radiation. The low response rate (<30%) to the basic survey complicates the estimation of health effects. There have been no cases of malignancy to date among 38 114 children who received thyroid ultrasound examinations. The importance of mental health care was revealed by the mental health and lifestyle survey and the pregnancy and birth survey. This long
Rohlfs, Izabella; Borrell, Carme; Artazcoz, Lucia; Escribà-Agüir, Vicenta
Most studies into social determinants of health conducted in Spain based on data from health surveys have focused on social class inequalities. This paper aims to review the progressive incorporation of gender perspective and sex differences into health surveys in Spain, and to suggest design, data collection and analytical proposals as well as to make policy proposals. Changes introduced into health surveys in Spain since 1995 to incorporate gender perspective are examined, and proposals for the future are made, which would permit the analysis of differences in health between women and men as a result of biology or because of gender inequalities. The introduction of gender perspective in health surveys requires the incorporation of questions related to family setting and reproductive work, workplace and society in general to detect gender differences and inequalities (for example, domestic work, intimate partner violence, discrimination, contract type or working hours). Health indicators reflecting differential morbidity and taking into account the different life cycle stages must also be incorporated. Analyses ought to be disaggregated by sex and interpretation of results must consider the complex theoretical frameworks explaining the differences in health between men and women based on sex differences and those related to gender. Analysis of survey data ought to consider the impact of social, political and cultural constructs of each society. Any significant modification in procedures for collection of data relevant to the study of gender will require systematic coordination between institutions generating the data and researchers who are trained in and sensitive to the topic.
Patankar, A M; Trivedi, P L
Mumbai, a mega city with a population of more than 12 million, is experiencing acute air pollution due to commercial activity, a boom in construction and vehicular traffic. This study was undertaken to investigate the link between air pollution and health impacts for Mumbai, and estimate the monetary burden of these impacts. Cross-sectional data were subjected to logistic regression to analyse the link between air pollution and health impacts, and the cost of illness approach was used to measure the monetary burden of these impacts. Data collected by the Environmental Pollution Research Centre at King Edward Memorial Hospital in Mumbai were analysed using logistic regression to investigate the link between air pollution and morbidity impacts. The monetary burden of morbidity was estimated through the cost of illness approach. For this purpose, information on treatment costs and foregone earnings due to illness was obtained through the household survey and interviews with medical practitioners. Particulate matter (PM(10)) and nitrogen dioxide (NO(2)) emerged as the critical pollutants for a range of health impacts, including symptoms such as cough, breathlessness, wheezing and cold, and illnesses such as allergic rhinitis and chronic obstructive pulmonary disease (COPD). This study developed the concentration-response coefficients for these health impacts. The total monetary burden of these impacts, including personal burden, government expenditure and societal cost, is estimated at 4522.96 million Indian Rupees (INR) or US$ 113.08 million for a 50-μg/m(3) increase in PM(10), and INR 8723.59 million or US$ 218.10 million for a similar increase in NO(2). The estimated monetary burden of health impacts associated with air pollution in Mumbai mainly comprises out-of-pocket expenses of city residents. These expenses form a sizable proportion of the annual income of individuals, particularly those belonging to poor households. These findings have implications for public
Dutra, Lissa; Grubbs, Kathleen; Greene, Carolyn; Trego, Lori L; McCartin, Tamarin L; Kloezeman, Karen; Morland, Leslie
Few studies have investigated the impact of deployment stressors on the mental health outcomes of women deployed to Iraq in support of Operation Iraqi Freedom. This pilot study examined exposure to combat experiences and military sexual harassment in a sample of 54 active duty women and assessed the impact of these stressors on post-deployment posttraumatic stress disorder (PTSD) symptoms and depressive symptoms. Within 3 months of returning from deployment to Iraq, participants completed (a) the Combat Experiences Scale and the Sexual Harassment Scale of the Deployment Risk and Resilience Inventory, (b) the Primary Care PTSD Screen, and (c) an abbreviated version of the Center for Epidemiological Studies-Depression scale. Approximately three quarters of the sample endorsed exposure to combat experiences, and more than half of the sample reported experiencing deployment-related sexual harassment, with nearly half of the sample endorsing both stressors. Approximately one third of the sample endorsed clinical or subclinical levels of PTSD symptoms, with 11% screening positive for PTSD and 9% to 14% of the sample endorsing depressive symptoms. Regression analyses revealed that combat experiences and sexual harassment jointly accounted for significant variance in post-deployment PTSD symptoms, whereas military sexual harassment was identified as the only unique significant predictor of these symptoms. Findings from the present study lend support to research demonstrating that military sexual trauma may be more highly associated with post-deployment PTSD symptoms than combat exposure among female service members and veterans.
Alotaibi, Naser; Shayea, Abdulaziz; Nadar, Mohammed; Abu Tariah, Hashem
To investigate the level of awareness of the occupational therapy profession among final-year health sciences students at Kuwait University. This study utilized a survey targeting final-year students in the Health Sciences Center at Kuwait University schools of medicine, pharmacy, dentistry, and allied health sciences. The survey addressed awareness of occupational therapy, its scope of practice, work environments, and preference for learning more about the profession. Of the 244 surveys distributed, 132 were returned, for a 54% response rate. The proportion of those who knew about occupational therapy ranged from 94% (radiologic science) to a low of 17% (medicine). Most respondents learned about occupational therapy from colleagues (77.1%), rather than from their academic programs (28.1%). RESULTS indicated that about one fifth of students (21.4%) were unsure about the role of occupational therapists as members of the health care team. Preferences for learning more about the profession were consistent with interprofessional opportunities, such as observing an occupational therapy session (64.5%) and attending a workshop (63.6%) or presentation (59.8%). Although most respondents had some awareness of occupational therapy, specifics about its scope of practice and relevance to the health care team were lacking. Preferences for learning more about occupational therapy were consistent with the current trend for interprofessional education in health care. Implications for interprofessional education are presented.
Caraher, Martin; Cowburn, Gill
To set out a policy analysis of food taxes as a way of influencing food consumption and behaviour. The study draws on examples of food taxes from the developed world imposed at national and local levels. Studies were identified from a systemised search in six databases with criteria designed to identity articles of policy relevance. The dominant approach identified from the literature was the imposition of food taxes on food to raise general revenue, such as Value Added Tax in the European Union. Food taxes can be applied in various ways, ranging from attempts to directly influence behaviour to those which collect taxes for identified campaigns on healthy eating through to those applied within closed settings such as schools. There is a case for combining taxes of unhealthy foods with subsidies of healthy foods. The evidence from the literature concerning the use and impact of food taxes on food behaviour is not clear and those cases identified are mainly retrospective descriptions of the process. Many food taxes have been withdrawn after short periods of time due to industry lobbying. CONCLUSIONS FOR POLICY: Small taxes with the clear purpose of promoting the health of key groups, e.g. children, are more likely to receive public support. The focus of many tax initiatives is unclear; although they are generally aimed at consumers, another focus could be food manufacturers, using taxes and subsidies to encourage the production of healthier foods, which could have an effect at a population level. Further consideration needs to be given to this aspect of food taxes. Taxing food (and subsidies) can influence food behaviour within closed systems such as schools and the workplace.
an income from their own business or partnership, and lowest among the unemployed and those in receipt of a government pension or benefit (which excluded the unemployed). Given that differences in income non-reporting were small to moderate across levels of the education and occupation variables, and that propensity to not report income was greater among higher socioeconomic groups, estimates of the relation between income and health are unlikely to be affected by socioeconomic variability in income non-response. Probability estimates from a logistic regression suggested that higher rates of income non-reporting among employed persons who received their income from a business or partnership were not attributable to socio-economic factors. Rather, it is proposed that these higher rates were attributable to recall effects, or concerns about having one's income information disclosed to taxation authorities. Future studies need to replicate this analysis to determine whether the results can be inferred to other survey and data collection contexts. The analysis should also be extended to include an examination of the relation between socio-economic position and accuracy of income reporting. Little is known about this issue, yet it represents a potential source of bias that may have important implications for studies that investigate the association between income and health.
Public health and its "basic science", epidemiology, have become colonised by the individualistic ethic of medicine and economics. Despite a history in public health dating back to John Snow that underlined the importance of social systems for health, an imbalance has developed in the attention given to generating "social capital" compared to such things as modification of individual's risk factors. In an illustrative analysis comparing the potential of six progressively less individualised and more community-focused interventions to prevent deaths from heart disease, social support and measures to increase social cohesion faired well against more individual medical care approaches. In the face of such evidence public health professionals and epidemiologists have an ethical and strategic decision concerning the relative effort they give to increasing social cohesion in communities vs expanding access for individuals to traditional public health programs. Practitioners' relative efforts will be influenced by the kind of research that is being produced by epidemiologists and by the political climate of acceptability for voluntary individual "treatment" approaches vs universal policies to build "social capital". For epidemiologists to further our emerging understanding of the link between social capital and health they must confront issues in measurement, study design and analysis. For public health advocates to sensitise the political environment to the potential dividend from building social capital, they must confront the values that focus on individual-level causal models rather than models of social structure (dis)integration. The evolution of explanations for inequalities in health is used to illustrate the nature of the change in values.
Depaoli, Sarah; Tiemensma, Jitske; Felt, John M
The multidimensional graded response model, an item response theory (IRT) model, can be used to improve the assessment of surveys, even when sample sizes are restricted. Typically, health-based survey development utilizes classical statistical techniques (e.g. reliability and factor analysis). In a review of four prominent journals within the field of Health Psychology, we found that IRT-based models were used in less than 10% of the studies examining scale development or assessment. However, implementing IRT-based methods can provide more details about individual survey items, which is useful when determining the final item content of surveys. An example using a quality of life survey for Cushing's syndrome (CushingQoL) highlights the main components for implementing the multidimensional graded response model. Patients with Cushing's syndrome (n = 397) completed the CushingQoL. Results from the multidimensional graded response model supported a 2-subscale scoring process for the survey. All items were deemed as worthy contributors to the survey. The graded response model can accommodate unidimensional or multidimensional scales, be used with relatively lower sample sizes, and is implemented in free software (example code provided in online Appendix). Use of this model can help to improve the quality of health-based scales being developed within the Health Sciences.
Stebbins, K R
This paper examines the expanding presence of multinational cigarette companies into almost every country in the world, and discusses the health implications of this global penetration. Cigarettes deserve special attention because tobacco is the only legally available consumer product that is harmful to one's health when used as intended. A temptation exists to blame governments for the existence of health-threatening products within their borders. However, this paper illustrates the extent to which extra-national forces influence domestic policies and circumstances. Cigarette smokers are often blamed for their lethal habit, despite billion-dollar promotional schemes which attract people to smoking, obscuring the harmful consequences of consuming a highly addictive drug. Multinational cigarette companies are increasingly targeting Asian and Third World populations. To facilitate this market penetration, political avenues are often pursued with considerable success, disregarding the health implications associated with cigarette tobacco. The use of tobacco in development programs (e.g. the U.S. 'Food for Peace' program) has political and economic implications for donor and recipient countries, and lucrative advantages for the tobacco companies. However, this paper recommends that corporate profits and foreign policy should not be pursued at the expense of tobacco-related diseases and premature deaths among Third World peoples.
White, M; Dorman, S M
Online support groups are expanding as the general public becomes more comfortable using computer-mediated communication technology. These support groups have certain benefits for users who may not be able to or do not have the desire to attend face-to-face sessions. Online support groups also present challenges when compared to traditional face-to-face group communication. Communication difficulties may arise resulting from lack of visual and aural cues found in traditional face-to-face communication. Online support groups have emerged within health care as a result of the need individuals have to know more about health conditions they are confronting. The proliferation of these online communities may provide an opportunity for health educators to reach target populations with specific messages. This paper reviews the development of health-related online support groups, examines research conducted within these communities, compares their utility with traditional support groups and discusses the implications of these groups for health education.
McCabe, Sean Esteban; Hughes, Tonda L; Bostwick, Wendy; Morales, Michele; Boyd, Carol J
Researchers are increasingly recognizing the need to include measures of sexual orientation in health studies. However, relatively little attention has been paid to how sexual identity, the cognitive aspect of sexual orientation, is defined and measured. Our study examined the impact of using two separate sexual identity question formats: a three-category question (response options included heterosexual, bisexual, or lesbian/gay), and a similar question with five response options (only lesbian/gay, mostly lesbian/gay, bisexual, mostly heterosexual, only heterosexual). A large probability-based sample of undergraduate university students was surveyed and a randomly selected subsample of participants was asked both sexual identity questions. Approximately one-third of students who identified as bisexual based on the three-category sexual identity measure chose "mostly heterosexual" or "mostly lesbian/gay" on the five-category measure. In addition to comparing sample proportions of lesbian/gay, bisexual, or heterosexual participants based on the two question formats, rates of alcohol and other drug use were also examined among the participants. Substance use outcomes among the sexual minority subgroups differed based on the sexual identity question format used: bisexual participants showed greater risk of substance use in analyses using the three-category measure whereas "mostly heterosexual" participants were at greater risk when data were analyzed using the five-category measure. Study results have important implications for the study of sexual identity, as well as whether and how to recode responses to questions related to sexual identity.
Freixas Sala, Núria; Monistrol Ruano, Olga; Espuñes Vendrell, Jordi; Sallés Creus, Montserrat; Gallardo González, Mónica; Ramón Cantón, Carme; Bueno Domínguez, María José; Llinas Vidal, Montserrat; Campo Osaba, María Antonia
This study aims to describe the implementation of the patient safety (PS) programs in catalan hospitals and to analyze the level of nursing involvement. Multicenter cross-sectional study. To obtain the data two questionnaires were developed; one addressed to the hospital direction and another to the nurse executive in PS. The survey was distributed during 2013 to the 65 acute care hospitals in Catalonia. The questionnaire was answered by 43 nursing directors and 40 nurse executive in PS. 93% of the hospitals responded that they had a PS Program and 81.4% used a specific scoreboard with PS indicators. The referent of the hospital in PS was a nurse in 55.8% of the centres. 92.5% had a system of notification of adverse effects with an annual average of 190.3 notifications. In 86% of the centres had a nurse involved in the PS program but only in the 16% of the centres the nurse dedication was at full-time. The nurse respondents evaluate the degree of implementation of the PBS program with a note of approved and they propound as improvement increase the staff dedicated to the PS and specific academic training in PS. The degree of implementation of programs for patient safety is high in Catalan acute hospitals, while the organizational structure is highly diverse. In more than half of the hospitals the PS referent was a nurse, confirming the nurse involvement in the PS programs. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.
Gonzalez, A.J.; Anderer, J.
In this Paper two elements of a multiphase analysis of radiation exposures in the living environment - the human health effects of ionizing radiation and the implications for radiation safety policy and practices - are presented. Part 1 draws together the current state of scientific knowledge and insight about the human health effects of radiation, describing these in terms of known cause-related deterministic effects and of the estimated incidence of stochastic effects as defined by biostatistics and biological models. The 1988 UNSCEAR report provides an authoritative basis for such an examination. Part 2 explores some of the major implications that the state-of-the-art of radiation biology has - or should have - for radiation safety policy and practices. (author)
Tiffany K. Gill
Full Text Available Abstract Background Feeling angry about their health status may influence disease progression in individuals, creating a greater burden on the health care system. Identifying associations between different variables and feeling angry about health status may assist health professionals to improve health outcomes. This study used path analysis to explore findings from a population-based survey, informed by qualitative descriptions obtained from focus groups, to determine the prevalence of health-related anger within the community and variables associated with reporting health-related anger. Methods A population-based Computer Assisted Telephone Interview (CATI survey of 3003 randomly selected adults Australia-wide was conducted to examine the prevalence of health-related anger. A wide range of other covariates were included in the survey. Multivariable logistic regression and path analysis were undertaken to identify the relationships between different variables associated with feeling angry about the health status of people, to explore the direction of these associations and as a consequence of the results, consider implications for health service use and delivery. Results Overall, 18.5 % of the population reported feeling angry about their health “some of the time”, “most of the time” or “all of the time”. People who felt angry about their health were more likely to have a severe health condition, at least one chronic condition, high psychological distress, fair to poor health status, and needed to adjust their daily lives because of a health condition. Having a tertiary level education was protective. Receiving some form of social support, usually from a support group, and not always doing as advised by a doctor, were also associated with a higher likelihood of being angry about their health. Conclusions People living with significant health problems are more likely to feel angry about their health. The path between illness and
Shahnazi, Hossein; Daniali, Seyede Shahrbanoo; Sharifirad, Gholamreza
Due to the importance of health care organizations with significant responsibility for prevention and care, assessment of job satisfaction among health care staff is essential. Quality of health services will be decreased provided they are not satisfied. This study was a cross-sectional analysis of health care staff in Khomeinishahr (centers, buildings, and networks) If they had at least 6 months work experience, they could enter the study. Data included a two-part questionnaire with a standardized questionnaire, demographic variables, and Smith job descriptive index, which is a questionnaire with six domains. Reliability was obtained for each domain and its validity was reported 0.93. The results showed an overall satisfaction score averages 43.55 ± 12.8 (from 100). Job satisfaction score was not significantly different between the sexes. However, within the current attitude toward job satisfaction, men scores was better than women (P = 0.001). Highest score in job satisfaction was related to relationships with colleagues and lowest score was related to the income, benefits, and job promotion. The more the years of work, the less the job satisfaction was. The attitude toward the current job had a direct relationship with income (P = 0.01). There was a significant inverse relationship between educational level and job satisfaction in domains promotion, income, and benefits (P = 0.01). The staff with higher education levels was less satisfied with income and job promotion qualification. Managers should focus on job qualification to increase job satisfaction and improve the quality of work.
Costich, Julia F; Honoré, Peggy A; Scutchfield, F Douglas
The work reported here builds on the identification of public health financial management practice competencies by a national expert panel. The next logical step was to provide a validity check for the competencies and identify priority areas for educational programming. We developed a survey for local public health finance officers based on the public health finance competencies and field tested it with a convenience sample of officials. We asked respondents to indicate the importance of each competency area and the need for training to improve performance; we also requested information regarding respondent education, jurisdiction size, and additional comments. Our local agency survey sample drew on the respondent list from the National Association of County and City Health Officials 2005 local health department survey, stratified by agency size and limited to jurisdiction populations of 25,000 to 1,000,000. Identifying appropriate respondents was a major challenge. The survey was fielded electronically, yielding 112 responses from 30 states. The areas identified as most important and needing most additional training were knowledge of budget activities, financial data interpretation and communication, and ability to assess and correct the organization's financial status. The majority of respondents had some postbaccalaureate education. Many provided additional comments and recommendations. Health department finance officers demonstrated a high level of general agreement regarding the importance of finance competencies in public health and the need for training. The findings point to a critical need for additional training opportunities that are accessible, cost-effective, and targeted to individual needs.
Full Text Available Household surveys are the primary data source of coverage indicators for children and women for most developing countries. Most of this information is generated by two global household survey programmes-the USAID-supported Demographic and Health Surveys (DHS and the UNICEF-supported Multiple Indicator Cluster Surveys (MICS. In this review, we provide an overview of these two programmes, which cover a wide range of child and maternal health topics and provide estimates of many Millennium Development Goal indicators, as well as estimates of the indicators for the Countdown to 2015 initiative and the Commission on Information and Accountability for Women's and Children's Health. MICS and DHS collaborate closely and work through interagency processes to ensure that survey tools are harmonized and comparable as far as possible, but we highlight differences between DHS and MICS in the population covered and the reference periods used to measure coverage. These differences need to be considered when comparing estimates of reproductive, maternal, newborn, and child health indicators across countries and over time and we discuss the implications of these differences for coverage measurement. Finally, we discuss the need for survey planners and consumers of survey results to understand the strengths, limitations, and constraints of coverage measurements generated through household surveys, and address some technical issues surrounding sampling and quality control. We conclude that, although much effort has been made to improve coverage measurement in household surveys, continuing efforts are needed, including further research to improve and refine survey methods and analytical techniques.
Gurewich, Deborah; Capitman, John; Sirkin, Jenna; Traje, Diana
Existing studies tell us little about care quality variation within the community health center (CHC) delivery system. They also tell us little about the organizational conditions associated with CHCs that deliver especially high quality care. The purpose of this study was to examine the operational practices associated with a sample of high performing CHCs. Qualitative case studies of eight CHCs identified as delivering high-quality care relative to other CHCs were used to examine operational practices, including systems to facilitate care access, manage patient care, and monitor performance. Four common themes emerged that may contribute to high performance. At the same time, important differences across health centers were observed, reflecting differences in local environments and CHC capacity. In the development of effective, community-based models of care, adapting care standards to meet the needs of local conditions may be important.
Cuellar, Norma G
Mindfulness meditation (MfM) is a mind-body therapy identified by the National Center for Complementary and Alternative Medicine. Initially taught in a formal classroom setting, MfM is a sustainable intervention with minimal costs that can be used over time. For veterans, after mastery, this technique shows promise in improving health outcomes and quality of life. This article describes MfM, discusses the conceptual framework and evidence-based research for MfM, and identifies the implications of MfM use by health care providers who are caring for war veterans.
Rouxel, Patrick L; Heilmann, Anja; Aida, Jun; Tsakos, Georgios; Watt, Richard G
In the last two decades, there has been increasing application of the concept of social capital in various fields of public health, including oral health. However, social capital is a contested concept with debates on its definition, measurement, and application. This study provides an overview of the concept of social capital, highlights the various pathways linking social capital to health, and discusses the potential implication of this concept for health policy. An extensive and diverse international literature has examined the relationship between social capital and a range of general health outcomes across the life course. A more limited but expanding literature has also demonstrated the potential influence of social capital on oral health. Much of the evidence in relation to oral health is limited by methodological shortcomings mainly related to the measurement of social capital, cross-sectional study designs, and inadequate controls for confounding factors. Further research using stronger methodological designs should explore the role of social capital in oral health and assess its potential application in the development of oral health improvement interventions. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Rouxel, P.; Duijster, D.; Tsakos, G.; Watt, R.G.
Objectives This study describes the oral health status and associated risk factors in a sample of female prisoners and compares their oral health to that of the female population from the 2009 Adult Dental Health Survey. Method A random sample of prisoners was selected from HMP Holloway, London.
Powell, John; Clarke, Aileen
A major use of the of the internet is for health information-seeking. There has been little research into its use in relation to mental health. To investigate the prevalence of internet use for mental health information-seeking and its relative importance as a mental health information source. General population survey. Questions covered internet use, past psychiatric history and the 12-item General Health Questionnaire. Eighteen per cent of all internet users had used the internet for information related to mental health. The prevalence was higher among those with a past history of mental health problems and those with current psychological distress. Only 12% of respondents selected the internet as one of the three most accurate sources of information, compared with 24% who responded that it was one of the three sources they would use. The internet has a significant role in mental health information-seeking. The internet is used more than it is trusted.
Carruthers, G. R.; Page, T.
The results from all-sky surveys with the S201 FUV camera/spectrograph from the moon during the Apollo 16 mission are summarized with respect to implications for future UV all-sky surveys. The scans provided imagery of 10 fields, each 20 deg in diameter, in the wavelength ranges 1050-1600 A and 1250-1600 A. Best detection thresholds were obtained with 10 and 30 min exposures at 1400 A. Only 7 percent sky coverage was recorded, and then only down to 11th mag. A Mark II camera may be flown on the Shuttle on the Spartan 3 mission, as may be an all-reflector Schmidt telescope. An additional 20 percent of the sky will be mapped and microchannel intensification will increase the diffuse source sensitivity by two orders of magnitude. Several objects sighted with the S201 will be reviewed with the Mark II.
Martín Romero-Martínez; Teresa Shamah-Levy; Lucia Cuevas-Nasu; Ignacio Méndez Gómez-Humarán; Elsa Berenice Gaona-Pineda; Luz María Gómez-Acosta; Juan Ángel Rivera-Dommarco; Mauricio Hernández-Ávila
Objective. Describe the design methodology of the halfway health and nutrition national survey (Ensanut-MC) 2016. Materials and methods. The Ensanut-MC is a national probabilistic survey whose objective population are the inhabitants of private households in Mexico. The sample size was determined to make inferences on the urban and rural areas in four regions. Describes main design elements: target population, topics of study, sampling procedure, measurement procedure and logistics organizat...
Gómez-Restrepo, Carlos; de Santacruz, Cecilia; Rodriguez, María Nelcy; Rodriguez, Viviana; Tamayo Martínez, Nathalie; Matallana, Diana; Gonzalez, Lina M
The 2015 National Mental Health Survey (NMHS) is the fourth mental survey conducted in Colombia, and is part of the National System of Surveys and Population Studies for health. A narrative description is used to explain the background, references, the preparation, and characteristics of the 2015 NMHS. The 2015 NMHS and its protocol emerge from the requirements that support the national and international policies related to mental health. Together with the Ministry of Health and Social Protection, the objectives, the collection tools, the sample, and the operational plan are defined. The main objective was to obtain updated information about the mental health, mental problems and disorders, accessibility to health services, and an evaluation of health conditions. Participants were inhabitants from both urban and rural areas, over 7 years old, and in whom the comprehension of social determinants and equity were privileged. An observational cross-sectional design with national, regional and age group representativity, was used. The age groups selected were 7-11, 12-17, and over 18 years old. The regions considered were Central, Orient, Atlantic, Pacific, and Bogota. The calculated sample had a minimum of 12,080 and a maximum of 14,496 participants. A brief summary of the protocol of the 2015 NMHS is presented. The full document with all the collection tools can be consulted on the Health Ministry webpage. Copyright © 2016. Publicado por Elsevier España.
Tourtelot, H A
Geochemical surveys in relation to health may be classified as having one, two or three dimensions. One-dimensional surveys examine relations between concentrations of elements such as Pb in soils and other media and burdens of the same elements in humans, at a given time. The spatial distributions of element concentrations are not investigated. The primary objective of two-dimensional surveys is to map the distributions of element concentrations, commonly according to stratified random sampling designs based on either conceptual landscape units or artificial sampling strata, but systematic sampling intervals have also been used. Political units have defined sample areas that coincide with the units used to accumulate epidemiological data. Element concentrations affected by point sources have also been mapped. Background values, location of natural or technological anomalies and the geographic scale of variation for several elements often are determined. Three-dimensional surveys result when two-dimensional surveys are repeated to detect environmental changes.
Bragge, Peter; Lowe, Dianne; Nunn, Jack S; O’Sullivan, Molly; Horvat, Lidia; Tong, Allison; Kay, Debra; Ghersi, Davina; McDonald, Steve; Poole, Naomi; Bourke, Noni; Lannin, Natasha; Vadasz, Danny; Oliver, Sandy; Carey, Karen; Hill, Sophie J
Objective To identify research priorities of consumers and other stakeholders to inform Cochrane Reviews in ‘health communication and participation’ (including such concepts as patient experience, shared decision-making and health literacy). Setting International. Participants We included anyone with an interest in health communication and participation. Up to 151 participants (18–80 years; 117 female) across 12 countries took part, including 48 consumers (patients, carers, consumer representatives) and 75 professionals (health professionals, policymakers, researchers) (plus 25 people who identified as both). Design Survey. Methods We invited people to submit their research ideas via an online survey open for 4 weeks. Using inductive thematic analysis, we generated priority research topics, then classified these into broader themes. Results Participants submitted 200 research ideas, which we grouped into 21 priority topics. Key research priorities included: insufficient consumer involvement in research (19 responses), ‘official’ health information is contradictory and hard to understand (18 responses), communication/coordination breakdowns in health services (15 responses), health information provision a low priority for health professionals (15 responses), insufficient eliciting of patient preferences (14 responses), health services poorly understand/implement patient-centred care (14 responses), lack of holistic care impacting healthcare quality and safety (13 responses) and inadequate consumer involvement in service design (11 responses). These priorities encompassed acute and community health settings, with implications for policy and research. Priority populations of interest included people from diverse cultural and linguistic backgrounds, carers, and people with low educational attainment, or mental illness. Most frequently suggested interventions focused on training and cultural change activities for health services and health professionals
Leach, Caitlin; Layson-Wolf, Cherokee
1) To measure the general perceptions and attitudes of community pharmacy residents toward transgender patients and health; 2) to identify gaps in didactic education regarding transgender health care among residents; and 3) to evaluate residents' level of support for pharmacists receiving education in transgender health care. This study was a cross-sectional survey delivered online. Community residency directors were e-mailed a cover letter and a 34-question online survey. The directors were asked to forward the survey to their residents for completion within 4 weeks. Responses were anonymous with no identifiers collected on the survey. Survey responses used a combination of open-response, multiple-choice, and Likert-scale questions aimed at gathering respondents' demographic information, perceptions of managing transgender patients and the need for receiving additional education in transgender health care. Overall, the results of the survey indicated that community pharmacy residents support integrating transgender health management into pharmacy education and recognize that the overwhelming barriers to care for these patients include discrimination and lack of provider knowledge. Significant findings include: 82.7% of community residents think that community pharmacists play an important role in providing care for transgender patients; 98.2% think that they have a responsibility to treat transgender patients; and 71.4% were not educated about transgender patient issues in pharmacy school. Only 36.2% of community residents felt confident in their ability to treat transgender patients. Community pharmacy residents list discrimination and lack of provider knowledge as the major barriers to care for transgender patients. Residents do not feel confident in their ability to treat and manage transgender patients. The majority of residents were not educated about transgender patient issues while in pharmacy school and think that community pharmacists need more education
Thrall, T H; Hoppszallern, S
Locating and keeping employees represents one of the greatest challenges facing health care leaders today. This is a key finding of the third Leadership Survey of executives in physician practices, managed care organizations and hospitals. The survey is sponsored by the Medical Group Management Association and Hospitals & Health Networks magazine. Other significant results: Practices put the most emphasis on teamwork, training and staff development as methods to combat labor shortages; practice executives count adequacy of reimbursements and physician productivity as top leadership challenges, along with the availability of qualified workers; practices choose print advertising and the addition of new products and services as the best ways for them to build market share.
Kim, Y S; Lee, H Y; Lee, M H; Simms, T; Park, B H
WHAT IS KNOWN ON THE SUBJECT?: Mental health literacy is a fairly new concept, first introduced in 1997. It refers to what people know and believe about mental health disorders. People's knowledge and beliefs help them to recognize, manage and prevent mental disorders. Generally, older adults have lower health literacy compared to young and middle-aged adults. WHAT THIS STUDY ADDS TO EXISTING KNOWLEDGE?: This is the first study on the mental health literacy of Korean older adults. This study looks beyond peoples' ability to recognize mental health disorders and their opinions about them. It identifies factors that are associated with mental health literacy (level of education and social support, the number of people in one's social circles and how individuals rate their health). WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Older adults might get more out of mental health literacy programmes in group or social settings. Programmes that use older adult peer educators/supporters, such as the "older people's champions" of the Healthy Passport programme in England, might make the programmes more effective. Mental health campaigns, such as Australia's beyondblue, might increase mental health literacy of older adults. Introduction Korea is experiencing rapid population ageing, spurring an increased need for mental health services for the elderly. Approximately one-third of Korean older adults experience depressive symptoms, and Korea has the highest elder suicide rate among 34 developed nations. Mental health literacy is an important component of promoting mental health, yet studies on the concept have been conducted in few countries. Aim This study examines the level of mental health literacy among Korean older adults and identifies factors associated with their mental health literacy. Method A cross-sectional survey was conducted with 596 community-dwelling Korean adults aged 65 and older. Andersen's Behavioral Model of Health Services Use framed the study. Results Overall
Paek, Hye-Jin; Hilyard, Karen; Freimuth, Vicki; Barge, J Kevin; Mindlin, Michele
Recent natural and human-caused disasters have awakened public health officials to the importance of emergency preparedness. Guided by health behavior and media effects theories, the analysis of a statewide survey in Georgia reveals that self-efficacy, subjective norm, and emergency news exposure are positively associated with the respondents' possession of emergency items and their stages of emergency preparedness. Practical implications suggest less focus on demographics as the sole predictor of emergency preparedness and more comprehensive measures of preparedness, including both a person's cognitive stage of preparedness and checklists of emergency items on hand. We highlight the utility of theory-based approaches for understanding and predicting public emergency preparedness as a way to enable more effective health and risk communication.
Pietromonaco, Paula R; Uchino, Bert; Dunkel Schetter, Christine
Health psychology has contributed significantly to understanding the link between psychological factors and health and well-being, but it has not often incorporated advances in relationship science into hypothesis generation and study design. We present one example of a theoretical model, following from a major relationship theory (attachment theory) that integrates relationship constructs and processes with biopsychosocial processes and health outcomes. We briefly describe attachment theory and present a general framework linking it to dyadic relationship processes (relationship behaviors, mediators, and outcomes) and health processes (physiology, affective states, health behavior, and health outcomes). We discuss the utility of the model for research in several health domains (e.g., self-regulation of health behavior, pain, chronic disease) and its implications for interventions and future research. This framework revealed important gaps in knowledge about relationships and health. Future work in this area will benefit from taking into account individual differences in attachment, adopting a more explicit dyadic approach, examining more integrated models that test for mediating processes, and incorporating a broader range of relationship constructs that have implications for health. A theoretical framework for studying health that is based in relationship science can accelerate progress by generating new research directions designed to pinpoint the mechanisms through which close relationships promote or undermine health. Furthermore, this knowledge can be applied to develop more effective interventions to help individuals and their relationship partners with health-related challenges. PsycINFO Database Record (c) 2013 APA, all rights reserved.
Piccolo, Rebecca S; Araujo, Andre B; Pearce, Neil; McKinlay, John B
The Boston Area Community Health (BACH) Survey is a community-based, random sample, epidemiologic cohort of n = 5502 Boston (MA) residents. The baseline BACH Survey (2002-05) was designed to explore the mechanisms conferring increased health risks on minority populations with a particular focus on urologic signs/symptoms and type 2 diabetes. To this end, the cohort was designed to include adequate numbers of US racial/ethnic minorities (Black, Hispanic, White), both men and women, across a broad age of distribution. Follow-up surveys were conducted ∼5 (BACH II, 2008) and 7 (BACH III, 2010) years later, which allows for both within- and between-person comparisons over time. The BACH Survey's measures were designed to cover the following seven broad categories: socio-demographics, health care access/utilization, lifestyles, psychosocial factors, health status, physical measures and biochemical parameters. The breadth of measures has allowed BACH researchers to identify disparities and quantify contributions to social disparities in a number of health conditions including urologic conditions (e.g. nocturia, lower urinary tract symptoms, prostatitis), type 2 diabetes, obesity, bone mineral content and density, and physical function. BACH I data are available through the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Central Repositories (www.niddkrepository.org). Further inquiries can be made through the New England Research Institutes Inc. website (www.neriscience.com/epidemiology).
Donnelly, Tam Truong
Providing high quality and effective health care services that are culturally acceptable and appropriate to clients has become an important issue for many health care providers. This paper explores problems associated with the traditional model that views coping according to hierarchical style and traits. While some scholars who have adopted this theoretical framework have made many contributions to the development of stress and coping theories, limitations are present. Using Vietnamese immigrants' experiences as examples, I argue that coping theories should emphasize the contextual nature of stress and coping, and that coping should be viewed as a dynamic process that varies under different social, cultural, political, economic, and historical conditions. Drawing from the work of others on coping, culture, imperialism, and colonialism, I explore the way that certain cultural conceptualizations determine how individuals cope. An understanding of the contextual nature of coping and of a Vietnamese immigrant's experience of coping with stressors and illness has implications for mental health care practice and research.
Gambescia, Stephen F; Cottrell, Randall R; Capwell, Ellen; Auld, M Elaine; Mullen Conley, Kathleen; Lysoby, Linda; Goldsmith, Malcolm; Smith, Becky
In July 2007, a market research report was produced by Hezel Associates on behalf of five sponsoring health education profession member organizations and the National Commission for Health Education Credentialing. The purpose of the survey was to learn about current or potential employers' knowledge, attitudes, and behaviors toward health educators and the health education profession and their future hiring practices. This article presents the background leading up to the production of this report, the major findings of the survey of employers, recommendations from the market research group regarding core messages, and implications for the profession having discovered for the first time information about employers' understanding of professionally prepared health educators. The article discusses the umbrella and key messages that may be incorporated into a marketing plan and other recommendations by the firm that should assist health educators in marketing the profession. Furthermore, this article presents reactions by leaders in this field to these messages and recommendations and concludes with next steps in this project and a call for the overall need to market the profession of health education.
Waylen, KJ; Martin-Ortega, J
The concept of Payments for Ecosystem Services (PES) is globally of increasing interest. However, little is known about the views and expectations of professionals and practitioners expected to enable or implement this concept. Since these individuals design, select, shape and deliver environmental management, their views and expectations are critical to understanding how PES may play out in practice. Using the first survey on this topic, in the UK this research discusses the implications for...
Champlin, Sara; Mackert, Michael
Create a screening measure of health literacy for use with the Health Information National Trends Survey (HINTS). Participants completed a paper-based survey. Items from the survey were used to construct a health literacy screening measure. A population-based survey conducted in geographic areas of high and low minority frequency and in Central Appalachia. Two thousand nine hundred four English-speaking participants were included in this study: 66% white, 93% completed high school, mean age = 52.53 years (SD = 16.24). A health literacy screening measure was created using four items included in the HINTS survey. Scores could range from 0 (no questions affirmative/correct) to 4 (all questions answered affirmatively/correctly). Multiple regression analysis was used to determine whether demographic variables known to predict health literacy were indeed associated with the constructed health literacy screening measure. The weighted average health literacy score was 2.63 (SD = 1.00). Those who were nonwhite (p = .0005), were older (p literacy screening measure scores. This study highlights the need to assess health literacy in national surveys, but also serves as evidence that screening measures can be created within existing datasets to give researchers the ability to consider the impact of health literacy. © The Author(s) 2016.
Livingood, William C; Morris, Michael; Sorensen, Bonita; Chapman, Karen; Rivera, Lillian; Beitsch, Les; Street, Phil; Coughlin, Susan; Smotherman, Carmen; Wood, David
The Florida Public Health Practice-Based Research Network conducted the study of Florida county health departments (CHDs) to assess relationships between self-assessed performance on essential services (ESs) and sources of funding. Primary data were collected using an online survey based on Public Health Accreditation Board standards for ES. Bivariate and multivariate analyses were conducted to assess the relationship of sources and amounts of revenue obtained from the Florida Department of Health financial system to responses to the survey of CHD capacity for ESs. Self-assessed CHD performance for each ES varied extensively among the CHDs and across the 10 ESs, ranging from a high of 98% CHDs completely or almost completely meeting the standards for ES 2 (Investigating Problems and Hazards) to a low of 32% completely or almost completely meeting standards for ES 10 (Research/Evidence). Medicaid revenue and fees were positively correlated with some ESs. Per capita revenue support varied extensively among the CHDs. Revenue for ES is decreasing and is heavily reliant on noncategorical (discretionary) revenue. This study has important implications for continued reliance on ES as an organizing construct for public health.
Idali Torres, M
This article examines the community process and data results of a health assessment conducted in an urban neighborhood of a middle-size city in Western Massachusetts. It describes the four-stage development process of the Health Assessment Project (HAP), a collaboration of the UMASS School of Public Health faculty and students, community based organizations and youth residents: (1) planning with a contemporary participatory approach, (2) implementing the data collection with traditional survey methodology, (3) tailoring the data analysis for a presentation at a community forum and report, and (4) incorporating the community's reaction to data results. In addition, it presents selected data results on health conditions of individual household members and perceived community health concerns and resources. Salient data results include high rates of chronic health conditions such as asthma and other respiratory problems among residents 0-18, back pain and other musculoskeletal among younger adults 19-54, and high blood pressure and other cardi-circulatory problems among older adults age 55 and older. The three most prevalent perceived community concerns are substance abuse, gangs and drug dealing. Identified community resources include sources of (1) providers of primary care, (2) health information as family/friends and Spanish media, (3) social activity such as churches and schools. Finally, this paper concludes by discussing implications for community health practice.
Sellers, Katie; Leider, Jonathon P; Harper, Elizabeth; Castrucci, Brian C; Bharthapudi, Kiran; Liss-Levinson, Rivka; Jarris, Paul E; Hunter, Edward L
Public health practitioners, policy makers, and researchers alike have called for more data on individual worker's perceptions about workplace environment, job satisfaction, and training needs for a quarter of a century. The Public Health Workforce Interests and Needs Survey (PH WINS) was created to answer that call. Characterize key components of the public health workforce, including demographics, workplace environment, perceptions about national trends, and perceived training needs. A nationally representative survey of central office employees at state health agencies (SHAs) was conducted in 2014. Approximately 25,000 e-mail invitations to a Web-based survey were sent out to public health staff in 37 states, based on a stratified sampling approach. Balanced repeated replication weights were used to account for the complex sampling design. A total of 10,246 permanently employed SHA central office employees participated in PH WINS (46% response rate). Perceptions about training needs; workplace environment and job satisfaction; national initiatives and trends; and demographics. Although the majority of staff said they were somewhat or very satisfied with their job (79%; 95% confidence interval [CI], 78-80), as well as their organization (65%; 95% CI, 64-66), more than 42% (95% CI, 41-43) were considering leaving their organization in the next year or retiring before 2020; 4% of those were considering leaving for another job elsewhere in governmental public health. The majority of public health staff at SHA central offices are female (72%; 95% CI, 71-73), non-Hispanic white (70%; 95% CI, 69-71), and older than 40 years (73%; 95% CI, 72-74). The greatest training needs include influencing policy development, preparing a budget, and training related to the social determinants of health. PH WINS represents the first nationally representative survey of SHA employees. It holds significant potential to help answer previously unaddressed questions in public health
de Pires, Denise Elvira Pires; Machado, Rosani Ramos; Soratto, Jacks; Scherer, Magda dos Anjos; Gonçalves, Ana Sofia Resque; Trindade, Letícia Lima
to identify the workloads of nursing professionals of the Family Health Strategy, considering its implications for the effectiveness of universal access. qualitative study with nursing professionals of the Family Health Strategy of the South, Central West and North regions of Brazil, using methodological triangulation. For the analysis, resources of the Atlas.ti software and Thematic Content Analysis were associated; and the data were interpreted based on the labor process and workloads as theorical approaches. the way of working in the Family Health Strategy has predominantly resulted in an increase in the workloads of the nursing professionals, with emphasis on the work overload, excess of demand, problems in the physical infrastructure of the units and failures in the care network, which hinders its effectiveness as a preferred strategy to achieve universal access to health. On the other hand, teamwork, affinity for the work performed, bond with the user, and effectiveness of the assistance contributed to reduce their workloads. investments on elements that reduce the nursing workloads, such as changes in working conditions and management, can contribute to the effectiveness of the Family Health Strategy and achieving the goal of universal access to health.
Beiser, Morton; Hou, Feng
Do refugees have lower levels of positive mental health than other migrants? If so, to what extent is this attributable to post-migration experiences, including discrimination? How does gender affect the relationships between post-migration experience and positive mental health? To address these questions, the current study uses data from Statistics Canada's 2013 General Social Survey (GSS), a nationally representative household study that included 27,695 Canadians 15 years of age and older. The study compares self-reported positive mental health among 651 refugees, 309 economic immigrants, and 448 family class immigrants from 50 source countries. Immigration-related predictors of mental health were examined including sociodemographic characteristics, discrimination, acculturation variables, and experiences of reception. Separate analyses were carried out for women and men. Refugees had lower levels of positive mental health than other migrants. Affiliative feelings towards the source country jeopardized refugee, but not immigrant mental health. A sense of belonging to Canada was a significant predictor of mental health. Perceived discrimination explained refugee mental health disadvantage among men, but not women. Bridging social networks were a mental health asset, particularly for women. The implications of anti-refugee discrimination net of the effects of anti-immigrant and anti-visible minority antipathies are discussed, as well as possible reasons for gender differences in the salience of mental health predictors.
Luckhaupt, Sara E; Sestito, John P
To describe data from the National Health Interview Survey (NHIS), both the annual core survey and periodic occupational health supplements (OHSs), available for examining national trends in worker health. The NHIS is an annual in-person household survey with a cross-sectional multistage clustered sample design to produce nationally representative health data. The 2010 NHIS included an OHS. Prevalence rates of various health conditions and health behaviors among workers based on multiple years of NHIS core data are available. In addition, the 2010 NHIS-OHS data provide prevalence rates of selected health conditions, work organization factors, and occupational exposures among US workers by industry and occupation. The publicly available NHIS data can be used to identify areas of concern for various industries and for benchmarking data from specific worker groups against national averages.
Cite as: Abimanyi-Ochom J. Practicalities of health survey field work research in a resource limited setting: challenges and ... vided only ART while TASO provided social support in ..... first aid box in case of any minor accident but was limited.
The survey purpose, methods, and statistical methods are presented. Results are discussed according to: area differences in background variables, area differences in health variables, area differences in annoyance reactions, and comparison of symptom frequencies with age, smoking, and drinking. Included in appendices are tables of data, enumeration forms, the questionnaire, interviewer cards, and interviewer instructions. (MHR)
A survey was conducted of health sciences libraries to obtain information about newer buildings, additions, remodeling, and renovations. An online survey was developed, and announcements of survey availability posted to three major email discussion lists: Medical Library Association (MLA), Association of Academic Health Sciences Libraries (AAHSL), and MEDLIB-L. Previous discussions of library building projects on email discussion lists, a literature review, personal communications, and the author's consulting experiences identified additional projects. Seventy-eight health sciences library building projects at seventy-three institutions are reported. Twenty-two are newer facilities built within the last ten years; two are space expansions; forty-five are renovation projects; and nine are combinations of new and renovated space. Six institutions report multiple or ongoing renovation projects during the last ten years. The survey results confirm a continuing migration from print-based to digitally based collections and reveal trends in library space design. Some health sciences libraries report loss of space as they move toward creating space for "community" building. Libraries are becoming more proactive in using or retooling space for concentration, collaboration, contemplation, communication, and socialization. All are moving toward a clearer operational vision of the library as the institution's information nexus and not merely as a physical location with print collections.
Fehr, Rainer, E-mail: firstname.lastname@example.org [Fakultaet fuer Gesundheitswissenschaften, Universitaet Bielefeld, Universitaetsstr. 25, 33615 Bielefeld (Germany); Mekel, Odile C.L., E-mail: email@example.com [Gesundheitsdaten und analysen, Versorgungsstrukturen, Landeszentrum Gesundheit Nordrhein-Westfalen (LZG.NRW), Westerfeldstr. 35-37, 33611 Bielefeld (Germany); Fintan Hurley, J., E-mail: firstname.lastname@example.org [Institute of Occupational Medicine (IOM), Research Avenue North, Riccarton, Edinburgh EH14 4AP, Scotland (United Kingdom); Mackenbach, Johan P., E-mail: email@example.com [Department of Public Health, Erasmus MC, P.O. Box 2040, 3000 CA Rotterdam (Netherlands)
Integrating human health into prospective impact assessments is known to be challenging. This is true for both approaches: dedicated health impact assessments (HIA) as well as inclusion of health into more general impact assessments. Acknowledging the full range of participatory, qualitative, and quantitative approaches, this study focuses on the latter, especially on computational tools for quantitative health modelling. We conducted a survey among tool developers concerning the status quo of development and availability of such tools; experiences made with model usage in real-life situations; and priorities for further development. Responding toolmaker groups described 17 such tools, most of them being maintained and reported as ready for use and covering a wide range of topics, including risk & protective factors, exposures, policies, and health outcomes. In recent years, existing models have been improved and were applied in new ways, and completely new models emerged. There was high agreement among respondents on the need to further develop methods for assessment of inequalities and uncertainty. The contribution of quantitative modeling to health foresight would benefit from building joint strategies of further tool development, improving the visibility of quantitative tools and methods, and engaging continuously with actual and potential users. - Highlights: • A survey investigated computational tools for health impact quantification. • Formal evaluation of such tools has been rare. • Handling inequalities and uncertainties are priority areas for further development. • Health foresight would benefit from tool developers and users forming a community. • Joint development strategies across computational tools are needed.
Fehr, Rainer; Mekel, Odile C.L.; Fintan Hurley, J.; Mackenbach, Johan P.
Integrating human health into prospective impact assessments is known to be challenging. This is true for both approaches: dedicated health impact assessments (HIA) as well as inclusion of health into more general impact assessments. Acknowledging the full range of participatory, qualitative, and quantitative approaches, this study focuses on the latter, especially on computational tools for quantitative health modelling. We conducted a survey among tool developers concerning the status quo of development and availability of such tools; experiences made with model usage in real-life situations; and priorities for further development. Responding toolmaker groups described 17 such tools, most of them being maintained and reported as ready for use and covering a wide range of topics, including risk & protective factors, exposures, policies, and health outcomes. In recent years, existing models have been improved and were applied in new ways, and completely new models emerged. There was high agreement among respondents on the need to further develop methods for assessment of inequalities and uncertainty. The contribution of quantitative modeling to health foresight would benefit from building joint strategies of further tool development, improving the visibility of quantitative tools and methods, and engaging continuously with actual and potential users. - Highlights: • A survey investigated computational tools for health impact quantification. • Formal evaluation of such tools has been rare. • Handling inequalities and uncertainties are priority areas for further development. • Health foresight would benefit from tool developers and users forming a community. • Joint development strategies across computational tools are needed.
Mary Clare Ahearn; James M. Williamson; Nyesha Black
The Affordable Care Act has implications for the source of health insurance for farm households and potentially how much of their time they allocate to off-farm jobs and even the rate at which new operators enter farming. The Act will likely have impacts for the 1% of farms defined to be large employers, which are required to provide coverage for their workers or pay a penalty. While a very small share of all farms, they account for upward of 40% of the production for some commodities. How th...
Affleck, William; Carmichael, Victoria; Whitley, Rob
Numerous scholars have stated that there is a silent crisis in men's mental health. In this article, we aim to provide an overview of core issues in the field of men's mental health, including a discussion of key social determinants as well as implications for mental health services. Firstly, we review the basic epidemiology of mental disorders with a high incidence and prevalence in men, including suicide and substance use disorder. Secondly, we examine controversies around the low reported rates of depression in men, discussing possible measurement and reporting biases. Thirdly, we explore common risk factors and social determinants that may explain higher rates of certain mental health outcomes in men. This includes a discussion of 1) occupational and employment issues; 2) family issues and divorce; 3) adverse childhood experience; and 4) other life transitions, notably parenthood. Fourthly, we document and analyze low rates of mental health service utilization in men. This includes a consideration of the role of dominant notions of masculinity (such as stubbornness and self-reliance) in deterring service utilization. Fifthly, we note that some discourse on the role of masculinity contains much "victim blaming," often adopting a reproachful deficit-based model. We argue that this can deflect attention away from social determinants as well as issues within the mental health system, such as claims that it is "feminized" and unresponsive to men's needs. We conclude by calling for a multipronged public health-inspired approach to improve men's mental health, involving concerted action at the individual, health services, and societal levels.
Lungu, Edgar Arnold; Biesma, Regien; Chirwa, Maureen; Darker, Catherine
In many developing countries including Malawi, health indicators are on average better in urban than in rural areas. This phenomenon has largely prompted Governments to prioritize rural areas in programs to improve access to health services. However, considerable evidence has emerged that some population groups in urban areas may be facing worse health than rural areas and that the urban advantage may be waning in some contexts. We used a descriptive study undertaking a comparative analysis of 13 child health indicators between urban and rural areas using seven data points provided by nationally representative population based surveys-the Malawi Demographic and Health Surveys and Multiple Indicator Cluster Surveys. Rate differences between urban and rural values for selected child health indicators were calculated to denote whether urban-rural differentials showed a trend of declining urban advantage in Malawi. The results show that all forms of child mortality have significantly declined between 1992 and 2015/2016 reflecting successes in child health interventions. Rural-urban comparisons, using rate differences, largely indicate a picture of the narrowing gap between urban and rural areas albeit the extent and pattern vary among child health indicators. Of the 13 child health indicators, eight (neonatal mortality, infant mortality, under-five mortality rates, stunting rate, proportion of children treated for diarrhea and fever, proportion of children sleeping under insecticide-treated nets, and children fully immunized at 12 months) show clear patterns of a declining urban advantage particularly up to 2014. However, U-5MR shows reversal to a significant urban advantage in 2015/2016, and slight increases in urban advantage are noted for infant mortality rate, underweight, full childhood immunization, and stunting rate in 2015/2016. Our findings suggest the need to rethink the policy viewpoint of a disadvantaged rural and much better-off urban in child health
Castillo, Richard J; Guo, Kristina L
The American Psychiatric Association (APA) has made major changes in the way mental illness is conceptualized, assessed, and diagnosed in its new diagnostic manual, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), published in 2013, and has far reaching implications for health care organizations and mental health policy. This paper reviews the four new principles in DSM-5: 1) A spectrum (also called "dimensional") approach to the definition of mental illness; 2) recognition of the role played by environmental risk factors related to stress and trauma in predisposing, precipitating, and perpetuating mental illness; 3) cultural relativism in diagnosis and treatment of mental illness; and 4) recognizing the adverse effects of psychiatric medications on patients. Each of these four principles will be addressed in detail. In addition, four major implications for health care organizations and mental health policy are identified as: 1) prevention; 2) client-centered psychiatry; 3) mental health workers retraining; and 4) medical insurance reform. We conclude that DSM- 5's new approach to diagnosis and treatment of mental illness will have profound implications for health care organizations and mental health policy, indicating a greater emphasis on prevention and cure rather than long-term management of symptoms.
Morikawa, Kaoru; Aoyama, Takashi; Kawagoe, Yasumitsu; Sunayashiki, Tadashi; Tanaka, Kiyoshi; Nishitani, Motohiro; Yoshinaga, Nobuharu
The Japanese Society of Radiological Technology asked radiation workers about the radiation doses and the state of their health as well as family. The reports by the Health and Welfare Ministry were referenced to compare radiation workers with others. The questionnaire was sent to about 4,000 members, and returned from 2,479. The survey showed that 684 persons (27.6%) felt health anxiety, 455 persons (18.4%) had medical check for recent one year, and 1,645 persons (66.4%) had anamnesis. Radiation doses for one year and cumulated doses varied according to engaging duration. (K.H.)
Shaw, Charles D; Braithwaite, Jeffrey; Moldovan, Max; Nicklin, Wendy; Grgic, Ileana; Fortune, Triona; Whittaker, Stuart
To describe global patterns among health-care accreditation organizations (AOs) and to identify determinants of sustainability and opportunities for improvement. Web-based questionnaire survey. Organizations offering accreditation services nationally or internationally to health-care provider institutions or networks at primary, secondary or tertiary level in 2010. s) External relationships, scope and activity public information. Forty-four AOs submitted data, compared with 33 in a survey 10 years earlier. Of the 30 AOs that reported survey activity in 2000 and 2010, 16 are still active and stable or growing. New and old programmes are increasingly linked to public funding and regulation. While the number of health-care AOs continues to grow, many fail to thrive. Successful organizations tend to complement mechanisms of regulation, health-care funding or governmental commitment to quality and health-care improvement that offer a supportive environment. Principal challenges include unstable business (e.g. limited market, low uptake) and unstable politics. Many organizations make only limited information available to patients and the public about standards, procedures or results.
Full Text Available Abstract Introduction Gendered practices of working life create gender inequalities through horizontal and vertical gender segregation in work, which may lead to inequalities in health between women and men. Gender equality could therefore be a key element of health equity in working life. Our aim was to analyze what gender (inequality means for the employees at a woman-dominated workplace and discuss possible implications for health experiences. Methods All caregiving staff at two workplaces in elder care within a municipality in the north of Sweden were invited to participate in the study. Forty-five employees participated, 38 women and 7 men. Seven focus group discussions were performed and led by a moderator. Qualitative content analysis was used to analyze the focus groups. Results We identified two themes. "Advocating gender equality in principle" showed how gender (inequality was seen as a structural issue not connected to the individual health experiences. "Justifying inequality with individualism" showed how the caregivers focused on personalities and interests as a justification of gender inequalities in work division. The justification of gender inequality resulted in a gendered work division which may be related to health inequalities between women and men. Gender inequalities in work division were primarily understood in terms of personality and interests and not in terms of gender. Conclusion The health experience of the participants was affected by gender (inequality in terms of a gendered work division. However, the participants did not see the gendered work division as a gender equality issue. Gender perspectives are needed to improve the health of the employees at the workplaces through shifting from individual to structural solutions. A healthy-setting approach considering gender relations is needed to achieve gender equality and fairness in health status between women and men.
Bilgrami, Zaid; McLAUGHLIN, Laura; Milanaik, Ruth; Adesman, Andrew
New-age technologies are ubiquitous in the lives of adolescents. Recent trends in media use suggest that adolescents are spending more time than ever engaging with technologies, and are able to do so in virtually all settings at any time. Given that new-age technologies are so heavily integrated within the daily life of adolescents, the health risks and benefits they offer must be closely examined. In this systematic review, we present recent literature related to the implications of new-age technologies on adolescent health. A total of 94 articles published since 2006 were collected using PubMed and Google Scholar on the most popular new-age technologies among adolescents: the internet, television, cell phones, and video games. The current body of research highlights several health risks related to these technologies. Nearly all have the potential for addiction, which can result in other symptoms and impair one's daily life. Excessive use can affect several components of health, such as quality of sleep, body composition, and mental well-being, and certain practices (viewing pornography, sexting) can lead to risky sexual behaviors. However, the technologies discussed in the present review also have tremendous potential to promote adolescent health. Pediatricians must educate parents and patients on how to safely use technology to minimize the potentially harmful outcomes.
Belcastro, P A; Gold, R S
Recent literature indicates teachers experience considerable stress in the workplace, and that such stress is associated with an increased frequency of physical illnesses and somatic complaints. This study was conducted to identify the relationship between reported levels of stress and somatic complaints and selected illnesses. The Maslach Burnout Inventory and the Teacher Somatic Complaints and Illness Inventory were distributed to 428 teachers in public schools in Southern Illinois. The MBI yields data allowing classification of teachers into two groups according to degrees of work related stress. A discriminant analysis was performed to examine the ability to discriminate between these groups based on their reported patterns of somatic complaints and illnesses. More than 11% of those responding to the study were classified as burned out according to conservative criteria for classification. The conclusion that burnout represents a health risk to teachers in this study has implications for school health personnel. Since school health personnel have experience in educating people about physiological and psychological factors that threaten health, and have experience in motivating individuals to take positive action regarding their health, they can provide teachers with information and skills to cope with occupational stress.
Berman, S J; Perkocha, V A; Novotny, T E
Continuing education (CE) is a vital component in strengthening the public health work force, and its importance has been emphasized by the Institute of Medicine and the Council for Education in Public Health. A CE preference survey was undertaken of alumni of the University of California, Berkeley, School of Public Health (UCB-SPH). Questionnaires were mailed to a one-third random sample of 1,500 graduates from 1981-1992 who currently reside in U.S. Department of Health and Human Services (HHS) Region IX. A response rate of 57% was achieved. Results of the survey show that CE activities are highly desired among respondents. Overall, 58% of respondents prefer a half-day to one-day seminar format during regular business hours, as opposed to night classes. They prefer a traditional didactic classroom presentation that is within one hour's automobile travel. The optimal setting for CE courses would be at the University of California, Berkeley, or in-house at their institution. Subject areas of interest noted by respondents are health policy development, communication in public health, community involvement, and research. Schools of public health may respond to the CE needs of their alumni through a variety of channels, including the mainstreaming of CE as part of a school's teaching responsibility, special seminars or institutes, extension courses through the larger university system, distance-based learning, and through a separately funded for-profit CE activity.
Granero-Molina, José; Fernández-Sola, Cayetano; Muñoz Terrón, José María; Aranda Torres, Cayetano
The Habermasian concept of 'interest' has had a profound effect on the characterization of scientific disciplines. Going beyond issues unrelated to the theory itself, intra-theoretical interest characterizes the specific ways of approaching any science-related discipline, defining research topics and methodologies. This approach was developed by Jürgen Habermas in relation to empirical-analytical sciences, historical-hermeneutics sciences, and critical sciences; however, he did not make any specific references to health sciences. This article aims to contribute to shaping a general epistemological framework for health sciences, as well as its specific implications for the medical and nursing areas, via an analysis of the basic knowledge interests developed by Habermas. © 2015 John Wiley & Sons Ltd.
Lee, Sandra Soo-Jin
Current practices of using "race" in pharmacogenomics research demands consideration of the ethical and social implications for understandings of group difference and for efforts to eliminate health disparities. This discussion focuses on an "infrastructure of racialization" created by current trajectories of research on genetic differences among racially identified groups, the use of race as a proxy for risk in clinical practice, and increasing interest in new market niches by the pharmaceutical industry. The confluence of these factors has resulted in the conflation of genes, disease, and race. I argue that public investment in pharmacogenomics requires careful consideration of current inequities in health status and social and ethical concerns over reifying race and issues of distributive justice.
Gomes-neto, J B; Hanushek, E A; Leite, R H; Frota-bezzera, R C
Health and education are typically viewed as distinct topics from both the research and policy perspectives. Accordingly, the direct interactions between health status and education have been neglected in both research and policy making. The authors use survey data collected from students during the 1980s in Piaui, Ceara, and Pernambuco states as part of an evaluation of a major educational intervention program, EDURURAL, to investigate the complementarities of health with school attainment and cognitive achievement. A series of anthropometric measures for individual students in rural northeast Brazil are used in educational performance models. The promotion models and value-added achievement models both demonstrate the importance of students' visual acuity. Poor vision systematically leads to higher drop-out rates, more grade repetition, and lower achievement. The achievement models also point to the role of good nutrition.
Full Text Available This mini-review examines the complex relationship between diet and sleep and explores the clinical and public health implications of the current evidence. Dietary quality and intake of specific nutrients can impact regulatory hormonal pathways to alter sleep quantity and quality. Sleep, in turn, affects the intake of total energy, as well as of specific foods and nutrients, through biological and behavioral mechanisms. Initial research in this field focused primarily on the effects of short sleep duration on nutritional quality. However, more recent studies have explored the dynamic relationship between long sleep duration and diet. Current evidence suggests that extremes of sleep duration alter sleep patterns, hormonal levels, and circadian rhythms, which contribute to weight-related outcomes and obesity, and other risk factors for the development of chronic disease such as type 2 diabetes and cardiovascular disease. These patterns may begin as early as childhood and have impacts throughout the life course. Given that non-communicable diseases are among the leading causes of death globally, deeper understanding of the interactions between sleep and nutrition has implications for both public health and clinical practice.
Kayode O. Osungbade; Olusimbo K. Ige
Objectives. Review of public health perspectives of preeclampsia in developing countries and implications for health system strengthening. Methods. Literature from Pubmed (MEDLINE), AJOL, Google Scholar, and Cochrane database were reviewed. Results. The prevalence of preeclampsia in developing countries ranges from 1.8% to 16.7%. Many challenges exist in the prediction, prevention, and management of preeclampsia. Promising prophylactic measures like low-dose aspirin and calcium supplem...
de Lissovoy, G; Kasper, J D; Di Carlo, S; Gabel, J
Employers are increasingly concerned by the cost of health benefits provided to retired workers. One reason is that the Financial Accounting Standards Board (FASB), the organization that establishes "generally accepted accounting principles," has proposed altering the way firms report expenditures for retiree medical coverage on financial statements. We recently completed a national survey of business firms offering retiree health benefits to address three issues: 1) What is the current structure of retiree health benefit plans? 2) What changes are firms planning to implement in the structure of their retiree health benefits? 3) To what extent are these changes due to the FASB proposal? The FASB reporting proposal is only one factor underlying these changes. More important is the real financial pressure on firms due to the accelerating cost of retiree health care.
Chung, Jae Eun
Increasing numbers of people have turned to the Internet for health information. Little has been done beyond speculation to empirically investigate patients' discussion of online health information with health care professionals (HCPs) and patients' perception of HCPs' reactions to such discussion. The author analyzed data from the 2007 Health Information National Trends Survey (HINTS) to identify the characteristics of patients (a) who search for health information on the Internet, (b) who discuss the information found on the Internet with HCPs, and (c) who positively assess HCPs' reaction to the online information. Findings show that men were more likely than were women to have a conversation on online information with HCPs. It is unfortunate that patients who had trouble understanding or trusting online health information were no more likely to ask questions to or seek guidance from HCPs. Reactions of HCPs to online information were perceived as particularly negative by certain groups of patients, such as those who experienced poor health and those who had more concerns about the quality of their searched information. Results are discussed for their implications for patient empowerment and patient-HCP relationships.
Colledge, Lisa; Hickson, Ford; Reid, David; Weatherburn, Peter
Bisexual- and lesbian-identified women have significantly worse mental health than heterosexual women. Less evidence exists about mental health differences between lesbian and bisexual women. Self-completion survey with community-based, opportunistic sampling recruited 937 bisexual-identified and 4769 lesbian-identified women. Associations between sexual identity and mental health indicators were assessed by logistic regression, controlling for age, income, student status and employment. As a group, bisexual women were younger, poorer, and more likely to be trans-identified, minority ethnic identified and to use marijuana, compared with lesbians. Bisexuals were more likely than lesbians to report eating problems (adjusted odds ratio (AOR) = 1.64, P women attended lesbian or bisexual social events, were 'out', or had experienced any sexuality-related discrimination, compared with lesbians. More bisexual women reported poor mental health or psychological distress than did lesbians. Bisexual women may be more likely to experience social stress due to the 'double discrimination' of homophobia and biphobia. This stress, experienced mainly as internalized and felt stigma, could result in greater risk for poor mental health compared with lesbians. Addressing both biphobia and homophobia within UK society has important preventative mental health implications. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: firstname.lastname@example.org.
Silva, Kênia Lara; Sena, Roseni Rosângela; Rodrigues, Andreza Trevenzoli; Araújo, Fernanda Lopes; Belga, Stephanie Marques Moura Franco; Duarte, Elysângela Dittz
to analyze health promotion programs in the supplementary health care. This was a multiple case study with a qualitative approach whose data were obtained from interviews with coordinators of providers contracted by the corporations of health insurance plans in Belo Horizonte, Minas Gerais. The data were submitted to Critical Discourse Analysis. Home care has been described as the main action in the field of health promotion transferred to the providers, followed by management of patients and cases, and the health education.groups. The existence of health promotion principles is questionable in all programs. Outsourcing is marked by a process with a division between cost and care management. Implications of this process occur within admission and interventions on the needs of the beneficiaries. Statements revealed rationalization of cost, restructuring of work, and reproduction of the dominant logic of capital accumulation by the health insurance companies.
Darlington, F; Norman, P; Ballas, D; Exeter, DJ
Issues of social justice and social and spatial inequalities in health have long been researched, yet there is a relative paucity of research on ethnic inequalities in health. Given the increasing ethnic diversity of England's population and the persistence of unjust differences in health this research is timely. We used annual data from the Health Survey for England between 1998 and 2011, combined into a time-series dataset, to examine the influence of socioeconomic and spatial factors on et...
Sorenson, Shawn C.; Romano, Russell; Scholefield, Robin M.; Schroeder, E. Todd; Azen, Stanley P.; Salem, George J.
Context Self-report questionnaires are an important method of evaluating lifespan health, exercise, and health-related quality of life (HRQL) outcomes among elite, competitive athletes. Few instruments, however, have undergone formal characterization of their psychometric properties within this population. Objective To evaluate the validity and reliability of a novel health and exercise questionnaire, the Trojan Lifetime Champions (TLC) Health Survey. Design Descriptive laboratory study. Setting A large National Collegiate Athletic Association Division I university. Patients or Other Participants A total of 63 university alumni (age range, 24 to 84 years), including former varsity collegiate athletes and a control group of nonathletes. Intervention(s) Participants completed the TLC Health Survey twice at a mean interval of 23 days with randomization to the paper or electronic version of the instrument. Main Outcome Measure(s) Content validity, feasibility of administration, test-retest reliability, parallel-form reliability between paper and electronic forms, and estimates of systematic and typical error versus differences of clinical interest were assessed across a broad range of health, exercise, and HRQL measures. Results Correlation coefficients, including intraclass correlation coefficients (ICCs) for continuous variables and κ agreement statistics for ordinal variables, for test-retest reliability averaged 0.86, 0.90, 0.80, and 0.74 for HRQL, lifetime health, recent health, and exercise variables, respectively. Correlation coefficients, again ICCs and κ, for parallel-form reliability (ie, equivalence) between paper and electronic versions averaged 0.90, 0.85, 0.85, and 0.81 for HRQL, lifetime health, recent health, and exercise variables, respectively. Typical measurement error was less than the a priori thresholds of clinical interest, and we found minimal evidence of systematic test-retest error. We found strong evidence of content validity, convergent
This article explores the social processes in stigmatization and the theoretical background on the impact in chronic illness. Review of literature from social sciences and applications to health issues. Understanding the social utility of stigmatization in preserving social cohesion and protecting the social order is an important function. However, this process can be harmful when applied to persons with chronic illness, such as HIV-AIDS, and psychiatric illness. These individuals often become shamed, ostracized, isolated, discredited, and socially and economically marginalized. Recent theoretical work on stigma has identified several issues and patient responses that may have implications in many other chronic conditions. Stigma is based on visible or nonvisible health conditions and can be both externally imposed or perceived in a process of self-stigma. Understanding stigma can aid clinicians in providing supportive help for patients with chronic illness. Stigma has been well researched in a few chronic illnesses; however, future studies in other conditions are much needed. Recognizing the underlying social factors has potential use in health-promoting behaviors. Sensitivity to stigma allows health professionals to critically reflect on ways the healthcare environment may add to stigma for their patients. ©2013 The Author(s) ©2013 American Association of Nurse Practitioners.
Scott, Kate M; McGee, Magnus A; Oakley Browne, Mark A; Wells, J Elisabeth
To show the extent and patterning of 12 month mental disorder comorbidity in the New Zealand population, and its association with case severity, suicidality and health service utilization. A nationwide face-to-face household survey was carried out in October 2003 to December 2004 with 12,992 participants aged 16 years and over, achieving a response rate of 73.3%. The measurement of mental disorder was with the World Mental Health Survey Initiative version of the Composite International Diagnostic Interview (CIDI 3.0). Comorbidity was analysed with hierarchy, consistent with a clinical approach to disorder count. Comorbidity occurred among 37% of 12 month cases. Anxiety and mood disorders were most frequently comorbid. Strong bivariate associations occurred between alcohol and drug use disorders and, to a lesser extent, between substance use disorders and some anxiety and mood disorders. Comorbidity was associated with case severity, with suicidal behaviour (especially suicide attempts) and with health sector use (especially mental health service use). The widespread nature of mental disorder comorbidity has implications for the configuration of mental health services and for clinical practice.
Weng, Yi-Hao; Kuo, Ken N; Yang, Chun-Yuh; Lo, Heng-Lien; Shih, Ya-Hui; Chiu, Ya-Wen
There are a variety of resources to obtain health information, but few studies have examined if main and allied health professionals prefer different methods. The current study was to investigate their information-searching behaviours. A constructed questionnaire survey was conducted from January through April 2011 in nationwide regional hospitals of Taiwan. Questionnaires were mailed to main professionals (physicians and nurses) and allied professionals (pharmacists, physical therapists, technicians and others), with 6160 valid returns collected. Among all professional groups, the most commonly used resource for seeking health information was a Web portal, followed by colleague consultations and continuing education. Physicians more often accessed Internet-based professional resources (online databases, electronic journals and electronic books) than the other groups (P < 0.05). In contrast, physical therapists more often accessed printed resources (printed journals and textbooks) than the other specialists (P < 0.05). And nurses, physical therapists and technicians more often asked colleagues and used continuing education than the other groups (P < 0.01). The most commonly used online database was Micromedex for pharmacists and MEDLINE for physicians, technicians and physical therapists. Nurses more often accessed Chinese-language databases rather than English-language databases (P < 0.001). This national survey depicts the information-searching pattern of various health professionals. There were significant differences between and within main and allied health professionals in their information searching. The data provide clinical implications for strategies to promote the accessing of evidence-based information. © 2012 John Wiley & Sons Ltd.
Ross, Alyson; Friedmann, Erika; Bevans, Margaret; Thomas, Sue
Summary Objectives to describe yoga practice and health characteristics of individuals who practice yoga, and to explore their beliefs regarding the effects of their yoga practice on their health. Design a cross-sectional design with anonymous online surveys Setting 4307 randomly selected individuals from 15 US Iyengar yoga studios (n = 18,160), representing 41 states; 1087 individuals responded, with 1045 (24.3%) surveys completed. Outcome Measures Freiberg Mindfulness Inventory, Mental Health Continuum (subjective well-being), Multi-factor Screener (diet), PROMIS sleep disturbance, fatigue, and social support, International Physical Activity Questionnaire. Results Age: 19 to 87 years (M = 51.7 ± 11.7), 84.2% female, 89.2% white, 87.4% well educated (≥ bachelor’s degree). Mean years of yoga practice = 11.4 (± 7.5). BMI = 12.1–49.4 (M = 23.1 ± 3.9). Levels of obesity (4.9%), smoking (2%), and fruit and vegetable consumption (M = 6.1 ± 1.1) were favorable compared to national norms. 60% reported at least one chronic/serious health condition, yet most reported very good (46.3%) or excellent (38.8%) general health. Despite high levels of depression (24.8 %), nearly all were moderately mentally healthy (55.2%) or flourishing (43.8%). Participants agreed yoga improved: energy (84.5%), happiness (86.5%), social relationships (67%), sleep (68.5%), and weight (57.3%), and beliefs did not differ substantially according to race or gender. The more they practiced yoga, whether in years or in amount of class or home practice, the higher their odds of believing yoga improved their health. Conclusions Individuals who practice yoga are not free of health concerns, but most believe their health improved because of yoga. Yoga might be beneficial for a number of populations including elderly women and those with chronic health conditions. PMID:23876562
To ascertain parents' preferences in sources of health information concerning their children's general health care needs, and caring for their children when they are sick. Exploratory/descriptive design. A telephone survey secured data for the study and qualitative content analysis and descriptive statistics were used for analysis. Part 2 of a larger study in which Part I evaluated parents' satisfaction with a paediatric telephone triage service. One hundred of the 101 parents who were recruited for Part 1 of the study participated in Part 2, an examination of parents' preferences in information sources relating to their child's health. Parents' preferences in child health information sources varied according to the perceived severity of their child's illness. Parents frequently selected more than one item on a list of health information sources provided. In a non-urgent situation when children were sick a total of 170 selections were made by parents, with 'telephone advice line' the source most frequently selected (58, 34%), followed by general practitioner (27, 15.8%). In an emergency situation the most frequently selected information source was again 'telephone advice line' (74, n=129, 57.4%), followed by 'other' (31, n=129, 24.3%) often identified as relating to dialing '000' (Australia's emergency services number). Finally, when parents required information about the general health care needs of their child, 'other' (most frequently identified as books) was selected on 40 (n=185, 21.6%) occasions, followed by child health clinic (35, n= 185, 18.9%). Parents prefer to receive information about the health care needs of their child from another person rather than a printed or audio-visual source.
Retrum, Jessica H; Chapman, Carrie L; Varda, Danielle M
Interorganizational collaboration is an essential function of public health agencies. These partnerships form social networks that involve diverse types of partners and varying levels of interaction. Such collaborations are widely accepted and encouraged, yet very little comparative research exists on how public health partnerships develop and evolve, specifically in terms of how subsequent network structures are linked to outcomes. A systems science approach, that is, one that considers the interdependencies and nested features of networks, provides the appropriate methods to examine the complex nature of these networks. Applying Mays and Scutchfields's categorization of "structural signatures" (breadth, density, and centralization), this research examines how network structure influences the outcomes of public health collaboratives. Secondary data from the Program to Analyze, Record, and Track Networks to Enhance Relationships (www.partnertool.net) data set are analyzed. This data set consists of dyadic (N = 12,355), organizational (N = 2,486), and whole network (N = 99) data from public health collaborations around the United States. Network data are used to calculate structural signatures and weighted least squares regression is used to examine how network structures can predict selected intermediary outcomes (resource contributions, overall value and trust rankings, and outcomes) in public health collaboratives. Our findings suggest that network structure may have an influence on collaborative-related outcomes. The structural signature that had the most significant relationship to outcomes was density, with higher density indicating more positive outcomes. Also significant was the finding that more breadth creates new challenges such as difficulty in reaching consensus and creating ties with other members. However, assumptions that these structural components lead to improved outcomes for public health collaboratives may be slightly premature. Implications of
João Porto de Albuquerque
Full Text Available This article evaluates social implications of the "SIGA" Health Care Information System (HIS in a public health care organization in the city of São Paulo. The evaluation was performed by means of an in-depth case study with patients and staff of a public health care organization, using qualitative and quantitative data. On the one hand, the system had consequences perceived as positive such as improved convenience and democratization of specialized treatment for patients and improvements in work organization. On the other hand, negative outcomes were reported, like difficulties faced by employees due to little familiarity with IT and an increase in the time needed to schedule appointments. Results show the ambiguity of the implications of HIS in developing countries, emphasizing the need for a more nuanced view of the evaluation of failures and successes and the importance of social contextual factors.
Barton, Christopher; Reeve, Joanne; Adams, Ann; McIntyre, Ellen
This study was undertaken to provide a snapshot of the academic primary health-care workforce in Australia and to provide some insight into research capacity in academic primary health care following changes to funding for this sector. A convenience sample of individuals self-identifying as working within academic primary health care (n=405) completed an anonymous online survey. Respondents were identified from several academic primary health-care mailing lists. The survey explored workforce demographics, clarity of career pathways, career trajectories and enablers/barriers to 'getting in' and 'getting on'. A mix of early career (41%), mid-career (25%) and senior academics (35%) responded. Early career academics tended to be female and younger than mid-career and senior academics, who tended to be male and working in 'balanced' (teaching and research) roles and listing medicine as their disciplinary background. Almost three-quarters (74%) indicated career pathways were either 'completely' or 'somewhat unclear', irrespective of gender and disciplinary backgrounds. Just over half (51%) had a permanent position. Males were more likely to have permanent positions, as were those with a medical background. Less than half (43%) reported having a mentor, and of the 57% without a mentor, more than two-thirds (69%) would like one. These results suggest a lack of clarity in career paths, uncertainty in employment and a large number of temporary (contract) or casual positions represent barriers to sustainable careers in academic primary health care, especially for women who are from non-medicine backgrounds. Professional development or a mentoring program for primary health-care academics was desired and may address some of the issues identified by survey respondents.
This document presents the results of the Bolivia Demographic and Health Survey (DHS), or Encuesta Nacional de Demografia y Salud 1998, conducted by the Instituto Nacional de Estadistica, La Paz, Bolivia, within the framework of the DHS Program of Macro International. Data were collected from 12,109 households and complete interviews were conducted with 11,187 women aged 15-49. A male survey was also conducted, which collected data from 3780 men aged 15-64. The information collected include the following: 1) general characteristics of the population, 2) fertility, 3) fertility preferences, 4) current contraceptive use, 5) contraception, 6) marital and contraceptive status, 7) postpartum variables, 8) infant mortality, 9) health: disease prevention and treatment, and 10) nutritional status: anthropometric measures.
Romero-Martínez, Martín; Shamah-Levy, Teresa; Cuevas-Nasu, Lucía; Gómez-Humarán, Ignacio Méndez; Gaona-Pineda, Elsa Berenice; Gómez-Acosta, Luz María; Rivera-Dommarco, Juan Ángel; Hernández-Ávila, Mauricio
Describe the design methodology of the halfway health and nutrition national survey (Ensanut-MC) 2016. The Ensanut-MC is a national probabilistic survey whose objective population are the inhabitants of private households in Mexico. The sample size was determined to make inferences on the urban and rural areas in four regions. Describes main design elements: target population, topics of study, sampling procedure, measurement procedure and logistics organization. A final sample of 9 479 completed household interviews, and a sample of 16 591 individual interviews. The response rate for households was 77.9%, and the response rate for individuals was 91.9%. The Ensanut-MC probabilistic design allows valid statistical inferences about interest parameters for Mexico´s public health and nutrition, specifically on overweight, obesity and diabetes mellitus. Updated information also supports the monitoring, updating and formulation of new policies and priority programs.
Yusoff, Fadhli; Saari, Riyanti; Naidu, Balkish M; Ahmad, Noor Ani; Omar, Azahadi; Aris, Tahir
The National School-Based Health Survey 2012 was a nationwide school health survey of students in Standard 4 to Form 5 (10-17 years of age), who were schooling in government schools in Malaysia during the period of data collection. The survey comprised 3 subsurveys: the Global School Health Survey (GSHS), the Mental Health Survey, and the National School-Based Nutrition Survey. The aim of the survey was to provide data on the health status of adolescents in Malaysia toward strengthening the adolescent health program in the country. The design of the survey was created to fulfill the requirements of the 3 subsurveys. A 2-stage stratified sampling method was adopted in the sampling. The methods for data collection were via questionnaire and physical examination. The National School-Based Health Survey 2012 adopted an appropriate methodology for a school-based survey to ensure valid and reliable findings. © 2014 APJPH.
Jones, Martin; Gillam, Marianne; May, Esther
Introduction Access to quality healthcare services is considered a moral right. However, for people living in regional locations, timely access to the services that they need may not always be possible because of structural and attitudinal barriers. This suggests that people living in regional areas may have unmet healthcare needs. The aim of this research will be to examine the healthcare needs, expectations and experiences of regional South Australians. Methods and analysis The Regional South Australia Health (RESONATE) survey is a cross-sectional study of adult health consumers living in any private or non-private dwelling, in any regional, rural, remote or very remote area of South Australia and with an understanding of written English. Data will be collected using a 45-item, multidimensional, self-administered instrument, designed to measure healthcare need, barriers to healthcare access and health service utilisation, attitudes, experiences and satisfaction. The instrument has demonstrated acceptable psychometric properties, including good content validity and internal reliability, good test–retest reliability and a high level of acceptability. The survey will be administered online and in hard-copy, with at least 1832 survey participants to be recruited over a 12-month period, using a comprehensive, multimodal recruitment campaign. Ethics and dissemination The study has been reviewed and approved by the Human Research Ethics Committee of the University of South Australia. The results will be actively disseminated through peer-reviewed journals, conference presentations, social media, broadcast media, print media, the internet and various community/stakeholder engagement activities. PMID:29654014
Andrade, Flávia Reis de; Narvai, Paulo Capel; Montagner, Miguel Ângelo
To analyze the ethics of in vivo calibration, using the discourse of the administrators of the National Oral Health Survey (SBBrasil 2010) as a starting point. This is a qualitative research involving semi-structured individual interviews with 12 members of the Steering Group and Technical Advisory Committee of the Ministry of Health, and two coordinators, one State and the other Municipal. The discourse of the collective subject technique was used for data analysis. When asked about the experiences of SBBrasil 2010, which included ethical aspects, respondents identified the forms of standardization and training of teams who collected field data. For them, there is little scientific evidence to ethically support the way the training stage, including calibration, is carried out in oral health epidemiological surveys, as a certain unease can be predicted in participants of these studies. The ethics of a research also derives from its methodological rigor; the training process; and calibration in particular, is a fundamental technical and ethical requirement in surveys such as the SBBrasil 2010. The unease of the volunteers in face of test repetition does not ethically invalidate the in vivo calibration, but mechanisms to minimize it must be developed.
Kamal, Mudasir; Newman, William J
Revenge pornography, also known as nonconsensual pornography, is a subtype of cyberharassment/cyberstalking, and a serious problem facing society in the Internet age. Revenge pornography can result in lifelong mental health consequences for victims, damaged relationships, and social isolation. Recently, a growing number of states have recognized the importance of this phenomenon and have enacted legislation that criminalizes it. The technology industry has also taken steps to assist victims of revenge pornography by creating web forms to request removal of links leading to the explicit content. The Cyber Civil Rights Initiative (CCRI) has been instrumental in promoting public awareness of this often overlooked problem and in providing services for victims. Although important steps have been made, greater recognition of the gravity of this problem and the mental health implications of revenge pornography is needed to expand legislation criminalizing such acts. A federal criminal law, in particular, is much overdue. Mental health professionals must understand the dimensions of revenge pornography to be able to identify and address the consequences in both forensic and clinical settings. © 2016 American Academy of Psychiatry and the Law.
Mills, Edward; Ernst, Edzard; Singh, Rana; Ross, Cory; Wilson, Kumanan
Many breast cancer patients use complementary and alternative medicine (CAM). We aimed to determine what advice health food store employees present to individuals seeking treatment options for breast cancer. Eight data gatherers asked employees of all retail health food stores in a major Canadian city, what they recommended for a patient with breast cancer. The data gatherers inquired about product safety, potential drug interactions, costs and efficacy. They also enquired about employee training related to the products. Thirty-four stores were examined. A total of 33 different products were recommended, none of which are supported by sufficient evidence of efficacy. The average cost of the products they recommended was $58.09 (CAD) (minimum $5.28, median $32.99, maximum $600) per month. Twenty-three employees (68%) did not ask whether the patient took prescription medications. Fifteen employees (44%) recommended visiting a healthcare professional (naturopaths (9), physicians (5), nutritionists (1). Three employees (8.8%) discussed potential adverse effects of the products. Eight employees (23.5%) discussed the potential for drug interactions. Two employees (5.9%) suggested a possible cure with the products and one employee (2.9%) suggested discontinuing Tamoxifen. Four employees (11.8%) recommended lifestyle changes and three employees (8.8%) recommended books for further reading on the products. This study draws attention to the heterogeneity of advice provided by natural health food stores to individuals seeking treatments for breast cancer, and the safety and cost implications of some of the products recommended. Physicians should enquire carefully about the use of natural health food products by patients with breast cancer. Regulators need to consider regulations to protect vulnerable patients from incurring significant costs in their purchasing of natural health food products lacking evidence of benefit and of questionable safety
The work contract is based on the norm of social reciprocity where appropriate rewards are provided for efforts and achievements at work. The effort-reward imbalance model of work stress maintains that contractual non-reciprocity in terms of high efforts spent and low rewards received is frequent if people have no alternative choice in the labour market, if they are exposed to heavy competition or if they are intrinsically motivated to engage in excessive work-related commitment. According to the model, long-term exposure to effort-reward imbalance increases the risk of stress-related disorders. An overview of results from prospective epidemiological investigations testing the model is given. Overall, people who experience failed reciprocity at work are twice as likely to suffer from incident cardiovascular disease, depression or alcohol dependence compared to those who are not exposed. Associations are stronger for men than for women. Policy implications of findings for improved worksite health promotion are discussed.
Yang, Qinghua; Chen, Yixin; Wendorf Muhamad, Jessica
We proposed a conceptual model to predict health information-seeking behaviors (HISBs) from three different sources (family, the Internet, doctors). To test the model, a structural equation modeling (SEM) analysis was conducted using data from the 2012 Annenberg National Health Communication Survey (ANHCS) (N = 3,285). Findings suggest higher social support from family predicts higher trust in health information from family members (abbreviated as trust in this article). Trust is positively related to HISBs from all three sources, with the path linking trust to HISB from family being the strongest. The effect of social support on HISB from family is partially mediated by trust, while effect of social support on HISBs from the Internet/doctors is fully mediated by trust. Implications of the study are discussed.
Joas, Anke; Knudsen, Lisbeth E.; Kolossa-Gehring, Marike
The potential of Human Biomonitoring (HBM) in exposure characterisation and risk assessment is well established in the scientific HBM community and regulatory arena by many publications. The European Environment and Health Strategy as well as the Environment and Health Action Plan 2004-2010 of th......, and EFSA. An economic frame with shared cost implications for national and European institutions is suggested benefitting from the capacity building set up by COPHES/DEMOCOPHES.......The potential of Human Biomonitoring (HBM) in exposure characterisation and risk assessment is well established in the scientific HBM community and regulatory arena by many publications. The European Environment and Health Strategy as well as the Environment and Health Action Plan 2004...
Turpin Karen VL
Full Text Available Abstract Background Health-related quality of life (HRQL in persons with multiple sclerosis (MS who reside within the community relative to the general population is largely unknown. Data from the Canadian Community Health Survey Cycle 1.1 (CCHS 1.1 were used to compare HRQL of persons with MS and the general population. Methods A representative sample of adults (18 years or older from the cross sectional population health survey, CCHS 1.1, was examined to compare scores on the Health Utilities Index Mark 3 (HUI3, a generic preference-based HRQL measure, of respondents with (n = 302 and without (n = 109,741 MS. Selected sociodemographic covariates were adjusted for in ANCOVA models. Normalized sampling weights and bootstrap variance estimates were used in the analysis. Results The mean difference in overall HUI3 scores between respondents with and without MS was 0.25 (95% CI: 0.20, 0.31; eight times greater than the clinically important difference. The largest differences in scores were seen with the ambulation (0.26; 95% CI: 0.20, 0.32 and pain attributes (0.14; 95% CI: 0.09, 0.19. Clinically important differences with dexterity and cognition were also observed. Conclusion While the proportion of the Canadian population with MS is relatively small in comparison to other diseases, the magnitude of the burden is severe relative to the general population.
Spitzer, William J; Davidson, Kay W
Major economic, political, demographic, social, and operational system factors are prompting evolutionary changes in health care delivery. Of particular significance, the "graying of America" promises new challenges and opportunities for health care social work. At the same time, the Patient Protection and Affordable Care Act of 2010, evolution of Accountable Care Organizations, and an emphasis on integrated, transdisciplinary, person-centered care represent fundamental shifts in service delivery with implications for social work practice and education. This article identifies the aging shift in American demography, its impact on health policy legislation, factors influencing fundamentally new service delivery paradigms, and opportunities of the profession to address the health disparities and care needs of an aging population. It underscores the importance of social work inclusion in integrated health care delivery and offers recommendations for practice education.
Russell, Cindy L
literature on the health implications of 2G, 3G, 4G exposure, including some of the available literature on 5G frequencies. The question of what constitutes a public health issue will be raised, as well as the need for a precautionary approach in advancing new wireless technologies. Copyright © 2018 Elsevier Inc. All rights reserved.
This survey aims at describing the health status of the population around the Tricastin site, and more particularly at determining whether there is a difference between death or cancer occurrence frequencies observed around this site with respect to reference frequencies. It does not aim at assessing the health impact of the site industrial installations. Cancer mortality data, cancer diagnosis data, demographic data, child cancer data, data related to hospital stays in relationship with cancer, long duration hospital stay data, and mortality data are used. Several indicators are defined and used: standardised mortality ratio, standardised hospitalisation ratio. Data are also analysed in terms of location, and socio-demographic categories. It appears that there is no specific health situation for the considered area, except for pancreas cancer for women
U.S. Department of Health & Human Services — This file includes data from the 2002 through 2013 National Survey on Drug Use and Health (NSDUH) survey. The only variables included in the data file are ones that...
U.S. Department of Health & Human Services — This file includes data from the 2002 through 2009 National Survey on Drug Use and Health (NSDUH) survey. The only variables included in the 8-year 2002-2009 data...
U.S. Department of Health & Human Services — This file includes data from the 2002 through 2011 National Survey on Drug Use and Health (NSDUH) survey. The only variables included in the data file are ones that...
Sarfaty, Mona; Bloodhart, Brittany; Ewart, Gary; Thurston, George D; Balmes, John R; Guidotti, Tee L; Maibach, Edward W
The American Thoracic Society (ATS), in collaboration with George Mason University, surveyed a random sample of ATS members to assess their perceptions of, clinical experiences with, and preferred policy responses to climate change. An e-mail containing an invitation from the ATS President and a link to an online survey was sent to 5,500 randomly selected U.S. members; up to four reminder e-mails were sent to nonrespondents. Responses were received from members in 49 states and the District of Columbia (n = 915); the response rate was 17%. Geographic distribution of respondents mirrored that of the sample. Survey estimates' confidence intervals were ±3.5% or smaller. Results indicate that a large majority of ATS members have concluded that climate change is happening (89%), that it is driven by human activity (68%), and that it is relevant to patient care ("a great deal"/"a moderate amount") (65%). A majority of respondents indicated they were already observing health impacts of climate change among their patients, most commonly as increases in chronic disease severity from air pollution (77%), allergic symptoms from exposure to plants or mold (58%), and severe weather injuries (57%). A larger majority anticipated seeing these climate-related health impacts in the next 2 decades. Respondents indicated that physicians and physician organizations should play an active role in educating patients, the public, and policy makers on the human health effects of climate change. Overall, ATS members are observing that human health is already adversely affected by climate change and support responses to address this situation.
Christian, Robin; Mellies, Amy Anderson; Bui, Alison Grace; Lee, Rita; Kattari, Leo; Gray, Courtney
Transgender people, those whose gender identity does not match their sex assigned at birth, face barriers to receiving health care. These include discrimination, prohibitive cost, and difficulty finding transgender-inclusive providers. As transgender identities are not typically recognized in public health research, the ability to compare the health of the transgender population to the overall population is limited. The Colorado Transgender Health Survey sought to explore current disparities and their effects on the health of transgender people in Colorado. The Colorado Transgender Health Survey, based on the Behavioral Risk Factor Surveillance System (BRFSS), was developed by the Colorado Department of Public Health and Environment, transgender advocates, and transgender community members. Outreach was targeted to transgender-inclusive events and organizations. Responses to the 2014 Colorado Transgender Health Survey were compared side by side to Colorado 2014 BRFSS data. Results from 406 transgender or gender-nonconforming adults who live in Colorado were included in the analysis. Forty percent of respondents report delaying medical care due to cost, inadequate insurance, and/or fear of discrimination. Respondents report significant mental health concerns, with 43% reporting depression, 36% reporting suicidal thoughts, and 10% attempting suicide in the past year. Respondents with a transgender-inclusive provider were more likely to receive wellness exams (76 versus 48%), less likely to delay care due to discrimination (24 versus 42%), less depressed (38 versus 54%), and less likely to attempt suicide (7 versus 15%) than those without. The transgender community in Colorado faces significant disparities, especially around mental health. However, a transgender-inclusive provider is associated with improved mental and physical health and health behaviors. Further population-level research and provider education on transgender health should to be incorporated into
Roelen, Corné; Thorsen, Sannie; Heymans, Martijn
LTSA during follow-up. Results: The 15-predictor model was reduced to a 9-predictor model including age, gender, education, self-rated health, mental health, prior LTSA, work ability, emotional job demands, and recognition by the management. Discrimination by the 9-predictor model was significant (AUC...... population. Implications for rehabilitation Long-term sickness absence risk predictions would enable healthcare providers to refer high-risk employees to rehabilitation programs aimed at preventing or reducing work disability. A prediction model based on health survey variables discriminates between...... employees at high and low risk of long-term sickness absence, but discrimination was not practically useful. Health survey variables provide insufficient information to determine long-term sickness absence risk profiles. There is a need for new variables, based on the knowledge and experience...
Manwell, Laurie A; Barbic, Skye P; Roberts, Karen; Durisko, Zachary; Lee, Cheolsoon; Ware, Emma; McKenzie, Kwame
Objective Lack of consensus on the definition of mental health has implications for research, policy and practice. This study aims to start an international, interdisciplinary and inclusive dialogue to answer the question: What are the core concepts of mental health? Design and participants 50 people with expertise in the field of mental health from 8 countries completed an online survey. They identified the extent to which 4 current definitions were adequate and what the core concepts of mental health were. A qualitative thematic analysis was conducted of their responses. The results were validated at a consensus meeting of 58 clinicians, researchers and people with lived experience. Results 46% of respondents rated the Public Health Agency of Canada (PHAC, 2006) definition as the most preferred, 30% stated that none of the 4 definitions were satisfactory and only 20% said the WHO (2001) definition was their preferred choice. The least preferred definition of mental health was the general definition of health adapted from Huber et al (2011). The core concepts of mental health were highly varied and reflected different processes people used to answer the question. These processes included the overarching perspective or point of reference of respondents (positionality), the frameworks used to describe the core concepts (paradigms, theories and models), and the way social and environmental factors were considered to act. The core concepts of mental health identified were mainly individual and functional, in that they related to the ability or capacity of a person to effectively deal with or change his/her environment. A preliminary model for the processes used to conceptualise mental health is presented. Conclusions Answers to the question, ‘What are the core concepts of mental health?’ are highly dependent on the empirical frame used. Understanding these empirical frames is key to developing a useful consensus definition for diverse populations. PMID:26038353
Jeong, Seok Hee; Kim, Hyun Kyung
To identify the level of health literacy and barriers to information seeking and to explore the predictors of health literacy. A cross-sectional descriptive design was used. A total of 1000 Korean adults were recruited through proportional quota sampling. Health literacy, barriers to health information seeking, sociodemographics, and health-related characteristics were surveyed. Descriptive statistics and binary logistic regression were performed for data analysis. About 61% of participants were classified as inadequately health literate. "No health fairs/activities near home" was the most frequently reported barrier. Older age, lower education, living in the capital city, barriers regarding how to get information and access to expensive books and magazines were predictors of inadequate health literacy. Strategies for improving health literacy and reducing barriers to health information seeking should be designed. Education on how to access health-related information with easily accessible sources either free or inexpensive could be a way to help adults with limited health literacy. Health care professionals should assess clients' health literacy levels, particularly amongst those who are older or have less education. They should provide clients with information on how to access credible and readily available sources of health-related information, considering their health literacy level. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Qayumi, Karim; Pachev, George; Zheng, Bin; Ziv, Amitai; Koval, Valentyna; Badiei, Sadia; Cheng, Adam
Simulation is rapidly penetrating the terrain of health care education and has gained growing acceptance as an educational method and patient safety tool. Despite this, the state of simulation in health care education has not yet been evaluated on a global scale. In this project, we studied the global status of simulation in health care education by determining the degree of financial support, infrastructure, manpower, information technology capabilities, engagement of groups of learners, and research and scholarly activities, as well as the barriers, strengths, opportunities for growth, and other aspects of simulation in health care education. We utilized a two-stage process, including an online survey and a site visit that included interviews and debriefings. Forty-two simulation centers worldwide participated in this study, the results of which show that despite enormous interest and enthusiasm in the health care community, use of simulation in health care education is limited to specific areas and is not a budgeted item in many institutions. Absence of a sustainable business model, as well as sufficient financial support in terms of budget, infrastructure, manpower, research, and scholarly activities, slows down the movement of simulation. Specific recommendations are made based on current findings to support simulation in the next developmental stages. PMID:25489254
Islam, Md Saiful; Ahmed, Md Kawser; Habibullah-Al-Mamun, Md
This research was conducted to evaluate the concentration of seven common heavy metals (Cr, Ni, Cu, Zn, As, Cd, and Pb) in cereals and pulses and associated health implications in Bangladesh. USEPA deterministic approaches were followed to assess the carcinogenic risk (CR) and noncarcinogenic risk which was measured by target hazard quotient (THQ) and hazard index (HI). Total THQ values for As and Pb were higher than 1, suggesting that people would experience significant health risks if they ingest As and Pb from cereals and pulses. However, the estimated HI value of 1.7 × 10(1) (>1) elucidates a potential noncarcinogenic risk to the consumers. Also, the estimation showed that the carcinogenic risk of As (5.8 × 10(-3)) and Pb (4.9 × 10(-5)) exceeded the USEPA accepted risk level of 1 × 10(-6). Thus, the carcinogenic risk of As and Pb with nutritional deficiency of essential elements for Bangladeshi people is a matter of concern.
Full Text Available Background Happiness is a lasting state and is associated with the absence of negative emotions, the presence of positive emotions, life satisfaction, social engagement and objectives in life. Researchers have demonstrated the benefits of happiness in many aspects of life, but few studies have been conducted within psychiatry.Objectives To develop a critical literature review of studies on happiness and health in order to bring some further and useful information to psychiatry updating the article “Happiness: a review” published in 2007 in Revista de Psiquiatria Clínica.Methods Computational searching was undertaken of digital data basis (PubMed and SciELO using the keywords “happiness” and “health”. One hundred twenty-seven papers published between 2004 and 2014 were found, but only 76 had the keywords in the title or abstract and with this were selected.Results Personality traits, such as self-direction; being married; being involved in physical and leisure activities; higher educational backgrounds and intelligence quotient; religiosity, volunteering and altruism; good physical and mental health; were positively related to happiness.Discussion Analysis of the concept of happiness and its associated emotions may be more complex than describing the symptoms of psychiatric disorders. Despite this, the study of happiness brings several positive implications for psychiatry.
Stubbs, Thomas; Kentikelenis, Alexander
Serving as lender of last resort to countries experiencing unsustainable levels of public debt, international financial institutions have attracted intense controversy over the past decades, exemplified most recently by the popular discontent expressed in Eurozone countries following several rounds of austerity measures. In exchange for access to financial assistance, borrowing countries must settle on a list of often painful policy reforms that are aimed at balancing the budget. This practice has afforded international financial institutions substantial policy influence on governments throughout the world and in a wide array of policy areas of direct bearing on human rights. This article reviews the consequences of policy reforms mandated by international financial institutions on the enjoyment of human rights, focusing on the International Monetary Fund and World Bank. It finds that these reforms undermine the enjoyment of health rights, labour rights, and civil and political rights, all of which have deleterious implications for public health. The evidence suggests that for human rights commitments to be met, a fundamental reorientation of international financial institutions' activities will be necessary.
Food additives and their health implications on children in Africa: a systematic review. ... Research Journal of Health Sciences ... at which many food industries turn out novel 'chemicals' aimed at increasing the acceptability of their products.
Obesity is an important worldwide public health problem. Obesogenic environments have been associated with increasing rates of overweight and obesity. The relationship between obesity and the built environment, along with its implications for health education are discussed in this article.
Synnot, Anneliese; Bragge, Peter; Lowe, Dianne; Nunn, Jack S; O'Sullivan, Molly; Horvat, Lidia; Tong, Allison; Kay, Debra; Ghersi, Davina; McDonald, Steve; Poole, Naomi; Bourke, Noni; Lannin, Natasha; Vadasz, Danny; Oliver, Sandy; Carey, Karen; Hill, Sophie J
To identify research priorities of consumers and other stakeholders to inform Cochrane Reviews in 'health communication and participation' (including such concepts as patient experience, shared decision-making and health literacy). International. We included anyone with an interest in health communication and participation. Up to 151 participants (18-80 years; 117 female) across 12 countries took part, including 48 consumers (patients, carers, consumer representatives) and 75 professionals (health professionals, policymakers, researchers) (plus 25 people who identified as both). Survey. We invited people to submit their research ideas via an online survey open for 4 weeks. Using inductive thematic analysis, we generated priority research topics, then classified these into broader themes. Participants submitted 200 research ideas, which we grouped into 21 priority topics. Key research priorities included: insufficient consumer involvement in research (19 responses), 'official' health information is contradictory and hard to understand (18 responses), communication/coordination breakdowns in health services (15 responses), health information provision a low priority for health professionals (15 responses), insufficient eliciting of patient preferences (14 responses), health services poorly understand/implement patient-centred care (14 responses), lack of holistic care impacting healthcare quality and safety (13 responses) and inadequate consumer involvement in service design (11 responses). These priorities encompassed acute and community health settings, with implications for policy and research. Priority populations of interest included people from diverse cultural and linguistic backgrounds, carers, and people with low educational attainment, or mental illness. Most frequently suggested interventions focused on training and cultural change activities for health services and health professionals. Consumers and other stakeholders want research addressing
Heiervang, Einar; Goodman, Robert
Web-based surveys may have advantages related to the speed and cost of data collection as well as data quality. However, they may be biased by low and selective participation. We predicted that such biases would distort point-estimates such as average symptom level or prevalence but not patterns of associations with putative risk-factors. A structured psychiatric interview was administered to parents in two successive surveys of child mental health. In 2003, parents were interviewed face-to-face, whereas in 2006 they completed the interview online. In both surveys, interviews were preceded by paper questionnaires covering child and family characteristics. The rate of parents logging onto the web site was comparable to the response rate for face-to-face interviews, but the rate of full response (completing all sections of the interview) was much lower for web-based interviews. Full response was less frequent for non-traditional families, immigrant parents, and less educated parents. Participation bias affected point estimates of psychopathology but had little effect on associations with putative risk factors. The time and cost of full web-based interviews was only a quarter of that for face-to-face interviews. Web-based surveys may be performed faster and at lower cost than more traditional approaches with personal interviews. Selective participation seems a particular threat to point estimates of psychopathology, while patterns of associations are more robust.
Khan, Sameer; Dasrath, Florence; Farghaly, Sara; Otobo, Emamuzo; Riaz, Muhammad Safwan; Rogers, Jason; Castillo, Anabella; Atreja, Ashish
In order to develop an application that addresses the most significant challenges facing IBD patients, this qualitative study explored the major hurdles of living with IBD, the information needs of IBD patients, and how application technology may be used to improve quality of life. 15 IBD patients participated in two focus groups of 120 minutes each. Data collection was achieved by combining focus groups with surveys and direct observation of patients looking at a patient-engaged app (HealthPROMISE) screenshots. The survey elicited information on demographics, health literacy and quality of life through the Short IBD Questionnaire (SIBDQ). The needs of IBD patients center around communication as it relates to both patient information needs and navigating the social impacts of IBD on patients' lives: Communication Challenges regarding Information Needs: Patients cited a doctor-patient communication divide where there is a continued lack of goal setting when discussing treatments and a lack of objectivity in disease control. When objectively compared with the SIBDQ, nearly half of the patients in the focus groups wrongly estimated their IBD control.Communication Challenges regarding Social Impacts of IBD: Patients strongly felt that while IBD disrupts routines, adds significant stress, and contributes to a sense of isolation, the impact of these issues would be significantly alleviated through more conversation and better support.Implication for Mobile Health Solutions: Patients want a tool that improves tracking of symptoms, medication adherence and provides education. Physician feedback to patient input on an application is required for long-term sustainability. IBD patients need mobile health technologies that evaluate disease control and the goals of care. Patients feel an objective assessment of their disease control, goal setting and physician feedback will greatly enhance utilization of all mobile health applications.
Many studies focusing on beliefs about health and health promotion have paid little attention to the life experiences of Black and other visible minority ethnic families in western societies. This paper is a report of a study exploring Black families' beliefs about health and the implications of such beliefs for health promotion. Ten Black…
Zhang, B; Zhai, F Y; Du, S F; Popkin, B M
The China Health and Nutrition Survey (CHNS) began in 1989 with the goal of creating a multilevel method of data collection from individuals and households and their communities to understand how the wide-ranging social and economic changes in China affect a wide array of nutrition and health-related outcomes. Initiated with a partial sample in 1989, the full survey runs from 1991 to 2011, and this issue documents the CHNS history. The CHNS cohort includes new household formation and replacement communities and households; all household members are studied. Furthermore, in-depth community data are collected. The sample began with eight provinces and added a ninth, Heilongjiang, in 1997 and three autonomous cities, Beijing, Shanghai, and Chongqing, in 2011. The in-depth community contextual measures have allowed us to create a unique measure of urbanicity that captures major dimensions of modernization across all 288 communities currently in the CHNS sample. The standardized, validated urbanicity measure captures the changes in 12 dimensions: population density; economic activity; traditional markets; modern markets; transportation infrastructure; sanitation; communications; housing; education; diversity; health infrastructure; and social services. Each is based on numerous measures applicable to each dimension. They are used jointly and separately in hundreds of studies. © 2014 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of the International Association for the Study of Obesity.
... Request; Survey of Health Care Professionals' Awareness and Perceptions of the National Cancer Institute's... approval. Proposed Collection: Title: The Survey of Health Care Professionals' Awareness and Perceptions of... respondents response (minutes/hour) hours Health care professionals who complete the 330 1 5/60 27.5 survey (0...
A wide range of handling practices for harvested fish exists and they have economic as well as public health implications. This paper is a review of the existing problems in fish handling technologies at post-harvest in Nigeria. The public health aspects with the associated implications are highlighted. Status of policy on fish ...
Full Text Available Biobanks are made all the more valuable when the biological samples they hold can be linked to health information collected in research, electronic health records, or public health practice. Public trust in such systems that share health information for research and health care practice is understudied. Our research examines characteristics of the general public that predict trust in a health system that includes researchers, health care providers, insurance companies and public health departments. We created a 119-item survey of predictors and attributes of system trust and fielded it using Amazon’s MTurk system (n = 447. We found that seeing one’s primary care provider, having a favorable view of data sharing and believing that data sharing will improve the quality of health care, as well as psychosocial factors (altruism and generalized trust were positively and significantly associated with system trust. As expected, privacy concern, but counterintuitively, knowledge about health information sharing were negatively associated with system trust. We conclude that, in order to assure the public’s trust, policy makers charged with setting best practices for governance of biobanks and access to electronic health records should leverage critical access points to engage a diverse public in joint decision making.
Downward, Paul; Hallmann, Kirstin; Rasciute, Simona
Policy agencies are now re-visiting early aspirations that sport, as a form of physical activity, can be an instrument to foster general health and also subjective well-being (SWB). Both of these concepts capture physical and mental health states. SWB also encompasses broader psychological and life satisfaction as well as mood and affect. Past and current policies also identify a link between sport, social capital and SWB. Structural Equation Modelling (SEM) is undertaken on data from the UK's Taking Part survey to investigate the interrelationships between sport, general health, social capital and SWB. The SEM shows a simultaneous relationship between sport and SWB. The effect is mediated through general health. The results also show that there is no relationship between social capital and sport but a clear relationship between SWB and social capital. From a health policy perspective there should be an emphasis on encouraging greater sport participation, despite the difficulties that this poses, because there is a potential 'multiplier' effect on SWB and on general health through mediation. The multiplier effect occurs because once someone engages in sport and has their general health and SWB enhanced, then even further sport participation becomes likely, and subsequent general health and SWB, which would comprise both physical and mental health benefits. To target traditional non participants the research suggests that physical activity should be promoted for enjoyment, with health benefits subsequently following. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.
Ward, Brian W; Dahlhamer, James M; Galinsky, Adena M; Joestl, Sarah S
To provide national estimates for indicators of health-related behaviors, health status, health care service utilization, and health care access by sexual orientation using data from the 2013 National Health Interview Survey (NHIS). NHIS is an annual multipurpose health survey conducted continuously throughout the year. Analyses were based on data collected in 2013 from 34,557 adults aged 18 and over. Sampling weights were used to produce national estimates that are representative of the civilian noninstitutionalized U.S. adult population. Differences in health-related behaviors, health status, health care service utilization, and health care access by sexual orientation were examined for adults aged 18-64, and separately for men and women. Based on the 2013 NHIS data, 96.6% of adults identified as straight, 1.6% identified as gay or lesbian, and 0.7% identified as bisexual. The remaining 1.1% of adults identified as ''something else,'' stated ''I don't know the answer,'' or refused to provide an answer. Significant differences were found in health-related behaviors, health status, health care service utilization, and health care access among U.S. adults aged 18-64 who identified as straight, gay or lesbian, or bisexual. NHIS sexual orientation data can be used to track progress toward meeting the Healthy People 2020 goals and objectives related to the health of lesbian, gay, and bisexual persons. In addition, the data can be used to examine a wide range of health disparities among adults identifying as straight, gay or lesbian, or bisexual. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.
Sørensen, Kristine; Pelikan, Jürgen M; Röthlin, Florian; Ganahl, Kristin; Slonska, Zofia; Doyle, Gerardine; Fullam, James; Kondilis, Barbara; Agrafiotis, Demosthenes; Uiters, Ellen; Falcon, Maria; Mensing, Monika; Tchamov, Kancho; van den Broucke, Stephan; Brand, Helmut
Health literacy concerns the capacities of people to meet the complex demands of health in modern society. In spite of the growing attention for the concept among European health policymakers, researchers and practitioners, information about the status of health literacy in Europe remains scarce. This article presents selected findings from the first European comparative survey on health literacy in populations. The European health literacy survey (HLS-EU) was conducted in eight countries: Austria, Bulgaria, Germany, Greece, Ireland, the Netherlands, Poland and Spain (n = 1000 per country, n = 8000 total sample). Data collection was based on Eurobarometer standards and the implementation of the HLS-EU-Q (questionnaire) in computer-assisted or paper-assisted personal interviews. The HLS-EU-Q constructed four levels of health literacy: insufficient, problematic, sufficient and excellent. At least 1 in 10 (12%) respondents showed insufficient health literacy and almost 1 in 2 (47%) had limited (insufficient or problematic) health literacy. However, the distribution of levels differed substantially across countries (29-62%). Subgroups within the population, defined by financial deprivation, low social status, low education or old age, had higher proportions of people with limited health literacy, suggesting the presence of a social gradient which was also confirmed by raw bivariate correlations and a multivariate linear regression model. Limited health literacy represents an important challenge for health policies and practices across Europe, but to a different degree for different countries. The social gradient in health literacy must be taken into account when developing public health strategies to improve health equity in Europe. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association.
Marcon, Alessandro; Nguyen, Giang; Rava, Marta; Braggion, Marco; Grassi, Mario; Zanolin, Maria Elisabetta
In environmental surveys, risk perception may be a source of bias when information on health outcomes is reported using questionnaires. Using the data from a survey carried out in the largest chipboard industrial district in Italy (Viadana, Mantova), we devised a score of health risk perception and described its determinants in an adult population. In 2006, 3697 parents of children were administered a questionnaire that included ratings on 7 environmental issues. Items dimensionality was studied by factor analysis. After testing equidistance across response options by homogeneity analysis, a risk perception score was devised by summing up item ratings. Factor analysis identified one latent factor, which we interpreted as health risk perception, that explained 65.4% of the variance of five items retained after scaling. The scale (range 0-10, mean ± SD 9.3 ± 1.9) had a good internal consistency (Cronbach's alpha 0.87). Most subjects (80.6%) expressed maximum risk perception (score = 10). Italian mothers showed significantly higher risk perception than foreign fathers. Risk perception was higher for parents of young children, and for older parents with a higher education, than for their counterparts. Actual distance to major roads was not associated with the score, while self-reported intense traffic and frequent air refreshing at home predicted higher risk perception. When investigating health effects of environmental hazards using questionnaires, care should be taken to reduce the possibility of awareness bias at the stage of study planning and data analysis. Including appropriate items in study questionnaires can be useful to derive a measure of health risk perception, which can help to identify confounding of association estimates by risk perception. Copyright © 2015 Elsevier B.V. All rights reserved.
Ostrow, Laysha; Penney, Darby; Stuart, Elizabeth; Leaf, Phillip J
The 2012 National Survey of Peer-Run Organizations is one of the first to survey a nationally representative sample of mental health peer-run organizations, nonprofit venues for support and advocacy which are defined by people with psychiatric histories being in positions of authority and control. This paper describes data collection methods and demonstrates how participatory strategies to involve people with psychiatric histories intersected with Internet research to achieve study aims. People with psychiatric histories were involved in designing and implementing a web-based survey to collect data on peer-run organizations' operations and views on national policy. Participatory approaches were used throughout design, data collection analysis, and dissemination. The extensive involvement of people with psychiatric histories in project design and implementation were important strategies that contributed to this study's success.
Cleary, J S; Schmieler, C R; Parascenzo, L C; Ambrosio, N
The authors examined students' perceptions, attitudes, and experiences of sexual harassment by faculty members at a state university, using a sample of 1,139 graduate and undergraduate students. Twenty-six percent (292) of those in the sample responded. The instrument used in the study, adapted from a survey previously used at the University of Iowa, operationally defined eight categories of behavior: sexist comments, undue attention, verbal sexual advances, body language, invitations, physical advances, explicit sexual propositions, and sexual bribery. As many as 8% of the respondents indicated they had experienced the three most extreme forms of harassment--physical advances, explicit sexual propositions, and sexual bribery. Although most students thought they would report sexual harassment, only three incidents of the most extreme forms of sexual harassment were actually reported. Those who experienced harassment indicated that it generally came from one rather than from several faculty members and that it came from both male and female faculty. Twenty-three percent of the men reported experiencing sexist comments, and 5 male students reported they had experienced at least one of the three most extreme forms of sexual harassment. Recommendations for policy revisions and campus health promotion programming that were made following the survey are discussed.
Koenen, K C; Ratanatharathorn, A; Ng, L; McLaughlin, K A; Bromet, E J; Stein, D J; Karam, E G; Meron Ruscio, A; Benjet, C; Scott, K; Atwoli, L; Petukhova, M; Lim, C C W; Aguilar-Gaxiola, S; Al-Hamzawi, A; Alonso, J; Bunting, B; Ciutan, M; de Girolamo, G; Degenhardt, L; Gureje, O; Haro, J M; Huang, Y; Kawakami, N; Lee, S; Navarro-Mateu, F; Pennell, B-E; Piazza, M; Sampson, N; Ten Have, M; Torres, Y; Viana, M C; Williams, D; Xavier, M; Kessler, R C
Traumatic events are common globally; however, comprehensive population-based cross-national data on the epidemiology of posttraumatic stress disorder (PTSD), the paradigmatic trauma-related mental disorder, are lacking. Data were analyzed from 26 population surveys in the World Health Organization World Mental Health Surveys. A total of 71 083 respondents ages 18+ participated. The Composite International Diagnostic Interview assessed exposure to traumatic events as well as 30-day, 12-month, and lifetime PTSD. Respondents were also assessed for treatment in the 12 months preceding the survey. Age of onset distributions were examined by country income level. Associations of PTSD were examined with country income, world region, and respondent demographics. The cross-national lifetime prevalence of PTSD was 3.9% in the total sample and 5.6% among the trauma exposed. Half of respondents with PTSD reported persistent symptoms. Treatment seeking in high-income countries (53.5%) was roughly double that in low-lower middle income (22.8%) and upper-middle income (28.7%) countries. Social disadvantage, including younger age, female sex, being unmarried, being less educated, having lower household income, and being unemployed, was associated with increased risk of lifetime PTSD among the trauma exposed. PTSD is prevalent cross-nationally, with half of all global cases being persistent. Only half of those with severe PTSD report receiving any treatment and only a minority receive specialty mental health care. Striking disparities in PTSD treatment exist by country income level. Increasing access to effective treatment, especially in low- and middle-income countries, remains critical for reducing the population burden of PTSD.
Borrud, Lori; Chiappa, Michele M; Burt, Vicki L; Gahche, Jaime; Zipf, George; Johnson, Clifford L; Dohrmann, Sylvia M
In October 2008, the federal government issued its first-ever Physical Activity Guidelines for Americans to provide science-based guidance on the types and amounts of physical activity that provide substantial health benefits for Americans (1). Guidelines for children and adolescents recommend 60 minutes or more of aerobic, muscle-strengthening, or bone-strengthening physical activity daily (1). While the number of children in the United States who meet the recommendations in the Physical Activity Guidelines is unknown, the percentage that is physically active in the United States may be declining. No recent national data exist on the fitness levels of children and adolescents. The National Health and Nutrition Examination Survey's (NHANES) National Youth Fitness Survey (NNYFS) was conducted in 2012 and collected data on physical activity and fitness levels for U.S. children and adolescents aged 3-15 years. The objective of NNYFS was to provide national-level estimates of the physical activity and fitness levels of children, based on interview and physical examination data. Results from the survey are intended to contribute to the development of policies and programs to improve youth fitness nationally. The data also may be used in the development of national reference standards for measures of fitness and physical activity. Methods The NNYFS survey design used the design for NHANES, which is a multistage probability sample of the civilian noninstitutionalized resident population of the United States. NNYFS consisted of a household interview and a physical activity and fitness examination in a mobile examination center. A total of 1,640 children and adolescents aged 3-15 were interviewed, and 1,576 were examined. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.
Lee, Soo; Knight, Denise
This article reports on a survey of district nurses' involvement in mental health interventions in one county. Seventy-nine questionnaires were sent and 46 were returned. Descriptive analysis was carried out using statistical software. The DNs reported encountering a wide range of mental health issues and interventions in practice: dementia, anxiety and depression featured highly. Over half (55%) of the respondents reported involvement in bereavement counselling, and 28% and 23% of respondents reported encountering anxiety management, and problem solving and alcohol advice respectively. A large proportion, however, reported no involvement in mental health interventions. Among the psychiatric professionals, district nurses tended to have most frequent contacts with social workers. GPs were the most likely person to whom DNs made referrals, followed by community psychiatric nurses. Despite the apparent awareness of the values of psychosocial interventions, DNs were equally influenced by the medical model of treatment. In order to realize the potential contribution of district nurses in mental health interventions, there is a need for primary care teams to foster a closer working relationship with mental health specialist services.
Easter, Sarah Rae; Raglan, Greta B; Little, Sarah E; Schulkin, Jay; Robinson, Julian N
Objective To characterize contemporary attitudes toward global health amongst board-certified obstetricians-gynecologists (Ob-Gyns) in the US. Methods A questionnaire was mailed to members of the American College of Obstetricians and Gynecologists. Respondents were stratified by interest and experience in global health and group differences were reported. Results A total of 202 of 400 (50.5%) surveys were completed; and 67.3% ( n = 136) of respondents expressed an interest in global health while 25.2% ( n = 51) had experience providing healthcare abroad. Personal safety was the primary concern of respondents (88 of 185, 47.6%), with 44.5% (57 of 128) identifying 2 weeks as an optimal period of time to spend abroad. The majority (113 of 186, 60.8%) cited hosting of local physicians in the US as the most valuable service to developing a nation's healthcare provision. Conclusion Despite high interest in global health, willingness to spend significant time abroad was limited. Concerns surrounding personal safety dovetailed with the belief that training local physicians in the US provides the most valuable service to international efforts. These attitudes and concerns suggest novel solutions will be required to increase involvement of Ob-Gyns in global women's health.
Barnes, Michael D.; Heaton, Thomas L.; Goates, Michael C.; Packer, Justin M.
The developmental origins of health and disease (DOHaD) theory and life course theory (LCT) are emerging fields of research that have significant implications for the public health and health promotion professions. Using a DOHaD/LCT perspective, social determinants of health (SDH) take on new critical meaning by which health promotion professionals can implement DOHaD/LCT guided interventions, including recommended policies. Through these interventions, public health could further address the...
Manganello, Jennifer; Gerstner, Gena; Pergolino, Kristen; Graham, Yvonne; Falisi, Angela; Strogatz, David
An understanding of the association of health literacy with patterns related to access and usage of digital technologies and preferences for sources of health information is necessary for public health agencies and organizations to appropriately target channels for health information dissemination. A cross-sectional telephone survey was conducted in New York State. Health literacy was assessed using the Morris Single-Item Screener, a self-report question. A weighted analysis was conducted utilizing Stata/SE. The final sample size of New York State residents used for analysis was 1350. In general, self-report health literacy did not predict digital technology use (ie, Internet and smartphone use, text messaging) but was associated with certain digital activities. People with low self-report health literacy were less likely to use search engines (P = .026) but more likely to get health information from social networking sites (P = .002) and use health-related phone apps (P = .046). With respect to health information seeking, those with lower self-report health literacy reported greater difficulty with their most recent search for health information. Furthermore, they were more likely to prefer text messages (P = .013) and radio (P = .022), 2 text-limited communication channels, to receive health information than those with higher self-report health literacy. While self-report health literacy does not appear to influence access to and use of digital technologies, there is a strong association with experiences searching for health information and preferences for health information sources. Public health agencies and organizations should consider the needs and preferences of people with low health literacy when determining channels for health information dissemination. They should also consider implementing interventions to develop health information-seeking skills in populations they serve and prepare information and materials that are easily accessible and
Kobau, R; Cui, W; Kadima, N; Zack, MM; Sajatovic, M; Kaiboriboon, K; Jobst, B
Objective This study provides population-based estimates of psychosocial health among U.S. adults with epilepsy from the 2010 National Health Interview Survey. Methods Multinomial logistic regression was used to estimate the prevalence of the following measures of psychosocial health among adults with and those without epilepsy: 1) the Kessler-6 scale of Serious Psychological Distress; 2) cognitive limitation; the extent of impairments associated with psychological problems; and work limitation; 3) Social participation; and 4) the Patient Reported Outcome Measurement Information System Global Health scale. Results Compared with adults without epilepsy, adults with epilepsy, especially those with active epilepsy, reported significantly worse psychological health, more cognitive impairment, difficulty in participating in some social activities, and reduced health-related quality of life (HRQOL). Conclusions These disparities in psychosocial health in U.S. adults with epilepsy serve as baseline national estimates of their HRQOL, consistent with Healthy People 2020 national objectives on HRQOL. PMID:25305435
Full Text Available Abstract Background In all countries people of lower socioeconomic status evaluate their health more poorly. Yet in reporting overall health, individuals consider multiple domains that comprise their perceived health state. Considered alone, overall measures of self-reported health mask differences in the domains of health. The aim of this study is to compare and assess socioeconomic inequalities in each of the individual health domains and in a separate measure of overall health. Methods Data on 247,037 adults aged 18 or older were analyzed from 57 countries, drawn from all national income groups, participating in the World Health Survey 2002-2004. The analysis was repeated for lower- and higher-income countries. Prevalence estimates of poor self-rated health (SRH were calculated for each domain and for overall health according to wealth quintiles and education levels. Relative socioeconomic inequalities in SRH were measured for each of the eight health domains and for overall health, according to wealth quintiles and education levels, using the relative index of inequality (RII. A RII value greater than one indicated greater prevalence of self-reported poor health among populations of lower socioeconomic status, called pro-rich inequality. Results There was a descending gradient in the prevalence of poor health, moving from the poorest wealth quintile to the richest, and moving from the lowest to the highest educated groups. Inequalities which favor groups who are advantaged either with respect to wealth or education, were consistently statistically significant in each of the individual domains of health, and in health overall. However the size of these inequalities differed between health domains. The prevalence of reporting poor health was higher in the lower-income country group. Relative socioeconomic inequalities in the health domains and overall health were higher in the higher-income country group than the lower-income country group
Rogers, Bonnie; Kono, Keiko; Marziale, Maria Helena Palucci; Peurala, Marjatta; Radford, Jennifer; Staun, Julie
Access to occupational health services for primary prevention and control of work-related injuries and illnesses by the global workforce is limited (World Health Organization [WHO], 2013). From the WHO survey of 121 (61%) participating countries, only one-third of the responding countries provided occupational health services to more than 30% of their workers (2013). How services are provided in these countries is dependent on legal requirements and regulations, population, workforce characteristics, and culture, as well as an understanding of the impact of workplace hazards and worker health needs. Around the world, many occupational health services are provided by occupational health nurses independently or in collaboration with other disciplines' professionals. These services may be health protection, health promotion, or both, and are designed to reduce health risks, support productivity, improve workers' quality of life, and be cost-effective. Rantanen (2004) stated that basic occupational health services must increase rather than decline, especially as work becomes more complex; workforces become more dynamic and mobile, creating new models of work-places; and jobs become more precarious and temporary. To better understand occupational health services provided by occupational health nurses globally and how decisions are made to provide these services, this study examined the scope of services provided by a sample of participating occupational health nurses from various countries. Copyright 2014, SLACK Incorporated.
Full Text Available Cigarette smoking remains a significant health threat for smokers and nonsmokers alike. Secondhand smoke (SHS is intrinsically more toxic than directly inhaled smoke. Recently, a new threat has been discovered - Thirdhand smoke (THS - the accumulation of SHS on surfaces that ages with time, becoming progressively more toxic. THS is a potential health threat to children, spouses of smokers and workers in environments where smoking is or has been allowed. The goal of this study is to investigate the effects of THS on liver, lung, skin healing, and behavior, using an animal model exposed to THS under conditions that mimic exposure of humans. THS-exposed mice show alterations in multiple organ systems and excrete levels of NNAL (a tobacco-specific carcinogen biomarker similar to those found in children exposed to SHS (and consequently to THS. In liver, THS leads to increased lipid levels and non-alcoholic fatty liver disease, a precursor to cirrhosis and cancer and a potential contributor to cardiovascular disease. In lung, THS stimulates excess collagen production and high levels of inflammatory cytokines, suggesting propensity for fibrosis with implications for inflammation-induced diseases such as chronic obstructive pulmonary disease and asthma. In wounded skin, healing in THS-exposed mice has many characteristics of the poor healing of surgical incisions observed in human smokers. Lastly, behavioral tests show that THS-exposed mice become hyperactive. The latter data, combined with emerging associated behavioral problems in children exposed to SHS/THS, suggest that, with prolonged exposure, they may be at significant risk for developing more severe neurological disorders. These results provide a basis for studies on the toxic effects of THS in humans and inform potential regulatory policies to prevent involuntary exposure to THS.
Kreps, Gary L.
Objective: This paper examines the influence of the digital divide on disparities in health outcomes for vulnerable populations, identifying implications for medical and public libraries. Method: The paper describes the results of the Digital Divide Pilot Projects demonstration research programs funded by the National Cancer Institute to test new strategies for disseminating relevant health information to underserved and at-risk audiences. Results: The Digital Divide Pilot Projects field-tested innovative systemic strategies for helping underserved populations access and utilize relevant health information to make informed health-related decisions about seeking appropriate health care and support, resisting avoidable and significant health risks, and promoting their own health. Implications: The paper builds on the Digital Divide Pilot Projects by identifying implications for developing health communication strategies that libraries can adopt to provide digital health information to vulnerable populations. PMID:16239960
Driouchi, Ahmed; Baijou, Ahmad
The interdependencies of health, education and poverty that are common knowledge to individuals are also present at the aggregate levels of countries and internationally. The assessment of these interdependencies is the central task of this research but based on the Demographic Health Surveys (DHS) of Egypt, Morocco and Turkey. The results attained through dependency tests and probit models, confirm the existence of major interdependencies at the levels of households. These findings support t...
Samuel adu Gyamfi
Full Text Available This article is basically a commentary on some sections on infant and maternal healthcare of the 2008 demographic and health survey of Ghana. The attention of both policy makers and academics are drawn to the need to ensure the expansion of the maternal and infant healthcare in Ghana. In same commentary, attention of readers have been drawn to the proclivity of the free maternal health policy to positively shape maternal and infant care in Ghana
Guidotti, T.L.; Last, J.
The possible impacts of the greenhouse effect, ozone depletion and ultraviolet irradiation, acid precipitation, and resulting demographic changes are reviewed, along with the implications of global ecological changes on society and sustainable development. Some manifestations of global warming caused by the greenhouse effect could include more frequently extreme weather conditions, rises in sea level, disruption of ocean currents, and changes in composition and distribution of vegetation. Consequences of these manifestations on human health include an increase in the frequency of droughts and heat waves, migration of disease carrying vectors to other areas, submergence of coastal areas and disruption of water supplies, destruction of tropical species potentially useful for medicinal purposes, and impaired production of crops leading to food shortages. Consequences of stratospheric ozone depletion due to chlorofluorocarbon pollution are thought to be a direct result of increased exposure to ultraviolet light; these consequences include higher risks of non-melanoma skin cancer. The effects of acid precipitation are thought to be primarily ecological and indirect. 61 refs,
Torner, Núria; Solano, Ruben; Rius, Cristina; Domínguez, Angela; Surveillance Network of Catalonia, Spain, the Measles Elimination Program
Healthcare personnel (HCP) play an important role in transmission of highly contagious diseases such as measles. Current immunization guidelines in Catalonia include Measles-Mumps-Rubella (MMR) immunization for HCP born after 1967 without evidence of immunity. Despite high vaccination coverage (90%) a high burden of measles cases related to outbreaks have occurred. The aim of this study was to assess the implication of HCP in measles transmission related to healthcare setting. A review of surveillance case data from 2001 to 2013 gathered through the Measles Elimination Program in Catalonia was performed. Twenty six outbreaks involving 797 cases were reported, 52 (6.5%) were HCP aged 21–41 years, 72,5% (38) patient were care personnel (doctors and nurses) and 22,5% (14) other health care related personnel. Forty six 87%) were unvaccinated, 4(10%) had only one dose and 2 had two doses of MMR. In community outbreaks 30 clusters with HCP involved were observed, yet none were identified as index cases. Non-vaccinated HCPs against measles were all under 45 years of age. Vaccination is the only reliable protection against nosocomial spread of measles from HCPs. Assessing vaccination status of HCPs and implementing a 2 dose vaccination in those lacking evidence of immunity is needed in order to set to zero the risk of acquiring and spreading measles in healthcare (HC) settings. PMID:25483548
Full Text Available Objective. Describe the design methodology of the halfway health and nutrition national survey (Ensanut-MC 2016. Materials and methods. The Ensanut-MC is a national probabilistic survey whose objective population are the inhabitants of private households in Mexico. The sample size was determined to make inferences on the urban and rural areas in four regions. Describes main design elements: target population, topics of study, sampling procedure, measurement procedure and logistics organization. Results. A final sample of 9 479 completed household interviews, and a sample of 16 591 individual interviews. The response rate for households was 77.9%, and the response rate for individuals was 91.9%. Conclusions. The Ensanut-MC probabilistic design allows valid statistical inferences about interest parameters for Mexico´s public health and nutrition, specifically on overweight, obesity and diabetes mellitus. Updated information also supports the monitoring, updating and formulation of new policies and priority programs.
Full Text Available Iranian Mental Health Survey (IranMHS was conducted to assess the twelve-month prevalence and severity of psychiatric disorders in the Iranian adult population and to determine the pattern of health care utilization and cost of services. IranMHS is a cross-sectional national household survey with face-to-face interviews as the main data collection method. The study was carried out between January and June 2011. A three-stage probability sampling was applied for the selection of a representative sample from the non-institutionalized population aged 15 to 64. The primary instrument utilized for assessing the prevalence of mental disorders was the Persian version of Composite International Diagnosis Interview, version 2.1. The instruments for assessing the service and cost of mental illness were developed by the research team. The response rate was 86.2%, and a total of 7886 individuals participated in the study. Sampling weights were the joint product of inverse probability of unit selection, non-response weights and post-stratification weights. This paper presents an overview of the study design, fieldwork organization and procedures, weightings and analysis. The strengths and limitations of the study are also discussed.
Nakas, Enita; Tiro, Alisa; Vrazalica, Lejla Redzepagic; Hadzihasanovic, Dzana; Dzemidzic, Vildana
The aim of our study is to compare incidence of orthodontic malocclusion based on occlusal indices and Index of Orthodontic Treatment Need (IOTN), and to evaluate the most commonly used method among the dentists for orthodontic treatment in Sarajevo. The sample consisted of 110 (31 female and 79 male)subjects older than 16 years with complete permanent dentition. Subjects were examined according to Occlusal Index (Angle classification of malocclusion, overjet, overbite, dental arch crowding and tooth rotation) and IOTN index. We conduct survey regarding which indexes are used in deciding on orthodontic treatment need, among primary health care and Orthodontist. The present study show differences between the presence of malocclusion and treatment need as assessed by these two used indices. Based on the survey that we conduct all primary health care doctors use Occlusal Index to decide need for orthodontic treatment, more than 95% of orthodontic specialist use Occlusal Index for treatment need estimation. When measuring and grading treatment needs we should rely on Index of orthodontic treatment need. In such high demand for orthodontic treatment need it is necessary to establish need for the orthodontic treatment as fundamental, so that individuals with greatest treatment need can be assigned priority.
Grundl, S; Kranz, J; Rosellen, J; Steffens, C; Steffens, J
Early detection examinations take place from birth to the age of 6 years. The youth screening is a continuation of the screening of the "U-series" and should be carried out between the age of 12-15 and 16-17, respectively. Afterwards adolescent girls have good contact with a gynecologist, but adolescent boys usually do not have a medical contact person who they can trust in. To evaluate the state of knowledge on boys' health, a 15-item comprehensive knowledge survey was conducted among ninth grade students at 7 secondary schools (Gymnasien) in North Rhine-Westphalia. The knowledge survey took place at three specified times (before, immediately after and approximately 3 months after adolescent sexual education classes). Only completed questionnaires were analyzed and evaluated in a gender-specific manner. Overall, 459 students participated from March-September 2017. Before sexual education instruction, about half of all questions were answered correctly by the students. Immediately after class, the proportion increased by a factor of 1.5 to a total of 79.24%. Then 2-3 months after the class, the percentage was 69.67%. Considering gender separately, this resulted in an increase of 15.32% for the female students and 16.99% for the male students. The knowledge survey reveals a need to catch up on facts on the subject of boys' health. Despite evidence of an increase in knowledge of both sexes after sexual education instruction, there is a gender gap. Hence, a preventive check-up especially for boys should be established and offered. Issues such as the prevention of sexually transmitted diseases, options for vaccination against human papillomavirus, etc. should be actively addressed.
Miyamoto, Keiko; Iwakuma, Miho; Nakayama, Takeo
A non-profit organization was formed in 2009 by lay citizens of Nagahama, Japan in response to a community-based genome-epidemiologic study, the 'Nagahama Zero(0)-ji Prevention Cohort Project (N0PCP)'. This organization aims to promote health by taking advantage of citizens' social networks. The Ottawa Charter for Health Promotion affirms the importance of creating supportive environments and coordinating social relationships. Supportive environments (infrastructure) and social relationships (resources) work together as aspects of social capital. This study sought to examine the association between self-rated health and social capital, at both individual and neighborhood levels, and to discuss suitable health promotion strategies for local circumstances.A cross-sectional survey was conducted in 2011, using a self-administered postal questionnaire. Social capital indicators included aspects of support in the environment (social support, neighborhood connectedness, informal social controls, neighborhood trust, general trust, and attachment to place) and social relationships (number of activities; participation in neighborhood activities; participation in recreational activities; and social leverage regarding physical health, mental health, and acquisition of health information). Neighborhood-level social capital was calculated as the percentage of individuals in a neighborhood in the 'high social capital' category. At the individual level, participation in recreational activities, high general trust, and discussion regarding mental health problems with family members were associated with self-rated health positively, whereas discussion of mental health problems with acquaintances had a negative correlation. At the neighborhood level, a highly supportive environment did not contribute to good health, whereas aggregated attachment to place had a positive correlation. There were no significant inter-regional health differences.The results of this study suggest that
Kessler, Ronald C; Aguilar-Gaxiola, Sergio; Alonso, Jordi; Benjet, Corina; Bromet, Evelyn J; Cardoso, Graça; Degenhardt, Louisa; de Girolamo, Giovanni; Dinolova, Rumyana V; Ferry, Finola; Florescu, Silvia; Gureje, Oye; Haro, Josep Maria; Huang, Yueqin; Karam, Elie G; Kawakami, Norito; Lee, Sing; Lepine, Jean-Pierre; Levinson, Daphna; Navarro-Mateu, Fernando; Pennell, Beth-Ellen; Piazza, Marina; Posada-Villa, José; Scott, Kate M; Stein, Dan J; Ten Have, Margreet; Torres, Yolanda; Viana, Maria Carmen; Petukhova, Maria V; Sampson, Nancy A; Zaslavsky, Alan M; Koenen, Karestan C
Background : Although post-traumatic stress disorder (PTSD) onset-persistence is thought to vary significantly by trauma type, most epidemiological surveys are incapable of assessing this because they evaluate lifetime PTSD only for traumas nominated by respondents as their 'worst.' Objective : To review research on associations of trauma type with PTSD in the WHO World Mental Health (WMH) surveys, a series of epidemiological surveys that obtained representative data on trauma-specific PTSD. Method : WMH Surveys in 24 countries (n = 68,894) assessed 29 lifetime traumas and evaluated PTSD twice for each respondent: once for the 'worst' lifetime trauma and separately for a randomly-selected trauma with weighting to adjust for individual differences in trauma exposures. PTSD onset-persistence was evaluated with the WHO Composite International Diagnostic Interview. Results : In total, 70.4% of respondents experienced lifetime traumas, with exposure averaging 3.2 traumas per capita. Substantial between-trauma differences were found in PTSD onset but less in persistence. Traumas involving interpersonal violence had highest risk. Burden of PTSD, determined by multiplying trauma prevalence by trauma-specific PTSD risk and persistence, was 77.7 person-years/100 respondents. The trauma types with highest proportions of this burden were rape (13.1%), other sexual assault (15.1%), being stalked (9.8%), and unexpected death of a loved one (11.6%). The first three of these four represent relatively uncommon traumas with high PTSD risk and the last a very common trauma with low PTSD risk. The broad category of intimate partner sexual violence accounted for nearly 42.7% of all person-years with PTSD. Prior trauma history predicted both future trauma exposure and future PTSD risk. Conclusions : Trauma exposure is common throughout the world, unequally distributed, and differential across trauma types with respect to PTSD risk. Although a substantial minority of PTSD cases remits
Turvey, Carolyn L; Zulman, Donna M; Nazi, Kim M; Wakefield, Bonnie J; Woods, Susan S; Hogan, Timothy P; Weaver, Frances M; McInnes, Keith
Personal health records provide patients with ownership of their health information and allow them to share information with multiple healthcare providers. However, the usefulness of these records relies on patients understanding and using their records appropriately. My HealtheVet is a Web-based patient portal containing a personal health record administered by the Veterans Health Administration. The goal of this study was to explore veterans' interest and use of My HealtheVet to transfer and share information as well as to identify opportunities to increase veteran use of the My HealtheVet functions. Two waves of data were collected in 2010 through an American Customer Satisfaction Index Web-based survey. A random sample of veterans using My HealtheVet was invited to participate in the survey conducted on the My HealtheVet portal through a Web-based pop-up browser window. Wave One results (n=25,898) found that 41% of veterans reported printing information, 21% reported saving information electronically, and only 4% ever sent information from My HealtheVet to another person. In Wave Two (n=18,471), 30% reported self-entering medication information, with 18% sharing this information with their Veterans Affairs (VA) provider and 9.6% sharing with their non-VA provider. Although veterans are transferring important medical information from their personal health records, increased education and awareness are needed to increase use. Personal health records have the potential to improve continuity of care. However, more research is needed on both the barriers to adoption as well as the actual impact on patient health outcomes and well-being.
Raymond, S U
Sustainability of development assistance programs depends greatly on the perceptions of priorities by recipient countries. A written survey was sent by the Catholic University of America's Institute for International Health and Development to 66 ministers of health in low-income and middle-income countries to assess their views of priority problems in health sector development. Response rate was 33%, coming from countries with highly diverse gross national products (GNPs), growth rates, mortality rates and life expectancies. Nevertheless, there was widespread agreement about priorities: 1) meeting costs of health care; 2) improving health care management and administration; and 3) extending communicable disease control. Communicable disease control and child health programs were more important to low-income countries than to middle-income countries. Costs, management and administration and the control of noncommunicable diseases were predicted to increase in importance. In demographics, urbanization, overall population growth and shift of workers from agriculture to industry and services were seen as the major problems of the past, and urbanization and the aging of populations accompanied by increasing life expectancies the major challenges of the future. Highest predicted training needs were for system managers and paramedical personnel. Government budgets, user fees and donor agencies were seen as the most important sources of past funding, with social security systems and fee-based payments increasing in importance in the future. The role of donor agencies would increase as would the need for more responsiveness. Future uncertainties include national economic growth, environmental problems, issues in ethics and changes in disease and technology.
The author here distills his long-time personal experience with the deleterious effects of globalization on health and on the health sector reforms embarked on in many of the more than 50 countries where he has worked in the last 25 years. He highlights the role that the "human right to health" framework can and should play in countering globalization's negative effects on health and in shaping future health policy. This is a testimonial article.
Watson, Barry; Osberg, Lars
Current literature confirms the negative consequences of contemporaneous economic insecurity for mental health, but ignores possible implications of repeated insecurity. This paper asks how much a person's history of economic insecurity matters for psychological distress by contrasting the implications of two models. Consistent with the health capital literature, the Healing model suggests psychological distress is a stock variable affected by shocks from life events, with past events having less impact than more recent shocks. Alternatively, the Breaking Point model considers that high levels of distress represent a distinct shift in life state, which occurs if the accumulation of past life stresses exceeds some critical value. Using five cycles of Canadian National Population Health Survey data (2000-2009), we model the impact of past economic insecurity shocks on current psychological distress in a way that can distinguish between these hypotheses. In our sample of 1775 males and 1883 females aged 25 to 64, we find a robust healing effect for one-time economic insecurity shocks. For males, only a recent one-time occurrence of economic insecurity is predictive of higher current psychological distress (0.19 standard deviations). Moreover, working age adults tend to recover from past accumulated experiences of economic insecurity if they were recently economically secure. However, consistent with the Breaking Point hypothesis, males experiencing three or four cycles of recent insecurity are estimated to have a level of current psychological distress that is 0.26-0.29 standard deviations higher than those who were employed and job secure throughout the same time period. We also find, consistent with other literature, distinct gender differences - for working age females, all economic insecurity variables are statistically insignificant at conventional levels. Our results suggest that although Canadians are resilient to one-time insecurity shocks, males most
Morgan, John P; Isyagi, Moses; Ntaganira, Joseph; Gatarayiha, Agnes; Pagni, Sarah E; Roomian, Tamar C; Finkelman, Matthew; Steffensen, Jane E M; Barrow, Jane R; Mumena, Chrispinus H; Hackley, Donna M
Oral health affects quality of life and is linked to overall health. Enhanced oral health research is needed in low- and middle-income countries to develop strategies that reduce the burden of oral disease, improve oral health and inform oral health workforce and infrastructure development decisions. To implement the first National Oral Health Survey of Rwanda to assess the oral disease burden and inform oral health promotion strategies. In this cross-sectional study, sample size and site selection were based on the World Health Organization (WHO) Oral Health Surveys Pathfinder stratified cluster methodologies. Randomly selected 15 sites included 2 in the capital city, 2 other urban centers and 11 rural locations representing all provinces and rural/urban population distribution. A minimum of 125 individuals from each of 5 age groups were included at each site. A Computer Assisted Personal Instrument (CAPI) was developed to administer the study instrument. Nearly two-thirds (64.9%) of the 2097 participants had caries experience and 54.3% had untreated caries. Among adults 20 years of age and older, 32.4% had substantial oral debris and 60.0% had calculus. A majority (70.6%) had never visited an oral health provider. Quality-of-life challenges due to oral diseases/conditions including pain, difficulty chewing, self-consciousness, and difficulty participating in usual activities was reported at 63.9%, 42.2% 36.2%, 35.4% respectively. The first National Oral Health Survey of Rwanda was a collaboration of the Ministry of Health of Rwanda, the University of Rwanda Schools of Dentistry and Public Health, the Rwanda Dental Surgeons and Dental (Therapists) Associations, and Tufts University and Harvard University Schools of Dental Medicine. The international effort contributed to building oral health research capacity and resulted in a national oral health database of oral disease burden. This information is essential for developing oral disease prevention and management
Gardening has been reported as being beneficial for mental well-being for vulnerable populations since 2000. However, little is known concerning its role in the general population. Therefore, the aim of the present study was to investigate the relationship of gardening and mental health in adults in a countrywide and population-based setting. Data was retrieved from and analysed in the Scottish Health Survey, 2012-2013. Information on demographics, lifestyle factors, gardening engagement, and adult mental health by General Health Questionnaire was obtained by household interview. Statistical analyses including chi-square test, t-test and survey-weighted logistic and multi-nominal regression modelling were performed. Of 9709 Scottish adults aged 16-99, 5 531 (57.0%) people did not do any gardening or building work in the last four weeks. A total of 888 (9.2%) people reported poor self-rated health. Gardening was associated with adult mental health in people both with or without heart conditions including ability to concentrate, feeling playing a useful part in things, feeling capable of making decisions, thinking of self as worthless, feeling reasonably happy, etc. General adults with or without heart conditions could benefit from engaging with gardening or building work. Future public health programmes promoting such activity should be encouraged in order to optimise adult mental health.
BACKGROUND: Those handling deceased individuals, including the funeral industry, face a variety of health and safety hazards including occupationally acquired infectious disease. AIMS: To identify the knowledge, attitudes and beliefs of Irish funeral industry workers towards occupational hazards and infectious disease in 2009. METHODS: The sample analysed consisted of all listed member premises of the Irish Association of Funeral Directors as at 1 July 2009. A postal survey was sent to each premises in July 2009, with two rounds of follow-up reviews sent to non-responders. Four main areas were covered--occupational hazards, embalming, industry expertise and demographics. The quantitative and qualitative results were analysed to assess knowledge, attitudes and beliefs. Data collection was completed on 31 December 2009. RESULTS: Two hundred and thirty listed member premises were contacted. Twenty-two were unsuitable for the survey. One hundred and thirty-eight valid replies were received from 130 premises, representing a premises response rate of 63% (130\\/208). Seventy-three premises (56%) identified themselves as embalmers. Embalmers had variable vaccine uptake and variable knowledge, attitude and beliefs towards embalming those with blood-borne viruses. Fifteen per cent of respondents reported a work-related injury, back injury being the most common. Splash and sharps injuries were reported as a work-related injury, and infections believed to be work related were also reported. CONCLUSIONS: This study demonstrates widespread occupational health concerns among this professional group. It confirms the need for occupational health advice and services. There is also a strong desire for regulation of this profession in Ireland.
Anoke, Sarah C; Mwai, Paul; Jeffery, Caroline; Valadez, Joseph J; Pagano, Marcello
Two common methods used to measure indicators for health programme monitoring and evaluation are the demographic and health surveys (DHS) and lot quality assurance sampling (LQAS); each one has different strengths. We report on both methods when utilised in comparable situations. We compared 24 indicators in south-west Uganda, where data for prevalence estimations were collected independently for the two methods in 2011 (LQAS: n = 8876; DHS: n = 1200). Data were stratified (e.g. gender and age) resulting in 37 comparisons. We used a two-sample two-sided Z-test of proportions to compare both methods. The average difference between LQAS and DHS for 37 estimates was 0.062 (SD = 0.093; median = 0.039). The average difference among the 21 failures to reject equality of proportions was 0.010 (SD = 0.041; median = 0.009); among the 16 rejections, it was 0.130 (SD = 0.010, median = 0.118). Seven of the 16 rejections exhibited absolute differences of 0.10 and 0.20 (mean = 0.261, SD = 0.083). There is 75.7% agreement across the two surveys. Both methods yield regional results, but only LQAS provides information at less granular levels (e.g. the district level) where managerial action is taken. The cost advantage and localisation make LQAS feasible to conduct more frequently, and provides the possibility for real-time health outcomes monitoring. © 2015 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.
Dragon, Christina N; Laffan, Alison M; Erdem, Erkan; Cahill, Sean R; Kenefick, Daniel; Ye, Jiahui; Haffer, Samuel C
Advances in lesbian, gay, and bisexual (sexual minority [SM]) acceptance and equality have been made in the past decade. However, certain SM subgroups continue to be disadvantaged due to lack of data and, thus, lack of knowledge about these populations. Data for older sexual minorities are especially lacking and will be increasingly important as more sexual minorities enter older age. This research explores results from a nationally representative health survey to elucidate some health indicators for older sexual minorities. Data from the 2013 and 2014 National Health Interview Surveys (NHIS) were pooled for increased sample size, and established research methods were followed as recommended by prior NHIS sexual orientation studies. We conducted descriptive analyses on the differences between SM and heterosexual groups, aged 65 years and older, for 12 health indicators. Four out of the 12 health indicators were significantly different for sexual minorities, and three out of those four indicated positive health outcomes or behaviors when compared with heterosexuals. Sexual minorities were more than three times as likely to receive HIV testing as heterosexual peers. Sexual minorities were more likely to receive an influenza vaccination, and much more likely to report excellent or very good health, than their heterosexual peers. Sexual minorities were more than twice as likely to report binge drinking, which is consistent with prior research for adult sexual minorities. This analysis is the first to examine national data on health indicators for sexual minorities, aged 65 years and older, using NHIS data. As more surveys begin to collect SMdata and more years of data are collected by NHIS, a clearer picture of the health of older adult sexual minorities should emerge.
Kaljee, Linda M.; Pach, Alfred; Thriemer, Kamala; Ley, Benedikt; Ali, Said M.; Jiddawi, Mohamed; Puri, Mahesh; von Seidlein, Lorenz; Deen, Jacqueline; Ochiai, Leon; Wierzba, Thomas; Clemens, John
Salmonella enterica serotype Typhi (S. Typhi) was estimated to cause over 200,000 deaths and more than 21 million illnesses worldwide, including over 400,000 illnesses in Africa. The current study was conducted in four villages on Pemba Island, Zanzibar, in 2010. We present data on policy makers', health administrators', and village residents' and leaders' perceptions of typhoid fever, and hypothetical and actual health care use among village residents for typhoid fever. Qualitative data provided descriptions of home-based treatment practices and use of western pharmaceuticals, and actual healthcare use for culture-confirmed typhoid fever. Survey data indicate health facility use was associated with gender, education, residency, and perceptions of severity for symptoms associated with typhoid fever. Data have implications for education of policy makers and health administrators, design and implementation of surveillance studies, and community-based interventions to prevent disease outbreaks, decrease risks of complications, and provide information about disease recognition, diagnosis, and treatment. PMID:23208887
Walker, Robin L; Gee, Marianne E; Bancej, Christina; Nolan, Robert P; Kaczorowski, Janusz; Joffres, Michel; Bienek, Asako; Gwadry-Sridhar, Femida; Campbell, Norman R C
Health professionals play an important role in providing health information to patients. The objectives of this study were to examine the type of advice that Canadians with hypertension recall receiving from health professionals to manage their condition, and to assess if there is an association between health behaviour advice provided by health professionals and self-reported engagement in health behaviour modification. Respondents of the 2009 Survey on Living with Chronic Diseases in Canada (N = 6142) were asked about sociodemographic characteristics, health care utilization, and health behaviour modification to control hypertension. Association between receipt of advice from health professional and ever engaging, continuing to engage, and not engaging in health behaviour modification was quantified by prevalence rate ratios. Most participants (90.9%; 95% confidence interval [CI], 89.6-92.2) reported that the health professional most responsible for treating their high blood pressure was their general practitioner. Approximately 9% reported that they had not received or do not recall receiving any advice for blood pressure control. The most commonly reported advice received from a health professional was to participate in physical activity or exercise (70.0%). Respondents who had received advice on health behaviour change to manage their high blood pressure were more likely to report engaging in the behaviour compared with those who did not receive such advice. Many Canadians with hypertension receive health behaviour change advice from their health professionals. Receiving this advice was associated with a greater likelihood of attempting health behaviour change and attempting to sustain that change. Copyright © 2011 Canadian Cardiovascular Society. All rights reserved.
Kijsanayotin, Boonchai; Speedie, Stuart
The Thailand universal health care coverage scheme was instituted in 2001 and The Thailand Ministry of Public Health (MOPH) is restructuring its information systems to support this reform. The MOPH anticipates developing computerized health information systems which can provide information for administration tasks and can improve both healthcare delivery and public health services. To achieve these target goals, knowledge about users and organizations is vital. The knowledge of how health center workers currently use information technology (IT), their knowledge of IT, and acceptance of IT are not only beneficial to policy makers but also to system designers and implementers. The primary objective of this study is to learn how health centers in Thailand use IT, the level of basic IT knowledge among their workers, and their acceptance of health IT. We surveyed a random cross sectional sample of 1,607 health centers representing the total of 9,806 in Thailand in 2005. With an 82% response rate, the preliminary results indicate that information technology usage is pervasive in health centers. The respondents showed a moderately high degree of health information technology acceptance with a modest level of basic IT knowledge. There were no differences in degrees of acceptance among the four geographic regions. The mean score of "intention to use IT" was 5.6 on a scale of 7 and the average basic IT knowledge score was 13 out of 20. These results suggests the possibility of project success if the national health center information system projects are developed and implemented.
This article presents the findings of a 1995 family planning survey conducted among 657 women aged 18-49 years in rural areas of Tangshan City, Zhoushou City, and Xingtai City in Hebei province, Northern China. 620 were married, 37 were single, and 6 were widowed. 85.8% of married rural women used a contraceptive method (female sterilization or IUD). There were 1219 pregnancies, 230 abortions, 31 miscarriages, and 3 stillbirths. 68.1% received prenatal check-ups at hospitals and health centers. 47.4% received prenatal care during the first trimester of pregnancy. 76.1% received check-ups at township health centers. Women were aware of the need for sound personal hygiene, sanitary napkins, and avoidance of heavy manual work during menstruation. 45.1% had less than 5 years of education; 51.8% had 6-10 years of education; and 3.1% had over 10 years of education. About 54% delivered at home. Home deliveries were due to lack of transportation, high expenses, and other reasons. Deliveries were attended by a doctor or midwife. Postpartum home visits were not assured. 32.4% had routine gynecological check-ups. 48.1% had never received gynecological services. 51.6% of married women had 2 children; 16.9% had more. The author recommended improved socioeconomic and cultural conditions, a women-centered reproductive health security system integrated with education, and legislative change. Reproductive health education should be integrated into family planning programs and include health awareness and more education. Men should participate in programs and share more responsibility for reproduction. Services should improve in quality.
Sirio Rossano Secondo Cividino
Full Text Available The work in the agricultural sector has taken on a fundamental role in the last decades, due to the still too high rate of fatal injuries, workplace accidents, and dangerous occurrences reported each year. The average old age of agricultural machinery is one of the main issues at stake in Italy. Numerous safety problems stem from that; therefore, two surveys were conducted in two different periods, on current levels of work safety in agriculture in relation to agricultural machinery’s age and efficiency, and to show the levels of actual implementation of the Italian legislation on safety and health at work in the agricultural sector. The surveys were carried out, considering a sample of 161 farms located in the region Friuli Venezia Giulia (North-East of Italy. The research highlights the most significant difficulties the sample of farms considered have in enforcing the law. One hand, sanitary surveillance and workers’ information and training represent the main deficiencies and weakest points in family farms. Moreover, family farms do not generally provide the proper documentation concerning health and safety at workplaces, when they award the contract to other companies. On the other hand, lack of maintenance program for machinery and equipment, and of emergency plans and participation of workers’ health and safety representative, are the most common issues in farms with employees. Several difficulties are also evident in planning workers’ training programs. Furthermore, the company physician’s task is often limited to medical controls, so that he is not involved in risk assessment and training. Interviews in heterogeneous samples of farms have shown meaningful outcomes, which have subsequently been used to implement new databases and guidelines for Health and Safety Experts and courses in the field of Work Safety in agriculture. In conclusion, although the legislation making training courses for tractor operators and tractor
Agius, P A; Aitken, C K; Breen, C; Dietze, P M
We sought to establish the extent of repeat participation in a large annual cross-sectional survey of people who inject drugs and assess its implications for analysis. We used "porn star names" (the name of each participant's first pet followed by the name of the first street in which they lived) to identify repeat participation in three Australian Illicit Drug Reporting System surveys. Over 2013-2015, 2468 porn star names (96.2%) appeared only once, 88 (3.4%) twice, and nine (0.4%) in all 3 years. We measured design effects, based on the between-cluster variability for selected estimates, of 1.01-1.07 for seven key variables. These values indicate that the complex sample is (e.g.) 7% less efficient in estimating prevalence of heroin use (ever) than a simple random sample, and 1% less efficient in estimating number of heroin overdoses (ever). Porn star names are a useful means of tracking research participants longitudinally while maintaining their anonymity. Repeat participation in the Australian Illicit Drug Reporting System is low (less than 5% per annum), meaning point-prevalence and effect estimation without correction for the lack of independence in observations is unlikely to seriously affect population inference.
Acampora, Giovanni; Cook, Diane J.; Rashidi, Parisa; Vasilakos, Athanasios V.
Ambient Intelligence (AmI) is a new paradigm in information technology aimed at empowering people’s capabilities by the means of digital environments that are sensitive, adaptive, and responsive to human needs, habits, gestures, and emotions. This futuristic vision of daily environment will enable innovative human-machine interactions characterized by pervasive, unobtrusive and anticipatory communications. Such innovative interaction paradigms make ambient intelligence technology a suitable candidate for developing various real life solutions, including in the health care domain. This survey will discuss the emergence of ambient intelligence (AmI) techniques in the health care domain, in order to provide the research community with the necessary background. We will examine the infrastructure and technology required for achieving the vision of ambient intelligence, such as smart environments and wearable medical devices. We will summarize of the state of the art artificial intelligence methodologies used for developing AmI system in the health care domain, including various learning techniques (for learning from user interaction), reasoning techniques (for reasoning about users’ goals and intensions) and planning techniques (for planning activities and interactions). We will also discuss how AmI technology might support people affected by various physical or mental disabilities or chronic disease. Finally, we will point to some of the successful case studies in the area and we will look at the current and future challenges to draw upon the possible future research paths. PMID:24431472
Acampora, Giovanni; Cook, Diane J; Rashidi, Parisa; Vasilakos, Athanasios V
Ambient Intelligence (AmI) is a new paradigm in information technology aimed at empowering people's capabilities by the means of digital environments that are sensitive, adaptive, and responsive to human needs, habits, gestures, and emotions. This futuristic vision of daily environment will enable innovative human-machine interactions characterized by pervasive, unobtrusive and anticipatory communications. Such innovative interaction paradigms make ambient intelligence technology a suitable candidate for developing various real life solutions, including in the health care domain. This survey will discuss the emergence of ambient intelligence (AmI) techniques in the health care domain, in order to provide the research community with the necessary background. We will examine the infrastructure and technology required for achieving the vision of ambient intelligence, such as smart environments and wearable medical devices. We will summarize of the state of the art artificial intelligence methodologies used for developing AmI system in the health care domain, including various learning techniques (for learning from user interaction), reasoning techniques (for reasoning about users' goals and intensions) and planning techniques (for planning activities and interactions). We will also discuss how AmI technology might support people affected by various physical or mental disabilities or chronic disease. Finally, we will point to some of the successful case studies in the area and we will look at the current and future challenges to draw upon the possible future research paths.
Barnes, Michael D.; Wykoff, Randy; King, Laura Rasar; Petersen, Donna J.
The article provides an overview of efforts to improve public health and health education training and on the potential use of Critical Component Elements (CCEs) for undergraduate health education programs toward more consistent quality assurance across programs. Considered in the context of the Galway Consensus Conference, the authors discuss the…
Santric-Milicevic, Milena; Jankovic, Janko; Trajkovic, Goran; Terzic-Supic, Zorica; Babic, Uros; Petrovic, Marija
The global burden of mental disorders is rising. In Serbia, anxiety is the leading cause of disability-adjusted life years. Serbia has no mental health survey at the population level. The information on prevalence of mental disorders and related socioeconomic inequalities are valuable for mental care improvement. To explore the prevalence of mental health disorders and socioeconomic inequalities in mental health of adult Serbian population, and to explore whether age years and employment status interact with mental health in urban and rural settlements. Cross-sectional study. This study is an additional analysis of Serbian Health Survey 2006 that was carried out with standardized household questionnaires at the representative sample of 7673 randomly selected households - 15563 adults. The response rate was 93%. A multivariate logistic regression modeling highlighted the predictors of the 5 item Mental Health Inventory (MHI-5), and of chronic anxiety or depression within eight independent variables (age, gender, type of settlement, marital status and self-perceived health, education, employment status and Wealth Index). The significance level in descriptive statistics, chi square analysis and bivariate and multivariate logistic regressions was set at pinequalities contributed by differences in age, education, employment, marriage and the wealth status of the adult population.
Dietrich, Thomas; Culler, Corinna; Garcia, Raul I; Henshaw, Michelle M
The authors evaluated racial/ethnic differences and their socioeconomic determinants in the oral health status of U.S. children, as reported by parents. The authors used interview data from the 2003 National Survey of Children's Health, a large representative survey of U.S. children. They calculated weighted, nationally representative prevalence estimates for non-Hispanic whites, non-Hispanic blacks and Hispanics, and they used logistic regression to explore the association between parents' reports of fair or poor oral health and various socioeconomic determinants of oral health. The results showed significant racial/ethnic differences in parental reports of fair or poor oral health, with prevalences of 6.5 percent for non-Hispanic whites, 12.0 percent for non-Hispanic blacks and 23.4 percent for Hispanics. Although adjustments for family socioeconomic status (poverty level and education) partially explained these racial/ethnic disparities, Hispanics still were twice as likely as non-Hispanic whites to report their children's oral health as fair or poor, independent of socioeconomic status. The authors did find differences in preventive-care attitudes among groups. However, in multivariate models, such differences did not explain the disparities. Significant racial/ethnic disparities exist in parental reports of their children's oral health, with Hispanics being the most disadvantaged group. Disparities appear to exist independent of preventive-care attitudes and socioeconomic status.
Full Text Available Abstract Background The Breast Health Surveys, conducted by the National Breast Cancer Centre (NBCC in 1996 and 2003, are designed to gain insight into the knowledge, attitudes and behaviours of a nationally representative sample of Australian women on issues relevant to breast cancer. In this article, we focus on major aspects of the design and present results on respondents' knowledge about mammographic screening. Methods The 2003 BHS surveyed English-speaking Australian women aged 30–69 without a history of breast cancer using computer-assisted telephone interviewing. Questions covered the following themes: knowledge and perceptions about incidence, mortality and risk; knowledge and behaviour regarding early detection, symptoms and diagnosis; mammographic screening; treatment; and accessibility and availability of information and services. Respondents were selected using a complex sample design involving stratification. Sample weights against Australian population benchmarks were used in all statistical analyses. Means and proportions for the entire population and by age group and area of residence were calculated. Statistical tests were conducted using a level of significance of 0.01. Results Of the 3,144 respondents who consented to being interviewed, 138 (4.4% had a previous diagnosis of breast cancer and were excluded leaving 3,006 completed interviews eligible for analysis. A majority of respondents (61.1% reported ever having had a mammogram and 29.1% identified mammography as being the best way of finding breast cancer. A majority of women (85.9% had heard of the BreastScreen Australia (BSA program, the national mammographic screening program providing free biennial screening mammograms, with 94.5% believing that BSA attendance was available regardless of the presence or absence of symptoms. There have been substantial gains in women's knowledge about mammographic screening over the seven years between the two surveys. Conclusion The
Villanueva, Elmer V; Jones, Sandra; Nehill, Caroline; Favelle, Simone; Steel, David; Iverson, Donald; Zorbas, Helen
The Breast Health Surveys, conducted by the National Breast Cancer Centre (NBCC) in 1996 and 2003, are designed to gain insight into the knowledge, attitudes and behaviours of a nationally representative sample of Australian women on issues relevant to breast cancer. In this article, we focus on major aspects of the design and present results on respondents' knowledge about mammographic screening. The 2003 BHS surveyed English-speaking Australian women aged 30-69 without a history of breast cancer using computer-assisted telephone interviewing. Questions covered the following themes: knowledge and perceptions about incidence, mortality and risk; knowledge and behaviour regarding early detection, symptoms and diagnosis; mammographic screening; treatment; and accessibility and availability of information and services. Respondents were selected using a complex sample design involving stratification. Sample weights against Australian population benchmarks were used in all statistical analyses. Means and proportions for the entire population and by age group and area of residence were calculated. Statistical tests were conducted using a level of significance of 0.01. Of the 3,144 respondents who consented to being interviewed, 138 (4.4%) had a previous diagnosis of breast cancer and were excluded leaving 3,006 completed interviews eligible for analysis. A majority of respondents (61.1%) reported ever having had a mammogram and 29.1% identified mammography as being the best way of finding breast cancer. A majority of women (85.9%) had heard of the BreastScreen Australia (BSA) program, the national mammographic screening program providing free biennial screening mammograms, with 94.5% believing that BSA attendance was available regardless of the presence or absence of symptoms. There have been substantial gains in women's knowledge about mammographic screening over the seven years between the two surveys. The NBCC Breast Health Surveys provide a valuable picture of the
Kessler, Ronald C.; Aguilar-Gaxiola, Sergio; Alonso, Jordi; Chatterji, Somnath; Lee, Sing; Ormel, Johan; Uestuen, T. Bedirhan; Wang, Philip S.
Aims - The paper reviews recent findings from the WHO World Mental Health (WMH) surveys oil the global burden of mental disorders. Methods - The WMH surveys are representative community surveys in 28 countries throughout the world aimed at providing information to mental health policy makers about
Nicholas Ralstion; Laura Raymond
Exposure to mercury (Hg) commonly results from eating fish containing bioaccumulated methylmercury (MeHg). However, conflicting observations and conclusions have arisen from the ongoing human studies of MeHg exposure from fish consumption. Resolving these uncertainties has important implications for human health since significant nutritional benefits will be lost if fish consumption is needlessly avoided. Selenium (Se), an important nutrient that is abundant in ocean fish, has a potent protective effect against Hg toxicity. This protective effect was thought to be due to the high binding affinities between Hg and Se resulting in Se sequestration of Hg to prevent its harmful effects. However, it is imperative to consider the opposing effect of Hg on Se physiology. Crucial proteins that require Se normally protect the brain and hormone-producing glands from oxidative damage. MeHg is able to cross all biological barriers and enter cells in these tissues, where its high Se affinity results in Se sequestration. Sequestration in association with Hg prevents Se from participating in proteins that perform essential antioxidant activities. Supplemental dietary Se is able to replace Se sequestered by Hg and maintain normal antioxidant protection of brain and glands. The goal of this research project was to assess the potency of normal dietary levels of Se in protection against MeHg toxicity. Results from this project indicate that MeHg toxicity is only evident in situations resulting in Hg occurring in high molar excess of Se. Additionally, the common method of MeHg risk assessments using measurements of toenail and blood levels of Hg was shown to provide an accurate reflection of Hg exposure but did not accurately indicate risk of toxicity resulting from that exposure. Instead, Hg:Se molar ratios are proposed as a superior means of assessing risks associated with MeHg exposure.
Full Text Available Incidence and mortality rates of colorectal carcinoma (CRC are higher in African Americans (AAs than in Caucasian Americans (CAs. Deficient micronutrient intake due to dietary restrictions in racial/ethnic populations can alter genetic and molecular profiles leading to dysregulated methylation patterns and the inheritance of somatic to germline mutations.Total DNA and RNA samples of paired tumor and adjacent normal colon tissues were prepared from AA and CA CRC specimens. Reduced Representation Bisulfite Sequencing (RRBS and RNA sequencing were employed to evaluate total genome methylation of 5'-regulatory regions and dysregulation of gene expression, respectively. Robust analysis was conducted using a trimming-and-retrieving scheme for RRBS library mapping in conjunction with the BStool toolkit.DNA from the tumor of AA CRC patients, compared to adjacent normal tissues, contained 1,588 hypermethylated and 100 hypomethylated differentially methylated regions (DMRs. Whereas, 109 hypermethylated and 4 hypomethylated DMRs were observed in DNA from the tumor of CA CRC patients; representing a 14.6-fold and 25-fold change, respectively. Specifically; CHL1, 4 anti-inflammatory genes (i.e., NELL1, GDF1, ARHGEF4, and ITGA4, and 7 miRNAs (of which miR-9-3p and miR-124-3p have been implicated in CRC were hypermethylated in DNA samples from AA patients with CRC. From the same sample set, RNAseq analysis revealed 108 downregulated genes (including 14 ribosomal proteins and 34 upregulated genes (including POLR2B and CYP1B1 [targets of miR-124-3p] in AA patients with CRC versus CA patients.DNA methylation profile and/or products of its downstream targets could serve as biomarker(s addressing racial health disparity.
Bruns, Deborah; Martinez, Alyssa; Campbell, Emily All
The purpose of this study was to examine oral health needs and dental care in individuals with trisomy 18 and trisomy 13 (full, mosaic, partial and other, mixed types). Primary feeding method was also examined. Data was collected from a parent-completed, mixed method survey (TRIS Survey). Mean age in months was 120.2 (range 38 to 394 months) and 133 (range 36 to 405 months), respectively, for trisomy 18 and trisomy 13 individuals. Results indicated the majority of individuals received routine dental care from their family dentist. Approximately 80% in both groups needed some form of specialized dental care. Close to 25% and 30% of trisomy 18 and trisomy 13 individuals, respectively, required hospital admission for specialized dental care. Responses indicated the presence of excessive plaque and tooth decay across the groups with a higher incidence for individuals with trisomy 13. Although not the primary form of intake, over half of the individuals received oral feedings. Implications for dental care and management are provided along with the need for additional research to confirm or disconfirm this study's findings. © 2015 Special Care Dentistry Association and Wiley Periodicals, Inc.
Karpur, Arun; Bruyere, Susanne M.
Workplace health-promotion programs have the potential to reduce health care expenditures, especially among people with disabilities. Utilizing nationally representative survey data, the authors provide estimates for health care expenditures related to secondary conditions, obesity, and health behaviors among working-age people with disabilities.…
Background: Although health information is of great interest and plays an important role in almost all media, there are very few studies on the actual work of health journalists. Methods: A quantitative online survey with qualitative elements on the definition and use of storytelling in health journalism was carried out among members of various professional journalists' associations (n=86). Results: The results suggest that health journalists understand storytelling especially as a term used when an article has a dramatic construction, and the story is about real people. As reasons for using storytelling, health journalists primarily name the understandable and clear presentation of medical issues. They see better chances for identification and establishing a relationship to the readers' lives. Of particular importance seems to be that narrative elements do not distort the facts and protect the privacy rights of persons mentioned in case reports. © Georg Thieme Verlag KG Stuttgart · New York.
Malhotra, Chetna; Malhotra, Rahul; Østbye, Truls; Subramanian, S V
The objective of this study was to examine the association of maternal autonomy with preventive and curative child health care utilization in India. Data from the National Family Health Survey 2005-2006 were used to ascertain association of maternal autonomy (in 3 dimensions: decision making, access to financial resources, freedom of movement) with child's primary immunization status (indicative of preventive health care use) and treatment seeking for child's acute respiratory infection (indicative of curative health care use). Low maternal freedom of movement was associated with higher odds of incomplete primary immunization of the child and for not seeking treatment for the child's acute respiratory infection. Low maternal financial access was associated with increased odds for incomplete primary immunization of the child. The findings show that improvement in autonomy of Indian mothers, especially their freedom of movement, may help improve utilization of health care for their children. © 2012 APJPH.
O'Sullivan, Elizabeth; Cutts, Emily; Kavikondala, Sushma; Salcedo, Alejandra; D'Souza, Karan; Hernandez-Torre, Martin; Anderson, Claire; Tiwari, Agnes; Ho, Kendall; Last, Jason
Social media is an asset that higher education students can use for an array of purposes. Studies have shown the merits of social media use in educational settings; however, its adoption in health science education has been slow, and the contributing reasons remain unclear. This multidisciplinary study aimed to examine health science students' opinions on the use of social media in health science education and identify factors that may discourage its use. Data were collected from the Universitas 21 "Use of social media in health education" survey, distributed electronically among the health science staff and students from 8 universities in 7 countries. The 1640 student respondents were grouped as users or nonusers based on their reported frequency of social media use in their education. Of the 1640 respondents, 1343 (81.89%) use social media in their education. Only 462 of the 1320 (35.00%) respondents have received specific social media training, and of those who have not, the majority (64.9%, 608/936) would like the opportunity. Users and nonusers reported the same 3 factors as the top barriers to their use of social media: uncertainty on policies, concerns about professionalism, and lack of support from the department. Nonusers reported all the barriers more frequently and almost half of nonusers reported not knowing how to incorporate social media into their learning. Among users, more than one fifth (20.5%, 50/243) of students who use social media "almost always" reported sharing clinical images without explicit permission. Our global, interdisciplinary study demonstrates that a significant number of students across all health science disciplines self-reported sharing clinical images inappropriately, and thus request the need for policies and training specific to social media use in health science education. ©Elizabeth O'Sullivan, Emily Cutts, Sushma Kavikondala, Alejandra Salcedo, Karan D'Souza, Martin Hernandez-Torre, Claire Anderson, Agnes Tiwari, Kendall
Moore, W B
Each day as Americans prepare to begin their days, many put on their clothing often without a thought as to how or where it was manufactured. The manufacture of clothing in the United States is a labor intensive industry pressed by competition in foreign countries where labor is abundant and less expensive; therefore, the manufacturers must look for every opportunity to reduce their costs. The survey presented here reviews the health benefit plans in the apparel industry and current initiatives for cost reduction. The results are interesting, for they give the hospital administrator vital information on the types of programs that might be in place in local manufacturers and the method of cost containment expected in this industry.
Sirirassamee, Tawima; Sirirassamee, Buppha
This study aims to establish the prevalence of risky health behaviors among Thai youth and to characterize the prevalence of these behaviors by gender, age group, educational status, and region. We analyzed data from a population-based, nationally representative, cross-sectional survey of 938 youth aged between 13 and 24 years, sampled from Bangkok and 4 regions of Thailand. The 2011 Youth Risk Behavior Surveillance System questionnaire was used to measure youth risk behaviors. This study finds that 15.9% of respondents had engaged in physical fights, and 8.1% had been cyber bullied. The prevalence of current cigarette smoking, alcohol, and marijuana use were 22.3%, 27.9%, and 2.3%, respectively. The prevalence of risky behaviors among Thai youth were found to be high, including behaviors that contribute to unintentional injuries and violence, unsafe sexual behaviors, and cigarette and alcohol consumption. © 2014 APJPH.
Doshi, V.B.; Gregat, I.K.; Kamat, S.R.; Papewar, V.N.; Raikar, U.R.; Sharma, S.M.; Ganatra, R.D.
As a part of health survey in relation to air pollution, 16 smokers(11 from 'high' and 5 from 'low' zone) were studied with extensive serial lung functions, chest radiography and radioaerosol lung scanning. The clinical diagnosis were chronic bronchitis(COPD) in 9 subjects; but others (4 'High' and 3 'Low') were considered normal. The values of FVC, FEV were normal in most of these three groups, but FEV 1 /FVC percent values were lower in subjects from 'high' zone.The functional declines were higher in normals of 'high' zone. Radioaerosol (ventilation) scans (with technetium 99 ) showed a normal picture in 2 COPD and 3 normal subjects; in 3 COPD and 1 normal subjects the abnormalities were definite. For perfusion scans, 2 COPD and 3 normal subjects showed a normal pattern while definite abnormalities were seen in 1 COPD and 1 normal subjects. Lung scans may pick up abnormalities in normal smokers at an early stage. (author)
This report presents findings of the 1996 Peru Demographic and Health Survey among 28,951 women 15-49 years old and 2487 men 15-59 years old. Fertility was 3.5 children/woman (5.6 in rural and 2.8 in urban areas). Fertility ranged from 2.1 among higher educated women to 6.9 among women with no formal education. 41.7% wanted the births in the 5 years preceding the survey. 23.2% wanted the birth later. 34.8% wanted no more births. A high percentage of women with 3 or more children wanted no more children. 22.9% currently used modern contraceptive methods. 41.3% used traditional methods. Contraceptive prevalence peaked at ages 35-39 years at 72.9%. Prevalence was 46.0% at 15-19 years old and 40.9% at 45-49 years old. 12% used the IUD. 18% used periodic abstinence. 42.7% of nonusers were menopausal. 12.4% were subfecund. 7.5% feared side effects. The median age at first birth was 21.5 years. Infant mortality was 43/100,000. Infant mortality was very high among rural and uneducated women. Only 1.1% were moderately to severely undernourished, but 25.8% were moderately to severely chronically undernourished.
Buka, Irena; Rogers, W Todd; Osornio-Vargas, Alvaro R; Hoffman, Harold; Pearce, Marni; Li, Yuen Yee
OBJECTIVES To conduct a survey in Edmonton, Alberta, to gather information regarding concerns about the influence of environmental factors on children’s health and to use the information to set an agenda for the resources of the Paediatric Environmental Health Specialty Unit at Misericordia Hospital (Edmonton, Alberta). METHODS Two questionnaires with 28 closed-ended questions were developed to examine parents’, guardians’ and health care professionals’ concerns. They comprised items about six environmental factors (air, water and food quality; household supplies; radiation; and waste disposal). Health care professionals were also asked four questions about their knowledge of and their needs in Paediatric Environmental Health. Parents and guardians attending the public health centres and nurses working therein received questionnaires. Physicians were surveyed by e-mail. RESULTS After verification, the questionnaire data from 400 parents or guardians and 152 health care professionals were used for analyses. Results from contingency table, Hotelling’s T2 and effect size analyses revealed similarities in the levels of concern in both groups, and the results were combined. The greatest concern of both groups was with environmental tobacco smoke, followed by pesticides in water. Concerns about six additional environmental elements were also expressed. The health care professionals showed a high level of concern about the need for resources, specific training and public education regarding paediatric environmental health. CONCLUSION A significant level of concern was consistently found between the two groups studied, regardless of professional training. The highest level of concern was with a well-documented topic (ie, environmental tobacco smoke). Less concern associated with decreased documentation calls for increasing the knowledge of society, including health care professionals, to address the adverse effects of environmental factors on children. PMID
Tonso, Michael A; Prematunga, Roshani Kanchana; Norris, Stephen J; Williams, Lloyd; Sands, Natisha; Elsom, Stephen J
The international literature suggests workplace violence in mental health settings is a significant issue, yet little is known about the frequency, nature, severity and health consequences of staff exposure to violence in Australian mental health services. To address this gap, we examined these aspects of workplace violence as reported by mental health services employees in Victoria, Australia. The project used a cross-sectional, exploratory descriptive design. A random sample of 1600 Health and Community Services Union members were invited to complete a survey investigating exposure to violence in the workplace, and related psychological health outcomes. Participants comprised employees from multiple disciplines including nursing, social work, occupational therapy, psychology and administration staff. A total of 411 members responded to the survey (26% response rate). Of the total sample, 83% reported exposure to at least one form of violence in the previous 12 months. The most frequently reported form of violence was verbal abuse (80%) followed by physical violence (34%) and then bullying/mobbing (30%). Almost one in three victims of violence (33%) rated themselves as being in psychological distress, 54% of whom reported being in severe psychological distress. The more forms of violence to which victims were exposed, the greater the frequency of reports of psychological distress. Workplace violence is prevalent in mental health facilities in Victoria. The nature, severity and health impact of this violence represents a serious safety concern for mental health employees. Strategies must be considered and implemented by healthcare management and policy makers to reduce and prevent violence. © 2016 Australian College of Mental Health Nurses Inc.
Baum, Nancy M; DesRoches, Catherine; Campbell, Eric G; Goold, Susan Dorr
The purpose of this study was to gain an empirical understanding of the types of allocation decisions local health officials (LHOs) make and the factors that influence those allocation decisions. We conducted a national survey of LHOs in the United States in 2008 to 2009. The sample was stratified by the size of the population served by the department. We merged our data with data from the 2008 National Association of County and City Health Officials Profile survey. Descriptive statistics were generated using weighted data. Our final sample size was 608 respondents, with an average of 10 years experience. The LHOs reported little shifting of resources among population groups but greater capacity to redirect staffing time. Less than half of LHOs reported using economic analyses or conducting needs assessments when setting priorities. Having sole provider status in a community strongly influenced LHOs' allocation decisions. In addition, the effectiveness of activities, previous budget allocations, and input from boards of health were influential factors in allocation decisions. Public expectations were moderately to very influential, but direct public input had a low impact on allocation decisions. Survey findings provide a clearer understanding of how LHOs fulfill their obligations as stewards of public health resources and ensure effective activities and access to needed services. It may be useful to assess the value of more structured allocation methods (eg, decision frameworks) in the allocation process. Expanding opportunities for public engagement in priority setting may also be valuable for difficult allocation decisions.
Wilkinson, Joanne E.; Saper, Robert B.; Rosen, Amy K.; Welles, Seth L.; Culpepper, Larry
Background and Objectives Prayer for health (PFH) is common; in 2002, 35% of US adults prayed for their health. We examined the relationship of PFH and primary care visits, with a special focus on African American women, using data from the 2002 National Health Interview Survey (NHIS). Methods We used chi-square analyses to compare the demographic (age group, gender, race, region, marital status, educational level, ethnicity) and health-related covariates (alcohol use, smoking status, and selected medical conditions) between individuals who did and did not pray for their health in the past year. Univariate associations between PFH and visit to primary care provider (PCP), with Mantel-Haenszel adjustment for confounding, were determined. Multivariate regression was used to determine independent factors associated with PFH and PCP visit, with SUDAAN to adjust for the clustered survey design. Results Subjects who prayed were more likely to be female, older than 58, Black, Southern, separated, divorced or widowed, and nondrinkers. Subjects who prayed were also more likely to have seen a PCP within the past year. Black women who prayed were also more likely to see a PCP. Conclusions These findings suggest that people who pray for their health do so in addition to, not instead of, seeking primary care. This finding is maintained but with a smaller effect size, in Black women. PMID:18830839
Ch. M. Kristanti
Full Text Available A series of National Household Health Surveys (NHHS reported the occurrence of epidemiological transition caused by demographic transition and prolonged economical diversity, Communicable diseases are still prevalent, followed by the emergence of Non Communicable Diseases (NCDs, which are due to an increasing level of behavior risk factors in the population. In the NHHS 2001, a morbidity survey collected information about behavioral risk indicators, whereas the WHO'S STEPwise approach was one of the study instruments. The 'WHO Step 1 questionnaire' was adapted with some modifications. Samples of NHHS, morbidity survey was sub-sample of module sample of National Social Economic Survey (NSES 2001. A sample of 15,148 people aged 10 years+ were analyzed to identify their behavior regarding smoking, alcohol consumption and physical activity. These findings are a representation of the national figures, which were presented by characteristics of the population such as: sex, age, residence, region and economic status. Economic status was divided into 5 strata, which were calculated from a quintile of household expenditure. The results showed that 29.7% of the population aged 10 years+ are daily smokers. This is more prevalent in males than females (58.9% vs. 3.7%. This behavior increases by age group, except for the oldest; there are slightly more smokers in rural areas than urban areas (31% vs. 28%, and no difference among regions (30-31%. Those with better economic status are less likely to smoke than poorer ones. Alcohol consumption is reportedly very low (2.7%, more prevalent in males than females (4.9% vs. 0.8%, and higher in rural areas than urban areas (3.1% vs. 2.1%. Eastern Indonesia, was higher than Sumatra, Java and Bali (6.3%, 4.7%, and 1.2% respectively. There were no differences in alcohol consumption according to economic status'.' Physical inactivity is very high (68%, more prevalent in females than males (73% vs. 63%, and higher in
Lebrun-Harris, Lydie A; Baggett, Travis P; Jenkins, Darlene M; Sripipatana, Alek; Sharma, Ravi; Hayashi, A Seiji; Daly, Charles A; Ngo-Metzger, Quyen
Objective To examine health status and health care experiences of homeless patients in health centers and to compare them with their nonhomeless counterparts. Data Sources/Study Setting Nationally representative data from the 2009 Health Center Patient Survey. Study Design Cross-sectional analyses were limited to adults (n = 2,683). We compared sociodemographic characteristics, health conditions, access to health care, and utilization of services among homeless and nonhomeless patients. We also examined the independent effect of homelessness on health care access and utilization, as well as factors that influenced homeless patients' health care experiences. Data Collection Computer-assisted personal interviews were conducted with health center patients. Principal Findings Homeless patients had worse health status—lifetime burden of chronic conditions, mental health problems, and substance use problems—compared with housed respondents. In adjusted analyses, homeless patients had twice the odds as housed patients of having unmet medical care needs in the past year (OR = 1.98, 95 percent CI: 1.24–3.16) and twice the odds of having an ED visit in the past year (OR = 2.00, 95 percent CI: 1.37–2.92). Conclusions There is an ongoing need to focus on the health issues that disproportionately affect homeless populations. Among health center patients, homelessness is an independent risk factor for unmet medical needs and ED use. PMID:23134588
Abstract The United States Supreme Court's Obergefell vs. Hodges groundbreaking marriage equality decision also created new terrain for lesbian, gay, bisexual, and transgender (LGBT) persons regarding health, healthcare, and health benefits. This article addresses the health implications of this decision by examining its impact on minority stress and stigmatization and health-related benefits. It also includes a discussion of several impending issues affecting LGBT health that remain after Obergefell. PMID:26788668
Beacham, Barbara L.; Deatrick, Janet A.
Synopsis Health care autonomy typically occurs during late adolescence but health care providers and families often expect children with chronic health conditions to master self-care earlier. Few studies have examined the development of health care autonomy as it pertains to self-care and family management. This review will link the three concepts and discuss implications for families and health care providers. Case studies are provided as exemplars to highlight areas where intervention and research is needed. PMID:23659815
Fu, Xu-ying; Yu, Bin; Zhang, Chun-ping; Zheng, Guan-hua; Bai, Lan; Zhang, Pan-pan
To investigate the occupational health of the workers simultaneously exposed to acrylonitrile, epoxyethane, epoxypropane, and styrene. A questionnaire survey was conducted in 70 front-line workers simultaneously exposed to acrylonitrile, epoxyethane, epoxypropane, and styrene (exposure group) and 50 managers (control group) in a polyether manufacturer; in addition, air monitoring at workplace and occupational health examination were also performed. The obtained data were analyzed. The female workers in exposure group and the spouses of male workers in exposure group had significantly higher spontaneous abortion rates than their counterparts in control group (P polyether-exposed working years had significantly higher mean levels of DNA damage than the control group (P polyether-exposed working years and those with not less than 20 polyether-exposed working years had significantly higher mean micronucleus rates than the control group (P polyether-exposed working years (P > 0.05); the workers with not less than 5 and less than 20 polyether-exposed working years and workers with not less than 20 polyether-exposed working years had significantly higher mean micronucleus rates than those with less than 5 polyether-exposed working years (P polyether manufacturer.
Woersching, Joanna C; Snyder, Audrey E
This is the first article in a series that evaluates the health concerns of people living in a Salvadoran rural community after major earthquakes. Part I reviews the background, methods, and results of post-earthquake conditions with regards to healthcare, access to healthcare, housing, food, water and sanitation. Part II reviews the implications of these results and recommendations for improvements within the community. Part III investigates the psychosocial and mental health consequences of the earthquakes and provides suggestions for improved mental health awareness, assessment, and intervention. El Salvador experienced 2 major earthquakes in January and February 2001. This study evaluates the effects of the earthquakes on the health practices in the rural town of San Sebastian. The research was conducted with use of a convenience sample survey of subjects affected by the earthquakes. The sample included 594 people within 100 households. The 32-question survey assessed post-earthquake conditions in the areas of health care and access to care, housing, food and water, and sanitation. Communicable diseases affected a number of family members. After the earthquakes, 38% of households reported new injuries, and 79% reported acute exacerbations of chronic illness. Rural inhabitants were 30% more likely to have an uninhabitable home than were urban inhabitants. Concerns included safe housing, water purification, and waste elimination. The findings indicate a need for greater public health awareness and community action to adapt living conditions after a disaster and prevent the spread of communicable disease.
Redmayne, Mary; Smith, Euan; Abramson, Michael J
We explored school cellphone rules and adolescent exposure to cellphone microwave emissions during school with a census and survey, respectively. The data were used to assess health and policy implications through a review of papers assessing reproductive bio-effects after exposure to cellphone emissions, this being most relevant to students' exposure. All schools banned private use of cellphones in class. However, 43% of student participants admitted breaking this rule. A high-exposure group of risk-takers was identified for whom prohibited in-school use was positively associated with high texting rates, carrying the phone switched-on >10h/day, and in-pocket use. The fertility literature is inconclusive, but increasingly points towards significant time- and dose-dependent deleterious effects from cellphone exposure on sperm. Genotoxic effects have been demonstrated from 'non-thermal' exposures, but not consistently. There is sufficient evidence and expert opinion to warrant an enforced school policy removing cellphones from students during the day. Copyright Â© 2011 Elsevier Inc. All rights reserved.
Sandfort, T.G.M.; Bakker, F.; Schellevis, F.G.; Vanwesenbeeck, I.
OBJECTIVES: We sought to determine whether sexual orientation is related to mental and physical health and health behaviors in the general population. METHODS: Data was derived from a health interview survey that was part of the second Dutch National Survey of General Practice, carried out in 2001
Sheridan, Nicolette F; Kenealy, Timothy W; Connolly, Martin J; Mahony, Faith; Barber, P Alan; Boyd, Mary Anne; Carswell, Peter; Clinton, Janet; Devlin, Gerard; Doughty, Robert; Dyall, Lorna; Kerse, Ngaire; Kolbe, John; Lawrenson, Ross; Moffitt, Allan
In all countries people experience different social circumstances that result in avoidable differences in health. In New Zealand, Māori, Pacific peoples, and those with lower socioeconomic status experience higher levels of chronic illness, which is the leading cause of mortality, morbidity and inequitable health outcomes. Whilst the health system can enable a fairer distribution of good health, limited national data is available to measure health equity. Therefore, we sought to find out whether health services in New Zealand were equitable by measuring the level of development of components of chronic care management systems across district health boards. Variation in provision by geography, condition or ethnicity can be interpreted as inequitable. A national survey of district health boards (DHBs) was undertaken on macro approaches to chronic condition management with detail on cardiovascular disease, chronic obstructive pulmonary disease, congestive heart failure, stroke and diabetes. Additional data from expert informant interviews on program reach and the cultural needs of Māori and Pacific peoples was sought. Survey data were analyzed on dimensions of health equity relevant to strategic planning and program delivery. Results are presented as descriptive statistics and free text. Interviews were transcribed and NVivo 8 software supported a general inductive approach to identify common themes. Survey responses were received from the majority of DHBs (15/21), some PHOs (21/84) and 31 expert informants. Measuring, monitoring and targeting equity is not systematically undertaken. The Health Equity Assessment Tool is used in strategic planning but not in decisions about implementing or monitoring disease programs. Variable implementation of evidence-based practices in disease management and multiple funding streams made program implementation difficult. Equity for Māori is embedded in policy, this is not so for other ethnic groups or by geography. Populations
Full Text Available Abstract Introduction In all countries people experience different social circumstances that result in avoidable differences in health. In New Zealand, Māori, Pacific peoples, and those with lower socioeconomic status experience higher levels of chronic illness, which is the leading cause of mortality, morbidity and inequitable health outcomes. Whilst the health system can enable a fairer distribution of good health, limited national data is available to measure health equity. Therefore, we sought to find out whether health services in New Zealand were equitable by measuring the level of development of components of chronic care management systems across district health boards. Variation in provision by geography, condition or ethnicity can be interpreted as inequitable. Methods A national survey of district health boards (DHBs was undertaken on macro approaches to chronic condition management with detail on cardiovascular disease, chronic obstructive pulmonary disease, congestive heart failure, stroke and diabetes. Additional data from expert informant interviews on program reach and the cultural needs of Māori and Pacific peoples was sought. Survey data were analyzed on dimensions of health equity relevant to strategic planning and program delivery. Results are presented as descriptive statistics and free text. Interviews were transcribed and NVivo 8 software supported a general inductive approach to identify common themes. Results Survey responses were received from the majority of DHBs (15/21, some PHOs (21/84 and 31 expert informants. Measuring, monitoring and targeting equity is not systematically undertaken. The Health Equity Assessment Tool is used in strategic planning but not in decisions about implementing or monitoring disease programs. Variable implementation of evidence-based practices in disease management and multiple funding streams made program implementation difficult. Equity for Māori is embedded in policy, this is not so
Robertson, Susan E; Valadez, Joseph J
We conducted a global review on the use of lot quality assurance sampling (LQAS) to assess health care services, health behaviors, and disease burden. Publications and reports on LQAS surveys were sought from Medline and five other electronic databases; the World Health Organization; the World Bank; governments, nongovernmental organizations, and individual scientists. We identified a total of 805 LQAS surveys conducted by different management groups during January 1984 through December 2004. There was a striking increase in the annual number of LQAS surveys conducted in 2000-2004 (128/year) compared with 1984-1999 (10/year). Surveys were conducted in 55 countries, and in 12 of these countries there were 10 or more LQAS surveys. Geographically, 317 surveys (39.4%) were conducted in Africa, 197 (28.5%) in the Americas, 115 (14.3%) in the Eastern Mediterranean, 114 (14.2%) in South-East Asia, 48 (6.0%) in Europe, and 14 (1.8%) in the Western Pacific. Health care parameters varied, and some surveys assessed more than one parameter. There were 320 surveys about risk factors for HIV/AIDS/sexually transmitted infections; 266 surveys on immunization coverage, 240 surveys post-disasters, 224 surveys on women's health, 142 surveys on growth and nutrition, 136 surveys on diarrheal disease control, and 88 surveys on quality management. LQAS surveys to assess disease burden included 23 neonatal tetanus mortality surveys and 12 surveys on other diseases. LQAS is a practical field method which increasingly is being applied in assessment of preventive and curative health services, and may offer new research opportunities to social scientists. When LQAS data are collected recurrently at multiple time points, they can be used to measure the spatial variation in behavior change. Such data provide insight into understanding relationships between various investments in social, human, and physical capital, and into the effectiveness of different public health strategies in achieving
Seiber, Eric E; Hotchkiss, David R; Rous, Jeffrey J; Berruti, Andrés A
Does the utilization of modern maternal and child health (MCH) services influence subsequent contraceptive use? The answer to this question holds important implications for proposals which advocate MCH and family planning service integration. This study uses data from the 1995/6 Guatemalan Demographic Health Survey and its 1997 Providers Census to test the influence of MCH service utilization on individual contraceptive use decisions. We use a full-information maximum likelihood regression model to control for unobserved heterogeneity. This model produces estimates of the MCH effect, independent of individual women's underlying receptiveness to MCH and contraceptive messages. The results of the analysis indicate that the intensity of MCH service use is indeed positively associated with subsequent contraceptive use among Guatemalan women, even after controlling for observed and unobserved individual- , household- , and community-level factors. Importantly, this finding holds even after controlling for the unobserved factors that 'predispose' some women to use both types of services. Simulations reveal that, for these Guatemalan women, key determinants such as age and primary schooling work indirectly through MCH service use to increase contraceptive utilization.
Karam, Elie G.; Friedman, Matthew J.; Hill, Eric D.; Kessler, Ronald C.; McLaughlin, Katie A.; Petukhova, Maria; Sampson, Laura; Shahly, Victoria; Angermeyer, Matthias C.; Bromet, Evelyn J.; de Girolamo, Giovanni; de Graaf, Ron; Demyttenaere, Koen; Ferry, Finola; Florescu, Silvia E.; Haro, Josep Maria; He, Yanling; Karam, Aimee N.; Kawakami, Norito; Kovess-Masfety, Viviane; Medina-Mora, María Elena; Browne, Mark A. Oakley; Posada-Villa, José A.; Shalev, Arieh Y.; Stein, Dan J.; Viana, Maria Carmen; Zarkov, Zahari; Koenen, Karestan C.
Background Clinical research suggests that posttraumatic stress disorder (PTSD) patients exposed to multiple traumatic events (TEs) rather than a single TE have increased morbidity and dysfunction. Although epidemiological surveys in the United States and Europe also document high rates of multiple TE exposure, no population-based cross-national data have examined this issue. Methods Data were analyzed from 20 population surveys in the World Health Organization World Mental Health Survey Initiative (n 51,295 aged 18+). The Composite International Diagnostic Interview (3.0) assessed 12-month PTSD and other common DSM-IV disorders. Respondents with 12-month PTSD were assessed for single versus multiple TEs implicated in their symptoms. Associations were examined with age of onset (AOO), functional impairment, comorbidity, and PTSD symptom counts. Results 19.8% of respondents with 12-month PTSD reported that their symptoms were associated with multiple TEs. Cases who associated their PTSD with four or more TEs had greater functional impairment, an earlier AOO, longer duration, higher comorbidity with mood and anxiety disorders, elevated hyper-arousal symptoms, higher proportional exposures to partner physical abuse and other types of physical assault, and lower proportional exposure to unexpected death of a loved one than cases with fewer associated TEs. Conclusions A risk threshold was observed in this large-scale cross-national database wherein cases who associated their PTSD with four or more TEs presented a more “complex” clinical picture with substantially greater functional impairment and greater morbidity than other cases of PTSD. PTSD cases associated with four or more TEs may merit specific and targeted intervention strategies. Depression and Anxiety 31:130–142, 2014. PMID:23983056
Schafer, Tim; Wood, Steve; Williams, Rena
This paper reports on a survey of attitudes to mental illness that was completed with a cohort of pre-registration nurses in 2007 in a large university in Essex. The background literature highlights the effects of attitudes on stigma, disadvantage and discrimination and presents a brief review of the literature on cultural variations in attitudes. It also briefly reviews the attitudes of health professionals to mental illness. A survey using the Community Attitudes to Mental Illness questionnaire was completed and ethnicity proved to be an important factor in accounting for variations in attitudes to mental illness. The Black and Black British group displayed less positive attitudes across all nursing branches when compared to the white group. The differences raised questions about how best nurse training can prepare nurses to practice in culturally sensitive ways that acknowledge the beliefs of patients whilst avoiding stereotyping and discrimination. Personal contact with someone with mental illness was also found to be a significant factor and the importance of user involvement in training is discussed. The paper concludes with some recommendations for nurse training that include greater use of teaching strategies that challenge beliefs and assumptions and promote a commitment to multicultural mental health practice. Copyright © 2010 Elsevier Ltd. All rights reserved.
Full Text Available A comprehensive feline health survey was conducted to reveal breed-specific inheritable diseases in Finnish pedigree cats for genetic research. Prevalences of 19 disease categories and 227 feline diseases were defined in a study population of 8175 cats belonging to 30 breeds. Dental and oral diseases with a prevalence of 28% and dental calculus and gingivitis (21% and 8%, respectively were the most prevalent disease category and diseases among all cats and in most of the breeds. An exception was Korats, which were more often affected by the diseases of the respiratory tract (23% and asthma (19%. Other prevalent disease categories affected various organ systems such as the skin (12%, the urinary system (12%, the digestive tract (11%, eyes, (10%, the musculoskeletal system (10%, and genitals of female cats (17%. Prevalent health or developmental issues included repetitive vomiting (4%, tail kink (4%, feline odontoclastic resorption lesion (FORL (4%, urinary tract infections (4%, as well as caesarean section (6% and stillborn kittens (6% among female cats. We found 57 breed-specific conditions by Fisher’s exact tests and logistic regression analyses, including 32 previously described and 19 new breed-specific diseases. The genetic defect has already been found in six of them: polycystic kidney disease (PKD, progressive retinal atrophy (PRA, hypertrophic cardiomyopathy (HCM and three types of tail malformations. Behavioral profiling revealed breed-specific traits, such as an increased human avoidance in British Short and Longhairs and a higher level of aggression in Turkish vans. Our epidemiological study reveals the overall health profile in Finnish pure and mixed breed cats and identifies many breed-specific conditions without molecular identity for genetic research.
Evans, David S.
n order to gain a measure of the health and wellbeing of staff in the Health and Wellbeing Division a survey was undertaken in late 2015 with results contained in this report. It highlights the areas that we are doing well in and identifies a number of areas where improvements are needed. The results and suggestions given provide a benchmark as to the current health and wellbeing status of those in our Division and pave the way for a set of recommendations which will be delivered through the action plan currently being developed. As a starting point and in recognition of the fact that many of our staff are based in other cross divisional worksites, the Staff Health and Wellbeing Funding Initiative 2016 was introduced.
Roelen, Corné; Thorsen, Sannie; Heymans, Martijn; Twisk, Jos; Bültmann, Ute; Bjørner, Jakob
The purpose of this study is to develop and validate a prediction model for identifying employees at increased risk of long-term sickness absence (LTSA), by using variables commonly measured in occupational health surveys. Based on the literature, 15 predictor variables were retrieved from the DAnish National working Environment Survey (DANES) and included in a model predicting incident LTSA (≥4 consecutive weeks) during 1-year follow-up in a sample of 4000 DANES participants. The 15-predictor model was reduced by backward stepwise statistical techniques and then validated in a sample of 2524 DANES participants, not included in the development sample. Identification of employees at increased LTSA risk was investigated by receiver operating characteristic (ROC) analysis; the area-under-the-ROC-curve (AUC) reflected discrimination between employees with and without LTSA during follow-up. The 15-predictor model was reduced to a 9-predictor model including age, gender, education, self-rated health, mental health, prior LTSA, work ability, emotional job demands, and recognition by the management. Discrimination by the 9-predictor model was significant (AUC = 0.68; 95% CI 0.61-0.76), but not practically useful. A prediction model based on occupational health survey variables identified employees with an increased LTSA risk, but should be further developed into a practically useful tool to predict the risk of LTSA in the general working population. Implications for rehabilitation Long-term sickness absence risk predictions would enable healthcare providers to refer high-risk employees to rehabilitation programs aimed at preventing or reducing work disability. A prediction model based on health survey variables discriminates between employees at high and low risk of long-term sickness absence, but discrimination was not practically useful. Health survey variables provide insufficient information to determine long-term sickness absence risk profiles. There is a need for
Lessick, Susan; Perryman, Carol; Billman, Brooke L; Alpi, Kristine M; De Groote, Sandra L; Babin, Ted D
The extent to which health sciences librarians are engaged in research is a little-studied question. This study assesses the research activities and attitudes of Medical Library Association (MLA) members, including the influence of work affiliation. An online survey was designed using a combination of multiple-choice and open-ended questions and distributed to MLA members. Responses were analyzed using descriptive statistics, content analysis, and significance testing. The authors used statistical tools and categorized open-ended question topics by the constant comparative method, also applying the broad subject categories used in a prior study. Pearson's chi-square analysis was performed on responses to determine significant differences among respondents employed in three different institutional environments. Analysis showed that 79% of respondents read research articles at least once a month; 58% applied published research studies to practice; 44% had conducted research; 62% reported acting on research had enhanced their libraries; 38% had presented findings; and 34% had authored research articles. Hospital librarians were significantly less likely than academic librarians to have participated in research activities. Highly ranked research benefits, barriers, and competencies of health sciences librarians are described. Findings indicate that health sciences librarians are actively engaged in research activities. Practice implications for practitioners, publishers, and stakeholders are discussed. Results suggest that practitioners can use published research results and results from their own research to affect practice decisions and improve services. Future studies are needed to confirm and extend these findings, including the need for intervention studies to increase research and writing productivity.
Beydoun, Hind A; Beydoun, May A; Jeng, Hueiwang Anna; Zonderman, Alan B; Eid, Shaker M
To evaluate bisphenol-A (BPA) level and its relationship to sleep adequacy in a nationally representative sample of U.S. adults. A population-based cross-sectional study was conducted using 2005-2010 National Health and Nutrition Examination Survey whereby data were collected using in-person interviews, physical examination and laboratory testing. BPA level was measured in urine samples and analyzed as loge-transformed variable and in quartiles (Sleep adequacy was operationalized with three questions: "How much sleep do you usually get at night on weekdays or workdays?", "Have you ever told a doctor or other health professionals that you have trouble sleeping?" and "Have you ever been told by a doctor or other health professional that you have a sleep disorder?" Sleep duration was further categorized as ( 8 h); (sleep duration defined, in hours, as a continuous variable, a dichotomous variable (≥ 6, sleep problems and diagnosis with sleep disorders were not significantly associated with loge-transformed BPA level in fully adjusted models. Loge-transformed BPA level may be associated with fewer hours of sleep among U.S. adults, with implications for prevention. Further research involving diverse populations are needed to confirm these study findings. © 2016 Associated Professional Sleep Societies, LLC.
Kreps, Gary L
This paper examines the influence of the digital divide on disparities in health outcomes for vulnerable populations, identifying implications for medical and public libraries. The paper describes the results of the Digital Divide Pilot Projects demonstration research programs funded by the National Cancer Institute to test new strategies for disseminating relevant health information to underserved and at-risk audiences. The Digital Divide Pilot Projects field-tested innovative systemic strategies for helping underserved populations access and utilize relevant health information to make informed health-related decisions about seeking appropriate health care and support, resisting avoidable and significant health risks, and promoting their own health. The paper builds on the Digital Divide Pilot Projects by identifying implications for developing health communication strategies that libraries can adopt to provide digital health information to vulnerable populations.
Ellis, Randall P; Fiebig, Denzil G; Johar, Meliyanni; Jones, Glenn; Savage, Elizabeth
Explaining individual, regional, and provider variation in health care spending is of enormous value to policymakers but is often hampered by the lack of individual level detail in universal public health systems because budgeted spending is often not attributable to specific individuals. Even rarer is self-reported survey information that helps explain this variation in large samples. In this paper, we link a cross-sectional survey of 267 188 Australians age 45 and over to a panel dataset of annual healthcare costs calculated from several years of hospital, medical and pharmaceutical records. We use this data to distinguish between cost variations due to health shocks and those that are intrinsic (fixed) to an individual over three years. We find that high fixed expenditures are positively associated with age, especially older males, poor health, obesity, smoking, cancer, stroke and heart conditions. Being foreign born, speaking a foreign language at home and low income are more strongly associated with higher time-varying expenditures, suggesting greater exposure to adverse health shocks. Copyright © 2013 John Wiley & Sons, Ltd.
Health definition consists of three domains namely, physical, mental, and social health that should be prioritized in delivering healthcare. The emergence of chronic diseases in aging populations has been a barrier to the realization of a healthier society. The value-based healthcare concept seems in line with the true health objective: increasing value. Value is created from health outcomes which matter to patients relative to the cost of achieving those outcomes. The health outcomes should include all domains of health in a full cycle of care. To implement value-based healthcare, transformations need to be done by both health providers and patients: establishing true health outcomes, strengthening primary care, building integrated health systems, implementing appropriate health payment schemes that promote value and reduce moral hazards, enabling health information technology, and creating a policy that fits well with a community.
Peterson, Karen Louise; Jacobs, Jane Philippa; Allender, Steven; Alston, Laura Veronica; Nichols, Melanie
Measuring and monitoring the true prevalence of risk factors for chronic conditions is essential for evidence-based policy and health service planning. Understanding the prevalence of risk factors for cardiovascular disease (CVD) in Australia relies heavily on self-report measures from surveys, such as the triennial National Health Survey. However, international evidence suggests that self-reported data may substantially underestimate actual risk factor prevalence. This study sought to characterise the extent of misreporting in a large, nationally-representative health survey that included objective measures of clinical risk factors for CVD. This study employed a cross-sectional analysis of 7269 adults aged 18 years and over who provided fasting blood samples as part of the 2011-12 Australian Health Survey. Self-reported prevalence of high blood pressure, high cholesterol and diabetes was compared to measured prevalence, and univariate and multivariate logistic regression analyses identified socio-demographic characteristics associated with underreporting for each risk factor. Approximately 16 % of the total sample underreported high blood pressure (measured to be at high risk but didn't report a diagnosis), 33 % underreported high cholesterol, and 1.3 % underreported diabetes. Among those measured to be at high risk, 68 % did not report a diagnosis for high blood pressure, nor did 89 % of people with high cholesterol and 29 % of people with high fasting plasma glucose. Younger age was associated with underreporting high blood pressure and high cholesterol, while lower area-level disadvantage and higher income were associated with underreporting diabetes. Underreporting has important implications for CVD risk factor surveillance, policy planning and decisions, and clinical best-practice guidelines. This analysis highlights concerns about the reach of primary prevention efforts in certain groups and implications for patients who may be unaware of their
Karen Louise Peterson
Full Text Available Abstract Background Measuring and monitoring the true prevalence of risk factors for chronic conditions is essential for evidence-based policy and health service planning. Understanding the prevalence of risk factors for cardiovascular disease (CVD in Australia relies heavily on self-report measures from surveys, such as the triennial National Health Survey. However, international evidence suggests that self-reported data may substantially underestimate actual risk factor prevalence. This study sought to characterise the extent of misreporting in a large, nationally-representative health survey that included objective measures of clinical risk factors for CVD. Methods This study employed a cross-sectional analysis of 7269 adults aged 18 years and over who provided fasting blood samples as part of the 2011–12 Australian Health Survey. Self-reported prevalence of high blood pressure, high cholesterol and diabetes was compared to measured prevalence, and univariate and multivariate logistic regression analyses identified socio-demographic characteristics associated with underreporting for each risk factor. Results Approximately 16 % of the total sample underreported high blood pressure (measured to be at high risk but didn’t report a diagnosis, 33 % underreported high cholesterol, and 1.3 % underreported diabetes. Among those measured to be at high risk, 68 % did not report a diagnosis for high blood pressure, nor did 89 % of people with high cholesterol and 29 % of people with high fasting plasma glucose. Younger age was associated with underreporting high blood pressure and high cholesterol, while lower area-level disadvantage and higher income were associated with underreporting diabetes. Conclusions Underreporting has important implications for CVD risk factor surveillance, policy planning and decisions, and clinical best-practice guidelines. This analysis highlights concerns about the reach of primary prevention efforts in certain
Maheshwari, Sunil; Bhat, Ramesh; Saha, Somen
Commitment, competencies and skills of people working in the health sector can significantly impact the performance and its reform process. In this study we attempted to analyse the commitment of state health officials and its implications for human resource practices in Gujarat. A self-administered questionnaire was used to measure commitment and its relationship with human resource (HR) variables. Employee's organizational commitment (OC) and professional commitment (PC) were measured using OC and PC scale. Fifty five medical officers from Gujarat participated in the study. Professional commitment of doctors (3.21 to 4.01) was found to be higher than their commitment to the organization (3.01 to 3.61). Doctors did not perceive greater fairness in the system on promotion (on the scale of 5, score: 2.55) and were of the view that the system still followed seniority based promotion (score: 3.42). Medical officers were upset about low autonomy in the department with regard to reward and recognition, accounting procedure, prioritization and synchronization of health programme and other administrative activities. Our study provided some support for positive effects of progressive HR practices on OC, specifically on affective and normative OC. Following initiatives were identified to foster a development climate among the health officials: providing opportunities for training, professional competency development, developing healthy relationship between superiors and subordinates, providing useful performance feedback, and recognising and rewarding performance. For reform process in the health sector to succeed, there is a need to promote high involvement of medical officers. There is a need to invest in developing leadership quality, supervision skills and developing autonomy in its public health institutions.
Tannenbaum, Cara; Mayo, Nancy; Ducharme, Francine
As women get older, their health priorities change. We surveyed a sample of older Canadian women to investigate what health priorities are of concern to them, their perceptions about the care delivered to address these priorities and the extent to which priorities and perceptions of care differ across age groups and provinces. The WOW (What Older women Want) cross-sectional health survey was mailed in October 2003 to 5000 community-dwelling women aged 55-95 years from 10 Canadian provinces. Women were asked questions on 26 health priorities according to the World Health Organization's International Classification of Functioning, Disability and Health, and their perceptions of whether these priorities were being addressed by health care providers through screening or counselling. Differences in priorities and perceptions of care delivery were examined across age groups and provinces. The response rate was 52%. The mean age of the respondents was 71 (standard deviation 7) years. The health priorities identified most frequently by the respondents were preventing memory loss (88% of the respondents), learning about the side effects of medications (88%) and correcting vision impairment (86%). Items least frequently selected were counselling about community programs (28%), counselling about exercise (33%) and pneumonia vaccination (33%). Up to 97% of the women recalled being adequately screened for heart disease and stroke risk factors, but as little as 11% reported receiving counselling regarding concerns about memory loss or end-of-life issues. Women who stated that specific priorities were of great concern or importance to them were more than twice as likely as those who stated that they were not of great concern or importance to perceive that these priorities were being addressed: osteoporosis (odds ratio [OR] 2.6, 95% confidence interval [CI] 2.1- 3.2), end-of-life care (OR 2.6, 95% CI 2.0-3.4), anxiety reduction (OR 2.2, 95% CI 1.8-2.6), fall prevention (OR 2.1, 95
Baksh, K S; Ganpat, W; Narine, L K
Trinidad has an aged farming population. For a host of reasons, young persons are not entering the agricultural sector; therefore, these aged farmers will continue to be the backbone of the industry. Hence, there is much need for improving the health and safety of the workers within this sector. This first-time study assessed the prevalence of occupational health and safety disorders and discomforts among Trinidad's vegetable farmers in an attempt to understand the extent of the problem within the general farm population. The implications for extension are highlighted, and several recommendations are provided. Small-scale commercial-oriented vegetable farmers (n = 100) from ten of the most populated agricultural areas across Trinidad were surveyed. Results indicated that there was an overall moderate prevalence of occupational injuries among vegetable farmers. Most prevalent were musculoskeletal disorders of the lower back and upper body extremities, watery/burning eyes, skin rashes/itching, headaches, fatigue, dehydration, stress, and injuries attributed to slips and falls. Based on the evidence that a problem exists with health and safety, the extension service can now prepare and deliver programs to educate farmers on the actions necessary to improve their personal health and safety and that of their workers. This type of study has not been done before among farmers in Trinidad. It brings a very important and timely issue to the fore because of the aged farming population. Additionally, since the farmer profile and farming systems are similar in the wider Caribbean, policy makers can take note of the findings and recommendations and embrace actions.
Mah, Daphne Ngar-yin; Vleuten, Johannes Marinus van der; Hills, Peter; Tao, Julia
Consumers have a major role to play in smart grid technologies which can be instrumental in addressing climate change and energy challenges. However, little is known about how consumers perceive, and how they might respond to the opportunities that smart grid technologies offer. This paper reports the results from a Hong Kong survey (n=505). It contributes to the literature by providing a better understanding of the perceptions and behaviour of electricity consumers about the possible deployment of smart grids. Our results indicate that Hong Kong consumers generally welcomed smart grid technologies and had a preference for energy saving, energy efficiency and renewable energy while they showed a high level of opposition to nuclear power. They displayed an interest in playing a much more informed and active role in energy decision-making, but they were sensitive to tariff increases. Motivations and barriers for consumers to support smart grid developments are also discussed. We conclude with a discussion of policy implications for effective consumer engagement. More policy attention is needed on demand-side measures, introducing institutional and regulatory changes, and modifying relationships between consumers, the government and utilities. - Highlights: ► Consumers have a major role in smart grid technologies. ► This paper reports findings of a Hong Kong survey on how consumers perceive and respond. ► Hong Kong consumers are interested in being informed and playing an active role in energy decision-making. ► Motivations and barriers are discussed. ► Policy recommendations for effective consumer engagement are suggested.
Liu, Yong-Bing; Liu, Liu; Li, Yan-Fei; Chen, Yan-Li
Background: Despite the large volume of research dedicated to health-related behavior change, chronic disease costs continue to rise, thus creating a major public health burden. Health literacy, the ability to seek, understand, and utilize health information, has been identified as an important factor in the course of chronic conditions. Little research has been conducted on the relationship between health literacy and health-related behaviors and health status in elderly Chinese. The aim of this study was to elucidate the relationship between health literacy and health-related behaviors and health status in China. Methods: The subjects enrolled in this study were selected based on a stratified cluster random sampling design. Information involving >4500 older adults in 44 pension institutions in Urumqi, Changji, Karamay, and Shihezi of Xinjiang between September 2011 and June 2012 was collected. The Chinese Citizen Health Literacy Questionnaire (China Health Education Centre, 2008) and a Scale of the General Status were administered and the information was obtained through face-to-face inquiries by investigators. A total of 1452 respondents met the inclusion criteria. A total of 1452 questionnaires were issued and the valid response rate was 96.14% (1396 of 1452). Factors affecting health literacy and the relationship to health literacy were identified by one-way ANOVA and a multiple linear regression model. Results: The average health literacy level of the elderly in nursing homes was relatively low (71.74 ± 28.35 points). There were significant differences in the health literacy score among the factors of age, gender, race, education level, household income, marital conditions, and former occupation (p 0.05). Multiple linear regression analysis showed that the independent influencing factors of health literacy included education level, race, former occupation, household income, age, physical exercise, health examination, smoking, and health information access (p
Spears, Barbara A; Taddeo, Carmel M; Daly, Anthony L; Stretton, Alexander; Karklins, Larisa T
To examine the relationship between young Australians' cyberbullying experiences, their help-seeking practices and associated mental well-being and social connectedness, with a view to informing national health and well-being agendas. An online survey was administered to young people aged 12-18 years (n = 2,338), recruited across Australia in year 2 of a larger 4-year study. Youth with no experience of cyberbullying had better well-being profiles and mental health overall. Conversely, cyberbully victims, had poorer well-being and mental health and tended not to engage with online support services, in spite of being more likely to be online after 11 pm. Parents and peers were identified as key sources of help for most young people when dealing with problems. Cyberbullying is a public health issue particularly for vulnerable youth whose mental health and well-being is impacted more than those not involved. As youth are spending increasing time in the 24/7 online environment, there is a need to develop initiatives that engage young people and encourage help-seeking online, whilst concomitantly building capacity of parents and peers to support their well-being.
Scott, W Guy; Scott, Helen M; Auld, Terry S
Providers of health care usually have much better information about health and health care interventions than do consumers. The internet is an important and rapidly evolving source of global health-related information and could provide a means of correcting for asymmetric information. However, little is known about who accesses this information and how it is used in New Zealand. The aims of this research were to: determine the nature of the health information sought, how respondents use the information, how helpful they perceive the information to be, and the self-assessed value of such information. The researchers conducted an anonymous five minute telephone and mall intercept survey of randomly selected Wellington residents who had searched for health-related information on the internet. Investigators entered the data into an Excel spreadsheet and transferred it to SPSS for data cleaning, data exploration and statistical analysis. Search time costs were based on the opportunity cost of income foregone and respondents were asked to provide a money value for the information found. Eighty-three percent of respondents accessed the internet from home, and 87% conducted the search for themselves. Forty-five percent of people were looking for general health and nutrition information, 42% for data about a specific illness and 40% for a medicine. After finding the information, 58% discussed it with a family member/friend/workmate, 36% consulted a general practitioner, 33% changed their eating or drinking habits, and 13% did nothing. Respondents found the information very quick to find and useful. It took them on average 0.47 hours and cost $12 (opportunity cost of time) to find the information. The average value of the data found was $60 and the net benefit to the consumer was $48 ($60 - $12). The results of this research could assist providers of health information via the internet to tailor their websites to better suit users' needs. Given the high perceived value of
Kim, Sujin; Sinn, Donghee; Syn, Sue Yeon
With abundant personal health information at hand, individuals are faced with a critical challenge in evaluating the informational value of health care records to keep useful information and discard that which is determined useless. Young, healthy college students who were previously dependents of adult parents or caregivers are less likely to be concerned with disease management. Personal health information management (PHIM) is a special case of personal information management (PIM) that is associated with multiple interactions among varying stakeholders and systems. However, there has been limited evidence to understand informational or behavioral underpinning of the college students' PHIM activities, which can influence their health in general throughout their lifetime. This study aimed to investigate demographic and academic profiles of college students with relevance to PHIM activities. Next, we sought to construct major PHIM-related activity components and perceptions among college students. Finally, we sought to discover major factors predicting core PHIM activities among college students we sampled. A Web survey was administered to collect responses about PHIM behaviors and perceptions among college students from the University of Kentucky from January through March 2017. A total of 1408 college students were included in the analysis. PHIM perceptions, demographics, and academic variations were used as independent variables to predict diverse PHIM activities using a principal component analysis (PCA) and hierarchical regression analyses (SPSS v.24, IBM Corp, Armonk, NY, USA). Majority of the participants were female (956/1408, 67.90%), and the age distribution of this population included an adequate representation of college students of all ages. The most preferred health information resources were family (612/1408, 43.47%), health care professionals (366/1408, 26.00%), friends (27/1408, 1.91%), and the internet (157/1408, 11.15%). Organizational or
Full Text Available Background: Despite the large volume of research dedicated to health-related behavior change, chronic disease costs continue to rise, thus creating a major public health burden. Health literacy, the ability to seek, understand, and utilize health information, has been identified as an important factor in the course of chronic conditions. Little research has been conducted on the relationship between health literacy and health-related behaviors and health status in elderly Chinese. The aim of this study was to elucidate the relationship between health literacy and health-related behaviors and health status in China. Methods: The subjects enrolled in this study were selected based on a stratified cluster random sampling design. Information involving >4500 older adults in 44 pension institutions in Urumqi, Changji, Karamay, and Shihezi of Xinjiang between September 2011 and June 2012 was collected. The Chinese Citizen Health Literacy Questionnaire (China Health Education Centre, 2008 and a Scale of the General Status were administered and the information was obtained through face-to-face inquiries by investigators. A total of 1452 respondents met the inclusion criteria. A total of 1452 questionnaires were issued and the valid response rate was 96.14% (1396 of 1452. Factors affecting health literacy and the relationship to health literacy were identified by one-way ANOVA and a multiple linear regression model. Results: The average health literacy level of the elderly in nursing homes was relatively low (71.74 ± 28.35 points. There were significant differences in the health literacy score among the factors of age, gender, race, education level, household income, marital conditions, and former occupation (p < 0.001. The health literacy score was significantly associated with smoking, drinking, physical exercise, and health examination (p < 0.001. The elderly with higher health literacy scores were significantly less likely to have risky behaviors
The way a country finances its health care system is a critical determinant for reaching universal health coverage (UHC). This is so because it determines whether the health services that are available are affordable to those that need them. In Nigeria, the health sector is financed through different sources and mechanisms.
Reddy, Sasiragha Priscilla; Mbewu, Anthony David
The developmental origins of health and disease (DOHaD) hypothesis states that environmental influences in utero and in early life can determine health and disease in later life through the programming of genes and/or altered gene expression. The DOHaD is likely to have had an effect in South Africa during the fifty years of apartheid; and during the twenty years since the dawn of democracy in 1994. This has profound implications for public health and health promotion policies in South Africa, a country experiencing increased prevalence of noncommunicable diseases (NCDs) and risk factors and behaviours for NCDs due to rapid social and economic transition, and because of the DOHaD. Public health policy and health promotion interventions, such as those introduced by the South African Government over the past 20 years, were designed to improve the health of pregnant women (and their unborn children). They could in addition, through the DOHaD mechanism, reduce NCDs and their risk factors in their offspring in later life. The quality of public health data over the past 40 years in South Africa precludes the possibility of proving the DOHaD hypothesis in that context. Nevertheless, public health and health promotion policies need to be strengthened, if South Africa and other low and middle income countries (LMICs) are to avoid the very high prevalence of NCDs seen in Europe and North America in the 50 years following the Second World War, as a result of socio economic transition and the DOHaD.
Song, SuJin; Song, Won O
Asian regions have been suffering from growing double burden of nutritional health problems, such as undernutrition and chronic diseases. National nutrition survey plays an essential role in helping to improve both national and global health and reduce health disparities. The aim of this review was to compile and present the information on current national nutrition surveys conducted in Asian countries and suggest relevant issues in implementation of national nutrition surveys. Fifteen countries in Asia have conducted national nutrition surveys to collect data on nutrition and health status of the population. The information on national nutrition survey of each country was obtained from government documents, international organizations, survey website of governmental agencies, and publications, including journal articles, books, reports, and brochures. The national nutrition survey of each country has different variables and procedures. Variables of the surveys include sociodemographic and lifestyle variables; foods and beverages intake, dietary habits, and food security of individual or household; and health indicators, such as anthropometric and biochemical variables. The surveys have focused on collecting data about nutritional health status in children aged under five years and women of reproductive ages, nutrition intake adequacy and prevalence of obesity and chronic diseases for all individuals. To measure nutrition and health status of Asian populations accurately, improvement of current dietary assessment methods with various diet evaluation tools is necessary. The information organized in this review is important for researchers, policy makers, public health program developers, educators, and consumers in improving national and global health.
Zachrisson, Henrik D; Rödje, Kjetil; Mykletun, Arnstein
Background Only a minority of adolescents reporting symptoms above case-levels on screenings for mental health seeks and receives help from specialist health services. The objective of this study was to a) examine help-seeking for symptoms of anxiety and depression in relation to symptom load dimensionally, b) identify the level of specialization in mental health among service-providers, and c) identify associations between mental health problems and contact with different types of health services. Methods This cross-sectional school-based study (response-rate 88%, n = 11154) is based on Norwegian health surveys among 15 and 16 year olds. Results We found a dose-response association between symptom-load and help seeking. Only 34% of individuals with mental symptom-load above 99th percentile reported help-seeking in the last 12 months. Forty percent of help seekers were in contact with specialists (psychiatrists or psychologists), the remaining were mainly in contact with GPs. Mental health problems increased help seeking to all twelve service providers examined. Conclusion It might not be reasonable to argue that all adolescents with case-level mental health problems are in need of treatment. However, concerning the 99th percentile, claiming treatment need is less controversial. Even in the Norwegian context where mental health services are relatively available and free of charge, help-seeking in individuals with the highest symptom-loads is still low. Most help seekers achieved contact with health care providers, half of them at a non specialized level. Our results suggest that adolescents' recognition of mental health problems or intention to seek help for these are the major "filters" restricting treatment. PMID:16480522
Jambroes, Marielle; Nederland, Trudi; Kaljouw, Marian; van Vliet, Katja; Essink-Bot, Marie-Louise; Ruwaard, Dirk
To explore the implications for public health policy of a new conceptualisation of health as 'The ability to adapt and to self-manage, in the face of social, physical and emotional challenges'. Secondary qualitative data analysis of 28 focus group interviews, with 277 participants involved in public
Jambroes, Marielle; Nederland, Trudi; Kaljouw, Marian; Van Vliet, Katja; Essink-Bot, Marie Louise; Ruwaard, Dirk
Background: To explore the implications for public health policy of a new conceptualisation of health as 'The ability to adapt and to self-manage, in the face of social, physical and emotional challenges'. Methods: Secondary qualitative data analysis of 28 focus group interviews, with 277
Health definition consists of three domains namely, physical, mental, and social health that should be prioritized in delivering healthcare. The emergence of chronic diseases in aging populations has been a barrier to the realization of a healthier society. The value-based healthcare concept seems in line with the true health objective: increasing value. Value is created from health outcomes which matter to patients relative to the cost of achieving those outcomes. The health outcomes should ...
Santin, G; Bénézet, L; Geoffroy-Perez, B; Bouyer, J; Guéguen, A
The decline in participation rates in surveys, including epidemiological surveillance surveys, has become a real concern since it may increase nonresponse bias. The aim of this study is to estimate the contribution of a complementary survey among a subsample of nonrespondents, and the additional contribution of paradata in correcting for nonresponse bias in an occupational health surveillance survey. In 2010, 10,000 workers were randomly selected and sent a postal questionnaire. Sociodemographic data were available for the whole sample. After data collection of the questionnaires, a complementary survey among a random subsample of 500 nonrespondents was performed using a questionnaire administered by an interviewer. Paradata were collected for the complete subsample of the complementary survey. Nonresponse bias in the initial sample and in the combined samples were assessed using variables from administrative databases available for the whole sample, not subject to differential measurement errors. Corrected prevalences by reweighting technique were estimated by first using the initial survey alone and then the initial and complementary surveys combined, under several assumptions regarding the missing data process. Results were compared by computing relative errors. The response rates of the initial and complementary surveys were 23.6% and 62.6%, respectively. For the initial and the combined surveys, the relative errors decreased after correction for nonresponse on sociodemographic variables. For the combined surveys without paradata, relative errors decreased compared with the initial survey. The contribution of the paradata was weak. When a complex descriptive survey has a low response rate, a short complementary survey among nonrespondents with a protocol which aims to maximize the response rates, is useful. The contribution of sociodemographic variables in correcting for nonresponse bias is important whereas the additional contribution of paradata in
Barbose, Galen; Goldman, Charles; Neenan, Bernard
Economists and policy makers frequently propose real time pricing (RTP) as a strategy for facilitating price responsive demand, thereby improving the performance of electricity markets and regional networks. While theoretically appealing, many practical and empirical issues related to RTP remain unresolved or poorly understood. Over the past two decades, more than 70 utilities in the U.S. have offered voluntary RTP tariffs, on either a pilot or permanent basis. However, most have operated in relative obscurity, and little information has made its way into the public domain. To address this gap, we conducted a conducted a comprehensive review of voluntary RTP programs in the U.S. by surveying 43 U.S. utilities and reviewing regulatory documents, tariffs, program evaluations, and other publicly available sources. Based on this review of RTP program experience, we identify key trends related to utilities' motivations and goals for implementing RTP, evolution of RTP tariff design, program participation, participant price response, and program outlook. Experience with voluntary RTP programs has been mixed. Several utilities have demonstrated that voluntary RTP programs are capable of generating significant load reductions. However, most programs have attracted relatively few participants and therefore have generated quite limited load reductions. About 2700 non-residential customers were enrolled in RTP programs in 2003, representing more than 11 000 MW of load. We then draw from these findings to identify implications for policy makers and regulators that are currently considering RTP as a strategy for facilitating price responsive demand
The survey includes degrees granted between September 1, 2007 and August 31, 2008. Enrollment information refers to the fall term 2008. Twenty-six academic programs were included in the survey universe, and all 26 programs provided data
Persson, Sophie Schön; Lindström, Petra Nilsson; Pettersson, Pär; Andersson, Ingemar
The impact of positive social relationships on the health of municipal employees in the elder care sector in Sweden needs further examination. To explore the association between health and relationships among elderly care employees using a salutogenic perspective. Survey of all employees (n = 997) in special housing, home care and Disabled Support and Services in a Swedish municipality. The questionnaire, which had a salutogenic perspective, included information on self-rated health from the previously validated SHIS (Salutogenic Health Indicator Scale), psychosocial work environment and experiences, social climate, and health-promoting workplace relationships. The response rate was 69% . Results of a multivariable linear regression model showed four significant predictors of health: general work experiences, colleague belongingness and positive relationships with managers and care recipients. In another model, colleague belongingness was significantly related to satisfaction with care recipients, work, length of employment as well as general work experiences and relationships with managers. Strengthening of positive work relationships, not only between workmates but also with managers and care recipients, seems to be an essential area for employee health promotion. Colleague belongingness may be deepened by development of a positive work climate, including satisfactory work experiences, positive manager relationships and a stable work force.
Morton, Kimberly; Turiano, Nicholas A.; Fiske, Amy
Objectives: To examine the associations between health conditions and passive suicidal ideation in middle-aged and older adults. Method: Multivariate logistic regression analyses were conducted on data from 35,664 middle-aged and older adults from the Survey of Health, Ageing, and Retirement in Europe. Mediation analyses were also conducted to test the roles of disability and depression in risk of ideation. Results: After including demographic variables, disability, depression, and other health conditions as covariates, heart attack, diabetes/high blood sugar, chronic lung disease, arthritis, ulcer, and hip/femoral fractures were associated with increased odds of passive suicidal ideation. When grouped by organ systems, conditions affecting the endocrine, respiratory, and musculoskeletal systems were associated with increased odds of passive suicidal ideation, as was the total number of conditions. Individuals with greater numbers of health conditions exhibited greater levels of disability and depression, which partially explained the increased risk of passive suicidal ideation among those with more health conditions. Discussion: Certain specific health conditions, as well as total number of conditions, are associated with passive suicidal ideation in middle age and older adulthood. Health is a critical risk factor for suicidal ideation in late life and should be further studied in this particularly at-risk population. PMID:27013533
Marta M. Jankowska
Full Text Available Background: Social and environmental factors are increasingly recognized for their ability to influence health outcomes at both individual and neighborhood scales in the developing urban world. Yet issues of spatial heterogeneity in these complex environments may obscure unique elements of neighborhood life that may be protective or harmful to human health. Resident perceptions of neighborhood effects on health may help to fill gaps in our interpretation of household survey results and better inform how to plan and execute neighborhood-level health interventions. Objective: We evaluate differences in housing and socioeconomic indicators and health, environment, and neighborhood perceptions derived from the analysis of a household survey and a series of focus groups in Accra, Ghana. We then explore how neighborhood perceptions can inform survey results and ultimately neighborhood-level health interventions. Design: Eleven focus groups were conducted across a socioeconomically stratified sample of neighborhoods in Accra, Ghana. General inductive themes from the focus groups were analyzed in tandem with data collected in a 2009 household survey of 2,814 women. In-depth vignettes expand upon the three most salient emergent themes. Results: Household and socioeconomic characteristics derived from the focus groups corroborated findings from the survey data. Focus group and survey results diverged for three complex health issues: malaria, health-care access, and sense of personal agency in promoting good health. Conclusion: Three vignettes reflecting community views about malaria, health-care access, and sense of personal agency in promoting good health highlight the challenges facing community health interventions in Accra and exemplify how qualitatively derived neighborhood-level health effects can help shape health interventions.
Oak Ridge Institute for Science and Education
The survey includes degrees granted between July 1, 2001 and June 30, 2002. Enrollment information refers to the fall term 2002. Thirty-six academic programs at 35 different institutions were in the survey universe and all responded (100% response rate). Several of these programs did not have any degrees awarded during the time period. Five programs included in the 2001 survey were either discontinued or out-of-scope and not included in 2002 survey
Oak Ridge Institute for Science and Education
The survey includes degrees granted between September 1, 2002 and August 31, 2003. Enrollment information refers to the fall term 2003. Thirty-four academic programs at 33 different institutions were included in the survey universe with all responding (100% response rate). Several of the programs did not have any degrees awarded during the time period. Two programs included in the 2002 survey were either discontinued or out-of-scope and not included in 2003 survey
Jirapinyo, Pichamol; Hunt, Rachel S; Tabak, Ying P; Proctor, Deborah D; Makrauer, Frederick L
Interest in global health (GH) education is increasing across disciplines. To assess exposure to and perception of GH training among gastroenterology fellows and program directors across the USA. Design: Electronic survey study. The questionnaire was circulated to accredited US gastroenterology fellowship programs, with the assistance of the American Gastroenterological Association. Gastroenterology program directors and fellows. The questionnaire was returned by 127 respondents (47 program directors, 78 fellows) from 55 training programs (36 % of all training programs). 61 % of respondents had prior experience in GH. 17 % of programs offered GH curriculum with international elective (13 %), didactic (9 %), and research activity (7 %) being the most common. Fellows had adequate experience managing hepatitis B (93 %), cholangiocarcinoma (84 %), and intrahepatic duct stones (84 %). 74, 69 and 68 % reported having little to no experience managing hepatitis E, tuberculosis mesenteritis, or epidemic infectious enteritis, respectively. Most fellows would participate in an elective in an underserved area locally (81 %) or a 4-week elective abroad (71 %), if available. 44 % of fellows planned on working or volunteering abroad after fellowship. Barriers to establishing GH curriculum included funding (94 %), scheduling (88 %), and a lack of standardized objectives (78 %). Lack of interest, however, was not a concern. Fellows (49 %), more than faculty (29 %) (χ 2 = 21.9; p = 0.03), believed that GH education should be included in fellowship curriculum. Program directors and trainees recognize the importance of GH education. However, only 17 % of ACGME-approved fellowship programs offer the opportunity. Global health curriculum may enhance gastroenterology training.
Miller, Daniel P; Bazzi, Angela R; Allen, Heidi L; Martinson, Melissa L; Salas-Wright, Christopher P; Jantz, Kathryn; Crevi, Katherine; Rosenbloom, David L
The substantial disparities in health and poorer outcomes in the United States relative to peer nations suggest the need to refocus health policy. Through direct contact with the most vulnerable segments of the population, social workers have developed an approach to policy that recognizes the importance of the social environment, the value of social relationships, and the significance of value-driven policymaking. This approach could be used to reorient health, health care, and social policies. Accordingly, social workers can be allies to public health professionals in efforts to eliminate disparities and improve population health.
Bazzi, Angela R.; Allen, Heidi L.; Martinson, Melissa L.; Salas-Wright, Christopher P.; Jantz, Kathryn; Crevi, Katherine; Rosenbloom, David L.
The substantial disparities in health and poorer outcomes in the United States relative to peer nations suggest the need to refocus health policy. Through direct contact with the most vulnerable segments of the population, social workers have developed an approach to policy that recognizes the importance of the social environment, the value of social relationships, and the significance of value-driven policymaking. This approach could be used to reorient health, health care, and social policies. Accordingly, social workers can be allies to public health professionals in efforts to eliminate disparities and improve population health. PMID:29236535
Milena Santric Milicevic
Full Text Available Background: The global burden of mental disorders is rising. In Serbia, anxiety is the leading cause of disability-adjusted life years. Serbia has no mental health survey at the population level. The information on prevalence of mental disorders and related socioeconomic inequalities are valuable for mental care improvement. Aims: То explore the prevalence of mental health disorders and socioeconomic inequalities in mental health of adult Serbian population, and to explore whether age years and employment status interact with mental health in urban and rural settlements. Study Design: Cross-sectional study. Methods: This study is an additional analysis of Serbian Health Survey 2006 that was carried out with standardized household questionnaires at the representative sample of 7673 randomly selected households – 15563 adults. The response rate was 93%. A multivariate logistic regression modeling highlighted the predictors of the 5 item Mental Health Inventory (MHI-5, and of chronic anxiety or depression within eight independent variables (age, gender, type of settlement, marital status and self-perceived health, education, employment status and Wealth Index. The significance level in descriptive statistics, chi square analysis and bivariate and multivariate logistic regressions was set at p<0.05. Results: Chronic anxiety or depression was seen in 4.9% of the respondents, and poor MHI-5 in 47% of respondents. Low education (Odds Ratios 1.32; 95% confidence intervals=1.16-1.51, unemployment (1.36; 1.18-1.56, single status (1.34; 1.23-1.45, and Wealth Index middle class (1.20; 1.08-1.32 or poor (1.33; 1.21-1.47 were significantly related with poor MHI-5. Unemployed persons in urban settlements had higher odds for poormMHI-5 than unemployed in rural areas (0.73; 0.59-0.89. Single (1.50; 1.26-1.78, unemployed (1.39; 1.07-1.80 and inactive respondents (1.42; 1.10-1.83 had a higher odds of chronic anxiety or depression than married individuals, or
Arita, Ken-ichi; Iwamori, Hiroshi; Kishi, Akihiro; Koutoku, Michiya
Health survey was undertaken among Korea survivors exposed to atomic bomb in Japan who now reside in South Korea. Of 232 A-bomb survivors on whom raditation exposure information was available, all were exposed to atomic bomb in Hiroshima. According to the distance from the hypocenter, one (0.4 %) A-bomb survior was exposed at < 1,000 m, 60 (25.9 %) at 1,000 - 2,000 m, 124 (53.4 %) at > 2,000 - 3,000 m, and 43 (18.5 %) at < 3,000 m. In the four remaining, it was unknown. According to age, 14.7 % were in their forties, 33.6 % in their fifties, 32.6 % in their sixties, 16.0 % in their severties, and 3.1 % in their eighties, indicating the tendency for the aging of older persons. Common subjective symptoms were lumbar pain and joint pain, which seemed atributable to osteoarthritis. Other diseases included hypertension, chronic obstructive pulmonary disease, sequelae of cerebral stroke, eczema, and mycosis. (Namekawa, K.).
de Assumpção, Daniela; Dias, Marcia Regina Messaggi Gomes; de Azevedo Barros, Marilisa Berti; Fisberg, Regina Mara; de Azevedo Barros Filho, Antonio
To analyze calcium intake in adolescents according to sociodemographic variables, health-related behaviors, morbidities, and body mass index. This was a cross-sectional population-based study, with a two-stage cluster sampling that used data from a survey conducted in Campinas, São Paulo, Brazil, between 2008 and 2009. Food intake was assessed using a 24-hour dietary recall. The study included 913 adolescents aged 10-19 years. Average nutrient intake was significantly lower in the segment with lower education of the head of the family and lower per capita family income, in individuals from other cities or states, those who consumed fruit less than four times a week, those who did not drink milk daily, those who were smokers, and those who reported the occurrence of headaches and dizziness. Higher mean calcium intake was found in individuals that slept less than seven hours a day. The prevalence of calcium intake below the recommendation was 88.6% (95% CI: 85.4-91.2). The results alert to an insufficient calcium intake and suggest that certain subgroups of adolescents need specific strategies to increase the intake of this nutrient. Copyright © 2015 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.
Daniela de Assumpção
Full Text Available Abstract Objective To analyze calcium intake in adolescents according to sociodemographic variables, health-related behaviors, morbidities, and body mass index. Methods This was a cross-sectional population-based study, with a two-stage cluster sampling that used data from a survey conducted in Campinas, São Paulo, Brazil, between 2008 and 2009. Food intake was assessed using a 24-hour dietary recall. The study included 913 adolescents aged 10-19 years. Results Average nutrient intake was significantly lower in the segment with lower education of the head of the family and lower per capita family income, in individuals from other cities or states, those who consumed fruit less than four times a week, those who did not drink milk daily, those who were smokers, and those who reported the occurrence of headaches and dizziness. Higher mean calcium intake was found in individuals that slept less than seven hours a day. The prevalence of calcium intake below the recommendation was 88.6% (95% CI: 85.4-91.2. Conclusion The results alert to an insufficient calcium intake and suggest that certain subgroups of adolescents need specific strategies to increase the intake of this nutrient.
This report presents the results of an agency-wide survey of employee health and wellness to determine workforce involvement in and satisfaction with the Federal Aviation Administration's Health Awareness Program (HAP...
U.S. Department of Health & Human Services — The primary objective of the National Pregnancy and Health Survey (NPHS) was to produce national annual estimates of the percentages and numbers of mothers of live...
McInerney, Melissa; Mellor, Jennifer M
A number of studies report that U.S. state mortality rates, particularly for the elderly, decline during economic downturns. Further, several prior studies use microdata to show that as state unemployment rates rise, physical health improves, unhealthy behaviors decrease, and medical care use declines. We use data on elderly mortality rates and data from the Medicare Current Beneficiary Survey from a time period that encompasses the start of the Great Recession. We find that elderly mortality is countercyclical during most of the 1994-2008 period. Further, as unemployment rates rise, seniors report worse mental health and are no more likely to engage in healthier behaviors. We find suggestive evidence that inpatient utilization increases perhaps because of an increased physician willingness to accept Medicare patients. Our findings suggest that either elderly individuals respond differently to recessions than do working age adults, or that the relationship between unemployment and health has changed. Copyright © 2012 Elsevier B.V. All rights reserved.
Chen, Yi-An; Quiñonez, Carlos
To: a) Familiarize readers with the concept of a basic income guarantee (BIG) and its different forms; b) Consider how BIG could improve oral health and decrease oral health disparities; c) Motivate readers to advocate for the evaluation of oral health outcomes in BIG experiments. Published articles and book chapters that have analyzed and reviewed data from past BIG pilot projects were examined for their findings on health and socioeconomic outcomes. Our findings suggest various areas and mechanisms whereby BIG can influence oral health-related outcomes, whether through impacts on work, illness and injury, education, a social multiplier effect, expenditure behavior, and/or mental illness and other health outcomes. Our findings illustrate the importance of assessing oral health-related outcomes in future BIG pilot projects. © 2017 American Association of Public Health Dentistry.
Full Text Available Background: There are more than 40 Health and Demographic Surveillance System (HDSS sites in 19 different countries. The running costs of HDSS sites are high. The financing of HDSS activities is of major importance, and adding external health surveys to the HDSS is challenging. To investigate the ways of improving data quality and collection efficiency in the Nouna HDSS in Burkina Faso, the stand-alone data collection activities of the HDSS and the Household Morbidity Survey (HMS were integrated, and the paper-based questionnaires were consolidated into a single tablet-based questionnaire, the Comprehensive Disease Assessment (CDA. Objective: The aims of this study are to estimate and compare the implementation costs of the two different survey approaches for measuring population health. Design: All financial costs of stand-alone (HDSS and HMS and integrated (CDA surveys were estimated from the perspective of the implementing agency. Fixed and variable costs of survey implementation and key cost drivers were identified. The costs per household visit were calculated for both survey approaches. Results: While fixed costs of survey implementation were similar for the two survey approaches, there were considerable variations in variable costs, resulting in an estimated annual cost saving of about US$45,000 under the integrated survey approach. This was primarily because the costs of data management for the tablet-based CDA survey were considerably lower than for the paper-based stand-alone surveys. The cost per household visit from the integrated survey approach was US$21 compared with US$25 from the stand-alone surveys for collecting the same amount of information from 10,000 HDSS households. Conclusions: The CDA tablet-based survey method appears to be feasible and efficient for collecting health and demographic data in the Nouna HDSS in rural Burkina Faso. The possibility of using the tablet-based data collection platform to improve the quality
Abbood, Hadeel Mohammed; Cherukara, George; Pathan, Ejaz; Macfarlane, Tatiana V
To investigate the link between self-reported oral health and arthritis in the Scottish population using data from the Scottish Health Survey. Data were available from 2008 to 2013 on self-reported arthritis, oral health conditions and oral hygiene habits from the Scottish Health Survey. Arthritis was defined in this survey by self-reported long standing illness, those who reported having arthritis, rheumatism and/or fibrositis. Oral conditions were defined by self-reported bleeding gums, toothache, biting difficulties and/or edentulousness. Oral hygiene habits were defined by self-reported brushing teeth and/or using dental floss on daily basis. Logistic regression was used for statistical analysis adjusted for age, gender, qualification, smoking and body mass index. Prevalence of self-reported arthritis was 9.3% (95% confidence interval [CI] = 9.03 to 9.57). Those who reported having bleeding gums (adjusted odds ratio [OR] = 1.63; 95% CI = 1.35 to 1.96), toothache (OR = 1.32; 95% CI = 1.16 to 1.5), biting difficulties (OR = 1.95; 95% CI = 1.62 to 2.34), and being edentulous (OR = 1.22; 95% CI = 1.08 to 1.37) had an increased risk of arthritis. Brushing teeth (OR = 1.25; 95% CI = 0.74 to 2.12), and using dental floss (OR = 1.11; 95% CI = 0.89 to 1.39) were not associated with arthritis. Self-reported oral conditions were associated with increased risk of self-reported arthritis. Oral hygiene habits were not associated with self-reported arthritis. Further investigation is required to assess the causal association between oral hygiene, oral disease and arthritis.
Full Text Available BACKGROUND: Accurate information on the prevalence and causes of musculoskeletal impairment (MSI is lacking in low income countries. We present a new survey methodology that is based on sound epidemiological principles and is linked to the World Health Organisation's International Classification of Functioning. METHODS: Clusters were selected with probability proportionate to size. Households were selected within clusters through compact segment sampling. 105 clusters of 80 people (all ages were included. All participants were screened for MSI by a physiotherapist and medical assistant. Possible cases plus a random sample of 10% of non-MSI cases were examined further to ascertain diagnosis, aetiology, quality of life, and treatment needs. FINDINGS: 6757 of 8368 enumerated individuals (80.8% were screened. There were 352 cases, giving an overall prevalence for MSI of 5.2%. (95% CI 4.5-5.9 The prevalence of MSI increased with age and was similar in men and women. Extrapolating these estimates, there are approximately 488,000 MSI diagnoses in Rwanda. Only 8.2% of MSI cases were severe, while the majority were moderate (43.7% or mild (46.3%. Diagnostic categories comprised 11.5% congenital, 31.3% trauma, 3.8% infection, 9.0% neurological, and 44.4% non-traumatic non infective acquired. The most common individual diagnoses were joint disease (13.3%, angular limb deformity (9.7% and fracture mal- and non-union (7.2%. 96% of all cases required further treatment. INTERPRETATION: This survey demonstrates a large burden of MSI in Rwanda, which is mostly untreated. The survey methodology will be useful in other low income countries, to assist with planning services and monitoring trends.
Russell, Elizabeth B.
This article explores the impact of practitioners' attitudes and knowledge of sexual health on clinical behaviors. Sexual health topics are often areas of concern for clients of any age in counseling. Thus, counselors must be trained and equipped to address sexual health across the life span. This study explored whether child and adolescent…
The Ghana Public Health Association organized a scientific seminar to examine the introduction of genetically modified organisms into public use and the health consequences. The seminar was driven by current public debate on the subject. The seminar identified some of the advantages of GMOs and also the health ...
Hathaway, Julia; Maibach, Edward W
Through a systematic search of English language peer-reviewed studies, we assess how health professionals and the public, worldwide, perceive the health implications of climate change. Among health professionals, perception that climate change is harming health appears to be high, although self-assessed knowledge is low, and perceived need to learn more is high. Among the public, few North Americans can list any health impacts of climate change, or who is at risk, but appear to view climate change as harmful to health. Among vulnerable publics in Asia and Africa, awareness of increasing health harms due to specific changing climatic conditions is high. Americans across the political and climate change opinion spectra appear receptive to information about the health aspects of climate change, although findings are mixed. Health professionals feel the need to learn more, and the public appears open to learning more, about the health consequences of climate change.
Chiang, Szu-Ying; Fleming, Theresa; Lucassen, Mathijs; Fenaughty, John; Clark, Terryann; Denny, Simon
Little population-based work has been published about the mental health of adolescents with both sexual/gender (SG) and ethnic minority (i.e. double minority) status. This study aimed to provide an overview on their mental health. Analysis of data from a total of 17,607 high school students from New Zealand's 2007 and 2012 cross-sectional nationally representative Adolescent Health Surveys, including a total of 1306 (7.4%) SG minority participants, of whom 581 (3.3%) were also an ethnic minority. SG minority status, minority ethnicity, and female sex were associated with higher mental distress and poorer well-being. Generally speaking, double minority students reported poorer mental health than SG majority students of the same ethnicity, but reported better mental health than SG minority New Zealand European students. Explanations and future directions for research were suggested to further explore how double minority students negotiate mental health in the context of their communities/cultures in New Zealand.
Ahnquist, Johanna; Wamala, Sarah P
Possible accumulative effects of a combined economic hardship's measure, including both income and non-income related economic hardships measures, on mental health has not been well investigated. The aim of this paper was to investigate; (i) independent associations between multiple measures of economic hardships and mental health problems, and (ii) associations between a combined economic hardships measure and mental health problems. We analysed data from the 2009 Swedish National Survey of Public Health comprising a randomly selected representative national sample combined with a randomly selected supplementary sample from four county councils and three municipalities consisting of 23,153 men and 28,261 women aged 16-84 years. Mental health problems included; psychological distress (GHQ-12), severe anxiety and use of antidepressant medication. Economic hardship was measured by a combined economic hardships measure including low household income, inability to meet expenses and lacking cash reserves. The results from multivariate adjusted (age, country of birth, educational level, occupational status, employment status, family status and long term illness) logistic regression analysis indicate that self-reported current economic difficulties (inability to pay for ordinary bills and lack of cash reserves), were significantly associated with both women's and men's mental health problems (all indicators), while low income was not. In addition, we found a statistically significant graded association between mental health problems and levels of economic hardships. The findings indicate that indicators of self-reported current economic difficulties seem to be more strongly associated with poor mental health outcomes than the more conventional measure low income. Furthermore, the likelihood of mental health problems differed significantly in a graded fashion in relation to levels of economic hardships.
Full Text Available Abstract Background Possible accumulative effects of a combined economic hardship's measure, including both income and non-income related economic hardships measures, on mental health has not been well investigated. The aim of this paper was to investigate; (i independent associations between multiple measures of economic hardships and mental health problems, and (ii associations between a combined economic hardships measure and mental health problems. Methods We analysed data from the 2009 Swedish National Survey of Public Health comprising a randomly selected representative national sample combined with a randomly selected supplementary sample from four county councils and three municipalities consisting of 23,153 men and 28,261 women aged 16-84 years. Mental health problems included; psychological distress (GHQ-12, severe anxiety and use of antidepressant medication. Economic hardship was measured by a combined economic hardships measure including low household income, inability to meet expenses and lacking cash reserves. Results The results from multivariate adjusted (age, country of birth, educational level, occupational status, employment status, family status and long term illness logistic regression analysis indicate that self-reported current economic difficulties (inability to pay for ordinary bills and lack of cash reserves, were significantly associated with both women's and men's mental health problems (all indicators, while low income was not. In addition, we found a statistically significant graded association between mental health problems and levels of economic hardships. Conclusions The findings indicate that indicators of self-reported current economic difficulties seem to be more strongly associated with poor mental health outcomes than the more conventional measure low income. Furthermore, the likelihood of mental health problems differed significantly in a graded fashion in relation to levels of economic hardships.
Baker, Wendy; Harris, Melanie; Battersby, Malcolm
Physical comorbidities shorten the lifespan of people with severe mental illness therefore mental health clinicians need to support service users in risk factor-related behaviour change. We investigated mental health care workers' views of a physical health self-management support program in order to identify implementation requirements. Qualitative interviews were conducted with workers who had differing levels of experience with a self-management support program. Themes were identified using interpretive descriptive analysis and then matched against domains used in implementation models to draw implications for successful practice change. Three main themes emerged related to: (1) understandings of disease management within job roles; (2) requirements for putting self-management support into practice; and (3) challenges of coordination in disease management. Priority domains from implementation models were inner and outer health service settings. While staff training is required, practice change for care which takes account of both mental and physical health also requires changes in organisational frameworks. © The Royal Australian and New Zealand College of Psychiatrists 2014.
Full Text Available Objective: This study analysed data from the Household Income and Labour Dynamics in Australia (HILDA Survey to examine the relationship between employment status and mental health, and the mediating effects of financial hardship, mastery and social support. In addition, the study sought to explore the effects of duration of unemployment on mental health. Methods: The primary analysis used three waves of data from the HILDA Survey with 4965 young adult respondents. Longitudinal population-averaged logistic regression models assessed the association of employment status and mental health, including the contribution of mastery, financial hardship and social support in explaining this association between employment groups (unemployed vs. employed; under employed vs. employed. Sensitivity analyses utilised a fixed-effects approach and also considered the full-range of working-age respondents. Regression analysis was used to explore the effect of duration of unemployment on mental health. Results: Respondents’ who identified as unemployed or underemployed were at higher risk of poor mental health outcomes when compared to their employed counterparts. This association was ameliorated when accounting for mastery, financial hardship and social support for the unemployed, and was fully mediated for the underemployed. The fixed-effects models showed the transition to unemployment was associated with a decline in mental health and that mastery in particular contributed to that change. The same results were found with a broader age range of respondents. Finally, the relationship between duration of unemployment and mental health was not linear, with mental health showing marked decline across the first 9 weeks of unemployment. Conclusions and implications: Mastery, social support and financial hardship are important factors in understanding the association of poor mental health with both unemployment and underemployment. Furthermore, the results suggest
Chauvin, James; Shukla, Mahesh; Rice, James; Rispel, Laetitia
National public health associations (PHAs) are key partners with governments and communities to improve, protect and promote the public's health. Governance and organizational capacity are among the key determinants of a PHA's effectiveness as an advocate for appropriate public health policies and practice. During 2014, the World Federation of Public Health Associations (WFPHA) conducted an on-line survey of its 82 PHA members, to identify the state of organizational governance of national public health associations, as well as the factors that influence optimal organizational governance. The survey consisted of 13 questions and focused on the main elements of organizational governance: cultivating accountability; engaging stakeholders; setting shared direction; stewarding resources; and, continuous governance enhancement. Four questions included a qualitative open-ended response for additional comments. The survey data were analyzed using Microsoft Excel. The qualitative data was analyzed using thematic content analysis Responses were received from 62 PHAs, constituting a 75.6 % response rate. The two most important factors that support governance effectiveness were a high degree of integrity and ethical behavior of the PHA's leaders (77 %) and the competence of people serving on the PHA's governing body (76 %). The lack of financial resources was considered as the most important factor that negatively affected organizational governance effectiveness (73 %). The lack of mentoring for future PHA leaders; ineffective or incompetent leadership; lack of understanding about good governance practices; and lack of accurate information for strategic planning were identified as factors influencing PHA governance effectiveness. Critical elements for PHA sustainability included diversity, gender-responsiveness and inclusive governance practices, and strategies to build the future generation of public health leaders. National PHA have a responsibility to put into place
Full Text Available Abstract Background National public health associations (PHAs are key partners with governments and communities to improve, protect and promote the public’s health. Governance and organizational capacity are among the key determinants of a PHA’s effectiveness as an advocate for appropriate public health policies and practice. Methods During 2014, the World Federation of Public Health Associations (WFPHA conducted an on-line survey of its 82 PHA members, to identify the state of organizational governance of national public health associations, as well as the factors that influence optimal organizational governance. The survey consisted of 13 questions and focused on the main elements of organizational governance: cultivating accountability; engaging stakeholders; setting shared direction; stewarding resources; and, continuous governance enhancement. Four questions included a qualitative open-ended response for additional comments. The survey data were analyzed using Microsoft Excel. The qualitative data was analyzed using thematic content analysis Results Responses were received from 62 PHAs, constituting a 75.6 % response rate. The two most important factors that support governance effectiveness were a high degree of integrity and ethical behavior of the PHA’s leaders (77 % and the competence of people serving on the PHA’s governing body (76 %. The lack of financial resources was considered as the most important factor that negatively affected organizational governance effectiveness (73 %. The lack of mentoring for future PHA leaders; ineffective or incompetent leadership; lack of understanding about good governance practices; and lack of accurate information for strategic planning were identified as factors influencing PHA governance effectiveness. Critical elements for PHA sustainability included diversity, gender-responsiveness and inclusive governance practices, and strategies to build the future generation of public health
Reamer, Frederic G
Integrated health care has come of age. What began modestly in the 1930s has evolved into a mature model of health care that is quickly becoming the standard of care. Social workers are now employed in a wide range of comprehensive integrated health care organizations. Some of these settings were designed as integrated health care delivery systems from their beginning. Others evolved over time, some incorporating behavioral health into existing primary care centers and others incorporating primary care into existing behavioral health agencies. In all of these contexts, social workers are encountering complex, sometimes unprecedented, ethical challenges. This article identifies and discusses ethical issues facing social workers in integrated health care settings, especially related to informed consent, privacy, confidentiality, boundaries, dual relationships, and conflicts of interest. The author includes practical resources that social workers can use to develop state-of-the-art ethics policies and protocols.
Nakamura, Saki; Maruyama, Takashi; Hasegawa, Kumi; Nagata, Tomohisa; Mori, Koji
We conducted a survey to clarify the present state of the occupational health practices (OHPs) of foreign-owned companies (FOCs) in Japan. The results reveal more strategic OHPs of FOCs located in Japan as local subsidiaries. Furthermore, the results should contribute to smoother global development of OHPs for international corporations with headquarters (HQs) in Japan. A total of 1,220 FOCs in Japan with at least 50 employees that are listed in Gaishikeikigyo-Soran (Overview of FOCs) 2009 published by Toyo Keizai, Inc. were targeted in our survey. A questionnaire with items concerning the (1) present situation of global and local OHP standards, (2) relationships with overseas HQ, and (3) impressions regarding daily OHPs was sent to a high-ranking person engaged in OHPs at each FOC. We ask about renkei-kan (sense of cooperation with overseas HQ), a positive Japanese word, in order to evaluate preferable relationships between FOCs and their HQs. There were 123 valid responses. Of these, only 50 had indicated the implementation of global standards (GS). Of the OHPs that were mentioned in GS, responses mainly included risk management for occupational diseases. With respect to local standards (LS), responses indicated that individual approaches toward each worker were an area of particular focus. Satisfaction with staff numbers and budget was high, although HQ involvement in staff numbers and budget control was low. Furthermore, 71.5% of respondents had low renkei-kan. We also found correlations among: renkei-kan, GS availability, frequency of reporting to overseas superiors, audit interval, and understanding of OHP organization at HQs. We found FOCs established OHPs independently of HQs and that they were satisfied with the present situation. On the other hand, there are many respondents who do not have positive feelings, renkei-kan, toward their relationships with HQs. OHP staff of FOCs can enhance renkei-kan by making use of GS, identifying key HQ personnel, and
Stansfeld, Stephen Alfred; Rasul, F R; Head, J; Singleton, N
To measure the prevalence of common mental disorder (CMD) by occupation in a representative sample of Great Britain and to identify occupations with increased and decreased risk of CMD. A cross-sectional interview-based survey was carried out including 5,497 working male and female respondents, 16-64 years from a stratified random survey of private households in Britain. Occupations were classified by the Standard Occupational Classification (SOC) into four groups: major, sub-major, minor and constituent unit groups. Common Mental Disorder was measured by the Revised Clinical Interview Schedule. Major SOC groups with higher prevalence of common mental disorder included clerical and secretarial, sales, and personal and protective services whereas craft and related, 'other' professional occupations and plant and machine operatives had lower prevalence compared to 13% overall prevalence in all adults. In sub-major SOC groups managers and administrators, teaching professionals, clerical and secretarial, 'other' sales and personal service occupations had higher prevalence whereas many professional and skilled occupations had lower prevalence. Specific SOC unit groups with higher prevalence included primary and secondary teachers, welfare community, youth workers, security staff, waiters, bar staff, nurse auxiliaries and care assistants. General managers in government and large organizations (OR=2.79, 95% CI 1.41-5.54), managers in transport and storing (OR=2.44, 95% CI 1.18-5.03), buyers and mobile sales persons (OR=2.48, 95% CI 1.09-5.60), sales occupations (NES) (OR=2.78, 95% CI 1.25-6.19) and clerks (NES) (OR=2.71, 95% CI 1.59-4.61) had increased risk of common mental disorder relative to specialist managers adjusting for social and financial factors and physical ill-health. Occupations with higher risk of common mental disorder may be typified by high levels of job demands, especially emotional demands and lack of job security. The reasons why occupations have low
Lanata, C F; Black, R E
Traditional survey methods, which are generally costly and time-consuming, usually provide information at the regional or national level only. The utilization of lot quality assurance sampling (LQAS) methodology, developed in industry for quality control, makes it possible to use small sample sizes when conducting surveys in small geographical or population-based areas (lots). This article describes the practical use of LQAS for conducting health surveys to monitor health programmes in developing countries. Following a brief description of the method, the article explains how to build a sample frame and conduct the sampling to apply LQAS under field conditions. A detailed description of the procedure for selecting a sampling unit to monitor the health programme and a sample size is given. The sampling schemes utilizing LQAS applicable to health surveys, such as simple- and double-sampling schemes, are discussed. The interpretation of the survey results and the planning of subsequent rounds of LQAS surveys are also discussed. When describing the applicability of LQAS in health surveys in developing countries, the article considers current limitations for its use by health planners in charge of health programmes, and suggests ways to overcome these limitations through future research. It is hoped that with increasing attention being given to industrial sampling plans in general, and LQAS in particular, their utilization to monitor health programmes will provide health planners in developing countries with powerful techniques to help them achieve their health programme targets.
Full Text Available Background: The aging population is a rapidly growing demographic. Isolation and limited autonomy render many of the elderly vulnerable to abuse, neglect and exploitation. As the population grows, so does the need for Adult Protective Services (APS. This study was conducted to examine current knowledge of older adult protection laws in Georgia among APS staff and to identify training opportunities to better prepare the APS workforce in case detection and intervention.Methods: The Georgia State University Institute of Public Health faculty developed a primary survey in partnership with the Georgia Division of Aging Services’ leadership to identify key training priority issues for APS caseworkers and investigators. A 47-item electronic questionnaire was delivered to all APS employees via work-issued email accounts. We conducted descriptive analyses, t-tests and chi-square analyses to determine APS employees’ baseline knowledge of Georgia’s elder abuse policies, laws and practices, as well as examine associations of age, ethnicity, and educational attainment with knowledge. We used a p-value of 0.05 and 95% confidence intervals to determine statistical significance of analyses performed.Result: Ninety-two out of 175 APS staff responded to the survey (53% response rate. The majority of respondents were Caucasian (56% women (92%. For over half the survey items, paired sample t-tests revealed significant differences between what APS staff reported as known and what APS staff members indicated they needed to know more about in terms of elder abuse and current policies. Chi-square tests revealed that non-Caucasians significantly preferred video conferencing as a training format (44% compared to 18%, [χ2(1 = 7.102, p < .008], whereas Caucasians preferred asynchronous online learning formats (55% compared to 28% [χ2(1 =5.951, p < .015].Conclusion: Results from this study provide the Georgia Division of Aging with insight into specific policy areas
Strasser, Sheryl M; Kerr, Judith; King, Patricia S; Payne, Brian; Beddington, Sarah; Pendrick, Danielle; Leyda, Elizabeth; McCarty, Frances
The aging population is a rapidly growing demographic. Isolation and limited autonomy render many of the elderly vulnerable to abuse, neglect and exploitation. As the population grows, so does the need for Adult Protective Services (APS). This study was conducted to examine current knowledge of older adult protection laws in Georgia among APS staff and to identify training opportunities to better prepare the APS workforce in case detection and intervention. The Georgia State University Institute of Public Health faculty developed a primary survey in partnership with the Georgia Division of Aging Services' leadership to identify key training priority issues for APS caseworkers and investigators. A 47-item electronic questionnaire was delivered to all APS employees via work-issued email accounts. We conducted descriptive analyses, t-tests and chi-square analyses to determine APS employees' baseline knowledge of Georgia's elder abuse policies, laws and practices, as well as examine associations of age, ethnicity, and educational attainment with knowledge. We used a p-value of 0.05 and 95% confidence intervals to determine statistical significance of analyses performed. Ninety-two out of 175 APS staff responded to the survey (53% response rate). The majority of respondents were Caucasian (56%) women (92%). For over half the survey items, paired sample t-tests revealed significant differences between what APS staff reported as known and what APS staff members indicated they needed to know more about in terms of elder abuse and current policies. Chi-square tests revealed that non-Caucasians significantly preferred video conferencing as a training format (44% compared to 18%), [χ(2)(1) = 7.102, p < .008], whereas Caucasians preferred asynchronous online learning formats (55% compared to 28%) [χ(2)(1) =5.951, p < .015]. Results from this study provide the Georgia Division of Aging with insight into specific policy areas that are not well understood by APS staff
Summary Health Statistics for U.S. Adults: National Health Interview Survey, 2009. Data from the National Health Interview Survey. Vital and Health Statistics. Series 10, Number 249. DHHS Publication No. (PHS) 2011-1577
Pleis, J. R.; Ward, B. W.; Lucas, J. W.
Objectives: This report presents health statistics from the 2009 National Health Interview Survey (NHIS) for the civilian noninstitutionalized adult population, classified by sex, age, race and ethnicity, education, family income, poverty status, health insurance coverage, marital status, and place and region of residence. Estimates are presented…
Dorman, Steve M.
Video and computer games have assumed a prominent role in the culture of U.S. children and adolescents. The paper examines the health effects of these games, suggests criteria upon which parents and teachers may evaluate the games, and notes some implications for health educators. (SM)
Goudswaard, A.; André, J.C.; Ekstedt, E.
Changes in the world of work can give rise to new risk areas or change the way that occupational safety and health needs to be managed. This has implications for workplaces themselves and also for the occupational safety and health system. For this reason the 'changing world of work' has been a
McLeroy, Kenneth R.
The screening of workers for health problems has been ubiquitous in the worksite for many years. These screening procedures may have ethical and policy implications. Three common types of screening in use include pre-employment, early identification of health problems, and employee monitoring. Pre-employment screening may be used to screen out…
Full Text Available Zika virus was first isolated in the year 1947 from the blood of sentinel rhesus macaque of Uganda. The virus was introduced in Brazil from Pacific Islands and thereon spread rapidly. It was considered the first infectious disease to have birth defects. This review highlights the transmission, clinical aspects, clinical features, diagnosis, and possible implications of the virus for the dental team.
Sandvik, Pernilla; Nydahl, Margaretha; Kihlberg, Iwona; Marklinder, Ingela
There is a wide variety of commercial bread types and the present study identifies potential pitfalls in consumer evaluations of bread from a health perspective. The aim is to describe consumers' health-related perceptions of bread by exploring which health-related quality attributes consumers associate with bread and whether there are differences with regard to age, gender and education level. A postal and web-based sequential mixed-mode survey (n = 1134, 62% responded online and 38% by paper) with open-ended questions and an elicitation task with pictures of commercial breads were used. Responses were content analyzed and inductively categorized. Three fourths (n = 844) knew of breads they considered healthy; these were most commonly described using terms such as "coarse," "whole grain," "fiber rich," "sourdough," "crisp," "less sugar," "dark," "rye," "seeds," "a commercial brand," "homemade" and "kernels." The breads were perceived as healthy mainly because they "contain fiber," are "good for the stomach," have good "satiation" and beneficial "glycemic properties." The frequency of several elicited attributes and health effects differed as a function of age group (18-44 vs. 45-80 years), gender and education level group (up to secondary education vs. university). Difficulties identifying healthy bread were perceived as a barrier for consumption especially among consumers with a lower education level. Several of the health effects important to consumers cannot be communicated on food packages and consumers must therefore use their own cues to identify these properties. This may lead to consumers being misled especially if a bread is labeled e.g., as a sourdough bread or a rye bread, despite a low content. Copyright © 2017 Elsevier Ltd. All rights reserved.
This study provides initial support for the methodological feasibility of pooling linked population health surveys however, challenges introduced by dissimilarities will require the use of innovative methodologies, and discussions regarding how to manage jurisdictional data restrictions and privacy issues are needed. Pooled population health data has the potential to improve national and international health surveillance and public health.
Tom K. Wong
Full Text Available Anecdotal evidence suggests that a significant percentage of unauthorized immigrants are potentially eligible for some sort of immigration relief, but they either do not know it or are not able to pursue lawful immigration status for other reasons. However, no published study that we are aware of has systematically analyzed this question. The purpose of this study is thus to evaluate and quantify the number of unauthorized immigrants who, during the course of seeking out legal services, have been determined to be potentially eligible for some sort of immigration benefit or relief that provides lawful immigration status. Using the recent implementation of the Deferred Action for Childhood Arrivals (DACA program as a laboratory for this work, this study attempts to answer the question of the number of unauthorized immigrants who, without knowing it, may already be potentially eligible for lawful immigration status. In surveying 67 immigrant-serving organizations that provide legal services, we find that 14.3 percent of those found to be eligible for DACA were also found to be eligible for some other form of immigration relief—put otherwise, 14.3 percent of individuals that were found to be eligible for DACA, which provides temporary relief from deportation, may now be on a path towards lawful permanent residency. We find that the most common legal remedies available to these individuals are family-based petitions (25.5 percent, U-Visas (23.9 percent, and Special Immigrant Juvenile Status (12.6 percent. These findings make clear that—with comprehensive immigration reform legislation or eligibility for administrative relief —legal screening can have significant and long-lasting implications on the lives of unauthorized immigrants and their families.
It is my opinion that time is apt for us all to have to reappraisal of health care delivery in Nigeria and fashion a practical and achievable way forward for the betterment of the health of the poor Nigerian. I thank the association for inviting me to participate in this symposium on “50 years of oral health in Nigeria”. It is my hope ...
Ernsting, Clemens; Dombrowski, Stephan U; Oedekoven, Monika; O Sullivan, Julie L; Kanzler, Melanie; Kuhlmey, Adelheid; Gellert, Paul
Chronic conditions are an increasing challenge for individuals and the health care system. Smartphones and health apps are potentially promising tools to change health-related behaviors and manage chronic conditions. The aim of this study was to explore (1) the extent of smartphone and health app use, (2) sociodemographic, medical, and behavioral correlates of smartphone and health app use, and (3) associations of the use of apps and app characteristics with actual health behaviors. A population-based survey (N=4144) among Germans, aged 35 years and older, was conducted. Sociodemographics, presence of chronic conditions, health behaviors, quality of life, and health literacy, as well as the use of the Internet, smartphone, and health apps were assessed by questionnaire at home visit. Binary logistic regression models were applied. It was found that 61.25% (2538/4144) of participants used a smartphone. Compared with nonusers, smartphone users were younger, did more research on the Internet, were more likely to work full-time and more likely to have a university degree, engaged more in physical activity, and less in low fat diet, and had a higher health-related quality of life and health literacy. Among smartphone users, 20.53% (521/2538) used health apps. App users were younger, less likely to be native German speakers, did more research on the Internet, were more likely to report chronic conditions, engaged more in physical activity, and low fat diet, and were more health literate compared with nonusers who had a smartphone. Health apps focused on smoking cessation (232/521, 44.5%), healthy diet (201/521, 38.6%), and weight loss (121/521, 23.2%). The most common app characteristics were planning (264/521, 50.7%), reminding (188/521, 36.1%), prompting motivation (179/521 34.4%), and the provision of information (175/521, 33.6%). Significant associations were found between planning and the health behavior physical activity, between feedback or monitoring and physical
Arun Pratap Singh
Full Text Available In view of a rampant increase in availability of and access to many health-compromising leisure choices and opportunities in India during the last few decades, this study examines the pattern of leisure practices in a sample of school-going adolescents from rural, urban, and metro regions of North India (n = 1,500. Data were collected through an anonymous leisure survey from consenting students. Results show a greater prevalence of the use of electronic media and telecommunication gadgets, reflecting a larger engagement in sedentary activities than in cultural, community, and physically demanding leisure activities. In particular, the students from metro and urban areas reported greater involvement in multiple sedentary activities, while rural adolescents reported greater engagement with watching television, listening to fast music and religious leisure. The results implicate an urgent need for revisiting adolescent health policy and promoting positive leisure education in schools.
Schatz, Bruce R
At the core of the healthcare crisis is fundamental lack of actionable data. Such data could stratify individuals within populations to predict which persons have which outcomes. If baselines existed for all variations of all conditions, then managing health could be improved by matching the measuring of individuals to their cohort in the population. The scale required for complete baselines involves effective National Surveys of Population Health (NSPH). Traditionally, these have been focused upon acute medicine, measuring people to contain the spread of epidemics. In recent decades, the focus has moved to chronic conditions as well, which require smaller measures over longer times. NSPH have long utilized quality of life questionnaires. Mobile Health Monitors, where computing technologies eliminate manual administration, provide richer data sets for health measurement. Older technologies of telephone interviews will be replaced by newer technologies of smartphone sensors to provide deeper individual measures at more frequent timings across larger-sized populations. Such continuous data can provide personal health records, supporting treatment guidelines specialized for population cohorts. Evidence-based medicine will become feasible by leveraging hundreds of millions of persons carrying mobile devices interacting with Internet-scale services for Big Data Analytics.
Agnelli, Ileana; Saglietti, Daniele; Zotti, Anna Maria
More and more Italian and European directives refers to organizational health promotion in work placements. As a matter of fact, organization well-being implies important benefits for individuals and improves business efficiency/efficacy. Improving factors involve listening tools aimed to analyze critical situations and needs, focus on working teams and communication development. In this respect, in a public health organization in Piedmont a research was devised for planning interventions of organizational health promotion and improvement, relying on climate analysis. The research process was supported by General Direction and involved the head of physicians and the departments CPSE (Coordinatore Professionale Sanitario Esperto: Professional Health Coordinator). The survey was carried out on the organizational population, focusing on teambuilding, which is the core of daily work life. Team Climate Inventory Questionnaire (TCI) was employed and administered on-line. Beyond the 5 original factorial scales, 6 item groups related to the individuals feeling in working team and consistent with the research interests were identified. 75.42% (n=1264) of employees answered the provided questionnaire. The data highlighted average scores--expressing organizational climate--over other public health organization data. The subjects also showed a good organizational climate perception. Elderly workers appeared more satisfied than the young ones. Furthermore, higher educated subjects took more advantage of technical and organizational supports.
Khang, Young-Ho; Cho, Sung-Il; Yang, Seungmi; Lee, Moo-Song
This study examined the socioeconomic differentials for the health and health related behaviors among South Korean middle school students. A nationwide cross-sectional interview survey of 3,449 middle school second-grade students and their parents was conducted using a stratified multi-stage cluster sampling method. The response rate was 93.3%. The socioeconomic position indicators were based on self-reported information from the students and their parents: parental education, father's occupational class, monthly family income, out-of-pocket expenditure for education, housing ownership, educational expectations, educational performance and the perceived economic hardships. The outcome variables that were measured were also based on the self-reported information from the students. The health measures included self-rated health conditions, psychological or mental problems, the feelings of loneliness at school, the overall satisfaction of life and the perceived level of stress. The health related behaviors included were smoking, alcohol drinking, sexual intercourse, violence, bullying and verbal and physical abuse by parents. Socioeconomic differences for the health and health related behaviors were found among the eighth grade boys and girls of South Korea. However, the pattern varied with gender, the socioeconomic position indicators and the outcome measures. The prevalence rates of the overall dissatisfaction with life for both genders differed according to most of the eight socioeconomic position indicators. All the health measures were significantly different according to the perceived economic hardship. However, the socioeconomic differences in the self-rated health conditions and the psychosocial or mental problems were not clear. The students having higher socioeconomic position tended to be a perpetrator of bullying while those students with lower socioeconomic position were more likely to be a victim. The perceived economic hardships predicted the health
Xing, Y; Jiang, C; Hua, W Y; Liu, F; Zhao, Z; Ding, Y J; Wang, L; Li, J
Objective: To study the epidemiological characteristics of an outbreak caused by norovirus infection in a school in Haidian district, Beijing. Methods: Basic information of the school and data related to patients in the fields survey were collected and analyzed descriptively. Laboratory tests were performed to test the stool and anal swab specimens of both patients and cooks as well as the environmental specimens. Risk factors related to the incidence were analyzed through a case-control study. Results: A total number of 119 patients were identified in the school. Clinical symptoms were mild, mainly involving vomiting (94.1 % , 112/119), abdominal pain (46.2 % , 55/119), but no need of hospitalization. The average age of the student patients was 6.38, with minimum and maximum between 5 and 11. Patients were found in 22 classes, but mainly in grade 1 and class 7 where 35 patients were found (30.17 % ). A total of 134 specimens of rectal swabs and stool were collected, with 7 positive for norovirus and 6 for sappovirus. Salmonella, Shigella, lapactic Escherichia coli and Vibrio parahaemolyticus were not found in on dinner sets, residual foods, bottled water or in drinking fountains. Index on water hygiene was unsatisfactory in classrooms or dormitories where more cases were found. Accommodation, north-facing-classrooms, abnormal water hygiene indexes were found related to the occurance of the disease ( P <0.05). Conclusions: The outbreak was identified a gastroenteritis infection, caused by norovirus with symptoms as vomiting and abdominal pain. This event reached the reporting standards of public health emergencies-level Ⅳ. Discovery and isolation of the first case was not timely while transmission of the disease might be water-borne. Surveillance programs on symptoms, disinfection of vomit and stool in places like nurseries and schools should be strengthened to prevent the norovirus outbreak.
Heinrich, J; Richter, K; Frye, C; Meyer, I; Wölke, G; Wjst, M; Nowak, D; Magnussen, H; Wichmann, H E
The European Community Respiratory Health Survey (ECRHS) was the first study to assess the geographical variation in asthma, allergy, and allergic sensitization in adults using the same instruments and definitions. The database of the ECRHS includes information from approximately 140 000 individuals aged 20 - 44 years from 22 countries. The aim of this review is to summarize the results of the ECRHS and to present the specific contribution of the German centers in Hamburg and Erfurt. The prevalence ranged from 2.0 - 11.9 % for asthma, 9.5 - 40.9 % for allergic rhinitis, 4.0 - 32.0 % for wheeze, 3.4 - 27.9 % for bronchial hyperreactivity, and 16.2 - 44.5 % for allergic sensitisation against common aeroallergens. Although the prevalence of these atopic disorders were found to be consistently higher for the Hamburg center compared to the Erfurt center, strong regional differences in the prevalences were also found within several other European countries. Overall Europe, the lowest prevalences were seen in the Eastern and Middle European countries with the center Erfurt, followed by the Mediterranean region. The highest prevalences were reported for all English speaking centers. Strong geographic variation was reported for medication for asthma. Asthma seems to be undertreated in several countries. Environmental exposures and in particular indoor factors, and exposures at the workplace are playing a major role for asthma in adulthood. Furthermore, protective effects on atopy were found for exposures to pets (dogs) and a large number of siblings in early childhood. In conclusion, the ECRHS has shown that the prevalence of asthma varies widely. The fact that the geographical pattern is consistent with the distribution of atopy and bronchial responsiveness supports the conclusion that the geographical variations in the prevalence of asthma are true and likely due to environmental factors.
Adolescents make up about one-sixth of the world's population. Most of the healthy and detrimental habits are adopted during childhood and adolescence. In the mid 1980s, a cross-national Health Behaviour in School-Aged Children (HBSC) survey was created to increase information about the well-being, health behaviours and social context of young people by using standard school-based questionnaires adopted by the World Health Organization (WHO) European office. The European Network of Health-Promoting Schools (HPS) was commenced in 1992, followed by the establishment of the WHO Global School Health Initiative in 1995. The initiative aims to improve the health of students, school personnel, families and other members of the community through schools by mobilizing and strengthening health promotion and educational activities at local, national, regional and global levels. The HBSC and HPS programmes have been accepted as activity areas for the WHO Collaborating Centre for Primary Oral Health Care in Kuwait. This article describes the HBSC and the HPS programmes and discusses the importance of establishing these programmes in Kuwait. © 2013 S. Karger AG, Basel.
Bowen, Mary; Lyons, Kevin J.; Young, Barbara E.
A survey of registered nurses who graduated in 1986 (n=50) and 1991 (n-58) revealed these opinions: insurance companies increasingly control patient care; workload and paperwork have increased; and there are fewer jobs and less job security. A significant number reported decreased job satisfaction. (SK)
Full Text Available Mary P Martinasek,1 Linda M Gibson-Young,2 Janiece N Davis,3 Robert J McDermott41Public Health Department of Health Sciences and Human Performance, University of Tampa, Kennedy Boulevard, Tampa, FL, 2College of Nursing and Health Sciences, Texas A&M University: Corpus Christi, Corpus Christi, TX, 3Department of Health – Palm Beach County, West Palm beach, FL, 4Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USABackground: Given the increasing evidence of its negative health effects, including contributions to both infectious and chronic diseases, waterpipe tobacco smoking raises public health concerns beyond even those presented by traditional smoking. Methods: Identification of Clean Indoor Air Acts (CIAAs from each of the 50 United States and District of Columbia were retrieved and examined for inclusion of regulatory measures where waterpipe tobacco smoking is concerned. Several instances of exemption to current CIAAs policies were identified. The cumulative policy lens is presented in this study. Results: States vary in their inclusion of explicit wording regarding CIAAs to the point where waterpipe tobacco smoking, unlike traditional smoking products, is excluded from some legislation, thereby limiting authorities’ ability to carry out enforcement. Conclusion: Consistent, comprehensive, and unambiguous legislative language is necessary to prevent establishments where waterpipe tobacco smoking occurs from skirting legislation and other forms of regulatory control. Stricter laws are needed due to the increasing negative health impact on both the smoker and the bystander. Actions at both the federal and state levels may be needed to control health risks, particularly among youth and young adult populations.Keywords: health policy, waterpipe tobacco, hookah smoking, tobacco regulation
Schaller, Mark; Murray, Damian R; Bangerter, Adrian
The 'behavioural immune system' is composed of mechanisms that evolved as a means of facilitating behaviours that minimized infection risk and enhanced fitness. Recent empirical research on human populations suggests that these mechanisms have unique consequences for many aspects of human sociality--including sexual attitudes, gregariousness, xenophobia, conformity to majority opinion and conservative sociopolitical attitudes. Throughout much of human evolutionary history, these consequences may have had beneficial health implications; but health implications in modern human societies remain unclear. This article summarizes pertinent ways in which modern human societies are similar to and different from the ecologies within which the behavioural immune system evolved. By attending to these similarities and differences, we identify a set of plausible implications-both positive and negative-that the behavioural immune system may have on health outcomes in contemporary human contexts. We discuss both individual-level infection risk and population-level epidemiological outcomes. We also discuss a variety of additional implications, including compliance with public health policies, the adoption of novel therapeutic interventions and actual immunological functioning. Research on the behavioural immune system, and its implications in contemporary human societies, can provide unique insights into relationships between fitness, sociality and health. © 2015 The Author(s) Published by the Royal Society. All rights reserved.
Full Text Available Anjali Patwardhan,1 Charles H Spencer21Nationwide Children’s Hospital Columbus, 2Ohio State University, Columbus, OH, USAAbstract: Improving the quality of care in international health services was made a high priority in 1977. The World Health Assembly passed a resolution to greatly improve “Health for all” by the year 2000. Since 1977, the use of patient surveys for quality improvement has become a common practice in the health-care industry. The use of surveys reflects the concept that patient satisfaction is closely linked with that of organizational performance, which is in turn closely linked with organizational culture. This article is a review of the role of patient surveys as a quality-improvement tool in health care. The article explores the characteristics, types, merits, and pitfalls of various patient surveys, as well as the impact of their wide-ranging application in dissimilar scenarios to identify gaps in service provision. It is demonstrated that the conducting of patient surveys and using the results to improve the quality of care are two different processes. The value of patient surveys depends on the interplay between these two processes and several other factors that can influence the final outcome. The article also discusses the business aspect of the patient surveys in detail. Finally, the authors make future recommendations on how the patient survey tool can be best used to improve the quality of care in the health-care sector.Keywords: patient surveys, quality improvement, service gaps
Koenig, Harold G.
This paper provides a concise but comprehensive review of research on religion/spirituality (R/S) and both mental health and physical health. It is based on a systematic review of original data-based quantitative research published in peer-reviewed journals between 1872 and 2010, including a few seminal articles published since 2010. First, I provide a brief historical background to set the stage. Then I review research on R/S and mental health, examining relationships with both positive and negative mental health outcomes, where positive outcomes include well-being, happiness, hope, optimism, and gratefulness, and negative outcomes involve depression, suicide, anxiety, psychosis, substance abuse, delinquency/crime, marital instability, and personality traits (positive and negative). I then explain how and why R/S might influence mental health. Next, I review research on R/S and health behaviors such as physical activity, cigarette smoking, diet, and sexual practices, followed by a review of relationships between R/S and heart disease, hypertension, cerebrovascular disease, Alzheimer's disease and dementia, immune functions, endocrine functions, cancer, overall mortality, physical disability, pain, and somatic symptoms. I then present a theoretical model explaining how R/S might influence physical health. Finally, I discuss what health professionals should do in light of these research findings and make recommendations in this regard. PMID:23762764
McCoyd, Judith L. M.
Identifying common patient dynamics is useful for developing social work practice sensitivity in health social work. This article draws on findings from a study of women who terminated desired pregnancies because of fetal anomalies and identifies dynamics that may be applicable to many health settings. Data suggest that women have expectations…
Licht, Kenneth F.
The Occupational Safety and Health Act (1970) concerns private schools but does not directly affect the operations of public schools or colleges. The intent, however, is to have the States develop and administer their own health and safety programs. Administrators should, therefore, initiate a comprehensive, districtwide safety education and…
Globalisation describes the increasing economic and social interdependence between countries. This article examines globalisation in terms of the opportunities and threats it poses to health, in particular increasing rates of non-communicable diseases. Nursing is challenged with responding to the changing health needs of the global population that have arisen as a result of globalisation.
Foti, Kathryn; Balaji, Alexandra; Shanklin, Shari
Background: To monitor priority health risk behaviors and school health policies and practices, respectively, the Centers for Disease Control and Prevention (CDC) developed the Youth Risk Behavior Surveillance System (YRBSS) and the School Health Profiles (Profiles). CDC is often asked about the use and application of these survey data to improve…
Buffie, William C
Significantly compromised health care delivery and adverse health outcomes are well documented for the lesbian, gay, bisexual, and transgender (LGBT) community in the United States compared with the population at large. LGBT individuals subject to societal prejudice in a heterosexist world also suffer from the phenomenon known as "minority stress," with its attendant negative mental and physical health effects. Reports in the medical and social science literature suggest that legal and social recognition of same-sex marriage has had positive effects on the health status of this at-risk community. Improved outcomes are to be expected because of the improved access to health care conferred by marriage benefits under federal or state law and as a result of attenuating the effects of institutionalized stigma on a sexual minority group.
Significantly compromised health care delivery and adverse health outcomes are well documented for the lesbian, gay, bisexual, and transgender (LGBT) community in the United States compared with the population at large. LGBT individuals subject to societal prejudice in a heterosexist world also suffer from the phenomenon known as “minority stress,” with its attendant negative mental and physical health effects. Reports in the medical and social science literature suggest that legal and social recognition of same-sex marriage has had positive effects on the health status of this at-risk community. Improved outcomes are to be expected because of the improved access to health care conferred by marriage benefits under federal or state law and as a result of attenuating the effects of institutionalized stigma on a sexual minority group. PMID:21493934
Dutta, Mohan Jyoti; King, Andy J
According to published scholarship on health services usage, an increasing number of Americans do not have health insurance coverage. The strong relationship between insurance coverage and health services utilization highlights the importance of reaching out to the uninsured via prevention campaigns and communication messages. This article examines the communication choices of the uninsured, documenting that the uninsured are more likely to consume entertainment-based television and are less likely to read, watch, and listen to information-based media. It further documents the positive relationship between interpersonal communication, community participation, and health insurance coverage. The entertainment-heavy media consumption patterns of the uninsured suggests the relevance of developing health marketing strategies that consider entertainment programming as an avenue for reaching out to this underserved segment of the population.
Carney, Terry; Beaupert, Fleur; Chiarella, Mary; Bennett, Belinda; Walton, Merrilyn; Kelly, Patrick J; Satchell, Claudette S
Complaints and disciplinary processes play a significant role in health professional regulation. Many countries are transitioning from models of self-regulation to greater external oversight through systems including meta-regulation, responsive (risk-based) regulation, and "networked governance". Such systems harness, in differing ways, public, private, professional and non-governmental bodies to exert influence over the conduct of health professionals and services. Interesting literature is emerging regarding complainants' motivations and experiences, the impact of complaints processes on health professionals, and identification of features such as complainant and health professional profiles, types of complaints and outcomes. This article concentrates on studies identifying vulnerable groups and their participation in health care regulatory systems.
Santiago, Sarah E; Park, Grace H; Huffman, Kelly J
Healthy post-pregnancy outcomes are contingent upon an informed regimen of prenatal care encouraging healthy maternal consumption habits. In this article, we describe aspects of maternal intake of food, drink, and medication in a population of predominantly Hispanic women in Southern California. Potential implications for unhealthy prenatal dietary choices are discussed. The Food, Beverage, and Medication Intake Questionnaire (FBMIQ) measures common practices of maternal consumption during pregnancy. The FBMIQ was administered to English and Spanish speaking pregnant and recently pregnant (36 weeks pregnant - 8 weeks post-partum) women over the age of 18 who were receiving care from a private medical group in Downey CA. A total of 200 women completed the FBMIQ. Consumption habits of healthy foods and beverages, unhealthy foods, unhealthy beverages, and medication are characterized in this article. Data indicate widespread consumption of fresh fruit, meats, milk and juice and indicate most women used prenatal vitamin supplements. Studies in developmental neuroscience have shown that certain substances may cause teratogenic effects on the fetus when ingested by the mother during pregnancy. Those potentially harmful substances included in our study were Bisphenol-A (BPA), methylmercury, caffeine, alcohol and certain medications. Our results show that a proportion of the women surveyed in our study consumed BPA, methylmercury, caffeine, alcohol, and certain medications at varied levels during pregnancy. This represents an interesting finding and suggests a disconnect between scientific data and general recommendations provided to pregnant mothers by obstetricians. The results of our study demonstrate that a proportion of pregnant women consume substances that are potentially teratogenic and may impact the health and well being of the offspring. It is important to appraise healthy and unhealthy consumption habits in order to encourage healthy practices and alleviate
Older adults are the most frequent and heaviest users of health services in the United States; however, previous research on older adults' use of health information technology (HIT) has not examined the possible association of HIT use among older adults with their use of health services. This study examined the relationship between US older adults' use of health services and their use of the Internet for health-related activities, controlling for socioeconomic characteristics and aging-related limitations in sensory and cognitive function. It also examined gender differences in the pattern of association between the types of health services used and HIT use. The data for this study were drawn from the 2009 US National Health Interview Survey (NHIS), which was the first nationally representative household survey to collect data on HIT (Internet) use. First, the rates of lifetime and 12-month HIT use among sample adults (n = 27,731) by age group (18-29 to 85 and over) were analyzed. Second, bivariate analysis of sociodemographic characteristics, health status, and health service use by HIT use status among those aged 65 or older (n = 5294) was conducted. Finally, multivariate binary logistic regression analysis was used to test the study hypotheses with 12-month HIT use as the dependent variable and 12-month health service uses among the age group 65 or older as possible correlates. The rates of HIT use were significantly lower among the age groups 65 or older compared with the younger age groups, although the age group 55 to 64 was not different from those younger. The rates of HIT use decreased from 32.2% in the age group 65 to 74 to 14.5% in the age group 75 to 84 and 4.9% in the 85 and older age group. For both genders, having seen or talked to a general practitioner increased the odds of HIT use. However, having seen or talked to a medical specialist, eye doctor, or physical therapist/occupational therapist (PT/OT) were significantly associated with HIT use only
Nuclear power production is, in principle, a safe technology when practised in accordance with the well established and very strict national and international rules and regulations. Yet management failures have occurred, resulting in injuries to personnel and, occasionally, escape of radioactive material. Such events may cause potential health problems, affecting physical, mental and social well-being. Public concern still tends to concentrate on nuclear-power-related facilities, yet the public's desire for a reduction in environmental pollution has led to increased demand for the development and use of low-waste or non-waste energy technologies. Nuclear energy production is one such technology, which has become established and well developed, particularly in highly industrialized countries. This was recognized by the WHO Regional Office for Europe as early as the 1970s, and led to a series of scientific working groups to discuss the most urgent issues related to the impact on health of the generation of electrical power by means of nuclear energy. Five major meetings took place between 1975 and 1985, resulting in five publications (1 - 5) covering various aspects of particular concern to the general public (and thus also to national authorities) such as handling plutonium, managing high-level radioactive waste, and preparing for accidental releases of radioactive material. The first such publication was issued in 1977. All five books were based on the collective knowledge and experience of groups of experts, and were published following the meetings of the respective working groups. The project was initiated at the request and with the support of the Government of Belgium, to study and discuss the effects of the nuclear power industry on people and the environment. The project served two objectives. First, it assisted Member States in developing the capacity to understand the public health implications of the widespread use of nuclear power. Second, it
Elwer, Sofia; Alex, Lena; Hammarström, Anne
Abstract Introduction Gendered practices of working life create gender inequalities through horizontal and vertical gender segregation in work, which may lead to inequalities in health between women and men. Gender equality could therefore be a key element of health equity in working life. Our aim was to analyze what gender (in)equality means for the employees at a woman-dominated workplace and discuss possible implications for health experiences. Methods All caregiving staff at two workplace...
Dorman, S M
Video and computer-based games have assumed a prominent role in the culture of American children and adolescents. Given the pervasiveness of their influence, it is likely that these games may affect the health and well-being of children. This paper examines the health effects of these games on children, suggests criteria upon which parents and teachers may evaluate the games, and notes some implications for health educators.
Background: Among the issues that determine the performance of a child at school is health. In recognition of this, the Uganda government has embarked on a school health program for the success of universal primary education. Although dental health is an important component of school health there is little information on ...
Full Text Available Summary A growing body of scientific studies has demonstrated a consistently positive association between religious-spiritual (R/S involvement and beneficial effects on physical health, culminating with increased longevity. This protective effect on the mortality risk is not only statistically significant but also clinically relevant. The mechanisms involved in this association include psycho-neuro-endocrine-immune pathways, greater adherence to healthy behaviors and diverse social factors. Public health strategies could better explore this association. This can be done on an individual (health professionals adopting simple measures or institutional scale (health institutions joining religious organizations. Some evidence suggests that the benefits of R/S to health and longevity would be more present in populations from more religious regions. In this sense, the Americas (Latin and North are privileged places for the exploration of this association, compared to regions where there is certain indifference about R/S practices. Exploring this interface can improve the supply and usage of health care, especially for marginalized populations. To achieve this, health professionals, religious leaders and policy makers need to work together.
Full Text Available Abstract China is a country with vast regional differences and uneven economic development, which have led to widening gaps between the rich and poor in terms of access to healthcare, quality of care, and health outcomes. China's healthcare reform efforts must be tailored to the needs and resources of each region and community. Building and strengthening primary care within the Chinese health care system is one way to effectively address health challenges. This paper begins by outlining the concept of primary care, including key definitions and measurements. Next, results from a number of studies will demonstrate that primary care characteristics are associated with savings in medical costs, improvements in health outcomes and reductions in health disparities. This paper concludes with recommendations for China on successfully incorporating a primary care model into its national health policy, including bolstering the primary care workforce, addressing medical financing structures, recognizing the importance of evidence-based medicine, and looking to case studies from countries that have successfully implemented health reform.
Stebounova, Larissa V; Morgan, Hallie; Grassian, Vicki H; Brenner, Sara
The rapid growth and commercialization of nanotechnology are currently outpacing health and safety recommendations for engineered nanomaterials. As the production and use of nanomaterials increase, so does the possibility that there will be exposure of workers and the public to these materials. This review provides a summary of current research and regulatory efforts related to occupational exposure and medical surveillance for the nanotechnology workforce, focusing on the most prevalent industrial nanomaterials currently moving through the research, development, and manufacturing pipelines. Their applications and usage precedes a discussion of occupational health and safety efforts, including exposure assessment, occupational health surveillance, and regulatory considerations for these nanomaterials. Copyright © 2011 Wiley Periodicals, Inc.
Abimbola, Seye; Ukwaja, Kingsley N; Onyedum, Cajetan C; Negin, Joel; Jan, Stephen; Martiniuk, Alexandra L C
Health care costs incurred prior to the appropriate patient-provider transaction (i.e., transaction costs of access to health care) are potential barriers to accessing health care in low- and middle-income countries. This paper explores these transaction costs and their implications for health system governance through a cross-sectional survey of adult patients who received their first diagnosis of pulmonary tuberculosis (TB) at the three designated secondary health centres for TB care in Ebonyi State, Nigeria. The patients provided information on their care-seeking pathways and the associated costs prior to reaching the appropriate provider. Of the 452 patients, 84% first consulted an inappropriate provider. Only 33% of inappropriate consultations were with qualified providers (QP); the rest were with informal providers such as pharmacy providers (PPs; 57%) and traditional providers (TP; 10%). Notably, 62% of total transaction costs were incurred during the first visit to an inappropriate provider and the mean transaction costs incurred was highest with QPs (US$30.20) compared with PPs (US$14.40) and TPs (US$15.70). These suggest that interventions for reducing transaction costs should include effective decentralisation to integrate TB care with services at the primary health care level, community engagement to address information asymmetry, enforcing regulations to keep informal providers within legal limits and facilitating referral linkages among formal and informal providers to increase early contact with appropriate providers.
Farmers' suicide in India is a cause of concern and government figures, though conservative, predict an impending epidemic. Various measures to curb this calamity are being made in a piecemeal manner. Considering it as an issue of social and mental health concern, this article attempts to evaluate the situation based on the tenet that health and illness are the result of a complex interplay between biological, psychological, social, environmental, economic and political factors. Thus in India the agrarian crisis, among other causes, has been largely debated as the major reason for the current state of farmers. It is important that (psychiatric) epidemiology and public mental health try to evolve mechanisms to understand and implement measures, and take this into consideration when attempting health promotion and prevention.
Isoniazid preventive therapy (IPT) is a key strategy recommended by the World ... In its continued effort to attain its vision of a Namibia where TB is no longer a ... In its health budget planning, the government of Namibia needs ... STATEMENT.
Conclusions: The results suggest a significant relationship between the LH and BMI. It is found that, the better the LH, the more appropriate is the BMI. This evidence reinforces the importance of promoting literacy for health to the Portuguese population.
David G. Shaw
Conclusion: The FASH Model may inform future curriculum innovation. Adopting a holistic approach to education of nurses about self-harm may assist in developing attitudes and skills to make care provision more effective in secure mental health settings.
care or the public heatth care sector, and that it may potentially promote ... The MHC approach controls costs through measures such as .... (managers, computer systems, accountants). If it does not, .... Health EconomICS 1994: 3: 351-357.
... for health, physical activity and sport of psychophysiological resonance, coherence and heart rate variability feedback applications involving respiration and facilitation of positive emotion. Keywords: Heart psychology, psychophysiology, resonance, coherence, transcultural context, heart rate variability, biofeedback.
Auerbach, R P; Alonso, J; Axinn, W G; Cuijpers, P; Ebert, D D; Green, J G; Hwang, I; Kessler, R C; Liu, H; Mortier, P; Nock, M K; Pinder-Amaker, S; Sampson, N A; Aguilar-Gaxiola, S; Al-Hamzawi, A; Andrade, L H; Benjet, C; Caldas-de-Almeida, J M; Demyttenaere, K; Florescu, S; de Girolamo, G; Gureje, O; Haro, J M; Karam, E G; Kiejna, A; Kovess-Masfety, V; Lee, S; McGrath, J J; O'Neill, S; Pennell, B-E; Scott, K; Ten Have, M; Torres, Y; Zaslavsky, A M; Zarkov, Z; Bruffaerts, R
Although mental disorders are significant predictors of educational attainment throughout the entire educational career, most research on mental disorders among students has focused on the primary and secondary school years. The World Health Organization World Mental Health Surveys were used to examine the associations of mental disorders with college entry and attrition by comparing college students (n = 1572) and non-students in the same age range (18-22 years; n = 4178), including non-students who recently left college without graduating (n = 702) based on surveys in 21 countries (four low/lower-middle income, five upper-middle-income, one lower-middle or upper-middle at the times of two different surveys, and 11 high income). Lifetime and 12-month prevalence and age-of-onset of DSM-IV anxiety, mood, behavioral and substance disorders were assessed with the Composite International Diagnostic Interview (CIDI). One-fifth (20.3%) of college students had 12-month DSM-IV/CIDI disorders; 83.1% of these cases had pre-matriculation onsets. Disorders with pre-matriculation onsets were more important than those with post-matriculation onsets in predicting subsequent college attrition, with substance disorders and, among women, major depression the most important such disorders. Only 16.4% of students with 12-month disorders received any 12-month healthcare treatment for their mental disorders. Mental disorders are common among college students, have onsets that mostly occur prior to college entry, in the case of pre-matriculation disorders are associated with college attrition, and are typically untreated. Detection and effective treatment of these disorders early in the college career might reduce attrition and improve educational and psychosocial functioning.
Potenza, Marc N; Fiellin, David A; Heninger, George R; Rounsaville, Bruce J; Mazure, Carolyn M
Over the past several decades, and particularly during the last 10 to 15 years, there has been a rapid increase in the accessibility of legalized gambling in the United States and other parts of the world. Few studies have systematically explored the relationships between patterns of gambling and health status. Existing data support the notion that some gambling behaviors, particularly problem and pathological gambling, are associated with nongambling health problems. The purpose of this arti...
This paper summarizes the 26th Annual Meeting of NCRP, which entails a strictly scientific meeting dealing with sources, doses, and derived health and ecological effects; and second, a quite different meeting that dealt with remedial measures. These measures, as many of the speakers suggested, often have little to do with human health, as revealed by scientific findings, but have much to do with the way a liberal democracy responds to technological hazard in this Age of Anxiety
Reidy, Dennis E.; Kearns, Megan C.; DeGue, Sarah; Lilienfeld, Scott O.; Massetti, Greta; Kiehl, Kent A.
Psychopathy is an early-appearing risk factor for severe and chronic violence. The violence largely attributable to psychopathy constitutes a substantial portion of the societal burden to the public health and criminal justice systems, and thus necessitates significant attention from prevention experts. Yet, despite a vast base of research in psychology and criminology, the public health approach to violence has generally neglected to consider this key variable. Fundamentally, the public health approach to violence prevention is focused on achieving change at the population level to provide the most benefit to the maximum number of people. Increasing attention to the individual-level factor of psychopathy in public health could improve our ability to reduce violence at the community and societal levels. We conclude that the research literature on psychopathy points to a pressing need for a broad-based public health approach with a focus on primary prevention. Further, we consider how measuring psychopathy in public health research may benefit violence prevention, and ultimately society, in general. PMID:29593448
Jaworowska, Agnieszka; Blackham, Toni; Davies, Ian G; Stevenson, Leonard
Consumption of takeaway and fast food continues to increase in Western societies and is particularly widespread among adolescents. Since food is known to play an important role in both the development and prevention of many diseases, there is no doubt that the observed changes in dietary patterns affect the quality of the diet as well as public health. The present review examines the nutritional characteristics of takeaway and fast food items, including their energy density, total fat, and saturated and trans fatty acid content. It also reports on the association between the consumption of such foods and health outcomes. While the available evidence suggests the nutrient profiles of takeaway and fast foods may contribute to a variety of negative health outcomes, findings on the specific effects of their consumption on health are currently limited and, in recent years, changes have been taking place that are designed to improve them. Therefore, more studies should be directed at gaining a firmer understanding of the nutrition and health consequences of eating takeaway and fast foods and determining the best strategy to reduce any negative impact their consumption may have on public health. © 2013 International Life Sciences Institute.
Beacham, Barbara L; Deatrick, Janet A
Health care autonomy typically occurs during late adolescence but health care providers and families often expect children with chronic health conditions to master self-care earlier. Few studies have examined the development of health care autonomy as it pertains to self-care and family management. This review links the 3 concepts and discusses the implications for families and health care providers. Case studies are provided as exemplars to highlight areas where intervention and research is needed. Copyright © 2013 Elsevier Inc. All rights reserved.
Susan Lessick, MA, MLS, AHIP, FMLA
Full Text Available Introduction: The extent to which health sciences librarians are engaged in research is a little-studied question. This study assesses the research activities and attitudes of Medical Library Association (MLA members, including the influence of work affiliation. Methods: An online survey was designed using a combination of multiple-choice and open-ended questions and distributed to MLA members. Responses were analyzed using descriptive statistics, content analysis, and significance testing. The authors used statistical tools and categorized openended question topics by the constant comparative method, also applying the broad subject categories used in a prior study. Pearson’s chi-square analysis was performed on responses to determine significant differences among respondents employed in three different institutional environments. Results: Analysis showed that 79% of respondents read research articles at least once a month; 58% applied published research studies to practice; 44% had conducted research; 62% reported acting on research had enhanced their libraries; 38% had presented findings; and 34% had authored research articles. Hospital librarians were significantly less likely than academic librarians to have participated in research activities. Highly ranked research benefits, barriers, and competencies of health sciences librarians are described. Conclusions: Findings indicate that health sciences librarians are actively engaged in research activities. Practice implications for practitioners, publishers, and stakeholders are discussed. Results suggest that practitioners can use published research results and results from their own research to affect practice decisions and improve services. Future studies are needed to confirm and extend these findings, including the need for intervention studies to increase research and writing productivity.
Dougall, Alison; Molina, Gustavo F; Eschevins, Caroline; Faulks, Denise
The concept of oral health is frequently reduced to the absence of disease, despite existing conceptual models exploring the wider determinants of oral health and quality of life. The International Classification of Functioning, Disability and Health (ICF) (WHO) is designed to qualify functional, social and environmental aspects of health. This survey aimed to reach a consensual description of adult oral health, derived from the ICF using international professional opinion. The Global Oral Health Survey involved a two-round, online survey concerning factors related to oral health including functioning, participation and social environment. Four hundred eighty-six oral health professionals from 74 countries registered online. Professionals were pooled into 18 groups of six WHO world regions and three professional groups. In a randomised stratification process, eight professionals from each pool (n=144) completed the survey. The first round consisted of eight open-ended questions. Open expression replies were analysed for meaningful concepts and linked using established rules to the ICF. In Round 2, items were rated for their relevance to oral health (88% response rate). Eighty-nine ICF items and 30 other factors were considered relevant by at least 80% of participants. International professionals reached consensus on a holistic description of oral health, which could be qualified and quantified using the ICF. These results represent the first step towards developing an ICF Core Set in Oral Health, which would provide a practical tool for reporting outcome measures in clinical practice, for research and epidemiology, and for the improvement of interdisciplinary communication regarding oral health. Professional consensus reached in this survey is the foundation stone for developing an ICF Core Set in Oral Health, allowing the holistic aspects of oral health to be qualified and quantified. This tool is necessary to widen our approach to clinical decision making
Rothman, Brian; Leonard, Joan C; Vigoda, Michael M
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
Aday, Lu Ann; Cornelius, Llewellyn Joseph
... and Carrying Out the Survey 311 14 Preparing the Data for Analysis 340 15 Planning and Implementing the Analysis of the Data 360 16 Writing the Research Report 391 Resource A: Personal Interview Sur...
Bourke, Ashling; Boduszek, Daniel; Kelleher, Caroline; McBride, Orla; Morgan, Karen
This study investigated the relationship between school sex education and sexual health behaviours at first sex and later in adulthood, using nationally representative data. Respondents were adults from the 2010 Irish Contraception and Crisis Pregnancy Survey, a cross-sectional survey designed to assess knowledge, attitudes and behaviours relating…
P. K. Bienfang
Full Text Available This paper overviews several examples of important public health impacts by marine microbes and directs readers to the extensive literature germane to these maladies. These examples include three types of dinoflagellates (Gambierdiscus spp., Karenia brevis, and Alexandrium fundyense, BMAA-producing cyanobacteria, and infectious microbes. The dinoflagellates are responsible for ciguatera fish poisoning, neurotoxic shellfish poisoning, and paralytic shellfish poisoning, respectively, that have plagued coastal populations over time. Research interest on the potential for marine cyanobacteria to contribute BMAA into human food supplies has been derived by BMAA's discovery in cycad seeds and subsequent implication as the putative cause of amyotrophic lateral sclerosis/parkinsonism dementia complex among the Chamorro people of Guam. Recent UPLC/MS analyses indicate that recent reports that BMAA is prolifically distributed among marine cyanobacteria at high concentrations may be due to analyte misidentification in the analytical protocols being applied for BMAA. Common infectious microbes (including enterovirus, norovirus, Salmonella, Campylobacter, Shigella, Staphylococcus aureus, Cryptosporidium, and Giardia cause gastrointestinal and skin-related illness. These microbes can be introduced from external human and animal sources, or they can be indigenous to the marine environment.
Full Text Available Genetic information such as DNA sequences has been limited to fully explain mechanisms of gene regulation and disease process. Epigenetic mechanisms, which include DNA methylation, histone modification and non-coding RNAs, can regulate gene expression and affect progression of disease. Although studies focused on epigenetics are being actively investigated in the field of medicine and biology, epigenetics in dental research is at the early stages. However, studies on epigenetics in dentistry deserve attention because epigenetic mechanisms play important roles in gene expression during tooth development and may affect oral diseases. In addition, understanding of epigenetic alteration is important for developing new therapeutic methods. This review article aims to outline the general features of epigenetic mechanisms and describe its future implications in the field of dentistry.
The relationship between social class and mental illness stigma has received little attention in recent years. At the same time, the concept of mental health literacy has become an increasingly popular way of framing knowledge and understanding of mental health issues. British Social Attitudes survey data present an opportunity to unpack the relationships between these concepts and social class, an important task given continuing mental health inequalities. Regression analyses were undertaken which centred on depression and schizophrenia vignettes, with an asthma vignette used for comparison. The National Statistics Socio-economic Classification, education and income were used as indicators of class. A number of interesting findings emerged. Overall, class variables showed a stronger relationship with mental health literacy than stigma. The relationship was gendered such that women with higher levels of education, especially those with a degree, had the lowest levels of stigma and highest levels of mental health literacy. Interestingly, class showed more of an association with stigma for the asthma vignette than it did for both the depression and schizophrenia vignettes, suggesting that mental illness stigma needs to be contextualised alongside physical illness stigma. Education emerged as the key indicator of class, followed by the National Statistics Socio-economic Classification, with income effects being marginal. These findings have implications for targeting health promotion campaigns and increasing service use in order to reduce mental health inequalities. © The Author(s) 2014.
McGetrick, Jennifer Ann; Raine, Kim D; Wild, T Cameron; Nykiforuk, Candace I J
Health in all policies can address chronic disease morbidity and mortality by increasing population-level physical activity and healthy eating, and reducing tobacco and alcohol use. Both governmental and nongovernmental policy influencers are instrumental for health policy that modifies political, economic, and social environments. Policy influencers are informed and persuaded by coalitions that support or oppose changing the status quo. Empirical research examining policy influencers' contact with coalitions, as a social psychological exposure with health policy outcomes, can benefit from application of health communication theories. Accordingly, we analyzed responses to the 2014 Chronic Disease Prevention Survey for 184 Canadian policy influencers employed in provincial governments, municipalities, large workplaces, school boards, and the media. In addition to contact levels with coalitions, respondents' jurisdiction, organization, and ideology were analyzed as potential moderators. Calculating authority score centrality using network analysis, we determined health policy supporters to be more central in policy influencer networks, and theorized their potential to impact health policy public agenda setting via priming and framing processes. We discuss the implications of our results as presenting opportunities to more effectively promote health policy through priming and framing by coordinating coalitions across risk behaviors to advance a societal imperative for chronic disease prevention.
Potenza, Marc N; Fiellin, David A; Heninger, George R; Rounsaville, Bruce J; Mazure, Carolyn M
Over the past several decades, and particularly during the last 10 to 15 years, there has been a rapid increase in the accessibility of legalized gambling in the United States and other parts of the world. Few studies have systematically explored the relationships between patterns of gambling and health status. Existing data support the notion that some gambling behaviors, particularly problem and pathological gambling, are associated with nongambling health problems. The purpose of this article is to provide a perspective on the relationship between gambling behaviors and substance use disorders, review the data regarding health associations and screening and treatment options for problem and pathological gambling, and suggest a role for generalist physicians in assessing problem and pathological gambling. A rationale for conceptualization of pathological gambling as an addictive disorder and a model proposing stress as a possible mediating factor in the relationship between gambling and health status are presented. More research is needed to investigate directly the biological and health correlates associated with specific types of gambling behaviors and to define the role for generalist physicians in the prevention and treatment of problem and pathological gambling.
Batras, Dimitri; Duff, Cameron; Smith, Ben J
Sophisticated understandings of organizational dynamics and processes of organizational change are crucial for the development and success of health promotion initiatives. Theory has a valuable contribution to make in understanding organizational change, for identifying influential factors that should be the focus of change efforts and for selecting the strategies that can be applied to promote change. This article reviews select organizational change models to identify the most pertinent insights for health promotion practitioners. Theoretically derived considerations for practitioners who seek to foster organizational change include the extent to which the initiative is modifiable to fit with the internal context; the amount of time that is allocated to truly institutionalize change; the ability of the agents of change to build short-term success deliberately into their implementation plan; whether or not the shared group experience of action for change is positive or negative and the degree to which agencies that are the intended recipients of change are resourced to focus on internal factors. In reviewing theories of organizational change, the article also addresses strategies for facilitating the adoption of key theoretical insights into the design and implementation of health promotion initiatives in diverse organizational settings. If nothing else, aligning health promotion with organizational change theory promises insights into what it is that health promoters do and the time that it can take to do it effectively. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: email@example.com.
Bradley, Paul S
As healthcare providers transition to outcome-based reimbursements, it is imperative that they make the transition to population health management to stay viable. Providers already have big data assets in the form of electronic health records and financial billing system. Integrating these disparate sources together in patient-centered datasets provides the foundation for probabilistic modeling of their patient populations. These models are the core technology to compute and track the health and financial risk status of the patient population being served. We show how the probabilistic formulation allows for straightforward, early identification of a change in health and risk status. Knowing when a patient is likely to shift to a less healthy, higher risk category allows the provider to intervene to avert or delay the shift. These automated, proactive alerts are critical in maintaining and improving the health of a population of patients. We discuss results of leveraging these models with an urban healthcare provider to track and monitor type 2 diabetes patients. When intervention outcome data are available, data mining and predictive modeling technology are primed to recommend the best type of intervention (prescriptions, physical therapy, discharge protocols, etc.) with the best likely outcome.
David G. Shaw
Methods: The study aimed to explore the attitudes of mental health nurses toward service users who self-harm in secure environments, and to inform mental health curriculum development. It was conducted in a large forensic mental health unit, containing medium and low secure facilities, to the west of London, UK. A qualitative multi-method approach was adopted, underpinned by interpretative phenomenological analysis. Data were obtained from mental health nurses using individual interviews and focus groups, and analysis followed a step-by-step thematic approach using interpretative phenomenological analysis. Results: Nurses' attitudes toward self-harm varied but were mainly negative, and this was usually related to limited knowledge and skills. The results of the study, framed by the Theory of Planned Behaviour, led to the development of a proposed educational model entitled ‘Factors Affecting Self-Harming Behaviours’ (FASH. Conclusion: The FASH Model may inform future curriculum innovation. Adopting a holistic approach to education of nurses about self-harm may assist in developing attitudes and skills to make care provision more effective in secure mental health settings.
Erdöl, Cevdet; Ergüder, Toker; Morton, Jeremy; Palipudi, Krishna; Gupta, Prakash; Asma, Samira
Waterpipe tobacco smoking (WTS) is an emerging tobacco product globally, especially among adolescents and young adults who may perceive WTS as a safe alternative to smoking cigarettes. Monitoring the use of WTS in Turkey in relation to the tobacco control policy context is important to ensure that WTS does not become a major public health issue in Turkey. The Global Adult Tobacco Survey (GATS) was conducted in Turkey in 2008 and was repeated in 2012. GATS provided prevalence estimates on current WTS and change over time. Other indicators of WTS were also obtained, such as age of initiation and location of use. Among persons aged 15 and older in Turkey, the current prevalence of WTS decreased from 2.3% in 2008 to 0.8% in 2012, representing a 65% relative decline. Among males, WTS decreased from 4.0% to 1.1% (72% relative decline). While the overall smoking prevalence decreased among females, there was no change in the rate of WTS (0.7% in 2008 vs. 0.5% in 2012), though the WTS prevalence rate was already low in 2008. Comprehensive tobacco control efforts have been successful in reducing the overall smoking prevalence in Turkey, which includes the reduction of cigarette smoking and WTS. However, it is important to continue monitoring the use of waterpipes in Turkey and targeting tobacco control efforts to certain groups that may be vulnerable to future WTS marketing (e.g., youth, women).
Anokye, Nana Kwame; Pokhrel, Subhash; Fox-Rushby, Julia
Changing the relative price of (in) activity is an important tool for health policies. Nonetheless, to date, analyses of correlates of physical activity (PA) have excluded the notion of price. Using the first nationwide dataset on prices of PA for England, we explore for the first time how money and time prices are associated with PA (in general) and specific activities. A nationally representative telephone follow-up survey to Health Survey for England (HSE) 2008 was undertaken in 2010. The sample covered individuals who reported to have undertaken some PA in the HSE 2008. Questions focussed on: ex-post money and time prices; type and quantity of PA; perceived benefits of PA and socio-economic details. Count regression models (all activities together, and swimming, workout, walking separately) were fitted to investigate the variation in quantity of PA. Of 1683 respondents, 83% participated in PA (one or more activities), and spent an average of £2.40 per occasion of participation in PA and 23 minutes travelling. Participation in PA was negatively associated with money prices per occasion (i.e. family member/child care fees, parking fees, and facility charges) and travel time price. Participation in PA was more sensitive to travel time price than money price. Among the specific activities, the money price effect was highest for swimming with a 10% higher price associated with 29% fewer occasions of swimming; followed by workout (3% fewer occasions) and walking (2% fewer occasions). Only swimming and workout were sensitive to travel time price. People who felt doing PA could help them 'get outdoors', 'have fun', or 'lose weight' were likely to do more PA. Two main policy implications emerge from the findings. First, the results support the notion that positive financial incentives, e.g. subsidising price of participation, could generally lead to an increase in quantity of PA among those already exercising. Second, such policies could lead to desired policy goals if
Brantsæter, Anne Lise; Ydersbond, Trond A; Hoppin, Jane A; Haugen, Margaretha; Meltzer, Helle Margrete
The market for organic food products is growing rapidly worldwide. Such foods meet certified organic standards for production, handling, processing, and marketing. Most notably, the use of synthetic fertilizers, pesticides, and genetic modification is not allowed. One major reason for the increased demand is the perception that organic food is more environmentally friendly and healthier than conventionally produced food. This review provides an update on market data and consumer preferences for organic food and summarizes the scientific evidence for compositional differences and health benefits of organic compared with conventionally produced food. Studies indicate some differences in favor of organic food, including indications of beneficial health effects. Organic foods convey lower pesticide residue exposure than do conventionally produced foods, but the impact of this on human health is not clear. Comparisons are complicated by organic food consumption being strongly correlated with several indicators of a healthy lifestyle and by conventional agriculture "best practices" often being quite close to those of organic.
Struve, James K
The role of religiousness/spirituality (R/S) in health has been of growing interest in the medical literature in recent years. Studies have demonstrated enhanced health effects from religious prescriptions and proscriptions, religious/spiritual social support, and specific attitudes and behaviors linked to deep spiritual belief (e.g., compassionate view toward others and active religious surrender). This article reviews the recent literature on the role of R/S in health and offers suggestions on how physicians can explore whether their patient's R/S is a source of strength. Examples of simple questions that can be incorporated into a routine visit are presented. Physicians who ask about R/S issues may help patients recognize new ways of coping, new avenues for social support, and new sources of courage and hope.
Tremblay, Mark Stephen; Colley, Rachel Christine; Saunders, Travis John; Healy, Genevieve Nissa; Owen, Neville
Sedentary behaviour is associated with deleterious health outcomes, which differ from those that can be attributed to a lack of moderate to vigorous physical activity. This has led to the field of "sedentary physiology", which may be considered as separate and distinct from exercise physiology. This paper gives an overview of this emerging area of research and highlights the ways that it differs from traditional exercise physiology. Definitions of key terms associated with the field of sedentary physiology and a review of the self-report and objective methods for assessing sedentary behaviour are provided. Proposed mechanisms of sedentary physiology are examined, and how they differ from those linking physical activity and health are highlighted. Evidence relating to associations of sedentary behaviours with major health outcomes and the population prevalence and correlates of sedentary behaviours are reviewed. Recommendations for future research are proposed.
that school children in Ogun State do not perceive themselves to be healthy and suggest the use of school health questionnaire to assess and identify common health problems in school children. Keywords: School-age children, common health problems, questionnaire, Nigeria. Nigerian Journal of Parasitology Vol.
Oak Ridge Institute for Science and Education
This annual report details the number of health physics bachelor's, master's, and postdoctoral degrees awarded at a sampling of academic programs from 1998-2005. It also looks at health physics degrees by curriculum and the number of students enrolled in health physics degree programs at 30 U.S. universities in 2005
Oak Ridge Institute for Science and Education
This annual report details the number of health physics bachelor's, master's, and doctoral degrees awarded at a sampling of academic programs from 1998-2004. It also looks at health physics degrees by curriculum and the number of students enrolled in health physics degree programs at 28 U.S. universities in 2004
In 1999 the Victorian primary care and community support system began a process of substantial reform, involving purchasing reforms and a contested selection process between providers in large catchment areas across the State. The Liberal Government's electoral defeat in September 1999 led to a review of these reforms. This paper questions the reforms from a rural perspective. They were based on a generic template that did not consider rural-urban differences in health needs or other differences including socio-economic status, and may have reinforced if not aggravated rural-urban differences in the quality of and access to primary health care in Victoria.
Full Text Available Notwithstanding a major body of evidence on the carcinogenicity of all asbestos fibres and a general consensus of the scientific community on the health impact of this agent, asbestos is still produced and used in a large number of countries, thus determining further harm for future generations. Prevention of asbestos-related disease requires international cooperation, transfer of know-how and dissemination of successful procedures in order to contrast asbestos exposure in the frame of a global environmental health approach.
Full Text Available Recreational sun exposure accounts for a large number of acute and chronic dermatological diseases, including skin cancer. This study aimed at estimating the one-year prevalence of sun exposure and skin health-associated knowledge and attitudes among Austrian citizens. The population-based UVSkinRisk survey investigated a representative sample of Austrian adults using a structured questionnaire. In total, 1500 study subjects (median age 33.0 years, 50.5% females participated in this questionnaire survey. Among study participants, prevalence of sun exposure was 47%, with slightly higher rates in males (48% compared to females (46%. Younger age, lower professional category, darker skin type, motives to tan, sunbed use, sunburn, and outdoor sport activity increased the odds for prevalent sun exposure. This is the first population-based study evaluating the prevailing sun exposure and recreational habits influencing skin health among Austrian citizens. Despite public media campaigns educating on the harmful effects of sunlight exposure, we found a high prevalence of self-reported sunlight exposure. The results suggest that multifaceted socio-cultural characteristics stimulate recreational sun exposure and tanning habits. Communicating individualized Public (Skin Health messages might be the key to prevent photo-induced skin health hazards in light-skinned populations. The practical and theoretical implications of these findings are discussed.
Asking participants to assess their social class may be an efficient approach to examining inequalities in heath from survey data. The present study investigated this possibility empirically by testing whether subjective class identification is related to overall health. I used pooled cross-sectional data from the 2012 and the 2014 General Social Survey, a nationally representative survey carried out among adults in the United States. The association between health and class was estimated separately by gender, race and age. The association follows a gradient pattern where health deteriorates with lower class position even after controlling for indicators typically used in research that examines class differences in health-educational attainment, family income and occupational prestige. The results largely hold when the data are stratified by gender, race and age. These findings demonstrate the empirical value of subjective class identification for assessing social inequalities in health from survey data.
Ilunga Tshiswaka, Daudet; Loggins Clay, Shondra; Chiu, Chung-Yi; Alston, Reginald; Lewis, Allen
To examine the relationships among Assistive Technology (AT) use, race, type of disability and selected other demographic characteristics. Using 2009 National Health Interview Survey, descriptive statistics, statistical interactions and binary logistic regression were performed to identify, contrast and predict the likelihood of using AT based on the type of disability among African Americans (AAs) and European Americans (EAs). We found that more AAs (10% within group proportion of total AAs) used AT compared to EAs (7.5% within group proportion of total EAs). Physical (p disabling conditions that predict the use of AT than AAs, whereas AAs had more demographic characteristics beyond race that predict AT use than EAs. Disparities were observed in AT usage by disability types and demographic characteristics between AAs and EAs. Moreover, the predictive strength of AT usage based on disability types and other demographic variables differed by races. Overall, the findings about the different relationships among race, disability type, and AT use are found. Implications for Rehabilitation The finding may inform the development of initiatives by rehabilitation leaders to encourage the use of AT by AAs and EAs according to their type of impairment. Having identified physical impairment as statistically significant predictor of AT use greater among AAs, rehabilitation leaders should ensure that people living with those types of disability have access to the corresponding type of AT and can use them effectively.
McLaughlin, Katie A.; Koenen, Karestan C.; Friedman, Matthew J.; Ruscio, Ayelet Meron; Karam, Elie G.; Shahly, Victoria; Stein, Dan J.; Hill, Eric D.; Petukhova, Maria; Alonso, Jordi; Andrade, Laura Helena; Angermeyer, Matthias C.; Borges, Guilherme; de Girolamo, Giovanni; de Graaf, Ron; Demyttenaere, Koen; Florescu, Silvia E.; Mladenova, Maya; Posada-Villa, Jose; Scott, Kate M.; Takeshima, Tadashi; Kessler, Ronald C.
Background Although only a minority of people exposed to a traumatic event (TE) develops PTSD, symptoms not meeting full PTSD criteria are common and often clinically significant. Individuals with these symptoms have sometimes been characterized as having sub-threshold PTSD, but no consensus exists on the optimal definition of this term. Data from a large cross-national epidemiological survey are used to provide a principled basis for such a definition. Methods The WHO World Mental Health (WMH) Surveys administered fully-structured psychiatric diagnostic interviews to community samples in 13 countries containing assessments of PTSD associated with randomly selected TEs. Focusing on the 23,936 respondents reporting lifetime TE exposure, associations of approximated DSM-5 PTSD symptom profiles with six outcomes (distress-impairment, suicidality, comorbid fear-distress disorders, PTSD symptom duration) were examined to investigate implications of different sub-threshold definitions. Results Although consistently highest distress-impairment, suicidality, comorbidity, and symptom duration were observed among the 3.0% of respondents with DSM-5 PTSD than other symptom profiles, the additional 3.6% of respondents meeting two or three of DSM-5 Criteria BE also had significantly elevated scores for most outcomes. The proportion of cases with threshold versus sub-threshold PTSD varied depending on TE type, with threshold PTSD more common following interpersonal violence and sub-threshold PTSD more common following events happening to loved ones. Conclusions Sub-threshold DSM-5 PTSD is most usefully defined as meeting two or three of the DSM-5 Criteria B-E. Use of a consistent definition is critical to advance understanding of the prevalence, predictors, and clinical significance of sub-threshold PTSD. PMID:24842116
Doughty, J; Lala, R; Marshman, Z
The popularity of cosmetic surgery has seen a rapid increase recently, with the trend mirrored in dentistry. The Department of Health expressed concerns about the potential for biological and psychosocial harm of these cosmetic procedures. Furthermore, the dental public health implications (DPH) of the growing uptake of cosmetic dental procedures have not been explored. Conduct a scoping review to explore the DPH implications of cosmetic dentistry and identify gaps for future research. A fivestage scoping review was conducted of studies identified using the search terms cosmetic AND dentistry. Data from the studies meeting the inclusion criteria were extracted, collated and summarised into themes. Fifty-seven papers met the inclusion criteria (11 cross-sectional studies, 10 literature reviews and 36 opinion pieces). The DPH implications were summarised into five emergent themes: dento-legal and ethical, marketing, psychosocial, biological and workforce. These themes revealed patients' increased expectations, expanding commercialisation of the profession, psychological risks to vulnerable patients, the iatrogenic consequences of invasive cosmetic dental procedures and workforce implications of the current trends. The scoping review found that existing literature on cosmetic dentistry is predominately anecdotal - professional opinions and discussions. Despite this, our findings demonstrated workforce training and governance implications due to increased demand for cosmetic dentistry. Further empirical research is needed to understand the DPH implications of the increasing demand and uptake of cosmetic dental procedures to guide evidence-based policy to safeguard patients and improve the quality of dental services. Copyright© 2016 Dennis Barber Ltd
animals highlights the public health significance of this infection. Key words: Cysticercosis, Cysticercus bovis, occurrence, taeniasis, Taenia saginata,. Introduction. Bovine cysticercosis is the infection of the cattle caused by Cysticercus bovis and consumption of the raw or undercooked meat results in human taeniasis. Also ...
Gearhardt, Ashley N; Grilo, Carlos M; DiLeone, Ralph J; Brownell, Kelly D; Potenza, Marc N
Data suggest that hyperpalatable foods may be capable of triggering an addictive process. Although the addictive potential of foods continues to be debated, important lessons learned in reducing the health and economic consequences of drug addiction may be especially useful in combating food-related problems. In the current paper, we review the potential application of policy and public health approaches that have been effective in reducing the impact of addictive substances to food-related problems. Corporate responsibility, public health approaches, environmental change and global efforts all warrant strong consideration in reducing obesity and diet-related disease. Although there exist important differences between foods and addictive drugs, ignoring analogous neural and behavioral effects of foods and drugs of abuse may result in increased food-related disease and associated social and economic burdens. Public health interventions that have been effective in reducing the impact of addictive drugs may have a role in targeting obesity and related diseases. © 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.
Steinberg, Francene M; Bearden, Monica M; Keen, Carl L
This paper offers a review of current scientific research regarding the potential cardiovascular health benefits of flavonoids found in cocoa and chocolate. Recent reports indicate that the main flavonoids found in cocoa, flavan-3-ols and their oligomeric derivatives, procyanidins, have a variety of beneficial actions, including antioxidant protection and modulation of vascular homeostasis. These findings are supported by similar research on other flavonoid-rich foods. Other constituents in cocoa and chocolate that may also influence cardiovascular health are briefly reviewed. The lipid content of chocolate is relatively high; however, one third of the lipid in cocoa butter is composed of the fat stearic acid, which exerts a neutral cholesterolemic response in humans. Cocoa and chocolate contribute to trace mineral intake, which is necessary for optimum functioning of all biologic systems and for vascular tone. Thus, multiple components in chocolate, particularly flavonoids, can contribute to the complex interplay of nutrition and health. Applications of this knowledge include recommendations by health professionals to encourage individuals to consume a wide range of phytochemical-rich foods, which can include dark chocolate in moderate amounts.
Social health insurance was introduced in Nigeria in 1999 and had since been restricted to workers in the formal public sector. There are plans for scaling up to include rural populations in a foreseeable future. Information on willingness to participate and pay a premium in the programme by rural populations is dearth.
Contemporary health and medical education in the present information dispensation must actively engage healthcare providers in opportunities for knowledge seeking, learning to learn, and motivation to continue learning. The favored pedagogical design to achieve this is Problem-Based Learning (PBL) enhanced with the ...
Rodriguez, C.; Lamothe, L.; Barten, F.J.M.H.; Haggerty, J.
The term governance is used more and more often in the formulation, implementation, and evaluation of public policies. The purpose of this paper is twofold: to shed light on its meaning, and to study its applicability for the study of recent public health policies in Latin America. After discussing
Yu, Chai Ping; Whynes, David K; Sach, Tracey H
This paper assesses the potential equity impact of Malaysia's projected reform of its current tax financed system towards National Health Insurance (NHI). The Kakwani's progressivity index was used to assess the equity consequences of the new NHI system (with flat rate NHI scheme) compared to the current tax financed system. It was also used to model a proposed system (with a progressive NHI scheme) that can generate the same amount of funding more equitably. The new NHI system would be less equitable than the current tax financed system, as evident from the reduction of Kakwani's index to 0.168 from 0.217. The new flat rate NHI scheme, if implemented, would reduce the progressivity of the health finance system because it is a less progressive finance source than that of general government revenue. We proposed a system with a progressive NHI scheme that generates the same amount of funding whilst preserving the equity at the Kakwani's progressivity index of 0.213. A NHI system with a progressive NHI scheme is proposed to be implemented to raise health funding whilst preserving the equity in health care financing. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.
Huang, Haiqiu; Krishnan, Hari B; Pham, Quynhchi; Yu, Liangli Lucy; Wang, Thomas T Y
Soy (Glycine max) is a major commodity in the United States, and soy foods are gaining popularity due to their reported health-promoting effects. In the past two decades, soy and soy bioactive components have been studied for their health-promoting/disease-preventing activities and potential mechanisms of action. Recent studies have identified gut microbiota as an important component in the human body ecosystem and possibly a critical modulator of human health. Soy foods' interaction with the gut microbiota may critically influence many aspects of human development, physiology, immunity, and nutrition at different stages of life. This review summarizes current knowledge on the effects of soy foods and soy components on gut microbiota population and composition. It was found, although results vary in different studies, in general, both animal and human studies have shown that consumption of soy foods can increase the levels of bifidobacteria and lactobacilli and alter the ratio between Firmicutes and Bacteroidetes. These changes in microbiota are consistent with reported reductions in pathogenic bacteria populations in the gut, thereby lowering the risk of diseases and leading to beneficial effects on human health.
The reuse of treated effluent (for agriculture and as supplement for drinking water needs) is currently receiving attention as a reliable water source. This paper is aimed at reviewing the environmental and health impacts of untreated or inadequately treated wastewater effluents. The quality of wastewater effluents is ...
AJRH Managing Editor
Number of Male Sex Workers in Nigeria. African Journal of Reproductive Health September 2016 (Special ... deaths per 100,000 live births2. Furthermore, hidden in these global averages are persistent and worsening gaps, as ... gender equality and empower all women and girls‖) are perhaps most salient. The ambitious.
Further analysis reveals that the quality of housing varies across the residential areas identified in the city. Similarly, environmental health challenges vary across the three residential areas in Lokoja. The study recommends that low cost housing scheme should be established in Lokoja as this may reduce housing problems ...
Suskind, Anne M.; Clemens, J. Quentin
Purpose of Review The U.S. healthcare system is undergoing fundamental changes in an effort to improve access to care, curtail healthcare spending, and improve quality of care. These efforts largely focused on Medicare, and therefore will have a fundamental impact on the care of geriatric patients. This article reviews contemporary health policy issues, with a focus on how these issues may impact the care of geriatric urology patients. Recent Findings The Affordable Care Act (ACA) has broadened the scope of Medicare coverage. Future Medicare reimbursement will be increasingly tied to care coordination, quality reporting, and demonstration of appropriate outcomes. Additional research is needed to better define the comparative effectiveness of urologic therapies in geriatric patients. Workforce projections indicate that there is a shortage of urologists in many areas of the country, and that this shortage will worsen over time unless a new funding model is instituted for graduate medical education. Summary Medicare spending drives many health policy decisions. Therefore, few health policy topics are unique to geriatrics or geriatric urology. However, certain health policy topics (e.g., care coordination, risk-stratification) are particularly germaine to the elderly patients. Urologists with a particular interest in geriatric urology should be familiar with these issues. PMID:26765043