WorldWideScience

Sample records for health system rises

  1. High and rising health care costs.

    Science.gov (United States)

    Ginsburg, Paul B

    2008-10-01

    The U.S. is spending a growing share of the GDP on health care, outpacing other industrialized countries. This synthesis examines why costs are higher in the U.S. and what is driving their growth. Key findings include: health care inefficiency, medical technology and health status (particularly obesity) are the primary drivers of rising U.S. health care costs. Health payer systems that reward inefficiencies and preempt competition have impeded productivity gains in the health care sector. The best evidence indicates medical technology accounts for one-half to two-thirds of spending growth. While medical malpractice insurance and defensive medicine contribute to health costs, they are not large enough factors to significantly contribute to a rise in spending. Research is consistent that demographics will not be a significant factor in driving spending despite the aging baby boomers.

  2. Modern trends in the health care system of Russia: drop or rise

    Directory of Open Access Journals (Sweden)

    Yuliya Zh. Sadykova

    2017-01-01

    Full Text Available In the period of the existence of post-soviet Russia, the health care system has remained and remains one of the most important and, at the same time, the problem element of it. We have to admit that not always medical services, offered by our state, are positive, if we consider them, for example, through the concept of “quality”. Undoubtedly, this is determined by the existing medical structure, starting with the number of different hospital establishments and ending with the degree of qualification and competence of medical specialists.Thus, the purpose of this article is a comprehensive analysis of the healthcare system that was established in the Russian Federation in 1990–2015, the object of the study is the entire Russian health care system, and the subject is specific statistical data on the hospital beds and hospitals in Russia.Problems of health development, as well as various methodological issues of statistical research, including the accounting of hospital facilities, hospital beds, doctors in the context of specialties, morbidity are considered in the works of both domestic and foreign scientists (V.Medic, M. Tokmachev, G. Ulumbekova, S. Banin, McKee Martin and others.The main directions of development of the national medicine for the specified period of time, its characteristic features and problems of concern that cause dysfunction in the work of the health care protection mechanism for the citizens were identified in the context of the dynamics in such statistical indexes as the total number of hospital and outpatient clinics, hospital beds in them, the number of doctors and the state of morbidity of the population, published by the Federal State Statistics Service.As a research task, attempts were made to assess the impact of changes in these indexes on the state of Russian health care over the period as a whole. Moreover, the work revealed the main content concepts on this topic, explained the nominal structure of the

  3. The rise of governmentality in the Italian National Health System: physiology or pathology of a decentralized and (ongoing) federalist system?

    Science.gov (United States)

    Lega, Federico; Sargiacomo, Massimo; Ianni, Luca

    2010-11-01

    In this paper, we aim to discuss the implications and lessons that can be learnt from the ongoing process of federalism affecting the Italian National Health System (INHS). Many countries are currently taking decisions concerning the decentralization or re-centralization of their health-care systems, with several key issues that are illustrated in the recent history of the INHS. The decentralization process of INHS has produced mixed results, as some regions took advantage of it to strengthen their systems, whereas others were not capable of developing an effective steering role. We argue that the mutual reinforcement of the decentralization and recentralization processes is not paradoxical, but is actually an effective way for the State to maintain control over the equity and efficiency of its health-care system while decentralizing at a regional level. In this perspective, we provide evidence backing up some of the assumptions made in previous works as well as new food-for thought - specifically on how governmentality and federalism should meet - to reshape the debate on decentralization in health care.

  4. The rise of private health insurande in Denmark

    DEFF Research Database (Denmark)

    Dejgaard, Thomas Engel

    2011-01-01

    The Danish healthcare system has since the early 1970s been tax financed and with free and equal access to health care. It still is, but within the last decade there has been an exponential growth in the number of private health insurances – from less than 50.000 in 2002 to approximately 1.......1 million in 2010. These private health insurances to great extent cover the same kind of treatments that can be obtained through the public tax financed system, but without the waiting lists that has been the an unsolvable problem for the public health care system over the past two decades. The rise...... of private health insurances in Denmark means that alongside the public healthcare institution there has grown a private institutional layer. The existence of this private institutional layer raises questions of what kind of influence the new private institutions can have on the existing public healthcare...

  5. POPULATION HEALTH AND THE RISE OF CONSUMERISM.

    Science.gov (United States)

    2015-09-01

    Earlier this summer, we convened a panel of health care executives and industry experts to consider how hospitals can balance the demands of high-value, more efficient care with the emergence of the savvy health care consumer. Their insights and words of advice are eye-opening.

  6. Technological innovations and the rise of social inequalities in health.

    Science.gov (United States)

    Weiss, Daniel; Eikemo, Terje Andreas

    2017-11-01

    Social inequalities in health have been categorised as a human-rights issue that requires action. Unfortunately, these inequalities are on the rise in many countries, including welfare states. Various theories have been offered to explain the persistence (and rise) of these inequalities over time, including the social determinants of health and fundamental cause theory. Interestingly, the rise of modern social inequalities in health has come at a time of great technological innovation. This article addresses whether these technological innovations are significantly influencing the persistence of modern social inequalities in health. A theoretical argument is offered for this potential connection and is discussed alongside the typical social determinants of health perspective and the increasingly popular fundamental cause perspective. This is followed by a proposed research agenda for further investigation of the potential role that technological innovations may play in influencing social inequalities in health.

  7. A Fall Protection System for High-Rise Construction

    Directory of Open Access Journals (Sweden)

    Haluk Çeçen

    2013-01-01

    Full Text Available In construction industry, the number of fatal and nonfatal occupational injuries is higher than other industries. Among causes of these accidents, “falls” play a key role. This situation reveals the importance for carrying out research in fall protection systems. In this paper, a practical, economical, and functional fall protection system is introduced. Following determination and evaluation of existing solutions, weekly brainstorming meetings were held among the responsible project staff (general coordinator, project coordinator, project manager, site manager, and health and safety manager. As a result of these meetings, design criteria were developed. Based on these criteria, the fall protection system for high-rise construction (FPSFHC was developed which satisfied all the specified design criteria. Required materials were procured from local dealers. In this paper, criteria used in design and details of the final design are presented. Field performance of the system is evaluated, and recommendations for further development and standardization of the system are added.

  8. Changes of Global Infectious Disease Governance in 2000s: Rise of Global Health Security and Transformation of Infectious Disease Control System in South Korea.

    Science.gov (United States)

    Choi, Eun Kyung; Lee, Jong-Koo

    2016-12-01

    This paper focus upon the changes of global infectious disease governance in 2000s and the transformation of infectious disease control system in South Korea. Traditionally, infectious disease was globally governed by the quarantine regulated by the international conventions. When an infectious disease outbreak occurred in one country, each country prevented transmission of the disease through the standardized quarantine since the installation of international sanitary convention in 1892. Republic of Korea also organized the infectious disease control system with quarantine and disease report procedure after the establishment of government. Additionally, Korea National Health Institute(KNIH) was founded as research and training institute for infectious disease. However, traditional international health regulation system faced a serious challenge by the appearance of emerging and re-emerging infectious disease in 1990s. As a result, global infectious disease governance was rapidly changed under the demand to global disease surveillance and response. Moreover, global health security frame became important after 2001 bioterror and 2003 SARS outbreak. Consequently, international health regulation was fully revised in 2005, which included not only infectious disease but also public health emergency. The new international health regime was differently characterized in several aspects; reinforcement of global cooperation and surveillance, enlargement of the role of supranational and international agencies, and reorganization of national capacity. KNIH was reorganized with epidemic control and research since late 1990s. However, in 2004 Korea Center for Disease Control and Prevention(KCDC) was established as a disease control institution with combining quarantine and other functions after 2003 SARS outbreak. KCDC unified national function against infectious disease including prevention, protection, response and research, as a national representative in disease control. The

  9. Changes of Global Infectious Disease Governance in 2000s: Rise of Global Health Security and Transformation of Infectious Disease Control System in South Korea

    Directory of Open Access Journals (Sweden)

    Eun Kyung CHOI

    2016-12-01

    Full Text Available This paper focus upon the changes of global infectious disease governance in 2000s and the transformation of infectious disease control system in South Korea. Traditionally, infectious disease was globally governed by the quarantine regulated by the international conventions. When an infectious disease outbreak occurred in one country, each country prevented transmission of the disease through the standardized quarantine since the installation of international sanitary convention in 1892. Republic of Korea also organized the infectious disease control system with quarantine and disease report procedure after the establishment of government. Additionally, Korea National Health Institute(KNIH was founded as research and training institute for infectious disease. However, traditional international health regulation system faced a serious challenge by the appearance of emerging and re-emerging infectious disease in 1990s. As a result, global infectious disease governance was rapidly changed under the demand to global disease surveillance and response. Moreover, global health security frame became important after 2001 bioterror and 2003 SARS outbreak. Consequently, international health regulation was fully revised in 2005, which included not only infectious disease but also public health emergency. The new international health regime was differently characterized in several aspects; reinforcement of global cooperation and surveillance, enlargement of the role of supranational and international agencies, and reorganization of national capacity. KNIH was reorganized with epidemic control and research since late 1990s. However, in 2004 Korea Center for Disease Control and Prevention(KCDC was established as a disease control institution with combining quarantine and other functions after 2003 SARS outbreak. KCDC unified national function against infectious disease including prevention, protection, response and research, as a national representative in

  10. Rising damp in building walls: the wall base ventilation system

    Energy Technology Data Exchange (ETDEWEB)

    Guimaraes, A.S.; Delgado, J.M.P.Q.; Freitas, V.P. de [Faculdade de Engenharia da Universidade do Porto, Laboratorio de Fisica das Construcoes (LFC), Departamento de Engenharia Civil, Porto (Portugal)

    2012-12-15

    This work intends to validate a new system for treating rising damp in historic buildings walls. The results of laboratory experiments show that an efficient way of treating rising damp is by ventilating the wall base, using the HUMIVENT technique. The analytical model presented describes very well the observed features of rising damp in walls, verified by laboratory tests, who contributed for a simple sizing of the wall base ventilation system that will be implemented in historic buildings. (orig.)

  11. The fall and rise of micropayment systems

    NARCIS (Netherlands)

    Parhonyi, R.; Nieuwenhuis, Lambertus Johannes Maria; Pras, Aiko; Lammer, T.

    2006-01-01

    In this article, we discuss the chance that the second generation systems will become more successful than their predecessors and to what extent do these sys-tems solve or avoid problems causing the failure of the first generation systems. We show that most failure causes are avoided in the second

  12. Population Aging in Iran and Rising Health Care Costs

    Directory of Open Access Journals (Sweden)

    Mohammad Mirzaie

    2017-09-01

    Conclusion Based on the results of this research, it can be said that people throughout their life cycle always allocate a percentage of their total spending to health care costs, but the percentage of this allocation is different at different ages. In a way the demand for healthcare costs increases with aging, it rises significantly in the old age. At the macro level, due to an increase in the percentage of elderly in the population over the next decade, there will also be an increase in the share of health care costs.

  13. The Rise of Digital Multimedia Systems

    Directory of Open Access Journals (Sweden)

    Ross Gibson

    2013-08-01

    Full Text Available With this essay, I want to understand why interactive and relational media forms have become so ubiquitous so quickly. Comparing the nexus of cinema and nationalism with the contemporary dyad of digital media and transnationalism (or globalisation, we can ask whether digital multimedia systems have arisen to reflect and impel our contemporary psychic and social conditions. Because multimedia rarely gets ‘locked-off’, its component elements can always be pulled apart, sent back to their databases and then instantaneously rearranged into newly iterated federations. In this respect it is like our unstable contemporary lives, so buffeted with ever-altering values, opportunities, anxieties and obligations all upwelling because of globalisation, migration and multiculturalism.

  14. Framing Political Change: Can a Left Populism Disrupt the Rise of the Reactionary Right?; Comment on “Politics, Power, Poverty and Global Health: Systems and Frames”

    Directory of Open Access Journals (Sweden)

    Ronald Labonté

    2017-09-01

    Full Text Available Solomon Benatar offers an important critique of the limited frame that sets the boundaries of much of what is referred to as ‘global health.’ In placing his comments within a criticism of increasing poverty (or certainly income and wealth inequalities and the decline in our environmental commons, he locates our health inequities within the pathology of our present global economy. In that respect it is a companion piece to an editorial I published around the same time. Both Benatar’s and my paralleling arguments take on a new urgency in the wake of the US presidential election. Although not a uniquely American event (the xenophobic right has been making inroads in many parts of the world, the degree of vitriol expressed by the President-elect of the world’s (still most powerful and militarized country is being used to further legitimate the policies of right-extremist parties in Europe while providing additional justification for the increasingly autocratic politics of leaders (elected or otherwise in many other of the world’s nations. To challenge right-populism’s rejection of the predatory inequalities that 4 years of (neo-liberal globalization have created demands strong and sustained left populism built, in part, on the ecocentric frame advocated by Benatar.

  15. Greenhouse effect, sea level rise, and coastal drainage systems

    Energy Technology Data Exchange (ETDEWEB)

    Titus, J G; Kuo, C Y; Gibbs, M J; LaRoche, T B; Webb, M K; Waddell, J O

    1987-01-01

    Increasing concentrations of carbon dioxide and other gases are expected to warm the earth several degrees in the next century, which would raise sea level a few feet and alter precipitation patterns. Both of these changes would have major impacts on the operation of coastal drainage systems. However, because sea level rise and climate change resulting from the greenhouse effect are still uncertain, most planners and engineers are ignoring the potential implications. Case studies of the potential impact on watersheds in Charleston, South Carolina, and Fort Walton Beach, Florida, suggest that the cost of designing a new system to accommodate a rise in sea level will sometimes be small compared with the retrofit cost that may ultimately be necessary if new systems are not designed for a rise. Rather than ignore the greenhouse effect until its consequences are firmly established, engineers and planners should evaluate whether it would be worthwhile to insure that new systems are not vulnerable to the risks of climate change and sea level rise.

  16. Framing Political Change: Can a Left Populism Disrupt the Rise of the Reactionary Right? Comment on "Politics, Power, Poverty and Global Health: Systems and Frames".

    Science.gov (United States)

    Labonté, Ronald

    2017-01-17

    Solomon Benatar offers an important critique of the limited frame that sets the boundaries of much of what is referred to as 'global health.' In placing his comments within a criticism of increasing poverty (or certainly income and wealth inequalities) and the decline in our environmental commons, he locates our health inequities within the pathology of our present global economy. In that respect it is a companion piece to an editorial I published around the same time. Both Benatar's and my paralleling arguments take on a new urgency in the wake of the US presidential election. Although not a uniquely American event (the xenophobic right has been making inroads in many parts of the world), the degree of vitriol expressed by the President-elect of the world's (still) most powerful and militarized country is being used to further legitimate the policies of right-extremist parties in Europe while providing additional justification for the increasingly autocratic politics of leaders (elected or otherwise) in many other of the world's nations. To challenge right-populism's rejection of the predatory inequalities that 4 years of (neo)-liberal globalization have created demands strong and sustained left populism built, in part, on the ecocentric frame advocated by Benatar. © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

  17. Use of formwork systems in high-rise construction

    Science.gov (United States)

    Kurakova, Oksana

    2018-03-01

    Erection of high quality buildings and structures within a reasonable time frame is the crucial factor for the competitiveness of any construction organization. The main material used in high-rise construction is insitu reinforced concrete. The technology of its use is directly related to the use of formwork systems. Formwork systems and formwork technologies basically determine the speed of construction and labor intensity of concreting operations. Therefore, it is also possible to achieve the goal of reducing the construction time and labor intensity of works performed by improving the technology of formwork systems use. Currently there are unresolved issues in the area of implementation of monolithic technology projects, and problems related to the selection of a formwork technology, high labor intensity of works, poor quality of materials and structures, etc. are the main ones. The article presents organizational and technological measures, by means of which introduction it is possible to shorten the duration of construction. A comparison of operations performed during formwork installation according to the conventional technology and taking into account the implemented organizational and technological measures is presented. The results of a comparative analysis of economic efficiency assessments are also presented on the example of a specific construction project before and after the implementation of the above mentioned measures. The study showed that introduction of the proposed organizational and technological model taking into account optimization of reinforcing and concreting works significantly improves the efficiency of a high-rise construction project. And further improvement of technologies for the use of insitu reinforced concrete is a promising direction in the construction of high-rise buildings.

  18. Use of formwork systems in high-rise construction

    Directory of Open Access Journals (Sweden)

    Kurakova Oksana

    2018-01-01

    Full Text Available Erection of high quality buildings and structures within a reasonable time frame is the crucial factor for the competitiveness of any construction organization. The main material used in high-rise construction is insitu reinforced concrete. The technology of its use is directly related to the use of formwork systems. Formwork systems and formwork technologies basically determine the speed of construction and labor intensity of concreting operations. Therefore, it is also possible to achieve the goal of reducing the construction time and labor intensity of works performed by improving the technology of formwork systems use. Currently there are unresolved issues in the area of implementation of monolithic technology projects, and problems related to the selection of a formwork technology, high labor intensity of works, poor quality of materials and structures, etc. are the main ones. The article presents organizational and technological measures, by means of which introduction it is possible to shorten the duration of construction. A comparison of operations performed during formwork installation according to the conventional technology and taking into account the implemented organizational and technological measures is presented. The results of a comparative analysis of economic efficiency assessments are also presented on the example of a specific construction project before and after the implementation of the above mentioned measures. The study showed that introduction of the proposed organizational and technological model taking into account optimization of reinforcing and concreting works significantly improves the efficiency of a high-rise construction project. And further improvement of technologies for the use of insitu reinforced concrete is a promising direction in the construction of high-rise buildings.

  19. Design of solar systems in high-rise buildings

    Science.gov (United States)

    Kolosov, Alexander; Chudinov, Dmitry; Yaremenko, Sergey

    2018-03-01

    Nowadays, the renovation program is being implemented in the megapolises of Russia. Innovative high-rise buildings are built instead of morally and physically obsolete houses, where non-traditional renewable energy sources are used to the fullest extent, under the effect of which they are located. The possibility to use solar systems with variation of their design parameters is considered. It is established that solar systems have high technical potential. The share of heat load, that is provided by using solar energy, varies from 4 to 84% depending on the time of the year. Economic indicators restrain the use of such panels. The payback period is about 8 years at the current cost for thermal energy.

  20. Wage and Benefit Changes in Response to Rising Health Insurance Costs

    OpenAIRE

    Dana Goldman; Neeraj Sood; Arleen Leibowitz

    2005-01-01

    Many companies have defined-contribution benefit plans requiring employees to pay the full cost (before taxes) of more generous health insurance choices. Research has shown that employee decisions are quite responsive to these arrangements. What is less clear is how the total compensation package changes when health insurance premiums rise. This paper examines employee compensation decisions during a three-year period when health insurance premiums were rising rapidly. The data come from a si...

  1. The rise and fall of an opt-out system.

    Science.gov (United States)

    Nordfalk, Francisca; Hoeyer, Klaus

    2018-04-01

    In Denmark, citizens participate in register-based research without the possibility of opting out. However, in 1995 it was made possible for Danish citizens to register an opt-out called 'researcher protection' [ forskerbeskyttelse], which implied that researchers could not contact people to invite them to participate in research projects, such as clinical trials or questionnaries, based on their registrations in national registers. Data already registered could still be used for research. In 2014, this possibility of opt-out was revoked by law. The aims of this paper are to understand how the Danish researcher protection system came about, why it was terminated and what we can we learn from this example. We conducted a descriptive analysis of a copy of the former researcher protection register along with policies and media debate surrounding the rise and revocation of the researcher protection system. Our results show how both the inception and the abolishment of researcher protection appear to be ad hoc and without specified criteria of success. An examination of the recorded entries in the researcher protection registry could have led to changes in its administration as an alternative to its total abolition. In future opt-out systems, there should be focus on monitoring register practices and the purpose and criteria for evaluation must be defined prior to implementation.

  2. France: Health System Review.

    Science.gov (United States)

    Chevreul, Karine; Berg Brigham, Karen; Durand-Zaleski, Isabelle; Hernandez-Quevedo, Cristina

    2015-01-01

    This analysis of the French health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. The French population has a good level of health, with the second highest life expectancy in the world for women. It has a high level of choice of providers, and a high level of satisfaction with the health system. However, unhealthy habits such as smoking and harmful alcohol consumption remain significant causes of avoidable mortality. Combined with the significant burden of chronic diseases, this has underscored the need for prevention and integration of services, although these have not historically been strengths of the French system. Although the French health care system is a social insurance system, it has historically had a stronger role for the state than other Bismarckian social insurance systems. Public financing of health care expenditure is among the highest in Europe and out-of-pocket spending among the lowest. Public insurance is compulsory and covers the resident population; it is financed by employee and employer contributions as well as increasingly through taxation. Complementary insurance plays a significant role in ensuring equity in access. Provision is mixed; providers of outpatient care are largely private, and hospital beds are predominantly public or private non-profit-making. Despite health outcomes being among the best in the European Union, social and geographical health inequities remain. Inequality in the distribution of health care professionals is a considerable barrier to equity. The rising cost of health care and the increasing demand for long-term care are also of concern. Reforms are ongoing to address these issues, while striving for equity in financial access; a long-term care reform including public coverage of long-term care is still pending. World Health Organization 2015 (acting as the host organization for, and secretariat of, the

  3. Early Childhood Dental Caries: A Rising Dental Public Health Crisis

    Science.gov (United States)

    Gomez, Grace Felix

    2013-01-01

    The aim of this article is to examine the literature and review the risk factors and disparities contributing to early childhood caries (ECC), which is a major health problem among preschoolers in the United States of America. A search was conducted using MEDLINE, PubMed, Google Scholar, and the Cochrane Library databases and the key terms…

  4. The Rise and Fall of Protein Malnutrition in Global Health.

    Science.gov (United States)

    Semba, Richard D

    2016-01-01

    From the 1950s to the mid-1970s, United Nations (UN) agencies were focused on protein malnutrition as the major worldwide nutritional problem. The goal of this review is to examine this era of protein malnutrition, the reasons for its demise, and the aftermath. The UN Protein Advisory Group was established in 1955. International conferences were largely concerned about protein malnutrition in children. By the early 1970s, UN agencies were ringing the alarm about a 'protein gap'. In The Lancet in 1974, Donald McLaren branded these efforts as 'The Great Protein Fiasco', declaring that the 'protein gap' was a fallacy. The following year, John Waterlow, the scientist who led most of the efforts on protein malnutrition, admitted that a 'protein gap' did not exist and that young children in developing countries only needed sufficient energy intake. The emphasis on protein malnutrition waned. It is recently apparent that quality protein and essential amino acids are missing in the diet and may have adverse consequences for child growth and the reduction of child stunting. Key Messages: It may be time to re-include protein and return protein malnutrition in the global health agenda using a balanced approach that includes all protective nutrients. © 2016 S. Karger AG, Basel.

  5. Mobile health systems and emergence

    NARCIS (Netherlands)

    Jones, Valerie M.; Graziosi, Barbara

    2015-01-01

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

  6. The rise of neoliberalism: how bad economics imperils health and what to do about it.

    Science.gov (United States)

    Labonté, Ronald; Stuckler, David

    2016-03-01

    The 2008 global financial crisis, precipitated by high-risk, under-regulated financial practices, is often seen as a singular event. The crisis, its recessionary consequences, bank bailouts and the adoption of 'austerity' measures can be seen as a continuation of a 40-year uncontrolled experiment in neoliberal economics. Although public spending and recapitalisation of failing banks helped prevent a 1930s-style Great Depression, the deep austerity measures that followed have stifled a meaningful recovery for the majority of populations. In the short term, these austerity measures, especially cuts to health and social protection systems, pose major health risks in those countries under its sway. Meanwhile structural changes to the global labour market, increasing under-employment in high-income countries and economic insecurity elsewhere, are likely to widen health inequities in the longer term. We call for four policy reforms to reverse rising inequalities and their harms to public health. First is re-regulating global finance. Second is rejecting austerity as an empirically and ethically unjustified policy, especially given now clear evidence of its deleterious health consequences. Third, there is a need to restore progressive taxation at national and global scales. Fourth is a fundamental shift away from the fossil fuel economy and policies that promote economic growth in ways that imperil environmental sustainability. This involves redistributing work and promoting fairer pay. We do not suggest these reforms will be politically feasible or even achievable in the short term. They nonetheless constitute an evidence-based agenda for strong, public health advocacy and practice. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  7. Rising inequalities in income and health in China: who is left behind?

    Science.gov (United States)

    Baeten, Steef; Van Ourti, Tom; van Doorslaer, Eddy

    2013-12-01

    In recent decades, China has experienced double-digit economic growth rates and rising inequality. This paper implements a new decomposition approach using the China Health and Nutrition Survey (1991-2006) to examine the extent to which changes in level and distribution of incomes and in income mobility are related to health disparities between rich and poor. We find that health disparities in China relate to rising income inequality and in particular to the adverse health and income experience of older (wo)men, but not to the growth rate of average incomes over the last decades. These findings suggest that replacement incomes and pensions at older ages may be one of the most important policy levers for reducing health disparities between rich and poor Chinese. Copyright © 2013 Elsevier B.V. All rights reserved.

  8. Rising inequalities in income and health in China: Who is left behind?

    Science.gov (United States)

    Baeten, Steef; Van Ourti, Tom; van Doorslaer, Eddy

    2013-01-01

    In recent decades, China has experienced double-digit economic growth rates and rising inequality. This paper implements a new decomposition approach using the China Health and Nutrition Survey (1991–2006) to examine the extent to which changes in level and distribution of incomes and in income mobility are related to health disparities between rich and poor. We find that health disparities in China relate to rising income inequality and in particular to the adverse health and income experience of older (wo)men, but not to the growth rate of average incomes over the last decades. These findings suggest that replacement incomes and pensions at older ages may be one of the most important policy levers for reducing health disparities between rich and poor Chinese. PMID:24189450

  9. Linking research to practice: the rise of evidence-based health sciences librarianship.

    Science.gov (United States)

    Marshall, Joanne Gard

    2014-01-01

    The lecture explores the origins of evidence-based practice (EBP) in health sciences librarianship beginning with examples from the work of Janet Doe and past Doe lecturers. Additional sources of evidence are used to document the rise of research and EBP as integral components of our professional work. FOUR SOURCES OF EVIDENCE ARE USED TO EXAMINE THE RISE OF EBP: (1) a publication by Doe and research-related content in past Doe lectures, (2) research-related word usage in articles in the Bulletin of the Medical Library Association and Journal of the Medical Library Association between 1961 and 2010, (3) Medical Library Association activities, and (4) EBP as an international movement. These sources of evidence confirm the rise of EBP in health sciences librarianship. International initiatives sparked the rise of evidence-based librarianship and continue to characterize the movement. This review shows the emergence of a unique form of EBP that, although inspired by evidence-based medicine (EBM), has developed its own view of evidence and its application in library and information practice. Health sciences librarians have played a key role in initiating, nurturing, and spreading EBP in other branches of our profession. Our close association with EBM set the stage for developing our own EBP. While we relied on EBM as a model for our early efforts, we can observe the continuing evolution of our own unique approach to using, creating, and applying evidence from a variety of sources to improve the quality of health information services.

  10. HEALTH SYSTEMS

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

    many levels, and underscores the fact that health ... The health of mothers and their children depends on the status of women. INSIGHT ... tions find fertile ground when poverty ... Dr Gita Sen, Professor of Public Policy at the Indian Institute.

  11. Canada: Health system review.

    Science.gov (United States)

    Marchildon, Gregory

    2013-01-01

    Canada is a high-income country with a population of 33 million people. Its economic performance has been solid despite the recession that began in 2008. Life expectancy in Canada continues to rise and is high compared with most OECD countries; however, infant and maternal mortality rates tend to be worse than in countries such as Australia, France and Sweden. About 70% of total health expenditure comes from the general tax revenues of the federal, provincial and territorial governments. Most public revenues for health are used to provide universal medicare (medically necessary hospital and physician services that are free at the point of service for residents) and to subsidise the costs of outpatient prescription drugs and long-term care. Health care costs continue to grow at a faster rate than the economy and government revenue, largely driven by spending on prescription drugs. In the last five years, however, growth rates in pharmaceutical spending have been matched by hospital spending and overtaken by physician spending, mainly due to increased provider remuneration. The governance, organization and delivery of health services is highly decentralized, with the provinces and territories responsible for administering medicare and planning health services. In the last ten years there have been no major pan-Canadian health reform initiatives but individual provinces and territories have focused on reorganizing or fine tuning their regional health systems and improving the quality, timeliness and patient experience of primary, acute and chronic care. The medicare system has been effective in providing Canadians with financial protection against hospital and physician costs. However, the narrow scope of services covered under medicare has produced important gaps in coverage and equitable access may be a challenge in these areas. World Health Organization 2013 (acting as the host organization for, and secretariat of, the European Observatory on Health Systems and

  12. Educational Systems and Rising Inequality: Eastern Germany after Unification

    Science.gov (United States)

    von Below, Susanne; Powell, Justin J. W.; Roberts, Lance W.

    2013-01-01

    Educational systems considerably influence educational opportunities and the resulting social inequalities. Contrasting institutional regulations of both structures and contents, the authors present a typology of educational system types in Germany to analyze their effects on social inequality in eastern Germany after unification. After 1990, the…

  13. Rising to the challenge of health care reform with entrepreneurial and intrapreneurial nursing initiatives.

    Science.gov (United States)

    Wilson, Anne; Whitaker, Nancy; Whitford, Deirdre

    2012-05-31

    Health reform worldwide is required due to the largely aging population, increase in chronic diseases, and rising costs. To meet these needs, nurses are being encouraged to practice to the full extent of their skills and take significant leadership roles in health policy, planning, and provision. This can involve entrepreneurial or intrapreneurial roles. Although nurses form the largest group of health professionals, they are frequently restricted in their scope of practice. Nurses can help to improve health services in a cost effective way, but to do so, they must be seen as equal partners in health service provision. This article provides a global perspective on evolving nursing roles for innovation in health care. A historical overview of entrepreneurship and intrapreneurship is offered. Included also is discussion of a social entrepreneurship approach for nursing, settings for nurse entre/intrapreneurship, and implications for research and practice.

  14. Linking research to practice: the rise of evidence-based health sciences librarianship*

    Science.gov (United States)

    Marshall, Joanne Gard

    2014-01-01

    Purpose: The lecture explores the origins of evidence-based practice (EBP) in health sciences librarianship beginning with examples from the work of Janet Doe and past Doe lecturers. Additional sources of evidence are used to document the rise of research and EBP as integral components of our professional work. Methods: Four sources of evidence are used to examine the rise of EBP: (1) a publication by Doe and research-related content in past Doe lectures, (2) research-related word usage in articles in the Bulletin of the Medical Library Association and Journal of the Medical Library Association between 1961 and 2010, (3) Medical Library Association activities, and (4) EBP as an international movement. Results: These sources of evidence confirm the rise of EBP in health sciences librarianship. International initiatives sparked the rise of evidence-based librarianship and continue to characterize the movement. This review shows the emergence of a unique form of EBP that, although inspired by evidence-based medicine (EBM), has developed its own view of evidence and its application in library and information practice. Implications: Health sciences librarians have played a key role in initiating, nurturing, and spreading EBP in other branches of our profession. Our close association with EBM set the stage for developing our own EBP. While we relied on EBM as a model for our early efforts, we can observe the continuing evolution of our own unique approach to using, creating, and applying evidence from a variety of sources to improve the quality of health information services. PMID:24415915

  15. The Rise of the Nuclear System of Innovation in Sweden

    International Nuclear Information System (INIS)

    Jonter, Thomas; Fjaestad, Maja

    2008-04-01

    The purpose of this article is twofold. Firstly, the ambition is to analyze the role of the government in relation to private industry in the development of the nuclear power infrastructure in Sweden in the period of 1945-1970. Secondly, the purpose is to account for what was actually made in terms of education, research and financial funding in 'the Swedish line' and to assess its importance for the swift take over by the light water reactor system

  16. Comparison of occlusion break responses and vacuum rise times of phacoemulsification systems.

    Science.gov (United States)

    Sharif-Kashani, Pooria; Fanney, Douglas; Injev, Val

    2014-07-30

    Occlusion break surge during phacoemulsification cataract surgery can lead to potential surgical complications. The purpose of this study was to quantify occlusion break surge and vacuum rise time of current phacoemulsification systems used in cataract surgery. Occlusion break surge at vacuum pressures between 200 and 600 mmHg was assessed with the Infiniti® Vision System, the WhiteStar Signature® Phacoemulsification System, and the Centurion® Vision System using gravity-fed fluidics. Centurion Active FluidicsTM were also tested at multiple intraoperative pressure target settings. Vacuum rise time was evaluated for Infiniti, WhiteStar Signature, Centurion, and Stellaris® Vision Enhancement systems. Rise time to vacuum limits of 400 and 600 mmHg was assessed at flow rates of 30 and 60 cc/minute. Occlusion break surge was analyzed by 2-way analysis of variance. The Centurion system exhibited substantially less occlusion break surge than the other systems tested. Surge area with Centurion Active Fluidics was similar to gravity fluidics at an equivalent bottle height. At all Centurion Active Fluidics intraoperative pressure target settings tested, surge was smaller than with Infiniti and WhiteStar Signature. Infiniti had the fastest vacuum rise time and Stellaris had the slowest. No system tested reached the 600-mmHg vacuum limit. In this laboratory study, Centurion had the least occlusion break surge and similar vacuum rise times compared with the other systems tested. Reducing occlusion break surge may increase safety of phacoemulsification cataract surgery.

  17. Prospects for development of heat supply systems in high-rise districts

    Science.gov (United States)

    Zhila, Viktor; Solovyeva, Elena

    2018-03-01

    The article analyzes the main advantages and disadvantages of centralized and decentralized heat supply systems in high-rise districts. The main schemes of centralized heat supply systems are considered. They include centralized heat supply from boiler houses, centralized heat supply from autonomous heat sources, heat supply from roof boiler houses and door-to-door heating supply. For each of these variant, the gas distribution systems are considered and analyzed. These systems vary depending on the heat source location. For each of these systems, technical and economic indicators are taken into account, the analysis of which allows choosing the best option for districts where high-rise buildings predominate.

  18. The Rise of Post-truth Populism in Pluralist Liberal Democracies: Challenges for Health Policy

    Science.gov (United States)

    Speed, Ewen; Mannion, Russell

    2017-01-01

    Recent years have witnessed the rise of populism and populist leaders, movements and policies in many pluralist liberal democracies, with Brexit and the election of Trump the two most recent high profile examples of this backlash against established political elites and the institutions that support them. This new populism is underpinned by a post-truth politics which is using social media as a mouthpiece for ‘fake news’ and ‘alternative facts’ with the intention of inciting fear and hatred of ‘the other’ and thereby helping to justify discriminatory health policies for marginalised groups. In this article, we explore what is meant by populism and highlight some of the challenges for health and health policy posed by the new wave of post-truth populism. PMID:28812811

  19. The Rise of Post-truth Populism in Pluralist Liberal Democracies: Challenges for Health Policy

    Directory of Open Access Journals (Sweden)

    Ewen Speed

    2017-04-01

    Full Text Available Recent years have witnessed the rise of populism and populist leaders, movements and policies in many pluralist liberal democracies, with Brexit and the election of Trump the two most recent high profile examples of this backlash against established political elites and the institutions that support them. This new populism is underpinned by a post-truth politics which is using social media as a mouthpiece for ‘fake news’ and ‘alternative facts’ with the intention of inciting fear and hatred of ‘the other’ and thereby helping to justify discriminatory health policies for marginalised groups. In this article, we explore what is meant by populism and highlight some of the challenges for health and health policy posed by the new wave of post-truth populism.

  20. Rising labor costs, earnings management, and financial performance of health care providers around the world.

    Science.gov (United States)

    Dong, Gang Nathan

    2015-01-01

    Amid increasing interest in how government regulation and market competition affect the cost and financial sustainability in health care sector, it remains unclear whether health care providers behave similarly to their counterparts in other industries. The goal of this chapter is to study the degree to which health care providers manipulate accruals in periods of financial difficulties caused, in part, by the rising costs of labor. We collected the financial information of health care provider in 43 countries from 1984 to 2013 and conducted a pooled cross-sectional study with country and year fixed-effects. The empirical evidence shows that health care providers with higher wage costs are more likely to smooth their earnings in order to maintain financial sustainability. The finding of this study not only informs regulators that earnings management is pervasive in health care organizations around the world, but also contributes to the studies of financial booktax reporting alignment, given the existing empirical evidence linking earnings management to corporate tax avoidance in this very sector.

  1. Unequal ‘Partners’. AIDS, Academia, and the Rise of Global Health

    Directory of Open Access Journals (Sweden)

    Johanna T. Crane

    2010-12-01

    Full Text Available The last decade has seen the proliferation of “global health” departments, centers, programs, and majors across top research universities in North America and Europe. This trend has been particularly pronounced in the United States, where it is connected to America′s new role as a major sponsor of HIV treatment in Africa. This paper describes the rise of “global health” as a research, funding, and training priority within U.S. academic medicine, and the increasing desirability of “global health partnerships” with institutions in sub-Saharan Africa. Leading spokespersons emphasize that “partnership” with poor nations is central to the mission of global health, an ethic that distinguishes it from older, more paternalistic traditions of international health and tropical medicine. However, at the same time, the field of academic global health depends on steep inequalities for its very existence, as it is the opportunity to work in impoverished, low-tech settings with high disease burdens that draws North American researchers and clinicians to global health programs and ensures their continued funding. This paradox – in which inequality is both a form of suffering to be redressed and a professional, knowledge-generating, opportunity to be exploited – makes the partnerships to which global health aspires particularly challenging.

  2. Hydraulic Control Method for Heating Systems of High-Rise Buildings

    Science.gov (United States)

    Makarov, D.; Chernenkov, V.; Likhachev, I.

    2017-11-01

    The following article reflects the ideas of possibility to increase energy efficiency of heating systems in high-rise buildings. The article also includes the principle ways of high-rise building heating systems operation as well as traditional engineering decisions aimed at the elimination of the increased pressure effect in heaters. The main disadvantages of such decisions are also presented for the reader. Moreover, the article offers the way of operation for the above-mentioned systems together with the equipment that implements this operation. An economic impact from such energy-saving technology application has been also evaluated.

  3. The rise of global health diplomacy: An interdisciplinary concept linking health and international relations.

    Science.gov (United States)

    Chattu, Vijay Kumar

    2017-01-01

    Global health diplomacy (GHD) is relatively a very new field that has yet to be clearly defined and developed though there are various definitions given by different experts from foreign policy, global health, diplomacy, international relations, governance, and law. With the intensification of globalization and increasing gaps between countries, new and reemerging health threats such as HIV/AIDS, tuberculosis, influenza, severe acute respiratory syndrome, Ebola, and Zika and a gradual rethinking on security concepts framed a new political context. The health problems addressed diplomatically have also become diverse ranging from neglected tropical diseases, infectious diseases, sale of unsafe, counterfeit drugs to brain drain crisis. We see that global health has become more diverse as the actors widened and also the interests appealing not only to the traditional humanitarian ideals associated with health but also to the principles grounded in national and global security. Recently, we are witnessing the increased priority given to the GHD because the issue of health is discussed by various actors outside the WHO to shape the global policy for health determinants. In fact, the area of health has become the part of UN Summit Diplomacy involving the G8, G20, BRICS, and the EU. The recent WHO Pandemic Influenza Framework, UN High Level Framework on Prevention and Control of Noncommunicable Diseases, and the WHO Framework Convention on Tobacco Control are some of the examples of long-term negotiation processes for agreements that took place.

  4. Constructive systems, load-bearing and enclosing structures of high-rise buildings

    Science.gov (United States)

    Anatol'evna Korol', Elena; Olegovna Kustikova, Yuliya

    2018-03-01

    As the height of the building increases, loads on load-carrying structures increase dramatically, and as a result of the development of high-rise construction, several structural systems of such buildings have been developed: frame, frame-frame, cross-wall, barrel, box-type, box-to-wall ("pipe in pipe", "Trumpet in the farm"), etc. In turn, the barrel systems have their own versions: cantilever support of the ceilings on the trunk, suspension of the outer part of the overlap to the upper carrying console "hanging house" or its support by means of the walls on the lower bearing cantilever, intermediate position of the supporting cantilevers in height to the floor, from a part of floors. The object of the study are the structural solutions of high-rise buildings. The subject of the study is the layout of structural schemes of high-rise buildings, taking into account the main parameters - altitude (height), natural climatic conditions of construction, materials of structural elements and their physical and mechanical characteristics. The purpose of the study is to identify the features and systematization of structural systems of high-rise buildings and the corresponding structural elements. The results of the research make it possible, at the stage of making design decisions, to establish rational parameters for the correspondence between the structural systems of high-rise buildings and their individual elements.

  5. Rising U.S. income inequality, gender and individual self-rated health, 1972-2004.

    Science.gov (United States)

    Zheng, Hui

    2009-11-01

    The effect of income inequality on health has been a contested topic among social scientists. Most previous research is based on cross-sectional comparisons rather than temporal comparisons. Using data from the General Social Survey and the U.S. Census Bureau, this study examines how rising income inequality affects individual self-rated health in the U.S. from 1972 to 2004. Data are analyzed using hierarchical generalized linear models. The findings suggest a significant association between income inequality and individual self-rated health. The dramatic increase in income inequality from 1972 to 2004 increases the odds of worse self-rated health by 9.4 percent. These findings hold for three measures of income inequality: the Gini coefficient, the Atkinson Index, and the Theil entropy index. Results also suggest that overall income inequality and gender-specific income inequality harm men's, but not women's, self-rated health. These findings also hold for the three measures of income inequality. These findings suggest that inattention to gender composition may explain apparent discrepancies across previous studies.

  6. Population health in an era of rising income inequality: USA, 1980-2015.

    Science.gov (United States)

    Bor, Jacob; Cohen, Gregory H; Galea, Sandro

    2017-04-08

    Income inequality in the USA has increased over the past four decades. Socioeconomic gaps in survival have also increased. Life expectancy has risen among middle-income and high-income Americans whereas it has stagnated among poor Americans and even declined in some demographic groups. Although the increase in income inequality since 1980 has been driven largely by soaring top incomes, the widening of survival inequalities has occurred lower in the distribution-ie, between the poor and upper-middle class. Growing survival gaps across income percentiles since 2001 reflect falling real incomes among poor Americans as well as an increasingly strong association between low income and poor health. Changes in individual risk factors such as smoking, obesity, and substance abuse play a part but do not fully explain the steeper gradient. Distal factors correlated with rising inequality including unequal access to technological innovations, increased geographical segregation by income, reduced economic mobility, mass incarceration, and increased exposure to the costs of medical care might have reduced access to salutary determinants of health among low-income Americans. Having missed out on decades of income growth and longevity gains, low-income Americans are increasingly left behind. Without interventions to decouple income and health, or to reduce inequalities in income, we might see the emergence of a 21st century health-poverty trap and the further widening and hardening of socioeconomic inequalities in health. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Health System Measurement Project

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Health System Measurement Project tracks government data on critical U.S. health system indicators. The website presents national trend data as well as detailed...

  8. Evaluating Maternal and Child Health and Leadership Competencies of Emerging MCH Leaders: The MCHC/RISE-UP Experience.

    Science.gov (United States)

    Belcher, Harolyn M E; Stone, Jacqueline D; McFadden, Jenese A; Hemmingson, Tyler A; Kreutzer, Cary; Harris, Lisa G; Wheeler, Barbara Y; Van Osdel, Joanne; Avila, Margaret; Yorker, Beatrice; Hoffman, Beth R; Turner-Musa, Jocelyn O

    2015-12-01

    This study examines maternal and child health core competencies and leadership characteristics of undergraduate students following participation in the Maternal and Child Health Careers/Research Initiatives for Student Enhancement-Undergraduate Program (MCHC/RISE-UP). MCHC/RISE-UP is a 10-week public health leadership program designed to promote diversity in public health workforce through mentored research, community engagement and advocacy, and clinical experiences for undergraduate students. The MCHC/RISE-UP is a national consortium of University Centers for Excellence in Developmental Disabilities including, (1) Kennedy Krieger Institute (Kennedy Krieger, lead institution) partnering with Morgan State University, a Historically Black University, (2) the University of South Dakota partnering with Tribal Serving Institutions; and (3) the University of Southern California Children's Hospital-Los Angeles and their partner institution, California State University Los Angeles, a Hispanic Serving Institution. Eighty-four junior and senior undergraduates and recent baccalaureate degree students who participated in the MCHC/RISE-UP worked on 48 maternal and child health projects. Following the MCHC/RISE-UP, students demonstrated statistically significant improvements in all maternal and child health core competencies. Transformational leadership characteristics also increased (mean increase 9.4, 95% CI 7.2-11.8; p leadership programs may extend the reach and recruitment of diverse students into the maternal and child health field. Experiential, didactic, and mentored learning opportunities may enhance student integration of maternal and child health competencies and transformational leadership characteristics.

  9. Modelling Morphological Response of Large Tidal Inlet Systems to Sea Level Rise

    NARCIS (Netherlands)

    Dissanayake, P.K.

    2011-01-01

    This dissertation qualitatively investigates the morphodynamic response of a large inlet system to IPCC projected relative sea level rise (RSLR). Adopted numerical approach (Delft3D) used a highly schematised model domain analogous to the Ameland inlet in the Dutch Wadden Sea. Predicted inlet

  10. Tank 241-SY-101 surface level rise remediation test and evaluation plan for transfer system

    International Nuclear Information System (INIS)

    BAUER, R.E.

    1999-01-01

    The purpose of this testing and evaluation plan (TEP) is to provide the high level guidance on testing requirements for ensuring that the equipment and systems to be implemented for remediation of the SY-101 waste level rise USQ are effective

  11. The Rise of Post-truth Populism in Pluralist Liberal Democracies: Challenges for Health Policy.

    Science.gov (United States)

    Speed, Ewen; Mannion, Russell

    2017-02-12

    Recent years have witnessed the rise of populism and populist leaders, movements and policies in many pluralist liberal democracies, with Brexit and the election of Trump the two most recent high profile examples of this backlash against established political elites and the institutions that support them. This new populism is underpinned by a post-truth politics which is using social media as a mouthpiece for 'fake news' and 'alternative facts' with the intention of inciting fear and hatred of 'the other' and thereby helping to justify discriminatory health policies for marginalised groups. In this article, we explore what is meant by populism and highlight some of the challenges for health and health policy posed by the new wave of post-truth populism. © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

  12. Modeling work of the dispatching service of high-rise building as queuing system

    Science.gov (United States)

    Dement'eva, Marina; Dement'eva, Anastasiya

    2018-03-01

    The article presents the results of calculating the performance indicators of the dispatcher service of a high-rise building as a queuing system with an unlimited queue. The calculation was carried out for three models: with a single control room and brigade of service, with a single control room and a specialized service, with several dispatch centers and specialized services. The aim of the work was to investigate the influence of the structural scheme of the organization of the dispatcher service of a high-rise building on the amount of operating costs and the time of processing and fulfilling applications. The problems of high-rise construction and their impact on the complication of exploitation are analyzed. The composition of exploitation activities of high-rise buildings is analyzed. The relevance of the study is justified by the need to review the role of dispatch services in the structure of management of the quality of buildings. Dispatching service from the lower level of management of individual engineering systems becomes the main link in the centralized automated management of the exploitation of high-rise buildings. With the transition to market relations, the criterion of profitability at the organization of the dispatching service becomes one of the main parameters of the effectiveness of its work. A mathematical model for assessing the efficiency of the dispatching service on a set of quality of service indicators is proposed. The structure of operating costs is presented. The algorithm of decision-making is given when choosing the optimal structural scheme of the dispatching service of a high-rise building.

  13. Effects of Sea Level Rise on Groundwater Flow Paths in a Coastal Aquifer System

    Science.gov (United States)

    Morrissey, S. K.; Clark, J. F.; Bennett, M. W.; Richardson, E.; Stute, M.

    2008-05-01

    Changes in groundwater flow in the Floridan aquifer system, South Florida, from the rise in sea level at the end of the last glacial period may be indicative of changes coastal aquifers will experience with continued sea level rise. As sea level rises, the hydraulic head near the coast increases. Coastal aquifers can therefore experience decreased groundwater gradients (increased residence times) and seawater intrusion. Stable isotopes of water, dissolved noble gas temperatures, radiocarbon and He concentrations were analyzed in water collected from 68 wells in the Floridan aquifer system throughout South Florida. Near the recharge area, geochemical data along groundwater flow paths in the Upper Floridan aquifer show a transition from recently recharged groundwater to glacial-aged water. Down gradient from this transition, little variation is apparent in the stable isotopes and noble gas recharge temperatures, indicating that most of the Upper Floridan aquifer contains groundwater recharged during the last glacial period. The rapid 120-meter rise in sea level marking the end of the last glacial period increased the hydraulic head in the Floridan aquifer system near the coast, slowing the flow of groundwater from the recharge area to the ocean and trapping glacial-aged groundwater. The raised sea level also flooded half of the Florida platform and caused seawater to intrude into the Lower Floridan. This circulation of seawater in the Lower Floridan continues today as our data indicate that the groundwater is similar to modern seawater with a freshwater component entering vertically from the recharge area to the Upper Floridan.

  14. Sea level rise impacts on wastewater treatment systems along the U.S. coasts

    Science.gov (United States)

    Hummel, M.; Berry, M.; Stacey, M. T.

    2017-12-01

    As sea levels rise, coastal communities will experience more frequent and persistent nuisance flooding, and some low-lying areas may be permanently inundated. Critical components of lifeline infrastructure networks in these areas are also at risk of flooding, which could cause significant service disruptions that extend beyond the flooded zone. Thus, identifying critical infrastructure components that are vulnerable to sea level rise is an important first step in developing targeted investment in protective actions and enhancing the overall resilience of coastal communities. Wastewater treatment plants are typically located at low elevations near the coastline to minimize the cost of collecting consumed water and discharging treated effluent, which makes them particularly susceptible to coastal flooding. For this analysis, we used geographic information systems to assess the vulnerability of wastewater infrastructure to various sea level rise projections at the national level. We then estimated the number of people who would lose wastewater services, which could be more than three times as high as previous predictions of the number of people at risk of direct flooding due to sea level rise. We also considered several case studies of wastewater infrastructure in mid-sized cities to determine how topography and system configuration (centralized versus distributed) impact vulnerability. Overall, this analysis highlights the widespread vulnerability of wastewater infrastructure in the U.S. and demonstrates that local disruptions to infrastructure networks may have far-ranging impacts on areas that do not experience direct flooding.

  15. Henry Ford Health Systems

    Science.gov (United States)

    Henry Ford Health Systems evolved from a hospital into a system delivering care to 2.5 million patients and includes the Cancer Epidemiology, Prevention and Control Program, which focuses on epidemiologic and public health aspects of cancer.

  16. Structural health monitoring on medium rise reinforced concrete building using ambient vibration method

    Science.gov (United States)

    Kamarudin, A. F.; Mokhatar, S. N.; Zainal Abidin, M. H.; Daud, M. E.; Rosli, M. S.; Ibrahim, A.; Ibrahim, Z.; Noh, M. S. Md

    2018-04-01

    Monitoring of structural health from initial stage of building construction to its serviceability is an ideal practise to assess for any structural defects or damages. Structural integrity could be intruded by natural destruction or structural deterioration, and worse if without remedy action on monitoring, building re-assessment or maintenance is taken. In this study the application of ambient vibration (AV) testing is utilized to evaluate the health of eighth stories medium rise reinforced concrete building in Universiti Tun Hussein Onn Malaysia (UTHM), based comparison made between the predominant frequency, fo, determined in year 2012 and 2017. For determination of fo, popular method of Fourier Amplitude Spectra (FAS) was used to transform the ambient vibration time series by using 1 Hz tri-axial seismometer sensors and City SharkII data recorder. From the results, it shows the first mode frequencies from FAS curves indicate at 2.04 Hz in 2012 and 1.97 Hz in 2017 with only 3.14% of frequency reduction. However, steady state frequencies shown at the second and third modes frequencies of 2.42 Hz and 3.31 Hz by both years. Two translation mode shapes were found at the first and second mode frequencies in the North-South (NS-parallel to building transverse axis) and East-West (EsW-parallel to building longitudinal axis) components, and the torsional mode shape shows as the third mode frequency in both years. No excessive deformation amplitude was found at any selective floors based on comparison made between three mode shapes produced, that could bring to potential feature of structural deterioration. Low percentages of natural frequency disparity within five years of duration interval shown by the first mode frequencies under ambient vibration technique was considered in good health state, according to previous researchers recommendation at acceptable percentages below 5 to 10% over the years.

  17. Sea Level Rise Impacts on Wastewater Treatment Systems Along the U.S. Coasts

    Science.gov (United States)

    Hummel, Michelle A.; Berry, Matthew S.; Stacey, Mark T.

    2018-04-01

    As sea levels rise, coastal communities will experience more frequent and persistent nuisance flooding, and some low-lying areas may be permanently inundated. Critical components of lifeline infrastructure networks in these areas are also at risk of flooding, which could cause significant service disruptions that extend beyond the flooded zone. Thus, identifying critical infrastructure components that are exposed to sea level rise is an important first step in developing targeted investment in protective actions and enhancing the overall resilience of coastal communities. Wastewater treatment plants are typically located at low elevations near the coastline to minimize the cost of collecting consumed water and discharging treated effluent, which makes them particularly susceptible to coastal flooding. For this analysis, we used geographic information systems to assess the exposure of wastewater infrastructure to various sea level rise projections at the national level. We then estimated the number of people who would lose wastewater services, which could be more than five times as high as previous predictions of the number of people at risk of direct flooding due to sea level rise. We also performed a regional comparison of wastewater exposure to marine and groundwater flooding in the San Francisco Bay Area. Overall, this analysis highlights the widespread exposure of wastewater infrastructure in the United States and demonstrates that local disruptions to infrastructure networks may have far-ranging impacts on areas that do not experience direct flooding.

  18. Denmark: Health system review

    DEFF Research Database (Denmark)

    Juul, Annegrete; Krasnik, Allan; Rudkjøbing, Andreas

    The Health Systems in Transition (HiT) series provide detailed descriptions of health systems in the countries of the WHO European Region as well as some additional OECD countries. An individual health system review (HiT) examines the specific approach to the organization, financing and delivery...... of health services in a particular country and the role of the main actors in the health system. It describes the institutional framework, process, content, and implementation of health and health care policies. HiTs also look at reforms in progress or under development and make an assessment of the health...... system based on stated objectives and outcomes with respect to various dimensions (health status, equity, quality, efficiency, accountability)....

  19. A livability rating system of a high-rise housing and its computer simulation

    Science.gov (United States)

    Liu, Zhengrui

    2017-09-01

    Aiming at the problems in housing choosing and purchasing in the high-rise residential buildings, this paper considers the factors that affect various livable degrees and analyzes the important degrees of the factors through the Analytic Hierarchy Process (AHP), quantifying the various factors by 10 point scoring system. Accordingly, this paper puts forward a habitable housing index, validating the correctness of the indicators by simulating the process of housing choosing through computer program.

  20. Rising Health Expenditure Due to Non-Communicable Diseases in India: An Outlook.

    Science.gov (United States)

    Barik, Debasis; Arokiasamy, Perianayagam

    2016-01-01

    With ongoing demographic transition, epidemiological transition has been emerged as a growing concern in India. The share of non-communicable disease in total disease burden has increased from 31% in 1990 to 45% in 2010. This paper seeks to explore the health scenario of India in the wake of the growing pace of non-communicable diseases such as diabetes and hypertension among Indian population using data from health and morbidity survey of the National Sample Survey Organisation (2004) and notifies about the resource needed to tackle this growing health risk. Given the share of private players (70%) in Indian health system, results indicate a higher private expenditure, mostly out-of-pocket expense, on account of non-communicable diseases. A timely look into the matter may tackle a more dreadful situation in near future.

  1. Rising Health Expenditure due to Non-communicable Diseases in India: An Outlook

    Directory of Open Access Journals (Sweden)

    Debasis Barik

    2016-11-01

    Full Text Available Abstract: With ongoing demographic transition, epidemiological transition in India has been emerged as a growing concern in India. The share of non-communicable disease in total disease burden has increased from 31 per cent in 1990 to 45 per cent in 2010. This paper seeks to explore the health scenario of India in the wake of the growing pace of non-communicable diseases like diabetes, hypertension among Indian population using data from health and morbidity survey of the National Sample Survey Organisation (2004 and notifies about the resource needed to tackle this growing health risk. Given the share of private players (70 per cent in Indian health system, results indicate a higher private expenditure, mostly out-of-pocket expense, on account of non-communicable diseases. A timely look into the matter may tackle a more dreadful situation in near future.

  2. Mental health issues from rising sea level in a remote coastal region of the Solomon Islands: current and future.

    Science.gov (United States)

    Asugeni, James; MacLaren, David; Massey, Peter D; Speare, Rick

    2015-12-01

    There is little published research about mental health and climate change in the Pacific, including Solomon Islands. Solomon Islands has one of the highest rates of sea-level rise globally. The aim of this research was to document mental health issues related to sea-level rise for people in East Malaita, Solomon Islands. A cross-sectional study was carried out in six low-lying villages in East Malaita, Solomon Islands. The researcher travelled to villages by dugout canoe. In addition to quantitative, closed-ended questions, open-ended questions with villagers explored individual and community responses to rising sea level. Of 60 people asked, 57 completed the questionnaire. Of these, 90% reported having seen a change in the weather patterns. Nearly all participants reported that sea-level rise is affecting them and their family and is causing fear and worry on a personal and community level. Four themes emerged from the qualitative analysis: experience of physical impacts of climate change; worry about the future; adaptation to climate change; government response needed. Given predictions of ongoing sea-level rise in the Pacific it is essential that more research is conducted to further understand the human impact of climate change for small island states which will inform local, provincial and national-level mental health responses. © The Royal Australian and New Zealand College of Psychiatrists 2015.

  3. Ukraine: health system review.

    Science.gov (United States)

    Lekhan, Valery; Rudiy, Volodymyr; Shevchenko, Maryna; Nitzan Kaluski, Dorit; Richardson, Erica

    2015-03-01

    This analysis of the Ukrainian health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. Since the country gained independence from the Soviet Union in 1991, successive governments have sought to overcome funding shortfalls and modernize the health care system to meet the needs of the population's health. However, no fundamental reform of the system has yet been implemented and consequently it has preserved the main features characteristic of the Semashko model; there is a particularly high proportion of total health expenditure paid out of pocket (42.3 % in 2012), and incentives within the system do not focus on quality or outcomes. The most recent health reform programme began in 2010 and sought to strengthen primary and emergency care, rationalize hospitals and change the model of health care financing from one based on inputs to one based on outputs. Fundamental issues that hampered reform efforts in the past re-emerged, but conflict and political instability have proved the greatest barriers to reform implementation and the programme was abandoned in 2014. More recently, the focus has been on more pressing humanitarian concerns arising from the conflict in the east of Ukraine. It is hoped that greater political, social and economic stability in the future will provide a better environment for the introduction of deep reforms to address shortcomings in the Ukrainian health system. World Health Organization 2015 (acting as the host organization for, and secretariat of, the European Observatory on Health Systems and Policies).

  4. Construction Costs Assessment of Structural Systems for Low-Rise and Social Welfare Housing

    Directory of Open Access Journals (Sweden)

    Carrillo Julián

    2015-09-01

    Full Text Available A comparative analysis of the costs related to the construction of low-rise, low-cost and social welfare housing was carried out. The study included three of the most commonly used structural systems for low-rise housing in Latin America, such as the traditional system of confined masonry walls, concrete walls conventionally reinforced with welded-wire meshes and concrete walls reinforced with steel fiber. The cost comparison was carried out by budgets analysis, which were performed based on construction quantities, unit prices and particular items for each structural system. It was found in the study that, from an economic point of view, the systems of concrete walls reinforced with welded-wire meshes or steel fibers are more advantageous than confined masonry systems. In addition, the integral comparison of the three structural systems demonstrates that the industrialized system of steel fiber reinforced concrete walls allows obtaining greater advantages of cleaning and sustainability, faster construction, lower cost and a more attractive scenario for builders investing in such projects.

  5. Slovenia: Health System Review.

    Science.gov (United States)

    Albreht, Tit; Pribakovic Brinovec, Radivoje; Josar, Dusan; Poldrugovac, Mircha; Kostnapfel, Tatja; Zaletel, Metka; Panteli, Dimitra; Maresso, Anna

    2016-06-01

    This analysis of the Slovene health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. The health of the population has improved over the last few decades. While life expectancy for both men and women is similar to EU averages, morbidity and mortality data show persistent disparities between regions, and mortality from external causes is particularly high. Satisfaction with health care delivery is high, but recently waiting times for some outpatient specialist services have increased. Greater focus on preventive measures is also needed as well as better care coordination, particularly for those with chronic conditions. Despite having relatively high levels of co-payments for many services covered by the universal compulsory health insurance system, these expenses are counterbalanced by voluntary health insurance, which covers 95% of the population liable for co-payments. However, Slovenia is somewhat unique among social health insurance countries in that it relies almost exclusively on payroll contributions to fund its compulsory health insurance system. This makes health sector revenues very susceptible to economic and labour market fluctuations. A future challenge will be to diversify the resource base for health system funding and thus bolster sustainability in the longer term, while preserving service delivery and quality of care. Given changing demographics and morbidity patterns, further challenges include restructuring the funding and provision of long-term care and enhancing health system efficiency through reform of purchasing and provider-payment systems. World Health Organization 2016 (acting as the host organization for, and secretariat of, the European Observatory on Health Systems and Policies).

  6. The Rise of Mental Health Nursing : A History of Psychiatric Care in Dutch Asylums, 1890-1920

    NARCIS (Netherlands)

    Boschma, Geertje

    2003-01-01

    The Rise of Mental Health Nursing onderzoekt de tegenstrijdigheden in de op het ziekenhuis georiënteerde inrichtingszorg, die rond 1900 opkwam. Bovendien illustreert het boek de sociale complexiteit van de psychiatrische zorg. Op basis van archiefmateriaal uit vier Nederlandse psychiatrische

  7. Belgium: Health system review.

    Science.gov (United States)

    Gerkens, Sophie; Merkur, Sherry

    2010-01-01

    The Health Systems in Transition (HiT) profiles are country-based reports that provide a detailed description of a health system and of policy initiatives in progress or under development. HiTs examine different approaches to the organization, financing and delivery of health services and the role of the main actors in health systems; describe the institutional framework, process, content and implementation of health and health care policies; and highlight challenges and areas that require more in-depth analysis. The Belgian population continues to enjoy good health and long life expectancy. This is partly due to good access to health services of high quality. Financing is based mostly on proportional social security contributions and progressive direct taxation. The compulsory health insurance is combined with a mostly private system of health care delivery, based on independent medical practice, free choice of physician and predominantly fee-for-service payment. This Belgian HiT profile (2010) presents the evolution of the health system since 2007, including detailed information on new policies. While no drastic reforms were undertaken during this period, policy-makers have pursued the goals of improving access to good quality of care while making the system sustainable. Reforms to increase the accessibility of the health system include measures to reduce the out-of-pocket payments of more vulnerable populations (low-income families and individuals as well as the chronically ill). Quality of care related reforms have included incentives to better integrate different levels of care and the establishment of information systems, among others. Additionally, several measures on pharmaceutical products have aimed to reduce costs for both the National Institute for Health and Disability Insurance (NIHDI) and patients, while maintaining the quality of care. World Health Organization 2010, on behalf of the European Observatory on health systems and Policies.

  8. Malta: Health system review.

    Science.gov (United States)

    Azzopardi Muscat, Natasha; Calleja, Neville; Calleja, Antoinette; Cylus, Jonathan

    2014-01-01

    This analysis of the Maltese health system reviews the developments in its organization and governance, health financing, health-care provision, health reforms and health system performance. The health system in Malta consists of a public sector, which is free at the point of service and provides a comprehensive basket of health services for all its citizens, and a private sector, which accounts for a third of total health expenditure and provides the majority of primary care. Maltese citizens enjoy one of the highest life expectancies in Europe. Nevertheless, non-communicable diseases pose a major concern with obesity being increasingly prevalent among both adults and children. The health system faces important challenges including a steadily ageing population, which impacts the sustainability of public finances. Other supply constraints stem from financial and infrastructural limitations. Nonetheless, there exists a strong political commitment to ensure the provision of a healthcare system that is accessible, of high quality, safe and also sustainable. This calls for strategic investments to underpin a revision of existing processes whilst shifting the focus of care away from hospital into the community. World Health Organization 2014 (acting as the host organization for, and secretariat of, the European Observatory on Health Systems and Policies).

  9. Austria: health system review.

    Science.gov (United States)

    Hofmarcher, Maria M; Quentin, Wilm

    2013-01-01

    This analysis of the Austrian health system reviews recent developments in organization and governance, health financing, health-care provision, health reforms and health-system performance. The Austrian health system provides universal coverage for a wide range of benefits and high-quality care. Free choice of providers and unrestricted access to all care levels (general practitioners, specialist physicians and hospitals) are characteristic features of the system. Unsurprisingly, population satisfaction is well above EU average. Income-related inequality in health has increased since 2005, although it is still relatively low compared to other countries. The health-care system has been shaped by both the federal structure of the state and a tradition of delegating responsibilities to self-governing stakeholders. On the one hand, this enables decentralized planning and governance, adjusted to local norms and preferences. On the other hand, it also leads to fragmentation of responsibilities and frequently results in inadequate coordination. For this reason, efforts have been made for several years to achieve more joint planning, governance and financing of the health-care system at the federal and regional level. As in any health system, a number of challenges remain. The costs of the health-care system are well above the EU15 average, both in absolute terms and as a percentage of GDP. There are important structural imbalances in healthcare provision, with an oversized hospital sector and insufficient resources available for ambulatory care and preventive medicine. This is coupled with stark regional differences in utilization, both in curative services (hospital beds and specialist physicians) and preventative services such as preventive health check-ups, outpatient rehabilitation, psychosocial and psychotherapeutic care and nursing. There are clear social inequalities in the use of medical services, such as preventive health check-ups, immunization or dentistry

  10. Health care delivery systems.

    NARCIS (Netherlands)

    Stevens, F.; Zee, J. van der

    2007-01-01

    A health care delivery system is the organized response of a society to the health problems of its inhabitants. Societies choose from alternative health care delivery models and, in doing so, they organize and set goals and priorities in such a way that the actions of different actors are effective,

  11. The rise and fall of democratic universalism: health care reform in Italy, 1978-1994.

    Science.gov (United States)

    Ferrera, M

    1995-01-01

    In 1978, a sweeping reform created the first national health service of continental Europe: Italy's Servizio Sanitario Nazionale. This new scheme was based on the principle of "full democratic universalism": The state would provide free and equal benefits to every citizen and the organization of public health would subject to popular control, essentially through political parties. However, the severe problems encountered in implementing the reform design and rapidly increasing health expenditures soon eroded any consensus on this principle. Thus the 1980s and early 1990s witnessed a gradual shift to "conditional and well managed universalism." These latter principles stress the need to differentiate access to care according to some criterion to regulate demand and the need for efficient use of scarce resources through adequate valorization of managerial skills and the use of "market-type" incentives. An elaborated system of user copayments was introduced gradually, and in 1992 a "reform of the reform" profoundly changed the organizational framework of the Servizio Sanitario Nazionale. The new government elected in the spring of 1994 announced ambitious plans to partially dismantle public universal insurance. Although these plans may prove difficult, the potential to form an anti-universalistic coalition seems strong in the contemporary Italian health care arena.

  12. Switzerland: Health System Review.

    Science.gov (United States)

    De Pietro, Carlo; Camenzind, Paul; Sturny, Isabelle; Crivelli, Luca; Edwards-Garavoglia, Suzanne; Spranger, Anne; Wittenbecher, Friedrich; Quentin, Wilm

    2015-01-01

    This analysis of the Swiss health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. The Swiss health system is highly complex, combining aspects of managed competition and corporatism (the integration of interest groups in the policy process) in a decentralized regulatory framework shaped by the influences of direct democracy. The health system performs very well with regard to a broad range of indicators. Life expectancy in Switzerland (82.8 years) is the highest in Europe after Iceland, and healthy life expectancy is several years above the European Union (EU) average. Coverage is ensured through mandatory health insurance (MHI), with subsidies for people on low incomes. The system offers a high degree of choice and direct access to all levels of care with virtually no waiting times, though managed care type insurance plans that include gatekeeping restrictions are becoming increasingly important. Public satisfaction with the system is high and quality is generally viewed to be good or very good. Reforms since the year 2000 have improved the MHI system, changed the financing of hospitals, strengthened regulations in the area of pharmaceuticals and the control of epidemics, and harmonized regulation of human resources across the country. In addition, there has been a slow (and not always linear) process towards more centralization of national health policy-making. Nevertheless, a number of challenges remain. The costs of the health care system are well above the EU average, in particular in absolute terms but also as a percentage of gross domestic product (GDP) (11.5%). MHI premiums have increased more quickly than incomes since 2003. By European standards, the share of out-of-pocket payments is exceptionally high at 26% of total health expenditure (compared to the EU average of 16%). Low and middle-income households contribute a greater share of their income to

  13. Estonia: health system review.

    Science.gov (United States)

    Lai, Taavi; Habicht, Triin; Kahur, Kristiina; Reinap, Marge; Kiivet, Raul; van Ginneken, Ewout

    2013-01-01

    This analysis of the Estonian health system reviews recent developments in organization and governance, health financing, health-care provision, health reforms and health system performance. Without doubt, the main issue has been the 2008 financial crisis. Although Estonia has managed the downturn quite successfully and overall satisfaction with the system remains high, it is hard to predict the longer-term effects of the austerity package. The latter included some cuts in benefits and prices, increased cost sharing for certain services, extended waiting times, and a reduction in specialized care. In terms of health outcomes, important progress was made in life expectancy, which is nearing the European Union (EU) average, and infant mortality. Improvements are necessary in smoking and alcohol consumption, which are linked to the majority of avoidable diseases. Although the health behaviour of the population is improving, large disparities between groups exist and obesity rates, particularly among young people, are increasing. In health care, the burden of out-of-pocket payments is still distributed towards vulnerable groups. Furthermore, the number of hospitals, hospital beds and average length of stay has decreased to the EU average level, yet bed occupancy rates are still below EU averages and efficiency advances could be made. Going forwards, a number of pre-crisis challenges remain. These include ensuring sustainability of health care financing, guaranteeing a sufficient level of human resources, prioritizing patient-centred health care, integrating health and social care services, implementing intersectoral action to promote healthy behaviour, safeguarding access to health care for lower socioeconomic groups, and, lastly, improving evaluation and monitoring tools across the health system. World Health Organization 2013 (acting as the host organization for, and secretariat of, the European Observatory on Health Systems and Policies).

  14. Poland health system review.

    Science.gov (United States)

    Sagan, Anna; Panteli, Dimitra; Borkowski, W; Dmowski, M; Domanski, F; Czyzewski, M; Gorynski, Pawel; Karpacka, Dorota; Kiersztyn, E; Kowalska, Iwona; Ksiezak, Malgorzata; Kuszewski, K; Lesniewska, A; Lipska, I; Maciag, R; Madowicz, Jaroslaw; Madra, Anna; Marek, M; Mokrzycka, A; Poznanski, Darius; Sobczak, Alicja; Sowada, Christoph; Swiderek, Maria; Terka, A; Trzeciak, Patrycja; Wiktorzak, Katarzyna; Wlodarczyk, Cezary; Wojtyniak, B; Wrzesniewska-Wal, Iwona; Zelwianska, Dobrawa; Busse, Reinhard

    2011-01-01

    Since the successful transition to a freely elected parliament and a market economy after 1989, Poland is now a stable democracy and is well represented within political and economic organizations in Europe and worldwide. The strongly centralized health system based on the Semashko model was replaced with a decentralized system of mandatory health insurance, complemented with financing from state and territorial self-government budgets. There is a clear separation of health care financing and provision: the National Health Fund (NFZ) the sole payer in the system is in charge of health care financing and contracts with public and non-public health care providers. The Ministry of Health is the key policy-maker and regulator in the system and is supported by a number of advisory bodies, some of them recently established. Health insurance contributions, borne entirely by employees, are collected by intermediary institutions and are pooled by the NFZ and distributed between the 16 regional NFZ branches. In 2009, Poland spent 7.4% of its gross domestic product (GDP) on health. Around 70% of health expenditure came from public sources and over 83.5% of this expenditure can be attributed to the (near) universal health insurance. The relatively high share of private expenditure is mostly represented by out-of-pocket (OOP) payments, mainly in the form of co-payments and informal payments. Voluntary health insurance (VHI) does not play an important role and is largely limited to medical subscription packages offered by employers. Compulsory health insurance covers 98% of the population and guarantees access to a broad range of health services. However, the limited financial resources of the NFZ mean that broad entitlements guaranteed on paper are not always available. Health care financing is overall at most proportional: while financing from health care contributions is proportional and budgetary subsidies to system funding are progressive, high OOP expenditures

  15. Lateral Load-Resisting System Using Mass Timber Panel for High-Rise Buildings

    Directory of Open Access Journals (Sweden)

    Zhiyong Chen

    2017-07-01

    Full Text Available As global interest in using engineered wood products in tall buildings intensifies due to the “green” credential of wood, it is expected that more tall wood buildings will be designed and constructed in the coming years. This, however, brings new challenges to the designers. One of the major challenges is how to design lateral load-resisting systems (LLRSs with sufficient stiffness, strength, and ductility to resist strong wind and earthquakes. In this study, an LLRS using mass timber panel on a stiff podium was developed for high-rise buildings in accordance with capacity-based design principle. The LLRS comprises eight shear walls with a core in the center of the building, which was constructed with structural composite lumber and connected with dowel-type connections and wood–steel composite system. The main energy dissipating mechanism of the LLRS was detailed to be located at the panel-to-panel interface. This LLRS was implemented in the design of a hypothetical 20-storey building. A finite element (FE model of the building was developed using general-purpose FE software, ABAQUS. The wind-induced and seismic response of the building model was investigated by performing linear static and non-linear dynamic analyses. The analysis results showed that the proposed LLRS using mass timber was suitable for high-rise buildings. This study provided a valuable insight into the structural performance of LLRS constructed with mass timber panels as a viable option to steel and concrete for high-rise buildings.

  16. Bulgaria health system review.

    Science.gov (United States)

    Dimova, Antoniya; Rohova, Maria; Moutafova, Emanuela; Atanasova, Elka; Koeva, Stefka; Panteli, Dimitra; van Ginneken, Ewout

    2012-01-01

    In the last 20 years, demographic development in Bulgaria has been characterized by population decline, a low crude birth rate, a low fertility rate, a high mortality rate and an ageing population. A stabilizing political situation since the early 2000s and an economic upsurge since the mid-2000s were important factors in the slight increase of the birth and fertility rates and the slight decrease in standardized death rates. In general, Bulgaria lags behind European Union (EU) averages in most mortality and morbidity indicators. Life expectancy at birth reached 73.3 years in 2008 with the main three causes of death being diseases of the circulatory system, malignant neoplasms and diseases of the respiratory system. One of the most important risk factors overall is smoking, and the average standardized death rate for smoking-related causes in 2008 was twice as high as the EU15 average. The Bulgarian health system is characterized by limited statism. The Ministry of Health is responsible for national health policy and the overall organization and functioning of the health system and coordinates with all ministries with relevance to public health. The key players in the insurance system are the insured individuals, the health care providers and the third party payers, comprising the National Health Insurance Fund, the single payer in the social health insurance (SHI) system, and voluntary health insurance companies (VHICs). Health financing consists of a publicprivate mix. Health care is financed from compulsory health insurance contributions, taxes, outofpocket (OOP) payments, voluntary health insurance (VHI) premiums, corporate payments, donations, and external funding. Total health expenditure (THE) as a share of gross domestic product (GDP) increased from 5.3% in 1995 to 7.3% in 2008. At the latter date it consisted of 36.5% OOP payments, 34.8% SHI, 13.6% Ministry of Health expenditure, 9.4% municipality expenditure and 0.3% VHI. Informal payments in the health

  17. Circumpolar Inuit health systems.

    Science.gov (United States)

    Ellsworth, Leanna; O'Keeffe, Annmaree

    2013-01-01

    The Inuit are an indigenous people totalling about 160,000 and living in 4 countries across the Arctic - Canada, Greenland, USA (Alaska) and Russia (Chukotka). In essence, they are one people living in 4 countries. Although there have been significant improvements in Inuit health and survival over the past 50 years, stark differences persist between the key health indicators for Inuit and those of the national populations in the United States, Canada and Russia and between Greenland and Denmark. On average, life expectancy in all 4 countries is lower for Inuit. Infant mortality rates are also markedly different with up to 3 times more infant deaths than the broader national average. Underlying these statistical differences are a range of health, social, economic and environmental factors which have affected Inuit health outcomes. Although the health challenges confronting the Inuit are in many cases similar across the Arctic, the responses to these challenges vary in accordance with the types of health systems in place in each of the 4 countries. Each of the 4 countries has a different health care system with varying degrees of accessibility and affordability for Inuit living in urban, rural and remote areas. To describe funding and governance arrangements for health services to Inuit in Canada, Greenland, USA (Alaska) and Russia (Chukotka) and to determine if a particular national system leads to better outcomes than any of the other 3 systems. Literature review. It was not possible to draw linkages between the different characteristics of the respective health systems, the corresponding financial investment and the systems' effectiveness in adequately serving Inuit health needs for several reasons including the very limited and inadequate collection of Inuit-specific health data by Canada, Alaska and Russia; and second, the data that are available do not necessarily provide a feasible point of comparison in terms of methodology and timing of the available data

  18. Circumpolar Inuit health systems

    Directory of Open Access Journals (Sweden)

    Leanna Ellsworth

    2013-08-01

    Full Text Available Background . The Inuit are an indigenous people totalling about 160,000 and living in 4 countries across the Arctic – Canada, Greenland, USA (Alaska and Russia (Chukotka. In essence, they are one people living in 4 countries. Although there have been significant improvements in Inuit health and survival over the past 50 years, stark differences persist between the key health indicators for Inuit and those of the national populations in the United States, Canada and Russia and between Greenland and Denmark. On average, life expectancy in all 4 countries is lower for Inuit. Infant mortality rates are also markedly different with up to 3 times more infant deaths than the broader national average. Underlying these statistical differences are a range of health, social, economic and environmental factors which have affected Inuit health outcomes. Although the health challenges confronting the Inuit are in many cases similar across the Arctic, the responses to these challenges vary in accordance with the types of health systems in place in each of the 4 countries. Each of the 4 countries has a different health care system with varying degrees of accessibility and affordability for Inuit living in urban, rural and remote areas. Objective . To describe funding and governance arrangements for health services to Inuit in Canada, Greenland, USA (Alaska and Russia (Chukotka and to determine if a particular national system leads to better outcomes than any of the other 3 systems. Study design . Literature review. Results . It was not possible to draw linkages between the different characteristics of the respective health systems, the corresponding financial investment and the systems’ effectiveness in adequately serving Inuit health needs for several reasons including the very limited and inadequate collection of Inuit-specific health data by Canada, Alaska and Russia; and second, the data that are available do not necessarily provide a feasible point of

  19. Health care financing and the sustainability of health systems.

    Science.gov (United States)

    Liaropoulos, Lycourgos; Goranitis, Ilias

    2015-09-15

    The economic crisis brought an unprecedented attention to the issue of health system sustainability in the developed world. The discussion, however, has been mainly limited to "traditional" issues of cost-effectiveness, quality of care, and, lately, patient involvement. Not enough attention has yet been paid to the issue of who pays and, more importantly, to the sustainability of financing. This fundamental concept in the economics of health policy needs to be reconsidered carefully. In a globalized economy, as the share of labor decreases relative to that of capital, wage income is increasingly insufficient to cover the rising cost of care. At the same time, as the cost of Social Health Insurance through employment contributions rises with medical costs, it imperils the competitiveness of the economy. These reasons explain why spreading health care cost to all factors of production through comprehensive National Health Insurance financed by progressive taxation of income from all sources, instead of employer-employee contributions, protects health system objectives, especially during economic recessions, and ensures health system sustainability.

  20. Health Information Systems

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

    the technology and expertise to process and share ... services. GEHS supports efforts that reach beyond healthcare institutions to capture evidence ... Health information systems are a foundation for quality care, and can increase accountability ...

  1. Two-stage commercial evaluation of engineering systems production projects for high-rise buildings

    Science.gov (United States)

    Bril, Aleksander; Kalinina, Olga; Levina, Anastasia

    2018-03-01

    The paper is devoted to the current and debatable problem of methodology of choosing the effective innovative enterprises for venture financing. A two-stage system of commercial innovation evaluation based on the UNIDO methodology is proposed. Engineering systems account for 25 to 40% of the cost of high-rise residential buildings. This proportion increases with the use of new construction technologies. Analysis of the construction market in Russia showed that the production of internal engineering systems elements based on innovative technologies has a growth trend. The production of simple elements is organized in small enterprises on the basis of new technologies. The most attractive for development is the use of venture financing of small innovative business. To improve the efficiency of these operations, the paper proposes a methodology for a two-stage evaluation of small business development projects. A two-stage system of commercial evaluation of innovative projects allows creating an information base for informed and coordinated decision-making on venture financing of enterprises that produce engineering systems elements for the construction business.

  2. Two-stage commercial evaluation of engineering systems production projects for high-rise buildings

    Directory of Open Access Journals (Sweden)

    Bril Aleksander

    2018-01-01

    Full Text Available The paper is devoted to the current and debatable problem of methodology of choosing the effective innovative enterprises for venture financing. A two-stage system of commercial innovation evaluation based on the UNIDO methodology is proposed. Engineering systems account for 25 to 40% of the cost of high-rise residential buildings. This proportion increases with the use of new construction technologies. Analysis of the construction market in Russia showed that the production of internal engineering systems elements based on innovative technologies has a growth trend. The production of simple elements is organized in small enterprises on the basis of new technologies. The most attractive for development is the use of venture financing of small innovative business. To improve the efficiency of these operations, the paper proposes a methodology for a two-stage evaluation of small business development projects. A two-stage system of commercial evaluation of innovative projects allows creating an information base for informed and coordinated decision-making on venture financing of enterprises that produce engineering systems elements for the construction business.

  3. Effects of sea-level rise on barrier island groundwater system dynamics: ecohydrological implications

    Science.gov (United States)

    Masterson, John P.; Fienen, Michael N.; Thieler, E. Robert; Gesch, Dean B.; Gutierrez, Benjamin T.; Plant, Nathaniel G.

    2014-01-01

    We used a numerical model to investigate how a barrier island groundwater system responds to increases of up to 60 cm in sea level. We found that a sea-level rise of 20 cm leads to substantial changes in the depth of the water table and the extent and depth of saltwater intrusion, which are key determinants in the establishment, distribution and succession of vegetation assemblages and habitat suitability in barrier islands ecosystems. In our simulations, increases in water-table height in areas with a shallow depth to water (or thin vadose zone) resulted in extensive groundwater inundation of land surface and a thinning of the underlying freshwater lens. We demonstrated the interdependence of the groundwater response to island morphology by evaluating changes at three sites. This interdependence can have a profound effect on ecosystem composition in these fragile coastal landscapes under long-term changing climatic conditions.

  4. System health monitoring

    International Nuclear Information System (INIS)

    Reneke, J.A.; Fryer, M.O.

    1995-01-01

    Well designed large systems include many instrument taking data. These data are used in a variety of ways. They are used to control the system and its components, to monitor system and component health, and often for historical or financial purposes. This paper discusses a new method of using data from low level instrumentation to monitor system and component health. The method uses the covariance of instrument outputs to calculate a measure of system change. The method involves no complicated modeling since it is not a parameter estimation algorithm. The method is iterative and can be implemented on a computer in real time. Examples are presented for a metal lathe and a high efficiency particulate air (HEPA) filter. It is shown that the proposed method is quite sensitive to system changes such as wear out and failure. The method is useful for low level system diagnostics and fault detection

  5. Greece: Health system review.

    Science.gov (United States)

    Economou, Charalambos

    2010-01-01

    The Health Systems in Transition (HiT) profiles are country-based reports that provide a detailed description of a health system and of policy initiatives in progress or under development. HiTs examine different approaches to the organization, financing and delivery of health services and the role of the main actors in health systems; describe the institutional framework, process, content and implementation of health and health care policies; and highlight challenges and areas that require more in-depth analysis. The health status of the Greek population has strongly improved over the last few decades and seems to compare relatively favourably with other OECD and European Union (EU) countries. The health system is a mixture of public integrated, public contract and public reimbursement models, comprising elements from both the public and private sectors and incorporating principles of different organizational patterns. Access to services is based on citizenship as well as on occupational status.The system is financed by the state budget, social insurance contributions and private payments.The largest share of health expenditure constitutes private expenditure, mainly in the form of out of pocket payments which is also the element contributing most to the overall increase in health expenditure. The delivery of health care services is based on both public and private providers. The presence of private providers is more obvious in primary care,especially in diagnostic technologies, private physicians' practices and pharmaceuticals. Despite success in improving the health of the population, the Greek health care system faces serious structural problems concerning the organization, financing and delivery of services. It suffers from the absence of cost-containment measures and defined criteria for funding, resulting in sickness funds experiencing economic constraints and budget deficits. The high percentage of private expenditure goes against the principle of fair

  6. [The League of Nations Health Organization and the rise of Latin American participation, 1920-40].

    Science.gov (United States)

    Weindling, Paul

    2006-01-01

    The League of Nations Health Organization collaborated with Latin American specialists in public health and infectious diseases from the early 1920s to the outbreak of the Second World War. The League developed studies of infant health and nutrition, and leprosy. The approach was expert-oriented, and designed to develop public health on a scientific basis. There were conferences, tours and reports in Latin America. This paper demonstrates that the Latin American collaboration with the Health Organization was extensive and multi-faceted.

  7. Health tourism on the rise? Evidence from the Balance of Payments Statistics.

    Science.gov (United States)

    Loh, Chung-Ping A

    2014-09-01

    The study assesses the presence and magnitude of global trends in health tourism using health-related travel (HRT) spending reported in the International Monetary Fund's Balance of Payments Statistics database. Linear regression and quantile regression are applied to estimate secular trends of the import and export of HRT based on a sample of countries from 2003 to 2009. The results show that from 2003 to 2009 the import and export of health tourism rose among countries with a high volume of such activities (accounting for the upper 40% of the countries), but not among those with a low volume. The uneven growth in health tourism has generated greater contrast between countries with high and low volumes of health tourism activities. However, the growth in the total import of health tourism did not outpace the population growth, implying that in general the population's tendency to engage in health tourism remained static.

  8. Resilience of Infrastructure Systems to Sea-Level Rise in Coastal Areas: Impacts, Adaptation Measures, and Implementation Challenges

    Directory of Open Access Journals (Sweden)

    Beatriz Azevedo de Almeida

    2016-11-01

    Full Text Available Expansive areas of low elevation in many densely populated coastal areas are at elevated risk of storm surges and flooding due to torrential precipitation, as a result of sea level rise. These phenomena could have catastrophic impacts on coastal communities and result in the destruction of critical infrastructure, disruption of economic activities and salt water contamination of the water supply. The objective of the study presented in this paper was to identify various impacts of sea level rise on civil infrastructures in coastal areas and examine the adaptation measures suggested in the existing literature. To this end, a systemic review of the existing literature was conducted in order to identify a repository of studies addressing sea level rise impacts and adaptation measures in the context of infrastructure systems. The study focused on three infrastructure sectors: water and wastewater, energy, and road transportation. The collected information was then analyzed in order to identify different categories of sea level rise impacts and corresponding adaptation measures. The findings of the study are threefold: (1 the major categories of sea level rise impacts on different infrastructure systems; (2 measures for protection, accommodation, and retreat in response to sea level rise impacts; and (3 challenges related to implementing adaptation measures.

  9. Oceans and Human Health: A Rising Tide of Challenges and Opportunities for Europe

    OpenAIRE

    Fleming, L. E.; Mcdonough, N.; Austen, M.; Mee, L.; Moore, Michelle; Hess, Philipp; Depledge, M. H.; White, M.; Philippart, Katja; Bradbrook, P.; Smalley, A.

    2014-01-01

    The European Marine Board recently published a position paper on linking oceans and human health as a strategic research priority for Europe. With this position paper as a reference, the March 2014 Cornwall Oceans and Human Health Workshop brought together key scientists, policy makers, funders, business, and non governmental organisations from Europe and the US to review the recent interdisciplinary and cutting edge research in oceans and human health specifically the growing evidence of the...

  10. Oceans and human health: a rising tide of challenges and opportunities for Europe

    NARCIS (Netherlands)

    Fleming, L.E.; McDonough, N.; Austen, M.; Mee, L.; Moore, M.; Hess, P.; Depledge, M.H.; White, M.; Philippart, K.; Bradbrook, P.; Smalley, A.

    2014-01-01

    The European Marine Board recently published a position paper on linking oceans and human health as a strategic research priority for Europe. With this position paper as a reference, the March 2014 Cornwall Oceans and Human Health Workshop brought together key scientists, policy makers, funders,

  11. Social Media Channels in Health Care Research and Rising Ethical Issues.

    Science.gov (United States)

    Azer, Samy A

    2017-11-01

    Social media channels such as Twitter, Facebook, and LinkedIn have been used as tools in health care research, opening new horizons for research on health-related topics (e.g., the use of mobile social networking in weight loss programs). While there have been efforts to develop ethical guidelines for internet-related research, researchers still face unresolved ethical challenges. This article investigates some of the risks inherent in social media research and discusses how researchers should handle challenges related to confidentiality, privacy, and consent when social media tools are used in health-related research. © 2017 American Medical Association. All Rights Reserved.

  12. Understanding innovation system build up. The rise and fall of the Dutch PV Innovation System

    International Nuclear Information System (INIS)

    Negro, S.O.; Vasseur, V.; Hekkert, M.P.; Van Sark, W.G.J.H.M.

    2009-01-01

    Renewable energy technologies have a hard time to break through in the existing energy regime. In this paper we focus on analysing the mechanisms behind this problematic technology diffusion. We take the theoretical perspective of innovation system dynamics and apply this to photovoltaic solar energy technology (PV) in the Netherlands. The reason for this is that there is a long history of policy efforts in The Netherlands to stimulate PV but results in terms of diffusion of PV panels is disappointingly low, which clearly constitutes a case of slow diffusion. The history of the development of the PV innovation system is analysed in terms of seven key processes that are essential for the build up of innovation systems. We show that the processes related to knowledge development are very stable but that large fluctuations are present in the processes related to 'guidance of the search' and 'market formation'. Surprisingly, entrepreneurial activities are not too much affected by fluctuating market formation activities. We relate this to market formation in neighbouring countries and discuss the theoretical implications for the technological innovation system framework.

  13. Newly discovered hydrothermal system on the Alarcón Rise, Mexico

    Science.gov (United States)

    Paduan, J. B.; Clague, D. A.; Caress, D. W.; Lundsten, L.; Martin, J. F.; Nieves-Cardoso, C.

    2012-12-01

    The Alarcón Rise lies at the mouth of the Gulf of California, and is the last segment of the East Pacific Rise before the plate boundary redirects into the gulf. As part of MBARI's expedition to the gulf in 2012, the neovolcanic zone of the entire ridge segment was mapped by MBARI's mapping AUV. 110 potential hydrothermal chimneys were identified in the new high resolution maps, and 70 were visited with the ROV Doc Ricketts, after having been sought in vain without the maps on an expedition in 2003. Two active vent fields were found, and have been named Meyibó and Ja sít from local native languages. They lie 2.5km apart at ~2300m depth, and are associated with a large, young sheet flow 1/3 of the way along the ridge from the south, on the most inflated part of the ridge. The southern field, Meyibó, contains 14 active chimneys (confirmed with ROV observations) nestled in grabens of several highly fractured cones surrounded by the sheet flow, and generally aligned with its discontinuous, 8km-long fissure system. The northern field, Ja sít, is a broad cluster of 8 active chimneys (also confirmed) rising above the sheet flow's channel system, more than 150m from the fissure. The chimneys stand as tall as 18 m. The most vigorous vent "black smoke" (mineral-rich fluid) >300°C and others are bathed in "white smoke". The active chimneys are populated with bacterial mat and dense clumps of Riftia pachyptila with tubes as long as 1.5m. Abundant limpets, Bythograea thermydron and galatheid crabs, and the pink vent fish Thermarces cerberus were on and near the giant tube worms. Alvinellid worms were observed at 2 chimneys. Some cracks in nearby lava flows vented clear fluid and were populated with tubeworms or Calyptogena magnifica clams. Several chimneys exhibited signs of waning activity: dead tubeworms were still attached and only a minor portion of the edifice supported bacterial mat and live tubeworms. Inactive chimneys are more numerous (48 were confirmed with ROV

  14. Globalization and the rise of precarious employment: the new frontier for workplace health promotion.

    Science.gov (United States)

    Caldbick, Sam; Labonte, Ronald; Mohindra, K S; Ruckert, Arne

    2014-06-01

    Global market integration over the past three decades has led to labour market restructuring in most countries around the world. Employment flexibility has been emphasized as a way for employers to restructure their organizations to remain globally competitive. This flexibility has resulted in the growth of precarious employment, which has been exacerbated by the global financial crisis and resulting recession in 2007/2008, and the ongoing economic uncertainty throughout much of the world. Precarious employment may result in short and long-term health consequences for many workers. This presents a deeper and more structural determinant of health than what health promoters have traditionally considered. It calls for a different understanding of workplace health promotion research and intervention that goes beyond enabling healthier lifestyle choices or advocating safer workplace conditions to ensuring adequate social protection floors that provide people with sufficient resources to lead healthy lives, and for advocacy for taxation justice to finance such protection.

  15. Comparison of vacuum rise time, vacuum limit accuracy, and occlusion break surge of 3 new phacoemulsification systems.

    Science.gov (United States)

    Han, Young Keun; Miller, Kevin M

    2009-08-01

    To compare vacuum rise time, vacuum limit accuracy, and occlusion break surge of 3 new phacoemulsification machines. Jules Stein Eye Institute and Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA. The vacuum rise time under normal and enhanced aspiration modes, vacuum limit accuracy, and occlusion break surge of the Infiniti Vision System, Stellaris Vision Enhancement System, and WhiteStar Signature Phacoemulsification System were tested. Vacuum rise time and limit accuracy were measured at limit settings of 400 mm Hg and 600 mm Hg. Surge area was recorded at vacuum limit settings of 200 mm Hg, 300 mm Hg, 400 mm Hg, and 500 mm Hg. The Infiniti had the fastest vacuum rise times under normal and enhanced aspiration modes. At 4 seconds, the vacuum limit accuracy was greatest with the Infiniti at the 400 mm Hg limit and the Signature at the 600 mm Hg limit. The Stellaris did not reach either vacuum target. The Infiniti performed better than the other 2 machines during testing of occlusion break surge at all vacuum limit settings above 200 mm Hg. Under controlled laboratory test conditions, the Infiniti had the fastest vacuum rise time, greatest vacuum limit accuracy at 400 mm Hg, and least occlusion break surge. These results can be explained by the lower compliance of the Infiniti system.

  16. Croatia: health system review.

    Science.gov (United States)

    Džakula, Aleksandar; Sagan, Anna; Pavić, Nika; Lonćčarek, Karmen; Sekelj-Kauzlarić, Katarina

    2014-01-01

    Croatia is a small central European country on the Balkan peninsula, with a population of approximately 4.3 million and a gross domestic product (GDP) of 62% of the European Union (EU) average (expressed in purchasing power parity; PPP) in 2012. On 1 July 2013, Croatia became the 28th Member State of the EU. Life expectancy at birth has been increasing steadily in Croatia (with a small decline in the years following the 1991 to 1995 War of Independence) but is still lower than the EU average. Prevalence of overweight and obesity in the population has increased during recent years and trends in physical inactivity are alarming. The Croatian Health Insurance Fund (CHIF), established in 1993, is the sole insurer in the mandatory health insurance (MHI) system that provides universal health coverage to the whole population. The ownership of secondary health care facilities is distributed between the State and the counties. The financial position of public hospitals is weak and recent reforms were aimed at improving this. The introduction of concessions in 2009 (public private partnerships whereby county governments organize tenders for the provision of specific primary health care services) allowed the counties to play a more active role in the organization, coordination and management of primary health care; most primary care practices have been privatized. The proportion of GDP spent on health by the Croatian government remains relatively low compared to western Europe, as does the per capita health expenditure. Although the share of public expenditure as a proportion of total health expenditure (THE) has been decreasing, at around 82% it is still relatively high, even by European standards. The main source of the CHIFs revenue is compulsory health insurance contributions, accounting for 76% of the total revenues of the CHIF, although only about a third of the population (active workers) is liable to pay full health care contributions. Although the breadth and scope

  17. Measuring name system health

    NARCIS (Netherlands)

    Casalicchio, Emiliano; Caselli, Marco; Coletta, Alessio; Di Blasi, Salvatore; Fovino, Igor Nai; Butts, Jonathan; Shenoi, Sujeet

    2012-01-01

    Modern critical infrastructure assets are exposed to security threats arising from their use of IP networks and the Domain Name System (DNS). This paper focuses on the health of DNS. Indeed, due to the increased reliance on the Internet, the degradation of DNS could have significant consequences for

  18. Health system reform.

    Science.gov (United States)

    Ortolon, Ken

    2009-06-01

    A vote on reforming the nation's health care system seems likely this summer as President Obama makes good on a campaign pledge. Although the Democratic leadership in Congress appears ready to push through reform legislation before the next election, TMA and AMA leaders say very little is known about what that "reform" likely will look like.

  19. Water Quality Considerations on the Rise as the Use of Managed Aquifer Recharge Systems Widens

    Directory of Open Access Journals (Sweden)

    Niels Hartog

    2017-10-01

    Full Text Available Managed Aquifer Recharge (MAR is a promising method of increasing water availability in water stressed areas by subsurface infiltration and storage, to overcome periods of drought, and to stabilize or even reverse salinization of coastal aquifers. Moreover, MAR could be a key technique in making alternative water resources available, such as reuse of communal effluents for agriculture, industry and even indirect potable reuse. As exemplified by the papers in this Special Issue, consideration of water quality plays a major role in developing the full potential for MAR application, ranging from the improvement of water quality to operational issues (e.g., well clogging or sustainability concerns (e.g., infiltration of treated waste water. With the application of MAR expanding into a wider range of conditions, from deserts to urban and coastal areas, and purposes, from large scale strategic storage of desalinated water and the reuse of waste water, the importance of these considerations are on the rise. Addressing these appropriately will contribute to a greater understanding, operational reliability and acceptance of MAR applications, and lead to a range of engineered MAR systems that help increase their effectiveness to help secure the availability of water at the desired quality for the future.

  20. Medical technology as a key driver of rising health expenditure: disentangling the relationship

    Directory of Open Access Journals (Sweden)

    Sorenson C

    2013-05-01

    Full Text Available Corinna Sorenson,1,2 Michael Drummond,2,3 Beena Bhuiyan Khan1 1LSE Health, London School of Economics and Political Science, London, UK; 2European Health Technology Institute for Socioeconomic Research, Brussels, Belgium; 3Centre for Health Economics, University of York, York, UK Abstract: Health care spending has risen steadily in most countries, becoming a concern for decision-makers worldwide. Commentators often point to new medical technology as the key driver for burgeoning expenditures. This paper critically appraises this conjecture, based on an analysis of the existing literature, with the aim of offering a more detailed and considered analysis of this relationship. Several databases were searched to identify relevant literature. Various categories of studies (eg, multivariate and cost-effectiveness analyses were included to cover different perspectives, methodological approaches, and issues regarding the link between medical technology and costs. Selected articles were reviewed and relevant information was extracted into a standardized template and analyzed for key cross-cutting themes, ie, impact of technology on costs, factors influencing this relationship, and methodological challenges in measuring such linkages. A total of 86 studies were reviewed. The analysis suggests that the relationship between medical technology and spending is complex and often conflicting. Findings were frequently contingent on varying factors, such as the availability of other interventions, patient population, and the methodological approach employed. Moreover, the impact of technology on costs differed across technologies, in that some (eg, cancer drugs, invasive medical devices had significant financial implications, while others were cost-neutral or cost-saving. In light of these issues, we argue that decision-makers and other commentators should extend their focus beyond costs solely to include consideration of whether medical technology results in

  1. EFFECT OF RECYCLE TIRE ISOLATOR AS EARTHQUAKE RESISTANCE SYSTEM FOR LOW RISE BUILDINGS IN MALAYSIA

    Directory of Open Access Journals (Sweden)

    SOW WEI JIE

    2016-08-01

    Full Text Available The purpose of this research is to investigate the effect of Recycle Tire Isolator (RTI as earthquake resistance system for low rise buildings in Malaysia. Most of the earthquake’s victims are due to the collapse of poorly designed concrete and masonry buildings. Therefore, an economical but reliable RTI is introduced to solve the problem in most of the developing countries such as Malaysia. This study focuses on the effect of RTI-5 (5 layers RTI in protecting three stories buildings. The vertical displacement of RTI-5 was determined through static compression test. The maximum vertical displacement of RTI-5 was obtained when the specimen was monotonically loaded to failure. Finite element analysis was carried out by using ANSYS V16.0 to model the RTI-5 and the results obtained were compared to the experimental results. The dynamic stiffness and damping ratio of RTI-5 were investigated through dynamic test. The behaviour of various thickness of RTI were examined and compared with Rubber Bearing (RB and Scrap Tire Rubber Pad (STRP.Total displacement of three stories buildings on fixed base and on base isolation were determined. The results from static compression test and finite element analysis showed that RTI-5 could sustain a vertical load of 380 kN with vertical deformation of 12.5 mm. It has been verified by finite element analysis (FEA where both of the results achieved close agreement in terms of vertical deformation. RTI-5 and STRP have similar vertical stiffness due to the employment of same material in fabrication. However, rubber bearing is stiffer than RTI-5 due to the present of embedded steel plates. Besides, RTI-4 is stiffer than RTI-5 due to the number of layers are lesser in RTI-4. The results of dynamic test shown that RTI-5 has higher damping ratio than RTI-4. In overall, total deformation at the top floor of the three stories building is reduced by 83% via implementation of RTI in the base of the building. It has been proven

  2. Oceans and Human Health: a rising tide of challenges and opportunities for Europe.

    Science.gov (United States)

    Fleming, L E; McDonough, N; Austen, M; Mee, L; Moore, M; Hess, P; Depledge, M H; White, M; Philippart, K; Bradbrook, P; Smalley, A

    2014-08-01

    The European Marine Board recently published a position paper on linking oceans and human health as a strategic research priority for Europe. With this position paper as a reference, the March 2014 Cornwall Oceans and Human Health Workshop brought together key scientists, policy makers, funders, business, and non governmental organisations from Europe and the US to review the recent interdisciplinary and cutting edge research in oceans and human health specifically the growing evidence of the impacts of oceans and seas on human health and wellbeing (and the effects of humans on the oceans). These impacts are a complex mixture of negative influences (e.g. from climate change and extreme weather to harmful algal blooms and chemical pollution) and beneficial factors (e.g. from natural products including seafood to marine renewable energy and wellbeing from interactions with coastal environments). Integrated approaches across disciplines, institutions, and nations in science and policy are needed to protect both the oceans and human health and wellbeing now and in the future. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  3. After Some Breast Cancer Treatments, Risk for Other Health Conditions May Rise

    Science.gov (United States)

    ... Skin Care Dining & Beverage Personal Care Services Sports & Outdoors Frequently Asked Questions 25th Anniversary Campaign Donors Share ... did not track how severe the co-existing health conditions were. What ... cases, the benefit of taking these treatments outweighs the potential risk ...

  4. Rising Poverty, Declining Health: The Nutritional Status of the Rural Poor.

    Science.gov (United States)

    Public Voice for Food and Health Policy, Washington, DC.

    Using five key indicators of nutritional status (dietary intake, biochemical tests for circulating levels of nutrients or their metabolites, anthropometric measures, low birth weight and infant mortality rates, and food, health, and income assistance program participation rates and benefit levels), this 1-year research project identified national,…

  5. PROLOGUE : Health Information System

    OpenAIRE

    Tomar, Shivanjali

    2013-01-01

    Prologue is a health information system developed for underserved communities in Bihar, India. It is aimed at helping people living in poverty and with low literacy to take the right steps to manage their and their family’s health. Bihar suffers from one of the worst healthcare records in the country. This is as much due to the lack of access to the right information as it is due to the economic condition of the region. The inaccessibility of information is aggravated by the complex social se...

  6. Near Surface Geophysical Methods Applied to the Rising Star Cave System

    Science.gov (United States)

    Webb, S. J.; Naidoo, M.; Elliott, M. C.; Kruger, A.; Roberts, E.; Dirks, P.

    2017-12-01

    The Rising Star Cave system is located approximately 40 km northwest of Johannesburg in the Malmani dolomites (Chuniespoort group,Transvaal Supergroup). The cave system is extensive with 4 km of mapped passages and chambers. The Dinaledi chamber, host to the Homo Naledi fossils, is reached by following a tortuous route with squeezes as small as 20 cm. The chamber is located 30 m below surface and 80 m from the entrance. The enigmatic find of fossils from at least 15 individual hominins, without the presence of other species, led to the idea of deliberate burial. The present access route is difficult and it is unclear how early hominins were able to navigate it, prompting the suggestion of an undiscovered entrance. We are using near surface geophysical methods to investigate possible connections between the surface and the caves. Using a Geometrics Cs-vapor Walkmag, we collected preliminary ground magnetic intensity measurements over a region 300 m x 200 m, using 1 m station spacing and 10 m line spacing. The average magnetic variation along line is 200 nT. We also collected over 100 susceptibility measurements on outcropping lithologies, surface soil and cave sediments using a SM-30 susceptibility meter. The surface soil was one to two orders of magnitude higher than surrounding lithologies (average = 1.5 x 10-3 SI) and the cave sediment samples were slightly higher (average = 3.07 x 10-3 SI). We were able to collect GPR data (GSSI SIR-3000, 400 MHz) in selected spots on the cave floor with the goal of locating the cave floor beneath the sediments. Dolomites usually have low magnetic susceptibilities, but erosion products of the nearby magnetic Hospital Hill or Rooihoogte shales may have been transported into or onto the cave system. This is a likely cause of the magnetic anomalies and larger amplitude anomalies may indicate an accumulation of sediments, extending to depth. These anomalies will be further investigated using gravity to determine if there are

  7. New joints: Private providers and rising demand in the English National Health Service

    OpenAIRE

    Kelly, Elaine; Stoye, George

    2015-01-01

    Reforms to public services have extended consumer choice by allowing for the entry of private providers. The aim is to generate competitive pressure to improve quality when consumers choose between providers. However, for many services new entrants could also affect whether a consumer demands the service at all. We explore this issue by considering how demand for elective surgery responds following the entry of private providers into the market for publicly funded health care in England. For ...

  8. The rise of Zika infection and microcephaly: what can we learn from a public health emergency?

    Science.gov (United States)

    McCloskey, B; Endericks, T

    2017-09-01

    To consider why Zika was declared a Public Health Emergency of International Concern (PHEIC), why it stopped being one and what we can learn from this for the future. This paper reviews the sequence of events and evidence base for the decision to declare Zika a PHEIC, the global response to this, the challenges in maintaining an evidence-based approach to outbreak response and identifies learning outcomes. Evidence review, all published articles in reputable UK and international journals were identified. The association between Zika virus infection and congenital malformations including microcephaly became a PHEIC on 1st February 2016 and was declared to be no longer an emergency in November 2016. This shaped the global response led by WHO in the first global emergency since Ebola in West Africa. The response to Zika highlights important issues and lessons for future outbreaks that might pose an international risk. Particular challenges arose in trying to maintain an evidence-based approach to public risk communication when the evidence is unclear or still evolving. The Zika incident also demonstrates the importance of public health practitioners and agencies understanding the political context in which outbreaks must be managed and understanding the competing factors that shape the political response. Copyright © 2017 The Royal Society for Public Health. All rights reserved.

  9. Mobile Patient Monitoring: the MobiHealth System

    NARCIS (Netherlands)

    Konstantas, D.; van Halteren, Aart; Bults, Richard G.A.; Wac, K.E.; Widya, I.A.; Dokovski, N.T.; Jones, Valerie M.; Dokovsky, Nicolai; Koprinkov, G.T.; Herzog, Rainer; Bos, L.; Laxminarayan, S.

    2004-01-01

    The forthcoming wide availability of high bandwidth public wireless networks will give rise to new mobile health care services. Towards this direction the MobiHealth1 project has developed and trialed a highly customisable vital signals’ monitoring system based on a Body Area Network (BAN) and an

  10. Health Information Systems.

    Science.gov (United States)

    Sirintrapun, S Joseph; Artz, David R

    2015-06-01

    This article provides surgical pathologists an overview of health information systems (HISs): what they are, what they do, and how such systems relate to the practice of surgical pathology. Much of this article is dedicated to the electronic medical record. Information, in how it is captured, transmitted, and conveyed, drives the effectiveness of such electronic medical record functionalities. So critical is information from pathology in integrated clinical care that surgical pathologists are becoming gatekeepers of not only tissue but also information. Better understanding of HISs can empower surgical pathologists to become stakeholders who have an impact on the future direction of quality integrated clinical care. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Gender and leadership for health literacy to combat the epidemic rise of noncommunicable diseases.

    Science.gov (United States)

    Manhanzva, Rufaro; Marara, Praise; Duxbury, Theodore; Bobbins, Amy Claire; Pearse, Noel; Hoel, Erik; Mzizi, Thandi; Srinivas, Sunitha C

    2017-08-01

    Until recently, the noncommunicable diseases (NCDs) epidemic has been considered only a significant burden to men in high-income countries. However, latest figures indicate that half of all NCD-related deaths affect women, especially in low- and middle-income countries (LMICs), with global responses to the NCD epidemic overlooking the significance of women and girls in their approaches and programs. This case study highlights the burden of disease challenging South Africa that disproportionately affects women in the country and suggests that the country, along with other LMICs internationally, requires a shift in the gender-based leadership of health literacy and self-empowerment.

  12. Medical technology as a key driver of rising health expenditure: disentangling the relationship

    Science.gov (United States)

    Sorenson, Corinna; Drummond, Michael; Bhuiyan Khan, Beena

    2013-01-01

    Health care spending has risen steadily in most countries, becoming a concern for decision-makers worldwide. Commentators often point to new medical technology as the key driver for burgeoning expenditures. This paper critically appraises this conjecture, based on an analysis of the existing literature, with the aim of offering a more detailed and considered analysis of this relationship. Several databases were searched to identify relevant literature. Various categories of studies (eg, multivariate and cost-effectiveness analyses) were included to cover different perspectives, methodological approaches, and issues regarding the link between medical technology and costs. Selected articles were reviewed and relevant information was extracted into a standardized template and analyzed for key cross-cutting themes, ie, impact of technology on costs, factors influencing this relationship, and methodological challenges in measuring such linkages. A total of 86 studies were reviewed. The analysis suggests that the relationship between medical technology and spending is complex and often conflicting. Findings were frequently contingent on varying factors, such as the availability of other interventions, patient population, and the methodological approach employed. Moreover, the impact of technology on costs differed across technologies, in that some (eg, cancer drugs, invasive medical devices) had significant financial implications, while others were cost-neutral or cost-saving. In light of these issues, we argue that decision-makers and other commentators should extend their focus beyond costs solely to include consideration of whether medical technology results in better value in health care and broader socioeconomic benefits. PMID:23807855

  13. Justification of directions of technological and price audit systems changes for the purpose of high-rise construction innovating

    Science.gov (United States)

    Rogacheva, Yana; Panenkov, Andrey; Petrikova, Zinaida; Nezhnikova, Ekaterina

    2018-03-01

    Improving the quality of high-rise buildings under modern conditions should be based not only on compliance with the norms of technical regulations, but also on ensuring energy efficiency, environmental friendliness, and intellectuality, which can be achieved only through the introduction of innovations at all stages of the life cycle of the investment project. Authors of this article justified the need for a mechanism of technological and price audit of projects. They also suggested the model of life cycle of organizational and economic changes, connected with implantation of the mechanism of projects audit. They showed innovation character of ecological high-rise construction for the whole life cycle. Authors also made proposals to change the audit system for high-rise construction projects in the focus of its environmental friendliness.

  14. Justification of directions of technological and price audit systems changes for the purpose of high-rise construction innovating

    Directory of Open Access Journals (Sweden)

    Rogacheva Yana

    2018-01-01

    Full Text Available Improving the quality of high-rise buildings under modern conditions should be based not only on compliance with the norms of technical regulations, but also on ensuring energy efficiency, environmental friendliness, and intellectuality, which can be achieved only through the introduction of innovations at all stages of the life cycle of the investment project. Authors of this article justified the need for a mechanism of technological and price audit of projects. They also suggested the model of life cycle of organizational and economic changes, connected with implantation of the mechanism of projects audit. They showed innovation character of ecological high-rise construction for the whole life cycle. Authors also made proposals to change the audit system for high-rise construction projects in the focus of its environmental friendliness.

  15. Subseafloor Microbial Life in Venting Fluids from the Mid Cayman Rise Hydrothermal System

    Science.gov (United States)

    Huber, J. A.; Reveillaud, J.; Reddington, E.; McDermott, J. M.; Sylva, S. P.; Breier, J. A.; German, C. R.; Seewald, J.

    2012-12-01

    In hard rock seafloor environments, fluids emanating from hydrothermal vents are one of the best windows into the subseafloor and its resident microbial community. The functional consequences of an extensive population of microbes living in the subseafloor remains unknown, as does our understanding of how these organisms interact with one another and influence the biogeochemistry of the oceans. Here we report the abundance, activity, and diversity of microbes in venting fluids collected from two newly discovered deep-sea hydrothermal vents along the ultra-slow spreading Mid-Cayman Rise (MCR). Fluids for geochemical and microbial analysis were collected from the Von Damm and Piccard vent fields, which are located within 20 km of one another, yet have extremely different thermal, geological, and depth regimes. Geochemical data indicates that both fields are highly enriched in volatiles, in particular hydrogen and methane, important energy sources for and by-products of microbial metabolism. At both sites, total microbial cell counts in the fluids ranged in concentration from 5 x 10 4 to 3 x 10 5 cells ml-1 , with background seawater concentrations of 1-2 x 10 4 cells ml-1 . In addition, distinct cell morphologies and clusters of cells not visible in background seawater were seen, including large filaments and mineral particles colonized by microbial cells. These results indicate local enrichments of microbial communities in the venting fluids, distinct from background populations, and are consistent with previous enumerations of microbial cells in venting fluids. Stable isotope tracing experiments were used to detect utilization of acetate, formate, and dissolve inorganic carbon and generation of methane at 70 °C under anaerobic conditions. At Von Damm, a putatively ultra-mafic hosted site located at ~2200 m with a maximum temperature of 226 °C, stable isotope tracing experiments indicate methanogenesis is occurring in most fluid samples. No activity was detected

  16. Does public insurance provide better financial protection against rising health care costs for families of children with special health care needs?

    Science.gov (United States)

    Yu, Hao; Dick, Andrew W; Szilagyi, Peter G

    2008-10-01

    Health care costs grew rapidly since 2001, generating substantial economic pressures on families, especially those with children with special health care needs (CSHCN). To examine how the growth of health care costs affected financial burden for families of CSHCN between 2001 and 2004 and to determine the extent to which health insurance coverage protected families of CSHCN against financial burden. In 2001-2004, 5196 families of CSHCN were surveyed by the national Medical Expenditure Panel Survey (MEPS). The main outcome was financial burden, defined as the proportion of family income spent on out-of-pocket (OOP) health care expenditures for all family members, including OOP costs and premiums. Family insurance coverage was classified as: (1) all members publicly insured, (2) all members privately insured, (3) all members uninsured, (4) partial coverage, and (5) a mix of public and private with no uninsured periods. An upward trend in financial burden for families of CSHCN occurred and was associated with growth of economy-wide health care costs. A multivariate analysis indicated that, given the economy-wide increase in medical costs between 2001 and 2004, a family with CSHCN was at increased risk in 2004 for having financial burden exceeding 10% of family income [odds ratio (OR) = 1.39; P financial burden exceeding 20% of family income. Over 15% of families with public insurance had financial burden exceeding 10% of family income compared with 20% of families with private insurance (P financial burden of >10% or 20% of family income than privately-insured families. Rising health care costs increased financial burden on families of CSHCN in 2001-2004. Public insurance coverage provided better financial protection than private insurance against the rapidly rising health care costs for families of CSHCN.

  17. On the merging rates of envelope-deprived components of binary systems which can give rise to supernova events

    International Nuclear Information System (INIS)

    Tornambe, Amedo

    1989-01-01

    We derive theoretical rates of mergings of envelope-deprived components of binary systems, which can give rise to supernova events. The effects of the various assumptions one is forced to make on the physical properties of the progenitor system and of its evolutionary behaviour through common envelope phases are discussed. Four cases have been analysed: CO-CO, He-CO, He-He double degenerate mergings and He star-CO dwarf merging. (author)

  18. Mobile patient monitoring: The MobiHealth system

    NARCIS (Netherlands)

    Wac, K.E.; Bults, Richard G.A.; van Beijnum, Bernhard J.F.; Widya, I.A.; Jones, Valerie M.; Konstantas, D.; Vollenbroek-Hutten, Miriam Marie Rosé; Hermens, Hermanus J.

    2009-01-01

    The emergence of high bandwidth public wireless networks and miniaturized personal mobile devices give rise to new mobile healthcare services. To this end, the MobiHealth system provides highly customizable vital signs tele-monitoring and tele-treatment system based on a body area network (BAN) and

  19. Explaining the Rise in Danish Vocational Education System Dropouts: The Effect of a Youth Unemployment Program

    DEFF Research Database (Denmark)

    Munk, Martin D.; Park, Do-Yeun

    This project focuses on the impact of Denmark’s Youth Unemployment Program(YUP) enacted in late 1990s on the rise in VET dropout rates. The Youth Unemployment Program targeted unemployed, low-educated youth to strengthen the employment possibilities and to motivate for them to undertake an educat......This project focuses on the impact of Denmark’s Youth Unemployment Program(YUP) enacted in late 1990s on the rise in VET dropout rates. The Youth Unemployment Program targeted unemployed, low-educated youth to strengthen the employment possibilities and to motivate for them to undertake...... an education. If the Youth Unemployment Program incentivized less capable/ambitious students to enter vocational education, it would increase the dropout rates via selection. This project investigates whether the program had an effect on the population characteristics of incoming VET students and the resulting...

  20. Is there a relationship between the rise in thyroid and neurodevelopmental health effects in North America and the rise in concentrations of PBDEs in the environment? An update

    Energy Technology Data Exchange (ETDEWEB)

    Muir, T. [Environment Canada, Burlington, ON (Canada)

    2004-09-15

    In a previous paper on this question, data on an apparently rising prevalence of hypothyroidism, and neurodevelopmental deficits in children was presented. In this context, the issue of the potential for the observed, exponentially increasing levels of PBDEs in the environment to contribute to this expressed clinical burden of disease was raised. This potential contribution was raised because of evidence that the toxicological endpoints of concern for PBDEs include thyroid hormone disruption and neurodevelopmental deficits, and are similar to those seen earlier for PCBs, and DDT. As well, structural and toxicological similarities to PBBs, PCDDs, PCDFs are also part of the concern. Also raised as issues for further research were two things. First, there is a need in risk assessment to move beyond the focus on the average or median body burden, tissue or human milk concentrations, to account for the population distribution of the concentrations, and the percentiles in the tails of the distribution, particularly the high exposure portion. Second, interactions and additive exposures to and effects of the above mentioned, and other compounds or substances, (e.g. perchlorate, mercury, lead) need to be considered when talking about the ''safety'' of individual compounds. The aim of this paper is to examine - using Monte Carlo methods applied to the reported human milk (lipid weight) concentrations - the probability distributions, and the population percentiles, of the times required for PBDEs to reach a critical value of 1250 ng/g found by the Jacobsons, for PCBs, to be associated with learning impairments, intellectual deficits, and IQ loss in the offspring. In addition, historical body burdens of PCBs and DDT will be taken from the literature, and using estimates derived here of the distribution of the 2002 human milk levels of these compounds, the times required for PBDEs, plus PCBs and DDT, to reach 1250 ng/g will be simulated. Finally, note will

  1. Study of the Effectiveness of Outrigger System for High-Rise Composite Buildings for Cyclonic Region

    OpenAIRE

    S. Fawzia; A. Nasir; T. Fatima

    2011-01-01

    The demands of taller structures are becoming imperative almost everywhere in the world in addition to the challenges of material and labor cost, project time line etc. This paper conducted a study keeping in view the challenging nature of high-rise construction with no generic rules for deflection minimizations and frequency control. The effects of cyclonic wind and provision of outriggers on 28-storey, 42-storey and 57-storey are examined in this paper and certain conclusions are made which...

  2. The Health Halo Trend in UK Television Food Advertising Viewed by Children: The Rise of Implicit and Explicit Health Messaging in the Promotion of Unhealthy Foods

    Science.gov (United States)

    Harrold, Joanne; Halford, Jason; Boyland, Emma

    2018-01-01

    Monitoring the creative content within food marketing to children is strongly advocated by public health authorities, but few studies address the prevalence of health-related messaging in television adverts. Food and beverage adverts (n = 18,888 in 2008, n = 6664 in 2010) from UK television channels popular with children were coded and analyzed. Physical-activity depiction displayed an 18.8 percentage point increase from 2008 (4.4%) to 2010 (23.2%). Of the food adverts containing physical-activity depiction in 2010, 81.1% were for non-core foods. The appearance of health claims in food adverts in 2010 increased 4.1 percentage points from 2008 levels (20.7% to 24.8%) where the majority of food adverts featuring health and nutrition claims were for non-core foods (58.3%). Health-related (e.g., health/nutrition, weight loss/diet) appeals were used in 17.1% of food adverts during peak child-viewing times, rising to 33.0% of adverts shown on dedicated children’s channels in 2010. Implicit (physical activity) and explicit (health claims) health messages are increasingly prevalent in UK television food advertising viewed by children, and are frequently used to promote unhealthy foods. Policy makers in the UK should consider amendments to the existing statutory approach in order to address this issue. PMID:29558457

  3. The Health Halo Trend in UK Television Food Advertising Viewed by Children: The Rise of Implicit and Explicit Health Messaging in the Promotion of Unhealthy Foods

    Directory of Open Access Journals (Sweden)

    Rosa Whalen

    2018-03-01

    Full Text Available Monitoring the creative content within food marketing to children is strongly advocated by public health authorities, but few studies address the prevalence of health-related messaging in television adverts. Food and beverage adverts (n = 18,888 in 2008, n = 6664 in 2010 from UK television channels popular with children were coded and analyzed. Physical-activity depiction displayed an 18.8 percentage point increase from 2008 (4.4% to 2010 (23.2%. Of the food adverts containing physical-activity depiction in 2010, 81.1% were for non-core foods. The appearance of health claims in food adverts in 2010 increased 4.1 percentage points from 2008 levels (20.7% to 24.8% where the majority of food adverts featuring health and nutrition claims were for non-core foods (58.3%. Health-related (e.g., health/nutrition, weight loss/diet appeals were used in 17.1% of food adverts during peak child-viewing times, rising to 33.0% of adverts shown on dedicated children’s channels in 2010. Implicit (physical activity and explicit (health claims health messages are increasingly prevalent in UK television food advertising viewed by children, and are frequently used to promote unhealthy foods. Policy makers in the UK should consider amendments to the existing statutory approach in order to address this issue.

  4. The Health Halo Trend in UK Television Food Advertising Viewed by Children: The Rise of Implicit and Explicit Health Messaging in the Promotion of Unhealthy Foods.

    Science.gov (United States)

    Whalen, Rosa; Harrold, Joanne; Child, Simon; Halford, Jason; Boyland, Emma

    2018-03-20

    Monitoring the creative content within food marketing to children is strongly advocated by public health authorities, but few studies address the prevalence of health-related messaging in television adverts. Food and beverage adverts ( n = 18,888 in 2008, n = 6664 in 2010) from UK television channels popular with children were coded and analyzed. Physical-activity depiction displayed an 18.8 percentage point increase from 2008 (4.4%) to 2010 (23.2%). Of the food adverts containing physical-activity depiction in 2010, 81.1% were for non-core foods. The appearance of health claims in food adverts in 2010 increased 4.1 percentage points from 2008 levels (20.7% to 24.8%) where the majority of food adverts featuring health and nutrition claims were for non-core foods (58.3%). Health-related (e.g., health/nutrition, weight loss/diet) appeals were used in 17.1% of food adverts during peak child-viewing times, rising to 33.0% of adverts shown on dedicated children's channels in 2010. Implicit (physical activity) and explicit (health claims) health messages are increasingly prevalent in UK television food advertising viewed by children, and are frequently used to promote unhealthy foods. Policy makers in the UK should consider amendments to the existing statutory approach in order to address this issue.

  5. Peak Oil, Food Systems, and Public Health

    Science.gov (United States)

    Parker, Cindy L.; Kirschenmann, Frederick L.; Tinch, Jennifer; Lawrence, Robert S.

    2011-01-01

    Peak oil is the phenomenon whereby global oil supplies will peak, then decline, with extraction growing increasingly costly. Today's globalized industrial food system depends on oil for fueling farm machinery, producing pesticides, and transporting goods. Biofuels production links oil prices to food prices. We examined food system vulnerability to rising oil prices and the public health consequences. In the short term, high food prices harm food security and equity. Over time, high prices will force the entire food system to adapt. Strong preparation and advance investment may mitigate the extent of dislocation and hunger. Certain social and policy changes could smooth adaptation; public health has an essential role in promoting a proactive, smart, and equitable transition that increases resilience and enables adequate food for all. PMID:21778492

  6. Revisiting the Rise of Electronic Nicotine Delivery Systems Using Search Query Surveillance.

    Science.gov (United States)

    Ayers, John W; Althouse, Benjamin M; Allem, Jon-Patrick; Leas, Eric C; Dredze, Mark; Williams, Rebecca S

    2016-06-01

    Public perceptions of electronic nicotine delivery systems (ENDS) remain poorly understood because surveys are too costly to regularly implement and, when implemented, there are long delays between data collection and dissemination. Search query surveillance has bridged some of these gaps. Herein, ENDS' popularity in the U.S. is reassessed using Google searches. ENDS searches originating in the U.S. from January 2009 through January 2015 were disaggregated by terms focused on e-cigarette (e.g., e-cig) versus vaping (e.g., vapers); their geolocation (e.g., state); the aggregate tobacco control measures corresponding to their geolocation (e.g., clean indoor air laws); and by terms that indicated the searcher's potential interest (e.g., buy e-cigs likely indicates shopping)-all analyzed in 2015. ENDS searches are rapidly increasing in the U.S., with 8,498,000 searches during 2014 alone. Increasingly, searches are shifting from e-cigarette- to vaping-focused terms, especially in coastal states and states where anti-smoking norms are stronger. For example, nationally, e-cigarette searches declined 9% (95% CI=1%, 16%) during 2014 compared with 2013, whereas vaping searches increased 136% (95% CI=97%, 186%), even surpassing e-cigarette searches. Additionally, the percentage of ENDS searches related to shopping (e.g., vape shop) nearly doubled in 2014, whereas searches related to health concerns (e.g., vaping risks) or cessation (e.g., quit smoking with e-cigs) were rare and declined in 2014. ENDS popularity is rapidly growing and evolving. These findings could inform survey questionnaire development for follow-up investigation and immediately guide policy debates about how the public perceives the health risks or cessation benefits of ENDS. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  7. Potential application of a centralized solar water-heating system for a high-rise residential building in Hong Kong

    International Nuclear Information System (INIS)

    Chow, T.T.; Fong, K.F.; Chan, A.L.S.; Lin, Z.

    2006-01-01

    There is a growing, government-led trend of applying renewable energy in Hong Kong. One area of interest lies in the wider use of solar-energy systems. The worldwide fast development of building-integrated solar technology has prompted the design alternative of fixing the solar panels on the external facades of buildings. In Hong Kong, high-rise buildings are found everywhere in the urban districts. How to make full use of the vertical facades of these buildings to capture the most solar radiation can be an important area in the technology promotion. In this numerical study, the potential application of a centralized solar water-heating system in high-rise residence was evaluated. Arrays of solar thermal collectors, that occupied the top two-third of the south and west facades of a hypothetical high-rise residence, were proposed for supporting the domestic hot-water system. Based on typical meteorological data, it was found that the annual efficiency of the vertical solar collectors could reach 38.4% on average, giving a solar fraction of 53.4% and a payback period of 9.2 years. Since the solar collectors were able to reduce the heat transmission through the building envelope, the payback was in fact even shorter if the energy saving in air-conditioner operation was considered

  8. Mapping Sea Level Rise Behavior in an Estuarine Delta System: A Case Study along the Shanghai Coast

    Directory of Open Access Journals (Sweden)

    H.Q. Cheng

    2018-02-01

    Full Text Available Sea level rise (SLR is a major projected threat of climate change that is expected to affect developing coastal cities located in estuarine delta regions. Shanghai is one such city, being located in the Yangtze River Delta (YRD. It is difficult, however, for decision-makers to implement adaptation due to the uncertain causes, magnitudes, and timings of SLR behaviors. This paper attempts to map the causes and magnitudes of SLR behaviors on a decadal scale. We analyze the tidal level records from 11 tidal gauge stations and the corresponding bathymetry measurements around these stations since 1921. We identify three new SLR behaviors along the Shanghai coast due to anthropogenic geomorphologic changes (AGCs, besides the well-known eustatic sea level rise (ESLR, tectonic subsidence (TS, and urban land subsidence (ULS. The first new behavior is regional sea level rise (RSLR, which occurs as a result of land reclamation and deep waterway regulation. The second is regional sea level fall (RSLF, which occurs because the channel bed is eroded due to sediment supply decline in the river catchment. The last SLR behavior is local tidal datum rise (LTDR. Thus, we project that the magnitude of SLR for the Shanghai coast ranges from 10 cm to 16 cm from 2011 to 2030. Clarifying SLR behaviors is important to aid local decision-makers in planning structural and non-structural measures to combat escalating flood damage costs in an estuarine delta system; this field is full of future challenges. Keywords: Sea level rise behavior, Anthropogenic geomorphologic change, Local tidal datum, Flood management, Adaptation

  9. The Child Health Care System of Croatia.

    Science.gov (United States)

    Mestrovic, Julije; Bralic, Irena; Simetin, Ivana Pavic; Mujkic, Aida; Radonić, Marija; Rodin, Urelija; Trošelj, Mario; Stevanović, Ranko; Benjak, Tomislav; Pristaš, Ivan; Mayer, Dijana; Tomić, Branimir

    2016-10-01

    The Republic of Croatia is a Parliamentary Republic with a population of 4.2 million people that sits on the Adriatic coast within Central Europe. Gross domestic product is approximately 60% of the European Union average, which in turn, limits health service spending. The health system is funded through universal health insurance administered by the Croatian Health Insurance Fund based on the principles of social solidarity and reciprocity. The children of Croatia are guaranteed access to universal primary, hospital, and specialist care provided by a network of health institutions. Pediatricians and school medicine specialists provide comprehensive preventive health care for both preschool and school-aged children. Despite the Croatian War of Independence in the late 20th century, indicators of child health and measures of health service delivery to children and families are steadily improving. However, similar to many European countries, Croatia is experiencing a rise in the "new morbidities" and is responding to these new challenges through a whole society approach to promote healthy lifestyles and insure good quality of life for children. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. A Blueprint for Innovation to Achieve Health System Transformation.

    Science.gov (United States)

    Snowdon, Anne W

    2017-01-01

    Global health systems are challenged by escalating costs and growing demands for care created by the demands of aging populations and rising rates of chronic illness which place unsustainable pressure on health systems to meet population health needs. To overcome these challenges, transformational change is needed to strengthen health system performance and sustainability. Innovation is widely viewed as the strategy to drive transformational change in health systems; yet to date, innovation has lacked a clearly defined focus or agenda to achieve transformation. An actionable innovation agenda is needed to achieve transformational change for health systems. The key conditions for success as an innovation strategy are examined, including clearly defined innovation objectives, key milestones, and actionable steps every system stakeholder must pursue in order to guide the innovation agenda and ultimately accelerate the transformational changes needed for a sustainable healthcare system that delivers value to populations.

  11. The Netherlands: health system review

    NARCIS (Netherlands)

    Schäfer, W.; Kroneman, M.; Boerma, W.; van den Berg, M.; Westert, G.; Devillé, W.; van Ginneken, E.

    2010-01-01

    The Health Systems in Transition (HiT) profiles are country-based reports that provide a detailed description of health systems and of policy initiatives in progress or under development. HiTs examine different approaches to the organization, financing and delivery of health services and the role of

  12. Community Psychology as a Process of Citizen Participation in Health Policy Comment on "The Rise of Post-truth Populism in Pluralist Liberal Democracies: Challenges for Health Policy".

    Science.gov (United States)

    Taggart, Danny

    2017-06-25

    This brief commentary discusses a recent paper by Speed and Mannion that explores "The Rise of post truth populism in liberal democracies: challenges for health policy." It considers their assertion that through meaningful democratic engagement in health policy, some of the risks brought about by an exclusionary populist politics can be mediated. With an overview of what participation means in modern healthcare policy and implementation, the field of community psychology is presented as one way to engage marginalized groups at risk of exploitation or exclusion by nativist populist policy. © 2018 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

  13. Rising equity

    International Nuclear Information System (INIS)

    Burr, M.T.

    1992-01-01

    This article reports on the results of a financial rankings survey of the independent energy industry indicating that lenders and investors provided more than five billion dollars in capital for new, private power projects during the first six months of 1992. The topics of the article include rising equity requirements, corporate finance, mergers and acquisitions, project finance investors, revenue bonds, project finance lenders for new projects, project finance lenders for restructurings, and project finance advisors

  14. TRICARE, Military Health System

    Science.gov (United States)

    ... Claim Get Proof of TRICARE Coverage View My Military Health Record Less TRICARE Enrollment Freeze Starting Dec. ... Disaster Information Download a Form Go Paperless My Military Health Records Multimedia Center Plan Information Kits Recoupment ...

  15. Is the U.S. Retirement System Contributing to Rising Wealth Inequality?

    Directory of Open Access Journals (Sweden)

    Sebastian Devlin-Foltz

    2016-10-01

    Full Text Available Data from the Survey of Consumer Finances for 1989 through 2013 reveal five broad findings. First, overall retirement plan participation was stable or rising through 2007, though overall participation fell noticeably in the wake of the Great Recession and has remained lower. Second, cohort-based analysis of life-cycle trajectories shows that participation in retirement plans is strongly correlated with income, and that the recent decline in participation is concentrated among younger and low- to middle-income families. Third, the shift in the type of pension coverage from defined benefit (DB to defined contribution (DC occurred within—not just across—income groups. Fourth, retirement wealth is less concentrated than nonretirement wealth, so the growth of retirement wealth relative to nonretirement wealth helped offset the increasing concentration in nonretirement wealth. Fifth, the shift from DB to DC had only a modest effect in the other direction because DC wealth is more concentrated than DB wealth.

  16. Predicting Land-Ice Retreat and Sea-Level Rise with the Community Earth System Model

    Energy Technology Data Exchange (ETDEWEB)

    Lipscomb, William [Los Alamos National Laboratory

    2012-06-19

    Coastal stakeholders need defensible predictions of 21st century sea-level rise (SLR). IPCC assessments suggest 21st century SLR of {approx}0.5 m under aggressive emission scenarios. Semi-empirical models project SLR of {approx}1 m or more by 2100. Although some sea-level contributions are fairly well constrained by models, others are highly uncertain. Recent studies suggest a potential large contribution ({approx}0.5 m/century) from the marine-based West Antarctic Ice Sheet, linked to changes in Southern Ocean wind stress. To assess the likelihood of fast retreat of marine ice sheets, we need coupled ice-sheet/ocean models that do not yet exist (but are well under way). CESM is uniquely positioned to provide integrated, physics based sea-level predictions.

  17. Tracking the rise in popularity of electronic nicotine delivery systems (electronic cigarettes) using search query surveillance.

    Science.gov (United States)

    Ayers, John W; Ribisl, Kurt M; Brownstein, John S

    2011-04-01

    Public interest in electronic nicotine delivery systems (ENDS) is undocumented. By monitoring search queries, ENDS popularity and correlates of their popularity were assessed in Australia, Canada, the United Kingdom (UK), and the U.S. English-language Google searches conducted from January 2008 through September 2010 were compared to snus, nicotine replacement therapy (NRT), and Chantix® or Champix®. Searches for each week were scaled to the highest weekly search proportion (100), with lower values indicating the relative search proportion compared to the highest-proportion week (e.g., 50=50% of the highest observed proportion). Analyses were performed in 2010. From July 2008 through February 2010, ENDS searches increased in all nations studied except Australia, there an increase occurred more recently. By September 2010, ENDS searches were several-hundred-fold greater than searches for smoking alternatives in the UK and U.S., and were rivaling alternatives in Australia and Canada. Across nations, ENDS searches were highest in the U.S., followed by similar search intensity in Canada and the UK, with Australia having the fewest ENDS searches. Stronger tobacco control, created by clean indoor air laws, cigarette taxes, and anti-smoking populations, were associated with consistently higher levels of ENDS searches. The online popularity of ENDS has surpassed that of snus and NRTs, which have been on the market for far longer, and is quickly outpacing Chantix or Champix. In part, the association between ENDS's popularity and stronger tobacco control suggests ENDS are used to bypass, or quit in response to, smoking restrictions. Search query surveillance is a valuable, real-time, free, and public method to evaluate the diffusion of new health products. This method may be generalized to other behavioral, biological, informational, or psychological outcomes manifested on search engines. Copyright © 2011 American Journal of Preventive Medicine. Published by Elsevier Inc

  18. [The health system of Ecuador].

    Science.gov (United States)

    Lucio, Ruth; Villacrés, Nilhda; Henríquez, Rodrigo

    2011-01-01

    This paper describes the health conditions in Ecuador and, in more detail, the characteristics of the Ecuadorian health system, including its structure and coverage, its financial sources, the physical, material and human resources available, and the stewardship activities developed by the Ministry of Public Health. It also describes the structure and content of its health information system, and the participation of citizens in the operation and evaluation of the health system. The paper ends with a discussion of the most recent policy innovations implemented in the Ecuadorian system, including the incorporation of a chapter on health into the new Constitution which recognizes the protection of health as a human right, and the construction of the Comprehensive Public Health Network.

  19. On the merging rates of envelope-deprived components of binary systems which can give rise to supernova events

    Science.gov (United States)

    Tornambe, Amedeo

    1989-08-01

    Theoretical rates of mergings of envelope-deprived components of binary systems, which can give rise to supernova events are described. The effects of the various assumptions on the physical properties of the progenitor system and of its evolutionary behavior through common envelope phases are discussed. Four cases have been analyzed: CO-CO, He-CO, He-He double degenerate mergings and He star-CO dwarf merging. It is found that, above a critical efficiency of the common envelope action in system shrinkage, the rate of CO-CO mergings is not strongly sensitive to the efficiency. Below this critical value, no CO-CO systems will survive for times larger than a few Gyr. In contrast, He-CO dwarf systems will continue to merge at a reasonable rate up to 20 Gyr, and more, also under extreme conditions.

  20. The Rise and Need for Mobile Apps for Maternal and Child Health Care in China: Survey Based on App Markets.

    Science.gov (United States)

    Zhang, Puhong; Dong, Le; Chen, Huan; Chai, Yanling; Liu, Jianbo

    2018-06-08

    -monitoring," the researchers found 47 specific tools supporting activities such as pregnancy preparation, fetal heart monitoring, blood glucose and blood pressure monitoring, and doctor visits. A few apps were equipped with external devices (n=3) or sensors. No app with intelligent decision-support features to support disease management for conditions such as gestational diabetes and pregnancy-induced hypertension was found. A small number of apps (n=5) had a Web connection with hospital information systems to support appointment making, payments, hospital service guidance, or checking of laboratory results. There are thousands of maternal and child health apps in the Chinese market. Child care, pregnancy, and before pregnancy were the mostly covered maternal and child health stages, in that order. Various app features and tools were adopted by maternal and child health apps, but the use of internal or external sensors, intelligent decision support, and tethering with existing hospital information systems was rare and these features need more research and development. ©Puhong Zhang, Le Dong, Huan Chen, Yanling Chai, Jianbo Liu. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 08.06.2018.

  1. Applications of network analysis for adaptive management of artificial drainage systems in landscapes vulnerable to sea level rise

    Science.gov (United States)

    Poulter, Benjamin; Goodall, Jonathan L.; Halpin, Patrick N.

    2008-08-01

    SummaryThe vulnerability of coastal landscapes to sea level rise is compounded by the existence of extensive artificial drainage networks initially built to lower water tables for agriculture, forestry, and human settlements. These drainage networks are found in landscapes with little topographic relief where channel flow is characterized by bi-directional movement across multiple time-scales and related to precipitation, wind, and tidal patterns. The current configuration of many artificial drainage networks exacerbates impacts associated with sea level rise such as salt-intrusion and increased flooding. This suggests that in the short-term, drainage networks might be managed to mitigate sea level rise related impacts. The challenge, however, is that hydrologic processes in regions where channel flow direction is weakly related to slope and topography require extensive parameterization for numerical models which is limited where network size is on the order of a hundred or more kilometers in total length. Here we present an application of graph theoretic algorithms to efficiently investigate network properties relevant to the management of a large artificial drainage system in coastal North Carolina, USA. We created a digital network model representing the observation network topology and four types of drainage features (canal, collector and field ditches, and streams). We applied betweenness-centrality concepts (using Dijkstra's shortest path algorithm) to determine major hydrologic flowpaths based off of hydraulic resistance. Following this, we identified sub-networks that could be managed independently using a community structure and modularity approach. Lastly, a betweenness-centrality algorithm was applied to identify major shoreline entry points to the network that disproportionately control water movement in and out of the network. We demonstrate that graph theory can be applied to solving management and monitoring problems associated with sea level rise

  2. Rising trends and inequalities in cesarean section rates in Pakistan: Evidence from Pakistan Demographic and Health Surveys, 1990-2013.

    Science.gov (United States)

    Mumtaz, Sarwat; Bahk, Jinwook; Khang, Young-Ho

    2017-01-01

    Despite global efforts to improve maternal health, many developing countries including Pakistan have failed to achieve the target of a 75% reduction in maternal deaths by 2015. Addressing socioeconomic inequalities in access to emergency obstetric care is crucial for reducing the maternal mortality rate. This study was done to examine the time trends and socioeconomic inequalities in the utilization of cesarean section (C-section) in Pakistan during 1990-2013. We used data from the Pakistan Demographic and Health Surveys (PDHS) conducted during 1990 to 2013. All these surveys are nationally representative surveys of ever-married women aged 15-49 years with a sample size of 6611, 10,023, and 13,558 women in 1990-1991, 2006-2007, and 2012-2013, respectively, with an overall response rate of over 90%. The unit of analysis for this study was women with their most recent live birth in the five years preceding the surveys. Bivariate analyses and multivariable logistic regression models were employed to investigate the prevalence of cesarean sections according to selected sociodemographic characteristics of women. C-section rates were found to have increased during this period, with an especially significant rise from 2.7% in 1990-1991 to 15.8% in 2012-2013 with lower utilization among the non-educated women (7.5%), compared with the women with higher education (40.3%). C-section rates ranged from 5.5% in the poorest women to 35.3% in the richest women. Only 11.5% of the rural women had a C-section compared to 25.6% of the urban women. A greater likelihood of having a cesarean section was observed in the richest, highly educated, and urban-living women while there was no significant difference observed in cesarean section rates between the private and public sectors in all three surveys. To improve maternal health, routine monitoring and evaluation of the provision of emergency obstetric services are needed to address the underuse of C-section in poor and rural areas and

  3. Rising trends and inequalities in cesarean section rates in Pakistan: Evidence from Pakistan Demographic and Health Surveys, 1990-2013.

    Directory of Open Access Journals (Sweden)

    Sarwat Mumtaz

    Full Text Available Despite global efforts to improve maternal health, many developing countries including Pakistan have failed to achieve the target of a 75% reduction in maternal deaths by 2015. Addressing socioeconomic inequalities in access to emergency obstetric care is crucial for reducing the maternal mortality rate. This study was done to examine the time trends and socioeconomic inequalities in the utilization of cesarean section (C-section in Pakistan during 1990-2013. We used data from the Pakistan Demographic and Health Surveys (PDHS conducted during 1990 to 2013. All these surveys are nationally representative surveys of ever-married women aged 15-49 years with a sample size of 6611, 10,023, and 13,558 women in 1990-1991, 2006-2007, and 2012-2013, respectively, with an overall response rate of over 90%. The unit of analysis for this study was women with their most recent live birth in the five years preceding the surveys. Bivariate analyses and multivariable logistic regression models were employed to investigate the prevalence of cesarean sections according to selected sociodemographic characteristics of women. C-section rates were found to have increased during this period, with an especially significant rise from 2.7% in 1990-1991 to 15.8% in 2012-2013 with lower utilization among the non-educated women (7.5%, compared with the women with higher education (40.3%. C-section rates ranged from 5.5% in the poorest women to 35.3% in the richest women. Only 11.5% of the rural women had a C-section compared to 25.6% of the urban women. A greater likelihood of having a cesarean section was observed in the richest, highly educated, and urban-living women while there was no significant difference observed in cesarean section rates between the private and public sectors in all three surveys. To improve maternal health, routine monitoring and evaluation of the provision of emergency obstetric services are needed to address the underuse of C-section in poor and

  4. United Kingdom (England): Health system review.

    Science.gov (United States)

    Boyle, Seán

    2011-01-01

    The Health Systems in Transition (HiT) profiles are country-based reports that provide a detailed description of a health system and of policy initiatives in progress or under development. HiTs examine different approaches to the organization, financing and delivery of health services and the role of the main actors in health systems; describe the institutional framework, process, content and implementation of health and health care policies; and highlight challenges and areas that require more in-depth analysis. Various indicators show that the health of the population has improved over the last few decades. However, inequalities in health across socioeconomic groups have been increasing since the 1970s. The main diseases affecting the population are circulatory diseases, cancer, diseases of the respiratory system and diseases of the digestive system. Risk factors such as the steadily rising levels of alcohol consumption, the sharp increases in adult and child obesity and prevailing smoking levels are among the most pressing public health concerns, particularly as they reflect the growing health inequalities among different socioeconomic groups. Health services in England are largely free at the point of use. The NHS provides preventive medicine, primary care and hospital services to all those ordinarily resident. Over 12% of the population is covered by voluntary health insurance schemes, known in the United Kingdom as private medical insurance (PMI), which mainly provides access to acute elective care in the private sector. Responsibility for publicly funded health care rests with the Secretary of State for Health, supported by the Department of Health. The Department operates at a regional level through 10 strategic health authorities (SHAs), which are responsible for ensuring the quality and performance of local health services within their geographic area. Responsibility for commissioning health services at the local level lies with 151 primary care

  5. Fixing Health Systems

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

    In Africa, health care has been in a state of crisis for several decades. ..... Instead, think about them as representations of real people — people with families that ...... blood screening; patient care, counseling, and social support; palliative care.

  6. Controllable outrigger damping system for high rise building with MR dampers

    Science.gov (United States)

    Wang, Zhihao; Chang, Chia-Ming; Spencer, Billie F., Jr.; Chen, Zhengqing

    2010-04-01

    A novel energy dissipation system that can achieve the amplified damping ratio for a frame-core tube structures is explored, where vertical dampers are equipped between the outrigger and perimeter columns. The modal characteristics of the structural system with linear viscous dampers are theoretically analyzed from the simplified finite element model by parametric analysis. The result shows that modal damping ratios of the first several modes can increase a lot with this novel damping system. To improve the control performance of system, the semi-active control devices, magnetorheological (MR) dampers, are adopted to develop a controllable outrigger damping system. The clipped optimal control with the linear-quadratic Gaussian (LQG) acceleration feedback is adopted in this paper. The effectiveness of both passive and semi-active control outrigger damping systems is evaluated through the numerical simulation of a representative tall building subjected to two typical earthquake records.

  7. Dynamical Chaos Rise in the System of Large Number of Nonlinear Coupled Oscillators

    International Nuclear Information System (INIS)

    Buts, V.A.; Koval'chuk, I.K.; Tarasov, D.V.

    2007-01-01

    The problem of dynamical chaos arising in distributed systems is considered. It was shown that in many cases it is possible to allocate relatively isolated subsystem which may be simpler for investigation. We suppose that chaos in this subsystem leads to chaotic behaviour of all system. Besides, the allocated subsystem may be used for describing complex dynamics of nonlinear three-wave interaction, in particular, in plasma systems. The analytical criterion of arising dynamics chaos in distributed system was obtained. This criterion was confirmed by numerical simulation

  8. Natural dissolved organic matter dynamics in karstic aquifer: O'Leno Sink-Rise system, Florida, USA

    Science.gov (United States)

    Jin, J.; Zimmerman, A. R.

    2010-12-01

    Natural dissolved organic matter (NDOM) dynamics in karstic aquifer remain poorly understood due to the inaccessibility and heterogeneity of the subsurface. Because the Santa Fe River sinks into the Floridan Aquifer and emerges 6 km down gradient, the O'Leno Sink-Rise system in Northern Florida provides an ideal setting to study NDOM transformation in groundwater. Water samples were collected at both high and low temporal resolutions over 3 years from the River Sink, Rise, and a series of shallow and deep wells. Analyses of dissolved organic and inorganic carbon, stable isotopic, and spectrophotometry (excitation-emission matrix or EEM) show that reversals of hydrologic head gradient in the conduit and matrix are closely related to the delivery of NDOM to the aquifer. In addition, the relative influence of biotic and abiotic processes varies along spatiotemporal gradients; regions of the aquifer with greatest connectivity to surface water (new NDOM and terminal electron acceptor supply) see the most microbial transformation of NDOM, while those with least connectivity see relatively greater abiotic transformation of NDOM. A source water mixing model was established for the Sink-Rise system using Mg2+ and SO42- concentrations from three end-members identified as allogenic recharge, upwelling deep water, and shallow groundwater of the Upper Floridan Aquifer. Biogeochemical processes were quantified after accounting for changes that occurred due to source water mixing, according to the model. In addition to NDOM remineralization by subsurface microbes which occurred mostly during wet periods, adsorption of NDOM onto aquifer materials as well as release of NDOM from aquifer materials was also observed. During wet periods when DOC-rich conduit water entered the matrix, progressive NDOM remineralization was found along the preferential flow paths from the conduits into the matrices. Both biotic and abiotic NDOM transformation processes were found to control channel

  9. Wearable medical systems for p-Health.

    Science.gov (United States)

    Teng, Xiao-Fei; Zhang, Yuan-Ting; Poon, Carmen C Y; Bonato, Paolo

    2008-01-01

    Driven by the growing aging population, prevalence of chronic diseases, and continuously rising healthcare costs, the healthcare system is undergoing a fundamental transformation, from the conventional hospital-centered system to an individual-centered system. Current and emerging developments in wearable medical systems will have a radical impact on this paradigm shift. Advances in wearable medical systems will enable the accessibility and affordability of healthcare, so that physiological conditions can be monitored not only at sporadic snapshots but also continuously for extended periods of time, making early disease detection and timely response to health threats possible. This paper reviews recent developments in the area of wearable medical systems for p-Health. Enabling technologies for continuous and noninvasive measurements of vital signs and biochemical variables, advances in intelligent biomedical clothing and body area networks, approaches for motion artifact reduction, strategies for wearable energy harvesting, and the establishment of standard protocols for the evaluation of wearable medical devices are presented in this paper with examples of clinical applications of these technologies.

  10. Solar eclipse. The rise and 'dusk' of the Dutch PV innovation system

    Energy Technology Data Exchange (ETDEWEB)

    Negro, S.O.; Hekkert, M.P. [Department of Innovation Studies, Copernicus Institute for Sustainable Development and Innovation, Utrecht University, Heidelberglaan 2, 3584 CS Utrecht (Netherlands); Vasseur, V. [International Centre for Integrated Assessment and Sustainable Development, University Maastricht, P.O. Box 616, 6200 MD Maastricht (Netherlands); Van Sark, W.G.J.H.M. [Department of Science, Technology and Society, Copernicus Institute for Sustainable Development and Innovation, Utrecht University, Heidelberglaan 2, 3584 CS Utrecht (Netherlands)

    2012-07-01

    In this paper, we take the theoretical perspective of innovation system dynamics and apply this to Photovoltaic (PV) solar energy technology in the Netherlands. The history of the development of the PV innovation system is analysed in terms of seven key processes that are essential for the build-up of innovation systems. We show that large fluctuations are present in the processes related to guidance of the search and market formation. Surprisingly, entrepreneurial activities are not too much affected by fluctuating market formation activities. We relate this to market formation in neighbouring countries and discuss the implications for policy making.

  11. Power system health analysis

    International Nuclear Information System (INIS)

    Billinton, Roy; Fotuhi-Firuzabad, Mahmud; Aboreshaid, Saleh

    1997-01-01

    This paper presents a technique which combines both probabilistic indices and deterministic criteria to reflect the well-being of a power system. This technique permits power system planners, engineers and operators to maximize the probability of healthy operation as well as minimizing the probability of risky operation. The concept of system well-being is illustrated in this paper by application to the areas of operating reserve assessment and composite power system security evaluation

  12. The internationalization of the Renminbi and the rise of a multipolar currency system

    OpenAIRE

    Campanella, Miriam

    2014-01-01

    The dollar's steady depreciation has had little impact on the official reserves of central banks. As scholars of the international monetary system debate whether the dollar can continue to play the dominant role in the international monetary system, actual developments in exchange relations already give reason to expect that the world's currency regime is changing. Recent measures taken by China to internationalize its renminbi, including several bilateral swap agreements signed with other ce...

  13. Modal–Physical Hybrid System Identification of High-rise Building via Subspace and Inverse-Mode Methods

    Directory of Open Access Journals (Sweden)

    Kohei Fujita

    2017-08-01

    Full Text Available A system identification (SI problem of high-rise buildings is investigated under restricted data environments. The shear and bending stiffnesses of a shear-bending model (SB model representing the high-rise buildings are identified via the smart combination of the subspace and inverse-mode methods. Since the shear and bending stiffnesses of the SB model can be identified in the inverse-mode method by using the lowest mode of horizontal displacements and floor rotation angles, the lowest mode of the objective building is identified first by using the subspace method. Identification of the lowest mode is performed by using the amplitude of transfer functions derived in the subspace method. Considering the resolution in measuring the floor rotation angles in lower stories, floor rotation angles in most stories are predicted from the floor rotation angle at the top floor. An empirical equation of floor rotation angles is proposed by investigating those for various building models. From the viewpoint of application of the present SI method to practical situations, a non-simultaneous measurement system is also proposed. In order to investigate the reliability and accuracy of the proposed SI method, a 10-story building frame subjected to micro-tremor is examined.

  14. Hawaii's public mental health system.

    Science.gov (United States)

    VanderVoort, Debra J

    2005-03-01

    The following article addresses the nature of and problems with the public mental health system in Hawaii. It includes a brief history of Hawaii's public mental health system, a description and analysis of this system, economic factors affecting mental health, as well as a needs assessment of the elderly, individuals with severe mental illness, children and adolescents, and ethnically diverse individuals. In addition to having the potential to increase suicide rates and unnecessarily prolong personal suffering, problems in the public mental health system such as inadequate services contribute to an increase in social problems including, but not limited to, an increase in crime rates (e.g., domestic violence, child abuse), divorce rates, school failure, and behavioral problems in children. The population in need of mental health services in Hawaii is under served, with this inadequacy of services due to economic limitations and a variety of other factors.

  15. Integrated Systems Health Management for Intelligent Systems

    Science.gov (United States)

    Figueroa, Fernando; Melcher, Kevin

    2011-01-01

    The implementation of an integrated system health management (ISHM) capability is fundamentally linked to the management of data, information, and knowledge (DIaK) with the purposeful objective of determining the health of a system. It is akin to having a team of experts who are all individually and collectively observing and analyzing a complex system, and communicating effectively with each other in order to arrive at an accurate and reliable assessment of its health. In this paper, concepts, procedures, and approaches are presented as a foundation for implementing an intelligent systems ]relevant ISHM capability. The capability stresses integration of DIaK from all elements of a system. Both ground-based (remote) and on-board ISHM capabilities are compared and contrasted. The information presented is the result of many years of research, development, and maturation of technologies, and of prototype implementations in operational systems.

  16. Lack of Critical Slowing Down Suggests that Financial Meltdowns Are Not Critical Transitions, yet Rising Variability Could Signal Systemic Risk

    Science.gov (United States)

    Hoarau, Quentin

    2016-01-01

    Complex systems inspired analysis suggests a hypothesis that financial meltdowns are abrupt critical transitions that occur when the system reaches a tipping point. Theoretical and empirical studies on climatic and ecological dynamical systems have shown that approach to tipping points is preceded by a generic phenomenon called critical slowing down, i.e. an increasingly slow response of the system to perturbations. Therefore, it has been suggested that critical slowing down may be used as an early warning signal of imminent critical transitions. Whether financial markets exhibit critical slowing down prior to meltdowns remains unclear. Here, our analysis reveals that three major US (Dow Jones Index, S&P 500 and NASDAQ) and two European markets (DAX and FTSE) did not exhibit critical slowing down prior to major financial crashes over the last century. However, all markets showed strong trends of rising variability, quantified by time series variance and spectral function at low frequencies, prior to crashes. These results suggest that financial crashes are not critical transitions that occur in the vicinity of a tipping point. Using a simple model, we argue that financial crashes are likely to be stochastic transitions which can occur even when the system is far away from the tipping point. Specifically, we show that a gradually increasing strength of stochastic perturbations may have caused to abrupt transitions in the financial markets. Broadly, our results highlight the importance of stochastically driven abrupt transitions in real world scenarios. Our study offers rising variability as a precursor of financial meltdowns albeit with a limitation that they may signal false alarms. PMID:26761792

  17. The rising of the Phoenix : building the European Monetary System on a meeting of minds

    NARCIS (Netherlands)

    van Esch, F.A.W.J.|info:eu-repo/dai/nl/169008436

    2009-01-01

    Decades later, the sudden and swift establishment of the European Monetary System (EMS) within the context of the 1970s economic downturn and Euro-sclerosis remains a strikingly remarkable achievement. This article argues that this unexpected leap forward in the European economic and monetary

  18. "Toyota" Production system as ability to rise effectivity and competitiveness for business entity

    OpenAIRE

    Kvetinskaya, A. V.; Кветинская, А. В.

    2013-01-01

    The article investigates Toyota’s system of production. The main principles of Lean production are described, such as Kaidzen”, “Just-in-Time”, “5 S” system, “Muda”, “Muri”, “Mura” and possibilities to adopt this system in Russian factories. В данной статье исследуется система производства которая используется в компании "Тойота". Описаны основные принципы "бережливого" производства, такие как "Кайдзен", "Точно в срок", "5С", "Муда", "Мури", "Мура" и описаны возможности применения данной с...

  19. The rise of a novel classification system for endometrial carcinoma; integration of molecular subclasses.

    Science.gov (United States)

    McAlpine, Jessica; Leon-Castillo, Alicia; Bosse, Tjalling

    2018-04-01

    Endometrial cancer is a clinically heterogeneous disease and it is becoming increasingly clear that this heterogeneity may be a function of the diversity of the underlying molecular alterations. Recent large-scale genomic studies have revealed that endometrial cancer can be divided into at least four distinct molecular subtypes, with well-described underlying genomic aberrations. These subtypes can be reliably delineated and carry significant prognostic as well as predictive information; embracing and incorporating them into clinical practice is thus attractive. The road towards the integration of molecular features into current classification systems is not without obstacles. Collaborative studies engaging research teams from across the world are working to define pragmatic assays, improve risk stratification systems by combining molecular features and traditional clinicopathological parameters, and determine how molecular classification can be optimally utilized to direct patient care. Pathologists and clinicians caring for women with endometrial cancer need to engage with and understand the possibilities and limitations of this new approach, because integration of molecular classification of endometrial cancers is anticipated to become an essential part of gynaecological pathology practice. This review will describe the challenges in current systems of endometrial carcinoma classification, the evolution of new molecular technologies that define prognostically distinct molecular subtypes, and potential applications of molecular classification as a step towards precision medicine and refining care for individuals with the most common gynaecological cancer in the developed world. Copyright © 2018 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd. Copyright © 2018 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.

  20. Czechoslovakia's changing health care system.

    Science.gov (United States)

    Raffel, M W; Raffel, N K

    1992-01-01

    Before World War II, Czechoslovakia was among the most developed European countries with an excellent health care system. After the Communist coup d'etat in 1948, the country was forced to adapt its existing health care system to the Soviet model. It was planned and managed by the government, financed by general tax money, operated in a highly centralized, bureaucratic fashion, and provided service at no direct charge at the time of service. In recent years, the health care system had been deteriorating as the health of the people had also been declining. Life expectancy, infant mortality rates, and diseases of the circulatory system are higher than in Western European countries. In 1989, political changes occurred in Czechoslovakia that made health care reform possible. Now health services are being decentralized, and the ownership of hospitals is expected to be transferred to communities, municipalities, churches, charitable groups, or private entities. Almost all health leaders, including hospital directors and hospital department heads, have been replaced. Physicians will be paid according to the type and amount of work performed. Perhaps the most important reform is the establishment of an independent General Health Care Insurance Office financed directly by compulsory contributions from workers, employers, and government that will be able to negotiate with hospitals and physicians to determine payment for services.

  1. Gadolinium-induced nephrogenic systemic fibrosis: the rise and fall of an iatrogenic disease

    DEFF Research Database (Denmark)

    Bennett, Charles L; Qureshi, Zaina P; Sartor, A Oliver

    2012-01-01

    BACKGROUND.: In 2006, nephrologists in Denmark unexpectedly identified chronic kidney disease (CKD) patients with a new syndrome, nephrogenic systemic fibrosis (NSF). Subsequently, 1603 NSF patients were reported to the Food and Drug Administration. Sixty hospitals in the USA account for 93......% of these cases, and two hospitals in Denmark account for 4% of these reports. We review Denmark's identification and subsequent rapid eradication of NSF. METHODS.: NSF reports from clinicians, the Danish Medicines Agency (DMA) and gadolinium-based contrast agents (GBCAs) manufacturers were reviewed (2002...... at Skejby Hospital and Herlev Hospital, respectively, began performing gadodiamide-enhanced magnetic resonance angiography scans (0.3 mmol/kg) of CKD patients. In 2005, Herlev clinicians requested assistance in evaluating etiological causes of NSF occurring among 10 CKD patients who had developed NSF...

  2. Breast Health Belief Systems Study

    National Research Council Canada - National Science Library

    Williams, Mary

    1999-01-01

    .... The hypothesis underlying this research is that a breast health promotion approach that is based in specific belief systems among three disparate African American rural populations of low socioeconomic status (SES...

  3. Organic and inorganic carbon dynamics in a karst aquifer: Santa Fe River Sink-Rise system, north Florida, USA

    Science.gov (United States)

    Jin, Jin; Zimmerman, Andrew R.; Moore, Paul J.; Martin, Jonathan B.

    2014-03-01

    Spatiotemporal variations in dissolved organic carbon (DOC), dissolved inorganic carbon (DIC), major ions concentrations and other geochemical parameters including stable carbon isotopes of DIC (δ13CDIC), were measured in surface water and deep and shallow well water samples of the Santa Fe River Sink-Rise eogenetic karst system, north Florida, USA. Three end-member water sources were identified: one DOC-rich/DIC-poor/δ13CDIC-depleted, one DOC-poor/DIC-rich/δ13CDIC-enriched, and one enriched in major ions. Given their spatiotemporal distributions, they were presumed to represent soil water, upper aquifer groundwater, and deep aquifer water sources, respectively. Using assumed ratios of Na+, Cl, and SO42- for each end-member, a mixing model calculated the contribution of each water source to each sample. Then, chemical effects of biogeochemical reactions were calculated as the difference between those predicted by the mixing model and measured species concentrations. In general, carbonate mineral dissolution occurred throughout the Sink-Rise system, surface waters were net autotrophic and the subsurface was in metabolic balance, i.e., no net DOC or DIC production or consumption. However, there was evidence for chemolithoautotrophy, perhaps by hydrogen oxidizing microbes, at some deep aquifer sites. Mineralization of this autochthonous natural dissolved organic matter (NDOM) led to localized carbonate dissolution as did surface water-derived NDOM supplied to shallow well sites during the highest flow periods. This study demonstrates linkages between hydrology, abiotic and microbial processes and carbon dynamics and has important implications for groundwater quality, karst morphologic evolution, and hydrogeologic projects such as aquifer storage and recovery in karst systems.

  4. [Corruption and health care system].

    Science.gov (United States)

    Marasović Šušnjara, Ivana

    2014-06-01

    Corruption is a global problem that takes special place in health care system. A large number of participants in the health care system and numerous interactions among them provide an opportunity for various forms of corruption, be it bribery, theft, bureaucratic corruption or incorrect information. Even though it is difficult to measure the amount of corruption in medicine, there are tools that allow forming of the frames for possible interventions.

  5. Health Systems Strengthening

    DEFF Research Database (Denmark)

    Hanlin, Rebecca; Andersen, Margrethe Holm

    The Global Network for the Economics of Learning, Innovation, and Competence Building Systems (Globelics) is an open and diverse community of scholars working on innovation and competence building in the context of economic development. The major purpose of the network is to contribute to buildin...

  6. Rise of Health Consumerism in China and Its Effects on Physicians' Professional Identity and the Physician-Patient Relationship and Communication.

    Science.gov (United States)

    Tang, Lu; Guan, Mengfei

    2018-05-01

    The physician-patient relationship in China is highly strained. This study examined the professional identity of physicians and their perceptions of the physician-patient relationship against the backdrop of the rise of health consumerism in China. Structured interviews with 29 physicians found that the marketization of medical care and the rise of health consumerism caused physicians to have a conflicted professional identity. The traditional bureaucratic relationship between physicians and patients based on implicit trust was gradually replaced by an arm's length relationship characterized by self-interest, opportunism, and mistrust. In addition, the transition from physician-centered communication to patient-centered communication in China was tenacious. Theoretical and practical implications of the current study are discussed.

  7. Intelligent Integrated System Health Management

    Science.gov (United States)

    Figueroa, Fernando

    2012-01-01

    Intelligent Integrated System Health Management (ISHM) is the management of data, information, and knowledge (DIaK) with the purposeful objective of determining the health of a system (Management: storage, distribution, sharing, maintenance, processing, reasoning, and presentation). Presentation discusses: (1) ISHM Capability Development. (1a) ISHM Knowledge Model. (1b) Standards for ISHM Implementation. (1c) ISHM Domain Models (ISHM-DM's). (1d) Intelligent Sensors and Components. (2) ISHM in Systems Design, Engineering, and Integration. (3) Intelligent Control for ISHM-Enabled Systems

  8. Interdisciplinary design study of a high-rise integrated roof wind energy system

    Directory of Open Access Journals (Sweden)

    Moonen S.P.G.

    2012-10-01

    Full Text Available Today’s market in micro-wind turbines is in constant development introducing more efficient solutions for the future. Besides the private use of tower supported turbines, opportunities to integrate wind turbines in the built environment arise. The Integrated Roof Wind Energy System (IRWES presented in this work is a modular roof structure integrated on top of existing or new buildings. IRWES is build up by an axial array of skewed shaped funnels used for both wind inlet and outlet. This inventive use of shape and geometry leads to a converging air capturing inlet to create high wind mass flow and velocity toward a Vertical Axis Wind Turbine (VAWT in the center-top of the roof unit for the generation of a relatively high amount of energy. The scope of this research aims to make an optimized structural design of IRWES to be placed on top of the Vertigo building in Eindhoven; analysis of the structural performance; and impact to the existing structure by means of Finite Element Modeling (FEM. Results show that the obvious impact of wind pressure to the structural design is easily supported in different configurations of fairly simple lightweight structures. In particular, the weight addition to existing buildings remains minimal.

  9. Decarbonization of the German energy system due to falling or rising power consumption?

    International Nuclear Information System (INIS)

    Guminski, Andrej; Roon, Serafin von

    2016-01-01

    Since the publication of the draft ''Climate Protection Plan 2050'' and the ''Green Paper on Energy Efficiency'', it is clear that the Federal Government is focusing on the electrification of the heat and transport sector in order to increase the share of renewable energies in these sectors. This step is not uncontroversial, and represents a paradigm shift in science and politics, because the reduction of the cross electricity consumption move into the background. It is now necessary to clearly distinguish between the conventional power consumption, which must continue to be tested for energy savings and efficiency potential, and the new power consumption, here referred to as the coupling current, which is accepted in order to achieve the objectives of the energy transition. Since the consideration of the energy transition as a purely national project is too short, possible positive and negative effects of the European Union Emission Trading System (EU ETS) deserve particular attention with regard to this reorientation. [de

  10. [The health system of Guatemala].

    Science.gov (United States)

    Becerril-Montekio, Víctor; López-Dávila, Luis

    2011-01-01

    This paper describes the health conditions in Guatemala and, in more detail, the characteristics of the Guatemalan health system, including its structure en coverage, its financial sources, the stewardship functions developed by the Ministry of Health, as well as the generation of health information and the development of research activities. It also discusses the recent efforts to extend coverage of essential health services, mostly to poor rural areas.The most recent innovations also discussed in this paper include the Program for the Expansion of Coverage of Essential Services, the Program to Expand Access to Essential Drugs and the agreements between the Ministry of Health and several non-governmental organizations to provide essential services in rural settings.

  11. Health and health-care systems in southeast Asia: diversity and transitions.

    Science.gov (United States)

    Chongsuvivatwong, Virasakdi; Phua, Kai Hong; Yap, Mui Teng; Pocock, Nicola S; Hashim, Jamal H; Chhem, Rethy; Wilopo, Siswanto Agus; Lopez, Alan D

    2011-01-29

    Southeast Asia is a region of enormous social, economic, and political diversity, both across and within countries, shaped by its history, geography, and position as a major crossroad of trade and the movement of goods and services. These factors have not only contributed to the disparate health status of the region's diverse populations, but also to the diverse nature of its health systems, which are at varying stages of evolution. Rapid but inequitable socioeconomic development, coupled with differing rates of demographic and epidemiological transitions, have accentuated health disparities and posed great public health challenges for national health systems, particularly the control of emerging infectious diseases and the rise of non-communicable diseases within ageing populations. While novel forms of health care are evolving in the region, such as corporatised public health-care systems (government owned, but operating according to corporate principles and with private-sector participation) and financing mechanisms to achieve universal coverage, there are key lessons for health reforms and decentralisation. New challenges have emerged with rising trade in health services, migration of the health workforce, and medical tourism. Juxtaposed between the emerging giant economies of China and India, countries of the region are attempting to forge a common regional identity, despite their diversity, to seek mutually acceptable and effective solutions to key regional health challenges. In this first paper in the Lancet Series on health in southeast Asia, we present an overview of key demographic and epidemiological changes in the region, explore challenges facing health systems, and draw attention to the potential for regional collaboration in health. Copyright © 2011 Elsevier Ltd. All rights reserved.

  12. Strengthening Governance in Health Systems for Reproductive ...

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

    Home · What we do ... As a result, Pakistan's health system has suffered and health service delivery has worsened. ... This four-year project aims to strengthen health systems governance for reproductive health and rights in Pakistan.

  13. Mobile health information system: a mobile app. to aid health ...

    African Journals Online (AJOL)

    Mobile health information system: a mobile app. to aid health workers relate health information. ... Global Journal of Mathematical Sciences ... phones in delivering vital health information and effective fieldwork reporting is of significance.

  14. Systemic antioxidants and skin health.

    Science.gov (United States)

    Nguyen, Gloria; Torres, Abel

    2012-09-01

    Most dermatologists agree that antioxidants help fight free radical damage and can help maintain healthy skin. They do so by affecting intracellular signaling pathways involved in skin damage and protecting against photodamage, as well as preventing wrinkles and inflammation. In today's modern world of the rising nutraceutical industry, many people, in addition to applying topical skin care products, turn to supplementation of the nutrients missing in their diets by taking multivitamins or isolated, man-made nutraceuticals, in what is known as the Inside-Out approach to skin care. However, ingestion of large quantities of isolated, fragmented nutrients can be harmful and is a poor representation of the kind of nutrition that can be obtained from whole food sources. In this comprehensive review, it was found that few studies on oral antioxidants benefiting the skin have been done using whole foods, and that the vast majority of current research is focused on the study of compounds in isolation. However, the public stands to benefit greatly if more research were to be devoted toward the impact that physiologic doses of antioxidants (obtained from fruits, vegetables, and whole grains) can have on skin health, and on health in general.

  15. Introduction on health recommender systems.

    Science.gov (United States)

    Sanchez-Bocanegra, C L; Sanchez-Laguna, F; Sevillano, J L

    2015-01-01

    People are looking for appropriate health information which they are concerned about. The Internet is a great resource of this kind of information, but we have to be careful if we don't want to get harmful info. Health recommender systems are becoming a new wave for apt health information as systems suggest the best data according to the patients' needs.The main goals of health recommender systems are to retrieve trusted health information from the Internet, to analyse which is suitable for the user profile and select the best that can be recommended, to adapt their selection methods according to the knowledge domain and to learn from the best recommendations.A brief definition of recommender systems will be given and an explanation of how are they incorporated in the health sector. A description of the main elementary recommender methods as well as their most important problems will also be made. And, to finish, the state of the art will be described.

  16. Embedding research in health systems: lessons from complexity theory.

    Science.gov (United States)

    Caffrey, Louise; Wolfe, Charles; McKevitt, Christopher

    2016-07-22

    Internationally, there has been increasing focus on creating health research systems. This article aims to investigate the challenges of implementing apparently simple strategies to support the development of a health research system. We focus on a case study of an English National Health Service Hospital Trust that sought to implement the national recommendation that health organisations should introduce a statement about research on all patient admission letters. We apply core concepts from complexity theory to the case study and undertake a documentary analysis of the email dialogue between staff involved in implementing this initiative. The process of implementing a research statement in patient admission letters in one clinical service took 1 year and 21 days. The length of time needed was influenced firstly by adaptive self-organisation, underpinned by competing interests. Secondly, it was influenced by the relationship between systems, rather than simply being a product of issues within those systems. The relationship between the health system and the research system was weaker than might have been expected. Responsibilities were unclear, leading to confusion and delayed action. Conventional ways of thinking about organisations suggest that change happens when leaders and managers change the strategic vision, structure or procedures in an organisation and then persuade others to rationally implement the strategy. However, health research systems are complex adaptive systems characterised by high levels of unpredictability due to self-organisation and systemic interactions, which give rise to 'emergent' properties. We argue for the need to study how micro-processes of organisational dynamics may give rise to macro patterns of behaviour and strategic organisational direction and for the use of systems approaches to investigate the emergent properties of health research systems.

  17. Dietary Health Behaviors of Women Living in High Rise Dwellings: A Case Study of an Urban Community in Malaysia

    OpenAIRE

    Karupaiah, Tilakavati; Swee, Winnie Chee Siew; Liew, Siew Ying; Ng, Boon Koon; Chinna, Karuthan

    2012-01-01

    Diet-related non-communicable disease (DR-NCD) occurrence is a serious problem amongst Malaysian women and urbanization is probably a challenge to their achieving the nutritional environment conducive to healthy eating. This case study aimed to determine diet quality of an urban community using women respondents from high rise dwellings in Kuala Lumpur. The sample consisted of 135 households and a healthy eating index (HEI) scale was used to evaluate the women?s diet quality. A total of 128 w...

  18. Portable Health Algorithms Test System

    Science.gov (United States)

    Melcher, Kevin J.; Wong, Edmond; Fulton, Christopher E.; Sowers, Thomas S.; Maul, William A.

    2010-01-01

    A document discusses the Portable Health Algorithms Test (PHALT) System, which has been designed as a means for evolving the maturity and credibility of algorithms developed to assess the health of aerospace systems. Comprising an integrated hardware-software environment, the PHALT system allows systems health management algorithms to be developed in a graphical programming environment, to be tested and refined using system simulation or test data playback, and to be evaluated in a real-time hardware-in-the-loop mode with a live test article. The integrated hardware and software development environment provides a seamless transition from algorithm development to real-time implementation. The portability of the hardware makes it quick and easy to transport between test facilities. This hard ware/software architecture is flexible enough to support a variety of diagnostic applications and test hardware, and the GUI-based rapid prototyping capability is sufficient to support development execution, and testing of custom diagnostic algorithms. The PHALT operating system supports execution of diagnostic algorithms under real-time constraints. PHALT can perform real-time capture and playback of test rig data with the ability to augment/ modify the data stream (e.g. inject simulated faults). It performs algorithm testing using a variety of data input sources, including real-time data acquisition, test data playback, and system simulations, and also provides system feedback to evaluate closed-loop diagnostic response and mitigation control.

  19. Safety demonstration tests on pressure rise in ventilation system and blower integrity of a fuel-reprocessing plant

    Energy Technology Data Exchange (ETDEWEB)

    Takada, Junichi; Suzuki, Motoe; Tsukamoto, Michio; Koike, Tadao; Nishio, Gunji [Japan Atomic Energy Research Inst., Tokai, Ibaraki (Japan). Tokai Research Establishment

    1996-12-01

    In JAERI, the demonstration test was carried out as a part of safety researches of the fuel-reprocessing plant using a large-scale facility consist of cells, ducts, dumpers, HEPA filters and a blower, when an explosive burning due to a rapid reaction of thermal decomposition for solvent/nitric acid occurs in a cell of the reprocessing plant. In the demonstration test, pressure response propagating through the facility was measured under a blowing of air from a pressurized tank into the cell in the facility to elucidate an influence of pressure rise in the ventilation system. Consequently, effective pressure decrease in the facility was given by a configuration of cells and ducts in the facility. In the test, transient responses of HEPA filters and the blower by the blowing of air were also measured to confirm the integrity. So that, it is confirmed that HEPA filters and the blower under pressure loading were sufficient to maintain the integrity. The content described in this report will contribute to safety assessment of the ventilation system in the event of explosive burning in the reprocessing plant. (author)

  20. [The health system of Brazil].

    Science.gov (United States)

    Montekio, Víctor Becerril; Medina, Guadalupe; Aquino, Rosana

    2011-01-01

    This paper describes the Brazilian health system, which includes a public sector covering almost 75% of the population and an expanding private sector offering health services to the rest of the population. The public sector is organized around the Sistema Único de Saúde (SUS) and it is financed with general taxes and social contributions collected by the three levels of government (federal, state and municipal). SUS provides health care through a decentralized network of clinics, hospitals and other establishments, as well as through contracts with private providers. SUS is also responsible for the coordination of the public sector. The private sector includes a system of insurance schemes known as Supplementary Health which is financed by employers and/or households: group medicine (companies and households), medical cooperatives, the so called Self-Administered Plans (companies) and individual insurance plans.The private sector also includes clinics, hospitals and laboratories offering services on out-of-pocket basis mostly used by the high-income population. This paper also describes the resources of the system, the stewardship activities developed by the Ministry of Health and other actors, and the most recent policy innovations implemented in Brazil, including the programs saúde da Familia and Mais Saúde.

  1. Reducing Technology-Induced Errors: Organizational and Health Systems Approaches.

    Science.gov (United States)

    Borycki, Elizabeth M; Senthriajah, Yalini; Kushniruk, Andre W; Palojoki, Sari; Saranto, Kaija; Takeda, Hiroshi

    2016-01-01

    Technology-induced errors are a growing concern for health care organizations. Such errors arise from the interaction between healthcare and information technology deployed in complex settings and contexts. As the number of health information technologies that are used to provide patient care rises so will the need to develop ways to improve the quality and safety of the technology that we use. The objective of the panel is to describe varying approaches to improving software safety from and organizational and health systems perspective. We define what a technology-induced error is. Then, we discuss how software design and testing can be used to improve health information technologies. This discussion is followed by work in the area of monitoring and reporting at a health district and national level. Lastly, we draw on the quality, safety and resilience literature. The target audience for this work are nursing and health informatics researchers, practitioners, administrators, policy makers and students.

  2. Can nurses rise to the public health challenge? How a novel solution in nurse education can address this contemporary question.

    Science.gov (United States)

    Turner-Wilson, Angela L; Mills, Anne M; Rees, Karen

    2017-10-01

    This paper raises the problem of how improvements in health outcomes, a key component in many governments' strategies, can be achieved. The work highlights a novel undergraduate educational approach which offers solutions to public health challenges within nursing. Against the backdrop of one UK university institution it discusses approaches that can guide nursing students towards a deeper understanding and engagement within the principles of public health. It then proposes how nurses can use their learning to become leaders of health improvement. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. The Chinese Health Care System

    DEFF Research Database (Denmark)

    Hougaard, Jens Leth; Østerdal, Lars Peter; Yu, Yi

    In the present paper we describe the structure of the Chinese health care system and sketch its future development. We analyse issues of provider incentives and the actual burden sharing between government, enterprises and people. We further aim to identify a number of current problems and link...

  4. Remote monitoring of air movement through a high-rise, brick veneer and steel-stud wall system

    Energy Technology Data Exchange (ETDEWEB)

    Niemeyer, T.A.; Genge, G.R. [GRG Building Consultants Inc. (Canada)

    2011-07-01

    Since the early 20th century, research on building enclosures has been going on in the form of field investigations and laboratory testing, but real-time monitoring of buildings is relatively new. Compact sensors and programmable data logging equipment have allowed thorough, real-time trend analysis of occupied buildings. This paper discusses the remote monitoring of air movement using a high-rise brick veneer and steel-stud wall system. This equipment was installed across the exterior wall assembly. Temperature and air moisture content within the stud cavity and outdoor to indoor air pressure difference was measured across the entire assembly and in series across the various components of the wall. For outdoor conditions, local airport weather records were used. Comparing collected temperature data and the theoretical thermal model, it was concluded that there was air leakage. From the overall project, lessons learned included that is was important to minimize discomfort, both in aesthetics and in the number of requests for access to homes for analyses.

  5. An improved empirical dynamic control system model of global mean sea level rise and surface temperature change

    Science.gov (United States)

    Wu, Qing; Luu, Quang-Hung; Tkalich, Pavel; Chen, Ge

    2018-04-01

    Having great impacts on human lives, global warming and associated sea level rise are believed to be strongly linked to anthropogenic causes. Statistical approach offers a simple and yet conceptually verifiable combination of remotely connected climate variables and indices, including sea level and surface temperature. We propose an improved statistical reconstruction model based on the empirical dynamic control system by taking into account the climate variability and deriving parameters from Monte Carlo cross-validation random experiments. For the historic data from 1880 to 2001, we yielded higher correlation results compared to those from other dynamic empirical models. The averaged root mean square errors are reduced in both reconstructed fields, namely, the global mean surface temperature (by 24-37%) and the global mean sea level (by 5-25%). Our model is also more robust as it notably diminished the unstable problem associated with varying initial values. Such results suggest that the model not only enhances significantly the global mean reconstructions of temperature and sea level but also may have a potential to improve future projections.

  6. Strengthening Health Systems Research Capacity in Mozambique ...

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

    Mozambique's health sector is dealing with system-wide challenges. ... the Ministry's work on national health accounts, resource allocation, and national health ... a combined INS-FIOCRUS program, and the master's in public health and field ...

  7. African Health Systems Initiative (AHSI) | IDRC - International ...

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

    The African Health Systems Initiative (AHSI) is a 10-year Canadian International ... for strengthening African-led health systems and human resources for health. ... IDRC congratulates first cohort of Women in Climate Change Science Fellows.

  8. Possible impacts of sea-level rise on the Diep river/Rietvlei system, Cape-Town

    CSIR Research Space (South Africa)

    Hughes, P

    1993-10-01

    Full Text Available Many of the Cape Province's estuaries and tidal inlets have sandy connections to the sea and are often intensively developed for industrial or residential purposes. The possible impacts of sea-level rise are of considerable interest...

  9. Private sector in public health care systems

    OpenAIRE

    Matějusová, Lenka

    2008-01-01

    This master thesis is trying to describe the situation of private sector in public health care systems. As a private sector we understand patients, private health insurance companies and private health care providers. The focus is placed on private health care providers, especially in ambulatory treatment. At first there is a definition of health as a main determinant of a health care systems, definition of public and private sectors in health care systems and the difficulties at the market o...

  10. Dietary health behaviors of women living in high rise dwellings: a case study of an urban community in Malaysia.

    Science.gov (United States)

    Karupaiah, Tilakavati; Swee, Winnie Chee Siew; Liew, Siew Ying; Ng, Boon Koon; Chinna, Karuthan

    2013-02-01

    Diet-related non-communicable disease (DR-NCD) occurrence is a serious problem amongst Malaysian women and urbanization is probably a challenge to their achieving the nutritional environment conducive to healthy eating. This case study aimed to determine diet quality of an urban community using women respondents from high rise dwellings in Kuala Lumpur. The sample consisted of 135 households and a healthy eating index (HEI) scale was used to evaluate the women's diet quality. A total of 128 women (Malays = 45, Chinese = 56, Indian = 27) participated. Total HEI score was significantly different (P 0.05) regardless of ethnicity. Income strata (ρ = 0.159, P = 0.048) and eating out frequency (ρ = -0.149, P = 0.046) also independently affected HEI scores. Income negatively correlated with sodium restriction score (ρ = -0.294, P = 0.001) but positively with cereals (ρ = 0.181; P = 0.025), fruits (ρ = 0.178; P = 0.022), dairy products (ρ = 0.198; P = 0.013) and food variety (ρ = 0.219, P = 0.007). Decreased vegetable intake (ρ = -0.320; P diet quality of urban women.

  11. [A health system's neoliberal reform: evidence from the Mexican case].

    Science.gov (United States)

    López-Arellano, Oliva; Jarillo-Soto, Edgar C

    2017-07-27

    This study addressed the shaping of Mexico's health system in recent years, with an analysis of the social determination conditioning the system's current formulation, the consequences for the population's living and working conditions, and the technical and legal reform measures that shaped the system's transformation. The article then analyzes the survival of social security institutions and the introduction of an individual insurance model and its current implications and consequences. From the perspective of the right to health, the article compares the measures, resources, and interventions in both health care models and highlights the relevance of the social security system for Popular Insurance. The article concludes that the measures implemented to reform the Mexican health system have failed to achieve the intended results; on the contrary, they have led to a reduction in interventions, rising costs, and a decrease in the installed capacity and professional personnel for the system's operation, thus falling far short of solving the problem, rather aggravating the inequities without solving the system's structural contradictions. Health systems face new challenges, inevitably requiring that the analyses be situated in a broader framework rather than merely focusing on the functional, administrative, and financial operation of the systems in the respective countries.

  12. [The dimension of the paradigm of complexity in health systems].

    Science.gov (United States)

    Fajardo-Ortiz, Guillermo; Fernández-Ortega, Miguel Ángel; Ortiz-Montalvo, Armando; Olivares-Santos, Roberto Antonio

    2015-01-01

    This article presents elements to better understand health systems from the complety paradigm, innovative perspective that offers other ways in the conception of the scientific knowledge prevalent away from linear, characterized by the arise of emerging dissociative and behaviors, based on the intra and trans-disciplinarity concepts such knowledges explain and understand in a different way what happens in the health systems with a view to efficiency and effectiveness. The complexity paradigm means another way of conceptualizing the knowledge, is different from the prevalent epistemology, is still under construction does not separate, not isolated, is not reductionist, or fixed, does not solve the problems, but gives other bases to know them and study them, is a different strategy, a perspective that has basis in the systems theory, informatics and cybernetics beyond traditional knowledge, the positive logics, the newtonian physics and symmetric mathematics, in which everything is centered and balanced, joint the "soft sciences and hard sciences", it has present the Social Determinants of Health and organizational culture. Under the complexity paradigm the health systems are identified with the following concepts: entropy, neguentropy, the thermodynamic second law, attractors, chaos theory, fractals, selfmanagement and self-organization, emerging behaviors, percolation, uncertainty, networks and robusteness; such expressions open new possibilities to improve the management and better understanding of the health systems, giving rise to consider health systems as complex adaptive systems. Copyright © 2015. Published by Masson Doyma México S.A.

  13. Calculation of critical heat transfer in horizontal evaporator pipes in cooling systems of high-rise buildings

    Science.gov (United States)

    Aksenov, Andrey; Malysheva, Anna

    2018-03-01

    An exact calculation of the heat exchange of evaporative surfaces is possible only if the physical processes of hydrodynamics of two-phase flows are considered in detail. Especially this task is relevant for the design of refrigeration supply systems for high-rise buildings, where powerful refrigeration equipment and branched networks of refrigerants are used. On the basis of experimental studies and developed mathematical model of asymmetric dispersed-annular flow of steam-water flow in horizontal steam-generating pipes, a calculation formula has been obtained for determining the boundaries of the zone of improved heat transfer and the critical value of the heat flux density. A new theoretical approach to the solution of the problem of the flow structure of a two-phase flow is proposed. The applied method of dissipative characteristics of a two-phase flow in pipes and the principle of a minimum rate of entropy increase in stabilized flows made it possible to obtain formulas that directly reflect the influence of the viscous characteristics of the gas and liquid media on their distribution in the flow. The study showed a significant effect of gravitational forces on the nature of the phase distribution in the cross section of the evaporative tubes. At a mass velocity of a two-phase flow less than 700 kg / m2s, the volume content of the liquid phase near the upper outer generating lines of the tube is almost an order of magnitude lower than the lower one. The calculation of the heat transfer crisis in horizontal evaporative tubes is obtained. The calculated dependence is in good agreement with the experimental data of the author and a number of foreign researchers. The formula generalizes the experimental data for pipes with the diameter of 6-40 mm in the pressure of 2-7 MPa.

  14. Numerical Modeling of the Hydrothermal System at East Pacific Rise 9°50'N Including Anhydrite Precipitation

    Science.gov (United States)

    Kolandaivelu, K. P.; Lowell, R. P.

    2015-12-01

    To better understand the effects of anhydrite precipitation on mid-ocean ridge hydrothermal systems, we conducted 2-D numerical simulations of two-phase hydrothermal circulation in a NaCl-H2O fluid at the East Pacific Rise 9°50'N. The simulations were constrained by key observational thermal data and seismicity that suggests the fluid flow is primarily along axis with recharge focused into a small zone near a 4th order discontinuity. The simulations considered an open-top square box with a fixed seafloor pressure of 25 MPa, and nominal seafloor temperature of 10 °C. The sides of the box were assumed to be impermeable and insulated. We considered two models: a homogeneous model with a permeability of 10-13 m2 and a heterogeneous model in which layer 2A extrusives were given a higher permeability. Both models had a fixed bottom temperature distribution and initial porosity of 0.1. Assuming that anhydrite precipitation resulted from the decrease in solubility with increasing temperature as downwelling fluid gets heated, we calculated the rate of porosity decrease and sealing times in each cell at certain time snapshots in the simulations. The results showed that sealing would occur most rapidly in limited regions near the base of the high-temperature plumes, where complete sealing could occur on decadal time scales. Though more detailed analysis is needed, it appeared that the areas of rapid sealing would likely have negligible impact on the overall circulation pattern and hydrothermal vent temperatures. The simulations also indicated that sealing due to anhydrite precipitation would occur more slowly at the margins of the ascending plumes. The sealing times in the deep recharge zone determined in these simulations were considerably greater than estimated from 1D analytical calculations, suggesting that with a 2D model, focused recharge at the EPR 9°50'N site may occur, at least on a decadal time scale.

  15. This Is My (Post) Truth, Tell Me Yours Comment on "The Rise of Post-truth Populism in Pluralist Liberal Democracies: Challenges for Health Policy".

    Science.gov (United States)

    Powell, Martin

    2017-05-15

    This is a commentary on the article 'The rise of post-truth populism in pluralist liberal democracies: challenges for health policy.' It critically examines two of its key concepts: populism and 'post truth.' This commentary argues that there are different types of populism, with unclear links to impacts, and that in some ways, 'post-truth' has resonances with arguments advanced in the period at the beginning of the British National Health Service (NHS). In short, 'post-truth' populism' may be 'déjà vu all over again,' and there are multiple (post) truths: this is my (post) truth, tell me yours. © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

  16. Thermal environmental case study of an existing underfloor air distribution (UFAD) system in a high-rise building in the tropics

    Science.gov (United States)

    Ya, Y. H.; Poh, K. S.

    2015-09-01

    The performance of an existing underfloor air distribution (UFAD) system in a renowned high-rise office tower in Malaysia was studied to identify the root cause issues behind the poor indoor air quality. Occupants are the best thermal sensor. The building was detected with the sick building syndrome (SBS) that causes runny noses, flu-like symptoms, irritated skin, and etc. Long period of exposure to indoor air pollutants may increase the occupant's health risk. The parameters such as the space temperature, relative humidity, air movement, air change, fresh air flow rate, chilled water supply and return are evaluated at three stories that consist of five open offices. A full traverse study was carried out at one of the fresh air duct. A simplified duct flow measurement method using pitot-tubes was developed. The results showed that the diffusers were not effective in creating the swirl effect to the space. Internal heat gain from human and office electrical equipment were not drawn out effectively. Besides, relative humidity has exceeded the recommended level. These issues were caused by the poor maintenance of the building. The energy efficiency strategy of the UFAD system comes from the higher supply air temperature. It may leads to insufficient cooling load for the latent heat gained under improper system performance. Special care and considerations in design, construction and maintenance are needed to ensure the indoor air quality to be maintained. Several improvements were recommended to tackle the existing indoor air quality issues. Solar system was studied as one of the innovative method for retrofitting.

  17. Energy Systems and Population Health

    Energy Technology Data Exchange (ETDEWEB)

    Ezzati, Majid; Bailis, Rob; Kammen, Daniel M.; Holloway, Tracey; Price, Lynn; Cifuentes, Luis A.; Barnes, Brendon; Chaurey, Akanksha; Dhanapala, Kiran N.

    2004-04-12

    It is well-documented that energy and energy systems have a central role in social and economic development and human welfare at all scales, from household and community to regional and national (41). Among its various welfare effects, energy is closely linked with people s health. Some of the effects of energy on health and welfare are direct. With abundant energy, more food or more frequent meals can be prepared; food can be refrigerated, increasing the types of food items that are consumed and reducing food contamination; water pumps can provide more water and eliminate the need for water storage leading to contamination or increased exposure to disease vectors such as mosquitoes or snails; water can be disinfected by boiling or using other technologies such as radiation. Other effects of energy on public health are mediated through more proximal determinants of health and disease. Abundant energy can lead to increased irrigation, agricultural productivity, and access to food and nutrition; access to energy can also increase small-scale income generation such as processing of agricultural commodities (e.g., producing refined oil from oil seeds, roasting coffee, drying and preserving fruits and meats) and production of crafts; ability to control lighting and heating allows education or economic activities to be shielded from daily or seasonal environmental constraints such as light, temperature, rainfall, or wind; time and other economic resources spent on collecting and/or transporting fuels can be used for other household needs if access to energy is facilitated; energy availability for transportation increases access to health and education facilities and allow increased economic activity by facilitating the transportation of goods and services to and from markets; energy for telecommunication technology (radio, television, telephone, or internet) provides increased access to information useful for health, education, or economic purposes; provision of energy

  18. Health system strengthening and hypertension management in China.

    Science.gov (United States)

    Huang, Kehui; Song, Yu Ting; He, Yong Huan; Feng, Xing Lin

    2016-01-01

    Non-communicable diseases are the leading causes of global burden of diseases, and hypertension is one of the most important risk factors. Hypertension prevalence doubled in China in the past decade and affects more than 300 million Chinese people. In the review we systematically searched peer-reviewed publications that link health system level factors with hypertension management in China and provide the current knowledge on how to improve a country's health system to manage the hypertension epidemic. A framework was developed to guide the review. The database of PubMed, CNKI were systematically searched from inception to April 13, 2016. Two authors independently screened the searched results for inclusion, conducted data extraction and appraised the quality of studies. Key findings were described according to the framework. Five hundred seventy-two publications were identified, where 11 articles were left according to the inclusion and exclusion criteria. The study periods range from 2010 to 2015. All about 11 researches linked health system factors to the outcome of hypertension management. And the outcomes were just focused on the awareness, treatment and control of hypertension but not hypertension incidence. One study is about the role of health system governance, investigating the performance of different organized community health care centers; three studies were about health financing comparing differences in insurance coverage; three studies were about health information practicing the hypertension guidelines of China or the WHO, and the rest three about mechanisms of health service delivery. No researches were identified about physical resources for health and human resources for health. Hypertension prevalence has been rising rapidly in China and the management of hypertension in China is a detection problem rather than treatment problem. Limited evidence shows the positive effect of health system factors on hypertension management and joint efforts

  19. Rising to the human rights challenge in compulsory treatment--new approaches to mental health law in Australia.

    Science.gov (United States)

    Callaghan, Sascha; Ryan, Christopher J

    2012-07-01

    To analyse, and explain to Australasian psychiatrists, recent proposed changes to the terms of coercive treatment for mental illness in Tasmania and Victoria and to place the proposals in the context of a broader human rights framework that is likely to impact the future shape of mental health legislation more generally. The Australian law reform proposals are reviewed against the requirements of numerous human rights instruments, including the recently ratified United Nations Convention on the Rights of Persons with Disabilities. Ethical and legal arguments are made to support the proposed changes and to introduce others, taking into account academic commentary on mental health law and recent empirical work on the ability to usefully categorise patients by their likelihood of harm to self and others. The Victorian and Tasmanian draft mental health bills propose a new basis for compulsory psychiatric treatment in Australasia. If they become law, coercive psychiatric treatment could only be applied to patients who lack decision-making capacity. The Tasmanian draft bill also sets a new benchmark for timely independent review of compulsory treatment. However both jurisdictions propose to retain an 'additional harm' test which must be satisfied before patients may be treated without consent. This differs from non-psychiatric cases, where if patients are unable to consent to medical treatment for themselves, they will be entitled to receive coercive treatment if it is in their best interests. The proposed changes under the Tasmanian and Victorian draft mental health bills will ensure that, in line with local and international human rights obligations, only patients who lack decision-making capacity may be coercively treated for mental illness. However the continuing 'additional harm' criteria may breach human rights obligations by imposing a discriminatory threshold for care on patients who are unable to consent to treatment for themselves. This could be avoided by

  20. Effect of health system reforms in Turkey on user satisfaction.

    Science.gov (United States)

    Stokes, Jonathan; Gurol-Urganci, Ipek; Hone, Thomas; Atun, Rifat

    2015-12-01

    In 2003, the Turkish government introduced major health system changes, the Health Transformation Programme (HTP), to achieve universal health coverage (UHC). The HTP leveraged changes in all parts of the health system, organization, financing, resource management and service delivery, with a new family medicine model introducing primary care at the heart of the system. This article examines the effect of these health system changes on user satisfaction, a key goal of a responsive health system. Utilizing the results of a nationally representative yearly survey introduced at the baseline of the health system transformation, multivariate logistic regression analysis is used to examine the yearly effect on satisfaction with health services. During the 9-year period analyzed (2004-2012), there was a nearly 20% rise in reported health service use, coinciding with increased access, measured by insurance coverage. Controlling for factors known to contribute to user satisfaction in the literature, there is a significant (P < 0.001) increase in user satisfaction with health services in almost every year (bar 2006) from the baseline measure, with the odds of being satisfied with health services in 2012, 2.56 (95% confidence interval (CI) of 2.01-3.24) times that in 2004, having peaked at 3.58 (95% CI 2.82-4.55) times the baseline odds in 2011. Additionally, those who used public primary care services were slightly, but significantly (P < 0.05) more satisfied than those who used any other services, and increasingly patients are choosing primary care services rather than secondary care services as the provider of first contact. A number of quality indicators can probably help account for the increased satisfaction with public primary care services, and the increase in seeking first-contact with these providers. The implementation of primary care focused UHC as part of the HTP has improved user satisfaction in Turkey.

  1. Effect of health system reforms in Turkey on user satisfaction

    Directory of Open Access Journals (Sweden)

    Jonathan Stokes

    2015-12-01

    Full Text Available In 2003, the Turkish government introduced major health system changes, the Health Transformation Programme (HTP, to achieve universal health coverage (UHC. The HTP leveraged changes in all parts of the health system, organization, financing, resource management and service delivery, with a new family medicine model introducing primary care at the heart of the system. This article examines the effect of these health system changes on user satisfaction, a key goal of a responsive health system. Utilizing the results of a nationally representative yearly survey introduced at the baseline of the health system transformation, multivariate logistic regression analysis is used to examine the yearly effect on satisfaction with health services. During the 9–year period analyzed (2004–2012, there was a nearly 20% rise in reported health service use, coinciding with increased access, measured by insurance coverage. Controlling for factors known to contribute to user satisfaction in the literature, there is a significant (P < 0.001 increase in user satisfaction with health services in almost every year (bar 2006 from the baseline measure, with the odds of being satisfied with health services in 2012, 2.56 (95% Confidence Interval (CI of 2.01–3.24 times that in 2004, having peaked at 3.58 (CI, 2.82–4.55 times the baseline odds in 2011. Additionally, those who used public primary care services were slightly, but significantly (P < 0.05 more satisfied than those who used any other services, and increasingly patients are choosing primary care services rather than secondary care services as the provider of first contact. A number of quality indicators can probably help account for the increased satisfaction with public primary care services, and the increase in seeking first–contact with these providers. The implementation of primary care focused UHC as part of the HTP has improved user satisfaction in Turkey.

  2. Walking in the high-rise city: a Health Enhancement and Pedometer-determined Ambulatory (HEPA program in Hong Kong

    Directory of Open Access Journals (Sweden)

    Leung AYM

    2014-08-01

    Full Text Available Angela YM Leung,1,2 Mike KT Cheung,3 Michael A Tse,4 Wai Chuen Shum,5 BJ Lancaster,1,6 Cindy LK Lam7 1School of Nursing, 2Research Centre on Heart, Brain, Hormone and Healthy Aging, Li Ka Shing Faculty of Medicine, University of Hong Kong, 3Centre on Research and Advocacy, Hong Kong Society for Rehabilitation, 4Institute of Human Performance, University of Hong Kong, 5Sheng Kung Hui Holy Carpenter Church Social Services, Hong Kong Special Administrative Region, People’s Republic of China; 6School of Nursing, Vanderbilt University, Nashville, TN, USA; 7Department of Family Medicine and Primary Care, University of Hong Kong, Hong Kong Special Administrative Region, People’s Republic of China Abstract: Due to the lack of good infrastructure in the public estates, many older adults in urban areas are sedentary. The Health Enhancement and Pedometer-Determined Ambulatory (HEPA program was developed to assist older adults with diabetes and/or hypertension to acquire walking exercise habits and to build social support, while engaged in regular physical activity. This study aimed to describe the HEPA program and to report changes in participants’ walking capacity and body strength after 10-week walking sessions. A pre- and postintervention design was used. Pedometers were used to measure the number of steps taken per day before and after the 10-week intervention. Upper and lower body strength, lower body flexibility, and quality of life were assessed. A total of 205 older adults completed the program and all health assessments. After the 10-week intervention, the average number of steps per day increased by 36%, from 6,591 to 8,934. Lower body strength, upper body strength, and aerobic fitness increased significantly after 10 weeks, along with improvement in the 12-item Short Form Health Survey (SF™-12 physical and mental health component summary scores. A social support network was built in the neighborhood, and the local environment was

  3. Health Care Information System (HCIS) Data File

    Data.gov (United States)

    U.S. Department of Health & Human Services — The data was derived from the Health Care Information System (HCIS), which contains Medicare Part A (Inpatient, Skilled Nursing Facility, Home Health Agency (Part A...

  4. Modeling vegetation community responses to sea-level rise on Barrier Island systems: A case study on the Cape Canaveral Barrier Island complex, Florida, USA.

    Directory of Open Access Journals (Sweden)

    Tammy E Foster

    Full Text Available Society needs information about how vegetation communities in coastal regions will be impacted by hydrologic changes associated with climate change, particularly sea level rise. Due to anthropogenic influences which have significantly decreased natural coastal vegetation communities, it is important for us to understand how remaining natural communities will respond to sea level rise. The Cape Canaveral Barrier Island complex (CCBIC on the east central coast of Florida is within one of the most biologically diverse estuarine systems in North America and has the largest number of threatened and endangered species on federal property in the contiguous United States. The high level of biodiversity is susceptible to sea level rise. Our objective was to model how vegetation communities along a gradient ranging from hydric to upland xeric on CCBIC will respond to three sea level rise scenarios (0.2 m, 0.4 m, and 1.2 m. We used a probabilistic model of the current relationship between elevation and vegetation community to determine the impact sea level rise would have on these communities. Our model correctly predicted the current proportions of vegetation communities on CCBIC based on elevation. Under all sea level rise scenarios the model predicted decreases in mesic and xeric communities, with the greatest losses occurring in the most xeric communities. Increases in total area of salt marsh were predicted with a 0.2 and 0.4 m rise in sea level. With a 1.2 m rise in sea level approximately half of CCBIC's land area was predicted to transition to open water. On the remaining land, the proportions of most of the vegetation communities were predicted to remain similar to that of current proportions, but there was a decrease in proportion of the most xeric community (oak scrub and an increase in the most hydric community (salt marsh. Our approach provides a first approximation of the impacts of sea level rise on terrestrial vegetation communities

  5. Modeling vegetation community responses to sea-level rise on Barrier Island systems: A case study on the Cape Canaveral Barrier Island complex, Florida, USA.

    Science.gov (United States)

    Foster, Tammy E; Stolen, Eric D; Hall, Carlton R; Schaub, Ronald; Duncan, Brean W; Hunt, Danny K; Drese, John H

    2017-01-01

    Society needs information about how vegetation communities in coastal regions will be impacted by hydrologic changes associated with climate change, particularly sea level rise. Due to anthropogenic influences which have significantly decreased natural coastal vegetation communities, it is important for us to understand how remaining natural communities will respond to sea level rise. The Cape Canaveral Barrier Island complex (CCBIC) on the east central coast of Florida is within one of the most biologically diverse estuarine systems in North America and has the largest number of threatened and endangered species on federal property in the contiguous United States. The high level of biodiversity is susceptible to sea level rise. Our objective was to model how vegetation communities along a gradient ranging from hydric to upland xeric on CCBIC will respond to three sea level rise scenarios (0.2 m, 0.4 m, and 1.2 m). We used a probabilistic model of the current relationship between elevation and vegetation community to determine the impact sea level rise would have on these communities. Our model correctly predicted the current proportions of vegetation communities on CCBIC based on elevation. Under all sea level rise scenarios the model predicted decreases in mesic and xeric communities, with the greatest losses occurring in the most xeric communities. Increases in total area of salt marsh were predicted with a 0.2 and 0.4 m rise in sea level. With a 1.2 m rise in sea level approximately half of CCBIC's land area was predicted to transition to open water. On the remaining land, the proportions of most of the vegetation communities were predicted to remain similar to that of current proportions, but there was a decrease in proportion of the most xeric community (oak scrub) and an increase in the most hydric community (salt marsh). Our approach provides a first approximation of the impacts of sea level rise on terrestrial vegetation communities, including important

  6. The energy-saving anaerobic baffled reactor membrane bioreactor (EABR-MBR) system for recycling wastewater from a high-rise building.

    Science.gov (United States)

    Ratanatamskul, Chavalit; Charoenphol, Chakraphan

    2015-01-01

    A novel energy-saving anaerobic baffled reactor-membrane bioreactor (EABR-MBR) system has been developed as a compact biological treatment system for reuse of water from a high-rise building. The anaerobic baffled reactor (ABR) compartment had five baffles and served as the anaerobic degradation zone, followed by the aerobic MBR compartment. The total operating hydraulic retention time (HRT) of the EABR-MBR system was 3 hours (2 hours for ABR compartment and very short HRT of 1 hour for aerobic MBR compartment). The wastewater came from the Charoen Wisawakam building. The results showed that treated effluent quality was quite good and highly promising for water reuse purposes. The average flux of the membrane was kept at 30 l/(m2h). The EABR-MBR system could remove chemical oxygen demand, total nitrogen and total phosphorus from building wastewater by more than 90%. Moreover, it was found that phosphorus concentration was rising in the ABR compartment due to the phosphorus release phenomenon, and then the concentration decreased rapidly in the aerobic MBR compartment due to the phosphorus uptake phenomenon. This implies that phosphorus-accumulating organisms inside the EABR-MBR system are responsible for biological phosphorus removal. The research suggests that the EABR-MBR system can be a promising system for water reuse and reclamation for high-rise building application in the near future.

  7. Human Factors in Green Office Building Design: The Impact of Workplace Green Features on Health Perceptions in High-Rise High-Density Asian Cities

    Directory of Open Access Journals (Sweden)

    Fei Xue

    2016-10-01

    Full Text Available There is a growing concern about human factors in green building, which is imperative in high-rise high-density urban environments. This paper describes our attempts to explore the influence of workplace green features (such as green certification, ventilation mode, and building morphology on health perceptions (personal sensation, sensorial assumptions, healing performance based on a survey in Hong Kong and Singapore. The results validated the relationship between green features and health perceptions in the workplace environment. Remarkably, participants from the air-conditioned offices revealed significant higher concerns about health issues than those participants from the mixed-ventilated offices. The mixed-ventilation design performs as a bridge to connect the indoor environment and outdoor space, which enables people to have contact with nature. Additionally, the preferred building morphology of the workplace is the pattern of a building complex instead of a single building. The complex form integrates the configuration of courtyards, podium gardens, green terrace, public plaza, and other types of open spaces with the building clusters, which contributes to better health perceptions. This research contributes to the rationalization and optimization of passive climate-adaptive design strategies for green buildings in high-density tropical or subtropical cities.

  8. How effects of chemicals might differ from those of radiations in giving rise to genetic ill-health in man

    International Nuclear Information System (INIS)

    Evans, H.J.

    1980-01-01

    Possible differences between the effects of the two groups of agents are considered. Two types of genetic damage are discussed. The first type involves mutational changes induced in germ cells or germ cell precursors which are then transmitted to the products of conception and to any resultant offspring and their descendants. The second kind is that damage sustained by the genome in somatic cells which is transmitted to daughter cells. Such somatic mutations are not heritable in the familiar sense, but they are transmitted to descendant cells within the body. It is concluded that a greater heterogeneity is expected in mutagenic response to chemical mutagens than to radiations in human populations, that the spectrum of mutations following chemical exposure may be quite different from that following radiation exposure, and that for many chemical agents, and in contrast to ionising radiations, one might expect a greater burden of genetic ill-health due to increased frequencies of mildly deleterious recessive and polygenic mutations. (Auth.)

  9. Health policy, health systems research and analysis capacity ...

    African Journals Online (AJOL)

    Introduction: Health Policy and Systems Research and Analysis (HPSR&A) is an applied science that deals with complexity as it tries to provide lessons, tools and methods to understand and improve health systems and health policy. It is defined by the kinds of questions asked rather than a particular methodology.

  10. Software for Intelligent System Health Management

    Science.gov (United States)

    Trevino, Luis C.

    2004-01-01

    This viewgraph presentation describes the characteristics and advantages of autonomy and artificial intelligence in systems health monitoring. The presentation lists technologies relevant to Intelligent System Health Management (ISHM), and some potential applications.

  11. The public health system in England

    National Research Council Canada - National Science Library

    Hunter, David J; Marks, Linda; Smith, Katherine E

    2010-01-01

    .... The Public Health System in England offers a wide-ranging, provocative and accessible assessment of challenges confronting a public health system, exploring how its parameters have shifted over time...

  12. CONSIDERATIONS ON CHINA’S ACCOUNTING SYSTEM – A RISING COUNTRY TRYING TO BECOME AN EXAMPLE OF SUSTAINABLE DEVELOPMENT

    Directory of Open Access Journals (Sweden)

    BREAHNĂ-PRAVĂŢ IONELA-CRISTINA

    2014-05-01

    Full Text Available China, a country with an economy and population whose values exceeded all expectations over the last century, still makes considerable efforts to answer several calls from policy makers to develop responsibly in terms of industrialization, used resources and their reuse, economic restructuring, environmental protection and health etc. The major goal of China, the fact that its economy could become leader until 2030, its direct involvement in The Global Markets Project, and other items, make the study of national particularities of the accounting system of this country to be a topic of great interest. The fact that China has become a key pawn in the economy and world politics, reflected it in the accounts also. Development of cross-border transactions, capital markets, tax, multiple ownership of economic entities, all of these and not only, lead to the need for convergence with international accounting standards. Therefore, we try by means of this paper, to approach a series of issues related to past, present and likely future of the Chinese accounting system, how the system will influence and will be influenced by the social, economic and political environment

  13. Strengthening health system to improve immunization for migrants in China.

    Science.gov (United States)

    Fang, Hai; Yang, Li; Zhang, Huyang; Li, Chenyang; Wen, Liankui; Sun, Li; Hanson, Kara; Meng, Qingyue

    2017-07-01

    Immunization is the most cost-effective method to prevent and control vaccine-preventable diseases. Migrant population in China has been rising rapidly, and their immunization status is poor. China has tried various strategies to strengthen its health system, which has significantly improved immunization for migrants. This study applied a qualitative retrospective review method aiming to collect, analyze and synthesize health system strengthening experiences and practices about improving immunizations for migrants in China. A conceptual framework of Theory of Change was used to extract the searched literatures. 11 searched literatures and 4 national laws and policies related to immunizations for migrant children were carefully studied. China mainly employed 3 health system strengthening strategies to significantly improve immunization for migrant population: stop charging immunization fees or immunization insurance, manage immunization certificates well, and pay extra attentions on immunization for special children including migrant children. These health system strengthening strategies were very effective, and searched literatures show that up-to-date and age-appropriate immunization rates were significantly improved for migrant children. Economic development led to higher migrant population in China, but immunization for migrants, particularly migrant children, were poor. Fortunately various health system strengthening strategies were employed to improve immunization for migrants in China and they were rather successful. The experiences and lessons of immunization for migrant population in China might be helpful for other developing countries with a large number of migrant population.

  14. [Health services research for the public health service (PHS) and the public health system].

    Science.gov (United States)

    Hollederer, A; Wildner, M

    2015-03-01

    There is a great need for health services research in the public health system and in the German public health service. However, the public health service is underrepresented in health services research in Germany. This has several structural, historical and disciplinary-related reasons. The public health service is characterised by a broad range of activities, high qualification requirements and changing framework conditions. The concept of health services research is similar to that of the public health service and public health system, because it includes the principles of multidisciplinarity, multiprofessionalism and daily routine orientation. This article focuses on a specified system theory based model of health services research for the public health system and public health service. The model is based on established models of the health services research and health system research, which are further developed according to specific requirements of the public health service. It provides a theoretical foundation for health services research on the macro-, meso- and microlevels in public health service and the public health system. Prospects for public health service are seen in the development from "old public health" to "new public health" as well as in the integration of health services research and health system research. There is a significant potential for development in a better linkage between university research and public health service as is the case for the "Pettenkofer School of Public Health Munich". © Georg Thieme Verlag KG Stuttgart · New York.

  15. Medicare's prospective payment system for hospitals: new evidence on transitions among health care settings

    OpenAIRE

    Qian, Xufeng; Russell, Louise B.; Valiyeva, Elmira; Miller, Jane E.

    2007-01-01

    Previous studies of Medicare’s prospective payment system for hospitals (PPS), introduced in 1983, evaluated only its first few years, using data collected during the hospital stay to control for patients’ health. We examine transitions among health care settings over a full decade following implementation of PPS, using survival models and a national longitudinal survey with independent information on health. We find that the rate of discharge from hospitals to nursing homes continued to rise...

  16. Strengthening of oral health systems

    DEFF Research Database (Denmark)

    Petersen, Poul Erik

    2014-01-01

    is either due to low availability and accessibility of oral health care or because oral health care is costly. In all countries, the poor and disadvantaged population groups are heavily affected by a high burden of oral disease compared to well-off people. Promotion of oral health and prevention of oral...... diseases must be provided through financially fair primary health care and public health intervention. Integrated approaches are the most cost-effective and realistic way to close the gap in oral health between rich and poor. The World Health Organization (WHO) Oral Health Programme will work......Around the globe many people are suffering from oral pain and other problems of the mouth or teeth. This public health problem is growing rapidly in developing countries where oral health services are limited. Significant proportions of people are underserved; insufficient oral health care...

  17. Integrated System Health Management Development Toolkit

    Science.gov (United States)

    Figueroa, Jorge; Smith, Harvey; Morris, Jon

    2009-01-01

    This software toolkit is designed to model complex systems for the implementation of embedded Integrated System Health Management (ISHM) capability, which focuses on determining the condition (health) of every element in a complex system (detect anomalies, diagnose causes, and predict future anomalies), and to provide data, information, and knowledge (DIaK) to control systems for safe and effective operation.

  18. The Far Right Challenge Comment on "The Rise of Post-truth Populism in Pluralist Liberal Democracies: Challenges for Health Policy".

    Science.gov (United States)

    Halikiopoulou, Daphne

    2017-07-11

    Speed and Mannion make a good case that the rise of populism poses significant challenges for health policy. This commentary suggests that the link between populism and health policy should be further nuanced in four ways. First, a deconstruction of the term populism itself and a focus on the far right dimension of populist politics; second, a focus on the supply side and more specifically the question of nationalism and the 'national preference'; third, the dynamics of party competition during economic crisis; and fourth the question of policy, and more specifically the extent to which certain labour market policies are able to mediate demand for the far right. © 2018 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

  19. Populism, Exclusion, Post-truth. Some Conceptual Caveats Comment on "The Rise of Post-truth Populism in Pluralist Liberal Democracies: Challenges for Health Policy".

    Science.gov (United States)

    De Cleen, Benjamin

    2017-07-15

    In their editorial, Speed and Mannion identify two main challenges "the rise of post-truth populism" poses for health policy: the populist threat to inclusive healthcare policies, and the populist threat to well-designed health policies that draw on professional expertise and research evidence. This short comment suggests some conceptual clarifications that might help in thinking through more profoundly these two important issues. It argues that we should approach right-wing populism as a combination of a populist down/up (people/elite) axis with an exclusionary nationalist in/out (member/non-member) axis. And it raises some questions regarding the equation between populism, demagogy and the rejection of expertise and scientific knowledge. © 2018 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

  20. Managing Health Information System | Campbell | Nigerian ...

    African Journals Online (AJOL)

    The effective planning, management monitoring and evaluation of health services, health resources and indeed the health system requires a wealth of health information, with its simultaneous effective and efficient management. It is an instrument used to help policy-making, decision making and day to day actions in the ...

  1. Synergy between indigenous knowledge systems, modern health ...

    African Journals Online (AJOL)

    ... the people of this country should harness a synergy between indigenous health care systems, scientific research and modern health care methods. This article attempts to address the historical evolution of health care methods in South Africa, its effect on the community as well as challenges facing the health professions.

  2. Military Health System Transformation Implications on Health Information Technology Modernization.

    Science.gov (United States)

    Khan, Saad

    2018-03-01

    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.

  3. Integrating ICTs within health systems | IDRC - International ...

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

    2016-06-10

    Jun 10, 2016 ... But for too long, ICT and health system researchers have worked in isolation ... be used to enable the governance and functioning of health systems in ... most African countries adopted direct payment for health services as the ...

  4. Occupational Health Record-keeping System (OHRS)

    Data.gov (United States)

    Department of Veterans Affairs — Occupational Health Record-keeping System (OHRS) is part of the Clinical Information Support System (CISS) portal framework and the initial CISS partner system. OHRS...

  5. [A Maternal Health Care System Based on Mobile Health Care].

    Science.gov (United States)

    Du, Xin; Zeng, Weijie; Li, Chengwei; Xue, Junwei; Wu, Xiuyong; Liu, Yinjia; Wan, Yuxin; Zhang, Yiru; Ji, Yurong; Wu, Lei; Yang, Yongzhe; Zhang, Yue; Zhu, Bin; Huang, Yueshan; Wu, Kai

    2016-02-01

    Wearable devices are used in the new design of the maternal health care system to detect electrocardiogram and oxygen saturation signal while smart terminals are used to achieve assessments and input maternal clinical information. All the results combined with biochemical analysis from hospital are uploaded to cloud server by mobile Internet. Machine learning algorithms are used for data mining of all information of subjects. This system can achieve the assessment and care of maternal physical health as well as mental health. Moreover, the system can send the results and health guidance to smart terminals.

  6. Mobile health monitoring system for community health workers

    CSIR Research Space (South Africa)

    Sibiya, G

    2014-09-01

    Full Text Available of hypertension as it provides real time information and eliminates the need to visit a healthcare facility to take blood pressure readings. Our proposed mobile health monitoring system enables faster computerization of data that has been recorded... pressure, heart rate and glucose readings. These reading closely related to most common NCDs. D. Feedback to health worker and the subject of care Community health workers are often not professionally trained on health. As a result they are not expected...

  7. Multipurpose Health Care Telemedicine System

    National Research Council Canada - National Science Library

    Kyriacou, E

    2001-01-01

    .... Ambulances, Rural Health Centers (RHC) or other remote health location, Ships navigating in wide seas and Airplanes in flight are common examples of possible emergency sites, while critical care telemetry, and telemedicine home follow-ups...

  8. Strengthening Health Systems Governance in Latin American ...

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

    This project seeks to improve the governance of health systems by designing and ... of the data (locally elected officials, health authorities, civil society groups), the ... In partnership with UNESCO's Organization for Women in Science for the ...

  9. Governance for Equity in Health Systems

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

    GEHS

    allocation, and power distribution in health systems are addressed to improve health ... development of a knowledge base on innovative and rigorous research ..... The Public Sector Anti-retroviral Treatment in Free State – Phase II; and Impact ...

  10. Participatory Action Research in Health Systems: Empowering ...

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

    2014-12-02

    Dec 2, 2014 ... Home · Resources · Publications ... A new publication, Participatory Action Research in Health Systems: a methods ... organizations, most African countries adopted direct payment for health services as the primary means.

  11. Fourth Global Health Systems Research Symposium features ...

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

    2017-01-13

    Jan 13, 2017 ... Home · Resources · Publications ... These solutions touch on diverse aspects of health systems, ... Read more on how IDRC is helping increase equitable access to health services for the poor in Mali and Burkina Faso.

  12. Systems Biology and Health Systems Complexity in;

    NARCIS (Netherlands)

    Donald Combs, C.; Barham, S.R.; Sloot, P.M.A.

    2016-01-01

    Systems biology addresses interactions in biological systems at different scales of biological organization, from the molecular to the cellular, organ, organism, societal, and ecosystem levels. This chapter expands on the concept of systems biology, explores its implications for individual patients

  13. An Interconnection of Armed Conflict and Health Service system in Rolpa District of Nepal

    Directory of Open Access Journals (Sweden)

    Sachin Kumar Ghimire

    2009-08-01

    Full Text Available The health service system is the part of the political system. Likewise, political systems should be an integral part of the health system. Contrary to this, local political tussle, national level power conflicts, long-term civil war, and crises in the bureaucracy have led to the continuous ignorance of people’s health issues in Rolpa. War is always detrimental for people's health, health service system and social well-being of the population. The chronic condition of exclusion prevalent in large section of the society is the “favorable” fertile ground to capitalize the expectations toward inclusive and healthy condition in Rolpa. The process of capitalizing such historical exclusion in the name of “revolution” gives rise to new sects of political actors. However, rising expectations and aspirations toward “equitable society” have been resulting in severe frustrations because no significant changes have been done to address the general living conditions of people. The continuous rise and fall of expectations after all lead to infinitive journey of producing ill health that could be extremely detrimental to people's expectation, even to live a normal life as a human.

  14. Mapping Health Needs to Support Health System Management in Poland

    Science.gov (United States)

    Holecki, Tomasz; Romaniuk, Piotr; Woźniak-Holecka, Joanna; Szromek, Adam R.; Syrkiewicz-Świtała, Magdalena

    2018-01-01

    In Poland, following the example of other EU countries, the first maps of health needs prepared by the Ministry of Health were presented in 2016. The maps constitute a foundation for rational decision-making in the management of health care resources, being potentially useful for all actors in health system. This refers in particular to the institutions responsible for distribution of funds and contracting health service, but also for decision-makers, who determine the scope of funds to be utilized in the health system, or the structure of benefits provided to patients. Service providers are also addressees of the maps, to give them a basis for planning future activities. The article presents a structured assessment of the current state of affairs, based on recent experience and sets out likely directions for the development of health needs in mapping in Poland in the future. We discuss the criticism addressed toward maps by representatives of various groups acting in health care. It includes the lack of recognition of some of the key health needs, or wrong emphases, where much more attention is paid to the recognition of current resources in the health system, instead of making prognoses regarding the future developments of health needs. Nonetheless, we find that this instrument is potentially of high usability, in case of elimination of the existing weaknesses. PMID:29662876

  15. The rise and fall of dental therapy in Canada: a policy analysis and assessment of equity of access to oral health care for Inuit and First Nations communities.

    Science.gov (United States)

    Leck, Victoria; Randall, Glen E

    2017-07-20

    Inequality between most Canadians and those from Inuit and First Nations communities, in terms of both access to oral health care services and related health outcomes, has been a long-standing problem. Efforts to close this equity gap led to the creation of dental therapy training programs. These programs were designed to produce graduates who would provide services in rural and northern communities. The closure of the last dental therapy program in late 2011 has ended the supply of dental therapists and governments do not appear to have any alternative solutions to the growing gap in access to oral health care services between most Canadians and those from Inuit and First Nations communities. A policy analysis of the rise and fall of the dental therapy profession in Canada was conducted using historical and policy documents. The analysis is framed within Kingdon's agenda-setting framework and considers why dental therapy was originally pursued as an option to ensure equitable access to oral health care for Inuit and First Nations communities and why this policy has now been abandoned with the closure of Canada's last dental therapy training school. The closure of the last dental therapy program in Canada has the potential to further reduce access to dental care in some Inuit and First Nations communities. Overlaps between federal and provincial jurisdiction have contributed to the absence of a coordinated policy approach to address the equity gap in access to dental care which will exacerbate the inequalities in comparison to the general population. The analysis suggests that while a technically feasible policy solution is available there continues to be no politically acceptable solution and thus it remains unlikely that a window of opportunity for policy change will open any time soon. In the absence of federal government leadership, the most viable option forward may be incremental policy change. Provincial governments could expand the scope of practice for

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

    Science.gov (United States)

    Janecka, Ivo

    2017-02-15

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

  17. Non-communicable diseases, mental ill-health: Is it a failure of the food system?

    Science.gov (United States)

    Crawford, Michel A

    2013-01-01

    The rise in brain disorders and mental ill-health is the most serious crisis facing the survival of humanity. Starting from an understanding of the origins of the nervous system and the brain, together with its nutritional requirements, the present direction of the food system since World War II (WWII) can be seen as departing from the biological essence of brain chemistry and its nutritional needs. Such advances in the food system would lead to epigenetic changes. Improper maternal/foetal nutrition is considered in this manner to lead to heart disease, stroke and diabetes in later life. Is there any reason why the brain would not be similarly susceptible to a nutritional background departing from its specific needs? The changing food system likely bears responsibility for the rise in mental ill health that has now overtaken all other burdens of ill health. Its globalisation is threatening civil society. © The Author(s) 2015.

  18. The rise of health biotechnology research in Latin America: A scientometric analysis of health biotechnology production and impact in Argentina, Brazil, Chile, Colombia, Cuba and Mexico

    Science.gov (United States)

    2018-01-01

    This paper analyzes the patterns of health biotechnology publications in six Latin American countries from 2001 to 2015. The countries studied were Argentina, Brazil, Chile, Colombia, Cuba and Mexico. Before our study, there were no data available on HBT development in half of the Latin-American countries we studied, i.e., Argentina, Colombia and Chile. To include these countries in a scientometric analysis of HBT provides fuller coverage of HBT development in Latin America. The scientometric study used the Web of Science database to identify health biotechnology publications. The total amount of health biotechnology production in the world during the period studied was about 400,000 papers. A total of 1.2% of these papers, were authored by the six Latin American countries in this study. The results show a significant growth in health biotechnology publications in Latin America despite some of the countries having social and political instability, fluctuations in their gross domestic expenditure in research and development or a trade embargo that limits opportunities for scientific development. The growth in the field of some of the Latin American countries studied was larger than the growth of most industrialized nations. Still, the visibility of the Latin American research (measured in the number of citations) did not reach the world average, with the exception of Colombia. The main producers of health biotechnology papers in Latin America were universities, except in Cuba were governmental institutions were the most frequent producers. The countries studied were active in international research collaboration with Colombia being the most active (64% of papers co-authored internationally), whereas Brazil was the least active (35% of papers). Still, the domestic collaboration was even more prevalent, with Chile being the most active in such collaboration (85% of papers co-authored domestically) and Argentina the least active (49% of papers). We conclude that the

  19. The rise of health biotechnology research in Latin America: A scientometric analysis of health biotechnology production and impact in Argentina, Brazil, Chile, Colombia, Cuba and Mexico.

    Science.gov (United States)

    León-de la O, Dante Israel; Thorsteinsdóttir, Halla; Calderón-Salinas, José Víctor

    2018-01-01

    This paper analyzes the patterns of health biotechnology publications in six Latin American countries from 2001 to 2015. The countries studied were Argentina, Brazil, Chile, Colombia, Cuba and Mexico. Before our study, there were no data available on HBT development in half of the Latin-American countries we studied, i.e., Argentina, Colombia and Chile. To include these countries in a scientometric analysis of HBT provides fuller coverage of HBT development in Latin America. The scientometric study used the Web of Science database to identify health biotechnology publications. The total amount of health biotechnology production in the world during the period studied was about 400,000 papers. A total of 1.2% of these papers, were authored by the six Latin American countries in this study. The results show a significant growth in health biotechnology publications in Latin America despite some of the countries having social and political instability, fluctuations in their gross domestic expenditure in research and development or a trade embargo that limits opportunities for scientific development. The growth in the field of some of the Latin American countries studied was larger than the growth of most industrialized nations. Still, the visibility of the Latin American research (measured in the number of citations) did not reach the world average, with the exception of Colombia. The main producers of health biotechnology papers in Latin America were universities, except in Cuba were governmental institutions were the most frequent producers. The countries studied were active in international research collaboration with Colombia being the most active (64% of papers co-authored internationally), whereas Brazil was the least active (35% of papers). Still, the domestic collaboration was even more prevalent, with Chile being the most active in such collaboration (85% of papers co-authored domestically) and Argentina the least active (49% of papers). We conclude that the

  20. Interrogating resilience in health systems development.

    Science.gov (United States)

    van de Pas, Remco; Ashour, Majdi; Kapilashrami, Anuj; Fustukian, Suzanne

    2017-11-01

    The Fourth Global Symposium on Health Systems Research was themed around 'Resilient and responsive health systems for a changing world.' This commentary is the outcome of a panel discussion at the symposium in which the resilience discourse and its use in health systems development was critically interrogated. The 2014-15 Ebola outbreak in West-Africa added momentum for the wider adoption of resilient health systems as a crucial element to prepare for and effectively respond to crisis. The growing salience of resilience in development and health systems debates can be attributed in part to development actors and philanthropies such as the Rockefeller Foundation. Three concerns regarding the application of resilience to health systems development are discussed: (1) the resilience narrative overrules certain democratic procedures and priority setting in public health agendas by 'claiming' an exceptional policy space; (2) resilience compels accepting and maintaining the status quo and excludes alternative imaginations of just and equitable health systems including the socio-political struggles required to attain those; and (3) an empirical case study from Gaza makes the case that resilience and vulnerability are symbiotic with each other rather than providing a solution for developing a strong health system. In conclusion, if the normative aim of health policies is to build sustainable, universally accessible, health systems then resilience is not the answer. The current threats that health systems face demand us to imagine beyond and explore possibilities for global solidarity and justice in health. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  1. A system of health accounts 2011

    National Research Council Canada - National Science Library

    2011-01-01

    .... As demands for information increase and more countries implement and institutionalize health accounts according to the system, the data produced are expected to be more comparable, more detailed...

  2. [The national health system in Peru].

    Science.gov (United States)

    Sánchez-Moreno, Francisco

    2014-01-01

    In 1975, a group of professionals in Peru who were experts on national health systems began a process that led the country to be the first in South America to initiate a modern organization of the health system. This pioneering development meant that the creation of the National Health Services System [in Peru] in 1978 occurred before the health system reforms in Chile (1980), Brazil (1990), Colombia (1993), and Ecuador (2008). This encouraging start has had permanent reformist fluctuations since then, with negative development because of the lack of a State policy. Current features of the Peruvian system are inefficient performance, discontinuity, and lack of assessment, which creates a major setback in comparison with other health systems in America. In the 21st century, significant technical efforts have been missed to modernize the system and its functions. The future is worrying and the role of new generations will be decisive.

  3. The rise of Chrome

    Directory of Open Access Journals (Sweden)

    Jonathan Tamary

    2015-10-01

    Full Text Available Since Chrome’s initial release in 2008 it has grown in market share, and now controls roughly half of the desktop browsers market. In contrast with Internet Explorer, the previous dominant browser, this was not achieved by marketing practices such as bundling the browser with a pre-loaded operating system. This raises the question of how Chrome achieved this remarkable feat, while other browsers such as Firefox and Opera were left behind. We show that both the performance of Chrome and its conformance with relevant standards are typically better than those of the two main contending browsers, Internet Explorer and Firefox. In addition, based on a survey of the importance of 25 major features, Chrome product managers seem to have made somewhat better decisions in selecting where to put effort. Thus the rise of Chrome is consistent with technical superiority over the competition.

  4. Health system vision of iran in 2025.

    Science.gov (United States)

    Rostamigooran, N; Esmailzadeh, H; Rajabi, F; Majdzadeh, R; Larijani, B; Dastgerdi, M Vahid

    2013-01-01

    Vast changes in disease features and risk factors and influence of demographic, economical, and social trends on health system, makes formulating a long term evolutionary plan, unavoidable. In this regard, to determine health system vision in a long term horizon is a primary stage. After narrative and purposeful review of documentaries, major themes of vision statement were determined and its context was organized in a work group consist of selected managers and experts of health system. Final content of the statement was prepared after several sessions of group discussions and receiving ideas of policy makers and experts of health system. Vision statement in evolutionary plan of health system is considered to be :"a progressive community in the course of human prosperity which has attained to a developed level of health standards in the light of the most efficient and equitable health system in visionary region(1) and with the regarding to health in all policies, accountability and innovation". An explanatory context was compiled either to create a complete image of the vision. Social values and leaders' strategic goals, and also main orientations are generally mentioned in vision statement. In this statement prosperity and justice are considered as major values and ideals in society of Iran; development and excellence in the region as leaders' strategic goals; and also considering efficiency and equality, health in all policies, and accountability and innovation as main orientations of health system.

  5. Embedded Sensor Systems for Health - A Step Towards Personalized Health.

    Science.gov (United States)

    Lindén, Maria; Björkman, Mats

    2018-01-01

    The demography is changing towards older people, and the challenge to provide an appropriate care is well known. Sensor systems, combined with IT solutions are recognized as one of the major tools to handle this situation. Embedded Sensor Systems for Health (ESS-H) is a research profile at Mälardalen University in Sweden, focusing on embedded sensor systems for health technology applications. The research addresses several important issues: to provide sensor systems for health monitoring at home, to provide sensor systems for health monitoring at work, to provide safe and secure infrastructure and software testing methods for physiological data management. The user perspective is important in order to solve real problems and to develop systems that are easy and intuitive to use. One of the overall aims is to enable health trend monitoring in home environments, thus being able to detect early deterioration of a patient. Sensor systems, signal processing algorithms, and decision support algorithms have been developed. Work on development of safe and secure infrastructure and software testing methods are important for an embedded sensor system aimed for health monitoring, both in home and in work applications. Patient data must be sent and received in a safe and secure manner, also fulfilling the integrity criteria.

  6. Effect of changing of the parameters of the cable network of monitoring systems of high-rise buildings on the basis of string converters on their operability

    Science.gov (United States)

    Gusev, Nikolay; Svatovskaya, Larisa; Kucherenko, Alexandr

    2018-03-01

    The article is devoted to the problem of improving the reliability of monitoring systems for the technical conditions of high-rise buildings. The improvement is based on string sensors with an impulsed excitation method ensuring the maximum signal-to-noise ratio at their output. The influence of the parameters of the monitoring system on the shape of the excitation impulses of the string, and, consequently, on the amplitude of the string vibration of the string converter is also considered in the article. It has been experimentally proved that the parameters of the excitation impulses of the string converters. The article presents the results of the experiments showing the effect of the fronts duration of the excitation impulses on the amplitude of the oscillations of the strings. The influence of the fronts duration of the excitation impulse with the frontal lengths up to 0.5 ms is studied at the excitation impulse duration not exceeding 0.5 times the duration of natural oscillation periods of the string. The experimental data are compared with the theoretical ones and hypotheses explaining their difference are advanced. The article suggests some methods of reducing the influence of the cable-switching equipment system parameters on the amplitude of string oscillations. The possibilities of improving the reliability of the systems developed on the basis of string sensors with an impulsed excitation method and used for monitoring the technical conditions of the high-rise buildings are proposed.

  7. Building health research systems to achieve better health

    Directory of Open Access Journals (Sweden)

    González Block Miguel

    2006-11-01

    Full Text Available Abstract Health research systems can link knowledge generation with practical concerns to improve health and health equity. Interest in health research, and in how health research systems should best be organised, is moving up the agenda of bodies such as the World Health Organisation. Pioneering health research systems, for example those in Canada and the UK, show that progress is possible. However, radical steps are required to achieve this. Such steps should be based on evidence not anecdotes. Health Research Policy and Systems (HARPS provides a vehicle for the publication of research, and informed opinion, on a range of topics related to the organisation of health research systems and the enormous benefits that can be achieved. Following the Mexico ministerial summit on health research, WHO has been identifying ways in which it could itself improve the use of research evidence. The results from this activity are soon to be published as a series of articles in HARPS. This editorial provides an account of some of these recent key developments in health research systems but places them in the context of a distinguished tradition of debate about the role of science in society. It also identifies some of the main issues on which 'research on health research' has already been conducted and published, in some cases in HARPS. Finding and retaining adequate financial and human resources to conduct health research is a major problem, especially in low and middle income countries where the need is often greatest. Research ethics and agenda-setting that responds to the demands of the public are issues of growing concern. Innovative and collaborative ways are being found to organise the conduct and utilisation of research so as to inform policy, and improve health and health equity. This is crucial, not least to achieve the health-related Millennium Development Goals. But much more progress is needed. The editorial ends by listing a wide range of topics

  8. Building National Health Research Information Systems (COHRED ...

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

    Building National Health Research Information Systems (COHRED). This grant will allow the Council on Health Research for Development (COHRED) to create, host and maintain a web-based resource on national health research in low- and middle-income countries in partnership with institutions in the South. Called ...

  9. The State Public Health Laboratory System.

    Science.gov (United States)

    Inhorn, Stanley L; Astles, J Rex; Gradus, Stephen; Malmberg, Veronica; Snippes, Paula M; Wilcke, Burton W; White, Vanessa A

    2010-01-01

    This article describes the development since 2000 of the State Public Health Laboratory System in the United States. These state systems collectively are related to several other recent public health laboratory (PHL) initiatives. The first is the Core Functions and Capabilities of State Public Health Laboratories, a white paper that defined the basic responsibilities of the state PHL. Another is the Centers for Disease Control and Prevention National Laboratory System (NLS) initiative, the goal of which is to promote public-private collaboration to assure quality laboratory services and public health surveillance. To enhance the realization of the NLS, the Association of Public Health Laboratories (APHL) launched in 2004 a State Public Health Laboratory System Improvement Program. In the same year, APHL developed a Comprehensive Laboratory Services Survey, a tool to measure improvement through the decade to assure that essential PHL services are provided.

  10. Mental health service delivery following health system reform in Colombia.

    Science.gov (United States)

    Romero-González, Mauricio; González, Gerardo; Rosenheck, Robert A

    2003-12-01

    In 1993, Colombia underwent an ambitious and comprehensive process of health system reform based on managed competition and structured pluralism, but did not include coverage for mental health services. In this study, we sought to evaluate the impact of the reform on access to mental health services and whether there were changes in the pattern of mental health service delivery during the period after the reform. Changes in national economic indicators and in measures of mental health and non-mental health service delivery for the years 1987 and 1997 were compared. Data were obtained from the National Administrative Department of Statistics of Colombia (DANE), the Department of National Planning and Ministry of the Treasury of Colombia, and from national official reports of mental health and non-mental health service delivery from the Ministry of Health of Colombia for the same years. While population-adjusted access to mental health outpatient services declined by -2.7% (-11.2% among women and +5.8% among men), access to general medical outpatient services increased dramatically by 46%. In-patient admissions showed smaller differences, with a 7% increase in mental health admissions, as compared to 22.5% increase in general medical admissions. The health reform in Colombia imposed competition across all health institutions with the intention of encouraging efficiency and financial autonomy. However, the challenge of institutional survival appears to have fallen heavily on mental health care institutions that were also expected to participate in managed competition, but that were at a serious disadvantage because their services were excluded from the compulsory standardized package of health benefits. While the Colombian health care reform intended to close the gap between those who had and those who did not have access to health services, it appears to have failed to address access to specialized mental health services, although it does seem to have promoted a

  11. Health Systems Sustainability and Rare Diseases.

    Science.gov (United States)

    Ferrelli, Rita Maria; De Santis, Marta; Egle Gentile, Amalia; Taruscio, Domenica

    2017-01-01

    The paper is addressing aspects of health system sustainability for rare diseases in relation to the current economic crisis and equity concerns. It takes into account the results of the narrative review carried out in the framework of the Joint Action for Rare Diseases (Joint RD-Action) "Promoting Implementation of Recommendations on Policy, Information and Data for Rare Diseases", that identified networks as key factors for health systems sustainability for rare diseases. The legal framework of European Reference Networks and their added value is also presented. Networks play a relevant role for health systems sustainability, since they are based upon, pay special attention to and can intervene on health systems knowledge development, partnership, organizational structure, resources, leadership and governance. Moreover, sustainability of health systems can not be separated from the analysis of the context and the action on it, including fiscal equity. As a result of the financial crisis of 2008, cuts of public health-care budgets jeopardized health equity, since the least wealthy suffered from the greatest health effects. Moreover, austerity policies affected economic growth much more adversely than previously believed. Therefore, reducing public health expenditure not only is going to jeopardise citizens' health, but also to hamper fair and sustainable development.

  12. E-health, health systems and social innovation

    DEFF Research Database (Denmark)

    Brem, Alexander; Sliwa, Sophie Isabel; Agarwal, Nivedita

    2017-01-01

    This paper explores telecare as one of the practical applications in the field of e-health. Using 11 expert interviews the study evaluates development of cross-national analogies between the different institutional contexts of health systems in Germany, Austria, and Denmark. Telecare is treated a...... to be driving socially innovative solutions. Implications for research and practice, as well as future research directions, are elaborated....... as a set of ideas regarding future processes in health and home care services, involving technological solutions, starting to change stakeholders' behaviour, work practices, and social roles. A system-centric framework is proposed to evaluate the interdependencies between telecare, the changing...

  13. United States of America: health system review.

    Science.gov (United States)

    Rice, Thomas; Rosenau, Pauline; Unruh, Lynn Y; Barnes, Andrew J; Saltman, Richard B; van Ginneken, Ewout

    2013-01-01

    This analysis of the United States health system reviews the developments in organization and governance, health financing, health-care provision, health reforms and health system performance. The US health system has both considerable strengths and notable weaknesses. It has a large and well-trained health workforce, a wide range of high-quality medical specialists as well as secondary and tertiary institutions, a robust health sector research program and, for selected services, among the best medical outcomes in the world. But it also suffers from incomplete coverage of its citizenry, health expenditure levels per person far exceeding all other countries, poor measures on many objective and subjective measures of quality and outcomes, an unequal distribution of resources and outcomes across the country and among different population groups, and lagging efforts to introduce health information technology. It is difficult to determine the extent to which deficiencies are health-system related, though it seems that at least some of the problems are a result of poor access to care. Because of the adoption of the Affordable Care Act in 2010, the United States is facing a period of enormous potential change. Improving coverage is a central aim, envisaged through subsidies for the uninsured to purchase private insurance, expanded eligibility for Medicaid (in some states) and greater protection for insured persons. Furthermore, primary care and public health receive increased funding, and quality and expenditures are addressed through a range of measures. Whether the ACA will indeed be effective in addressing the challenges identified above can only be determined over time. World Health Organization 2013 (acting as the host organization for, and secretariat of, the European Observatory on Health Systems and Policies).

  14. Primary health care and public health: foundations of universal health systems.

    Science.gov (United States)

    White, Franklin

    2015-01-01

    The aim of this review is to advocate for more integrated and universally accessible health systems, built on a foundation of primary health care and public health. The perspective outlined identified health systems as the frame of reference, clarified terminology and examined complementary perspectives on health. It explored the prospects for universal and integrated health systems from a global perspective, the role of healthy public policy in achieving population health and the value of the social-ecological model in guiding how best to align the components of an integrated health service. The importance of an ethical private sector in partnership with the public sector is recognized. Most health systems around the world, still heavily focused on illness, are doing relatively little to optimize health and minimize illness burdens, especially for vulnerable groups. This failure to improve the underlying conditions for health is compounded by insufficient allocation of resources to address priority needs with equity (universality, accessibility and affordability). Finally, public health and primary health care are the cornerstones of sustainable health systems, and this should be reflected in the health policies and professional education systems of all nations wishing to achieve a health system that is effective, equitable, efficient and affordable. © 2015 S. Karger AG, Basel.

  15. Robust automatic control system of vessel descent-rise device for plant with distributed parameters “cable – towed underwater vehicle”

    Science.gov (United States)

    Chupina, K. V.; Kataev, E. V.; Khannanov, A. M.; Korshunov, V. N.; Sennikov, I. A.

    2018-05-01

    The paper is devoted to a problem of synthesis of the robust control system for a distributed parameters plant. The vessel descent-rise device has a heave compensation function for stabilization of the towed underwater vehicle on a set depth. A sea state code, parameters of the underwater vehicle and cable vary during underwater operations, the vessel heave is a stochastic process. It means that the plant and external disturbances have uncertainty. That is why it is necessary to use the robust theory for synthesis of an automatic control system, but without use of traditional methods of optimization, because this cable has distributed parameters. The offered technique has allowed one to design an effective control system for stabilization of immersion depth of the towed underwater vehicle for various degrees of sea roughness and to provide its robustness to deviations of parameters of the vehicle and cable’s length.

  16. Reforming the health care system: implications for health care marketers.

    Science.gov (United States)

    Petrochuk, M A; Javalgi, R G

    1996-01-01

    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.

  17. Health record systems that meet clinical needs

    Directory of Open Access Journals (Sweden)

    Gabriella Negrini

    2012-10-01

    Full Text Available Introduction Increased attention has recently been focused on health record systems as a result of accreditation programs, a growing emphasis on patient safety, and the increase in lawsuits involving allegations of malpractice. Health-care professionals frequently express dissatisfaction with the health record systems and complain that the data included are neither informative nor useful for clinical decision making. This article reviews the main objectives of a hospital health record system, with emphasis on its roles in communication and exchange among clinicians, patient safety, and continuity of care, and asks whether current systems have responded to the recent changes in the Italian health-care system.Discussion If health records are to meet the expectations of all health professionals, the overall information need must be carefully analyzed, a common data set must be created, and essential specialist contributions must be defined. Working with health-care professionals, the hospital management should define how clinical information is to be displayed and organized, identify a functionally optimal layout, define the characteristics of ongoing patient assessment in terms of who will be responsible for these activities and how often they will be performed. Internet technology can facilitate data retrieval and meet the general requirements of a paper-based health record system, but it must also ensure focus on clinical information, business continuity, integrity, security, and privacy.Conclusions The current health records system needs to be thoroughly revised to increase its accessibility, streamline the work of health-care professionals who consult it, and render it more useful for clinical decision making—a challenging task that will require the active involvement of the many professional classes involved.

  18. Rising Company’s Performance through Leadership Role: Culture, Strategies, and Management System as a Marine State

    Science.gov (United States)

    Wardi, Jeni; Yandra, Alexsander

    2018-05-01

    This research aims to learn the direct influence of transformational and transactional leaderships on Indonesian company’s performance through company’s culture, strategy, management accounting and control system as a marine state. This research involves descriptive and inferential designs in solving the research problem. To test the model and the hypothesis, SEM analysis is used. The populations of this research are companies registered in Indonesian stock exchange in 2012. The sampling technique uses purposive sampling. The data of the research are obtained from questionnaires distributed to respondents. The respondents are companies’ managers represented by accounting and finance managers with the positions 1 and 2 levels below top management team who have direct communication with the top management. The results of the research show that transformational leadership influences company’s performance directly, but not the transactional leadership. The company’s culture is not the mediation variable in indirect influence on the company’s performance, either in transformational or transactional leadership. On the other hand, management control system proves to be the mediation in transactional leadership on the performance but not for transformational leadership. Meanwhile, management accounting system proves to be the mediation variable in the influence of transformational and transactional leaderships. Except the variables of company’s culture, strategy, management accounting system and management control system, each directly influences the performance.

  19. Welcome to health information science and systems.

    Science.gov (United States)

    Zhang, Yanchun

    2013-01-01

    Health Information Science and Systems is an exciting, new, multidisciplinary journal that aims to use technologies in computer science to assist in disease diagnoses, treatment, prediction and monitoring through the modeling, design, development, visualization, integration and management of health related information. These computer-science technologies include such as information systems, web technologies, data mining, image processing, user interaction and interface, sensors and wireless networking and are applicable to a wide range of health related information including medical data, biomedical data, bioinformatics data, public health data.

  20. Environmental health risk assessment: Energy systems

    International Nuclear Information System (INIS)

    Krewski, D.; Somers, E.; Winthrop, S.O.

    1984-01-01

    Most industrialized nations have come to rely on a variety of systems for energy production, both of a conventional and non-conventional nature. In the paper, the spectrum of energy systems currently in use in Canada is outlined along with their potential health risks. Several examples of environmental health studies involving both outdoor and indoor air pollution related to energy production in Canada are reported. The limitations of current technologies for assessing health risks are discussed and possible approaches to managing energy related health risks are indicated. (author)

  1. The capitalist world-system and international health.

    Science.gov (United States)

    Elling, R H

    1981-01-01

    A number of world health problems which have been discretely considered in the past are viewed in this paper as interwoven with each other and with the functioning of the capitalist political-economic world-system. Thus, climactic explanations ("tropical medicine"), and even poverty when conceived in cultural terms or as a structural problem resident entirely within a single nation, are seen as inadequate for understanding any or all of the problems discussed briefly here: poor general health levels in peripheral and semi-peripheral nations, especially rising infant mortality rates in countries such as Brazil; comerciogenic malnutrition; dumping and exploitative sale of drugs, pesticides and other products banned or restricted in core nations; genocidal and other threatening approaches to population control; export of hazardous and polluting industry to peripheral and semi-peripheral nations; similar export of human experimentation; the sale of irrelevant, high medical technology to countries lacking basic public health measures, the "brain drain", and medical imperialism. Also discounted are moralistic inveighing, complaints about inadequate information and its transfer, discussions of bureaucratic bumbling or inter-agency politics and professional rivalries, various forms of victim-blaming, and other explanations and corrective approaches which ignore class structure and the control, distribution, and expropriation of resources in nations and the world-system. The framework suggests the importance of a worldwide cultural hegemony, including a medical cultural hegemony, established by and in the service of the ruling classes. Socialist-oriented nations which are quasi-independent of the capitalist world-system are seen as suffering less from its effects. This suggests that we should conceive of world socialist health and world capitalist health, rather than any kind of unified phenomenon called "international health".

  2. New Reforms to the Health System

    OpenAIRE

    Tran Dai, Candice; Duchâtel, Mathieu

    2012-01-01

    Based on:– Li Ling, “Successful reform of the health system hangs on two key elements,” Zhongguo jingyingbao (China Management News), 18 April 2009.– Li Hongmei, Li Xiaohong, Wang Junping, “Ten experts comment on the new reform of the health system: Providing better and cheaper access to medical care,” Renmin ribao (People’s Daily), 15 April 2009.– Yao Qi, “The new reform of the health system must first and foremost compensate for the shortcomings in the local hospitals,” Yangcheng wanbao (Ya...

  3. Digital health and the challenge of health systems transformation.

    Science.gov (United States)

    Alami, Hassane; Gagnon, Marie-Pierre; Fortin, Jean-Paul

    2017-01-01

    Information and communication technologies have transformed all sectors of society. The health sector is no exception to this trend. In light of "digital health", we see multiplying numbers of web platforms and mobile health applications, often brought by new unconventional players who produce and offer services in non-linear and non-hierarchal ways, this by multiplying access points to services for people. Some speak of a "uberization" of healthcare. New realities and challenges have emerged from this paradigm, which question the abilities of health systems to cope with new business and economic models, governance of data and regulation. Countries must provide adequate responses so that digital health, based increasingly on disruptive technologies, can benefit for all.

  4. Health for All - Italia, an informative health system

    Directory of Open Access Journals (Sweden)

    Marzia Loghi

    2008-06-01

    Full Text Available

    Background: On ISTAT website the informative system Health for All – Italia is available. It collects indicators on health coming from various sources to make up a basis for constructing an organic and joint framework on the country’s health reality. The system includes more than 4000 indicators about: demographic and socioeconomic context; causes of death; life styles; disease prevention; chronic and infectious diseases; disability; health status and life expectancy; health facilities; hospital discharges by diagnosis; health care resources. The database-related software was developed by the World Health Organization to make it easier for any user to access the information available either as tables, graphs and territorial maps.

    Methods: The system has been built considering data coming from different sources and using, if possible, the same definitions, classifications and desegregations. Time series goes from 1980 to the last year available (which can differ among the different sources. Indicators are calculated by provinces (if possible, regions, big areas and Italy. In order to compare indicators over time and space, standardised rates are calculated, using the same population reference. For each indicator metadata are available to give users additional notes necessary to correctly read and use the data, and publications or internet websites to examine more in-depth the argument.

    Results: Different kind of users find Health for All – Italia very useful for their aims: students, researchers, doctors, socio-sanitary operators, policy makers. Some examples of official reports from public institutions are briefly described in the paper.

    Conclusions: The increasing number of users of Health for All – Italia make necessary the online version and an English version for international comparisons.

  5. Cognitive systems engineering in health care

    CERN Document Server

    Bisantz, Ann M; Fairbanks, Rollin J

    2014-01-01

    Cognitive Engineering for Better Health Care Systems, Ann M. Bisantz, Rollin J. Fairbanks, and Catherine M. BurnsThe Role of Cognitive Engineering in Improving Clinical Decision Support, Anne Miller and Laura MilitelloTeam Cognitive Work Analysis as an Approach for Understanding Teamwork in Health Care, Catherine M. BurnsCognitive Engineering Design of an Emergency Department Information System, Theresa K. Guarrera, Nicolette M. McGeorge, Lindsey N. Clark, David T. LaVergne, Zachary A. Hettinger, Rollin J. Fairbanks, and Ann M. BisantzDisplays for Health Care Teams: A Conceptual Framework and Design Methodology, Avi ParushInformation Modeling for Cognitive Work in a Health Care System, Priyadarshini R. PennathurSupport for ICU Clinician Cognitive Work through CSE, Christopher Nemeth, Shilo Anders, Jeffrey Brown, Anna Grome, Beth Crandall, and Jeremy PamplinMatching Cognitive Aids and the "Real Work" of Health Care in Support of Surgical Microsystem Teamwork, Sarah Henrickson Parker and Shawna J. PerryEngageme...

  6. Introduction – Political Governance and Strategic Relations: Domestic-Foreign Policy Nexus and China’s Rise in the Global System

    Directory of Open Access Journals (Sweden)

    Emile Kok-Kheng Yeoh

    2016-04-01

    Full Text Available Recent years have witnessed several momentous developments in the political economy of the People’s Republic of China (PRC both on the domestic front and in her foreign relations. Deriving correct interpretation of such fast-paced developments and changes has preoccupied much of the circles of China-watchers these days, with political scientists, economists, sociologists and international relations experts focusing their respective attentions on either the domestic transformation occurring within the PRC or on her foreign relations. While the volatile series of incidents involving a year of crackdowns on domestic civil societal movements, civil rights lawyers, labour activists and Hong Kong’s book publishers and distributors were unfolding dramatically, the year also witnessed the continued rise of China’s economic might culminating in the realisation of her initiative for the Asian Infrastructure Investment Bank (AIIB that started operation on 25th December 2015 and the continued progress of her “One Belt, One Road” (OBOR proposal after the creation of the State-owned Silk Road Fund on 29th December 2014. Such developments on China’s domestic and global fronts have to be properly placed in the overall context of China’s domestic-foreign policy nexus that has uniquely evolved during her recent decades of continuous, astounding economic tour de force amidst the stagnation of the modernisation and democratisation of her political structure and sociopolitical power configuration, and the rise of her influence in the global system.

  7. Introduction – Political Governance and Strategic Relations: Domestic-Foreign Policy Nexus and China’s Rise in the Global System

    Directory of Open Access Journals (Sweden)

    Emile Kok-Kheng Yeoh

    2016-04-01

    Full Text Available Recent years have witnessed several momentous developments in the political economy of the People’s Republic of China (PRC both on the domestic front and in her foreign relations. Deriving correct interpretation of such fast-paced developments and changes has preoccupied much of the circles of China-watchers these days, with political scientists, economists, sociologists and international relations experts focusing their respective attention on either the domestic transformation occurring within the PRC or on her foreign relations. While the volatile series of incidents involving a year of crackdowns on domestic civil societal movements, civil rights lawyers, labour activists and Hong Kong’s book publishers and distributors were unfolding dramatically, the year also witnessed the continued rise of China’s economic might culminating in the realisation of her initiative for the Asian Infrastructure Investment Bank (AIIB that started operation on 25th December 201 5 and the continued progress of her “One Belt, One Road” (OBOR proposal after the creation of the State-owned Silk Road Fund on 29th December 201 4. Such developments on China’s domestic and global fronts has to be properly placed in the overall context of China’s domestic-foreign policy nexus that has uniquely evolved during from her recent decades of continuous, astounding economic tour de force amidst the stagnation of the modernisation and democratisation of her political structure and sociopolitical power configuration, and the rise of her influence in the global system.

  8. Networked Biomedical System for Ubiquitous Health Monitoring

    Directory of Open Access Journals (Sweden)

    Arjan Durresi

    2008-01-01

    Full Text Available We propose a distributed system that enables global and ubiquitous health monitoring of patients. The biomedical data will be collected by wearable health diagnostic devices, which will include various types of sensors and will be transmitted towards the corresponding Health Monitoring Centers. The permanent medical data of patients will be kept in the corresponding Home Data Bases, while the measured biomedical data will be sent to the Visitor Health Monitor Center and Visitor Data Base that serves the area of present location of the patient. By combining the measured biomedical data and the permanent medical data, Health Medical Centers will be able to coordinate the needed actions and help the local medical teams to make quickly the best decisions that could be crucial for the patient health, and that can reduce the cost of health service.

  9. Budget-makers and health care systems.

    Science.gov (United States)

    White, Joseph

    2013-10-01

    Health programs are shaped by the decisions made in budget processes, so how budget-makers view health programs is an important part of making health policy. Budgeting in any country involves its own policy community, with key players including budgeting professionals and political authorities. This article reviews the typical pressures on and attitudes of these actors when they address health policy choices. The worldview of budget professionals includes attitudes that are congenial to particular policy perspectives, such as the desire to select packages of programs that maximize population health. The pressures on political authorities, however, are very different: most importantly, public demand for health care services is stronger than for virtually any other government activity. The norms and procedures of budgeting also tend to discourage adoption of some of the more enthusiastically promoted health policy reforms. Therefore talk about rationalizing systems is not matched by action; and action is better explained by the need to minimize blame. The budget-maker's perspective provides insight about key controversies in healthcare policy such as decentralization, competition, health service systems as opposed to health insurance systems, and dedicated vs. general revenue finance. It also explains the frequency of various "gaming" behaviors. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  10. Veneto Region, Italy. Health system review.

    Science.gov (United States)

    Toniolo, Franco; Mantoan, Domenico; Maresso, Anna

    2012-01-01

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

  11. Big Data: Implications for Health System Pharmacy.

    Science.gov (United States)

    Stokes, Laura B; Rogers, Joseph W; Hertig, John B; Weber, Robert J

    2016-07-01

    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.

  12. Implementing the learning health care system.

    NARCIS (Netherlands)

    Verheij, R.; Barten, D.J.; Hek, K.; Nielen, M.; Prins, M.; Zwaanswijk, M.; Bakker, D. de

    2014-01-01

    Background: As computerisation of primary care facilities is rapidly increasing, a wealth of data is created in routinely recorded electronic health records (EHRs). This data can be used to create a true learning health care system, in which routinely available data are processed and analysed in

  13. Software for Intelligent System Health Management (ISHM)

    Science.gov (United States)

    Trevino, Luis C.

    2004-01-01

    The slide presentation is a briefing in four areas: overview of health management paradigms; overview of the ARC-Houston Software Engineering Technology Workshop held on April 20-22, 2004; identified technologies relevant to technical themes of intelligent system health management; and the author's thoughts on these topics.

  14. Quality systems in Dutch health care institutions.

    NARCIS (Netherlands)

    Casparie, A.F.; Sluijs, E.M.; Wagner, C.; Bakker, D.H. de

    1997-01-01

    The implementation of quality systems in Dutch health care was supervised by a national committee during 1990-1995. To monitor the progress of implementation a large survey was conducted in the beginning of 1995. The survey enclosed all subsectors in health care. A postal questionnaire-derived

  15. Revisiting Health System Performance Assessment in Africa

    NARCIS (Netherlands)

    Achoki, Tom

    2016-01-01

    Health systems in Africa have long faced a huge burden of disease, amidst pressing resource constraints. However, despite the constraints, the last three decades have seen the region make progress in tackling some of the most critical health challenges. Notably, many countries have registered

  16. Health-system strengthening and tuberculosis control.

    Science.gov (United States)

    Atun, Rifat; Weil, Diana E C; Eang, Mao Tan; Mwakyusa, David

    2010-06-19

    Weak health systems are hindering global efforts for tuberculosis care and control, but little evidence is available on effective interventions to address system bottlenecks. This report examines published evidence, programme reviews, and case studies to identify innovations in system design and tuberculosis control to resolve these bottlenecks. We outline system bottlenecks in relation to governance, financing, supply chain management, human resources, health-information systems, and service delivery; and adverse effects from rapid introduction of suboptimum system designs. This report also documents innovative solutions for disease control and system design. Solutions pursued in individual countries are specific to the nature of the tuberculosis epidemic, the underlying national health system, and the contributors engaged: no one size fits all. Findings from countries, including Bangladesh, Cambodia, India, Tanzania, Thailand, and Vietnam, suggest that advances in disease control and system strengthening are complementary. Tuberculosis care and control are essential elements of health systems, and simultaneous efforts to innovate systems and disease response are mutually reinforcing. Highly varied and context-specific responses to tuberculosis show that solutions need to be documented and compared to develop evidence-based policies and practice. Copyright 2010 Elsevier Ltd. All rights reserved.

  17. Improving mental health systems in Africa

    African Journals Online (AJOL)

    problematic. To comment on mental health systems in Africa, .... be an option for assisting with both de-stigmatization and ... deinstitutionalization with a reduction in both chronic and ... such as the family, societal change, bullying in schools,.

  18. Wearable Health Monitoring Systems, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — The objective of this proposal is to demonstrate the feasibility of producing a wearable health monitoring system for the human body that is functional, comfortable,...

  19. FIXING HEALTH SYSTEMS / Executive Summary (2008 update ...

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

    2010-12-14

    Dec 14, 2010 ... FIXING HEALTH SYSTEMS / Executive Summary (2008 update) ... In several cases, specific approaches recommended by the TEHIP team have been acted upon regionally and internationally, including the ... Related articles ...

  20. Wearable Health Monitoring Systems, Phase II

    Data.gov (United States)

    National Aeronautics and Space Administration — The objective of this proposal is to demonstrate the feasibility of producing a wearable health monitoring system for the human body that is functional, comfortable,...

  1. The military health system's personal health record pilot with Microsoft HealthVault and Google Health.

    Science.gov (United States)

    Do, Nhan V; Barnhill, Rick; Heermann-Do, Kimberly A; Salzman, Keith L; Gimbel, Ronald W

    2011-01-01

    To design, build, implement, and evaluate a personal health record (PHR), tethered to the Military Health System, that leverages Microsoft® HealthVault and Google® Health infrastructure based on user preference. A pilot project was conducted in 2008-2009 at Madigan Army Medical Center in Tacoma, Washington. Our PHR was architected to a flexible platform that incorporated standards-based models of Continuity of Document and Continuity of Care Record to map Department of Defense-sourced health data, via a secure Veterans Administration data broker, to Microsoft® HealthVault and Google® Health based on user preference. The project design and implementation were guided by provider and patient advisory panels with formal user evaluation. The pilot project included 250 beneficiary users. Approximately 73.2% of users were Microsoft® HealthVault, and 81 (32.4%) selected Google® Health as their PHR of preference. Sample evaluation of users reflected 100% (n = 60) satisfied with convenience of record access and 91.7% (n = 55) satisfied with overall functionality of PHR. Key lessons learned related to data-transfer decisions (push vs pull), purposeful delays in reporting sensitive information, understanding and mapping PHR use and clinical workflow, and decisions on information patients may choose to share with their provider. Currently PHRs are being viewed as empowering tools for patient activation. Design and implementation issues (eg, technical, organizational, information security) are substantial and must be thoughtfully approached. Adopting standards into design can enhance the national goal of portability and interoperability.

  2. The chinese health care system

    DEFF Research Database (Denmark)

    Hougaard, Jens Leth; Østerdal, Lars Peter Raahave; Yu, Yi

    2011-01-01

    We describe the structure and present situation of the Chinese healthcare system and discuss its primary problems and challenges. We discuss problems with inefficient burden sharing, adverse provider incentives and huge inequities, and seek explanations in the structural features of the Chinese...

  3. Rise, stagnation, and rise of Danish women's life expectancy

    DEFF Research Database (Denmark)

    Lindahl-Jacobsen, Rune; Rau, Roland; Jeune, Bernard

    2016-01-01

    Health conditions change from year to year, with a general tendency in many countries for improvement. These conditions also change from one birth cohort to another: some generations suffer more adverse events in childhood, smoke more heavily, eat poorer diets, etc., than generations born earlier...... favor forecasts that hinge on cohort differences. We use a combination of age decomposition and exchange of survival probabilities between countries to study the remarkable recent history of female life expectancy in Denmark, a saga of rising, stagnating, and now again rising lifespans. The gap between...... female life expectancy in Denmark vs. Sweden grew to 3.5 y in the period 1975-2000. When we assumed that Danish women born 1915-1945 had the same survival probabilities as Swedish women, the gap remained small and roughly constant. Hence, the lower Danish life expectancy is caused by these cohorts...

  4. Improving the use of health data for health system strengthening

    Directory of Open Access Journals (Sweden)

    Tara Nutley

    2013-02-01

    Full Text Available Background: Good quality and timely data from health information systems are the foundation of all health systems. However, too often data sit in reports, on shelves or in databases and are not sufficiently utilised in policy and program development, improvement, strategic planning and advocacy. Without specific interventions aimed at improving the use of data produced by information systems, health systems will never fully be able to meet the needs of the populations they serve. Objective: To employ a logic model to describe a pathway of how specific activities and interventions can strengthen the use of health data in decision making to ultimately strengthen the health system. Design: A logic model was developed to provide a practical strategy for developing, monitoring and evaluating interventions to strengthen the use of data in decision making. The model draws on the collective strengths and similarities of previous work and adds to those previous works by making specific recommendations about interventions and activities that are most proximate to affect the use of data in decision making. The model provides an organizing framework for how interventions and activities work to strengthen the systematic demand, synthesis, review, and use of data. Results: The logic model and guidance are presented to facilitate its widespread use and to enable improved data-informed decision making in program review and planning, advocacy, policy development. Real world examples from the literature support the feasible application of the activities outlined in the model. Conclusions: The logic model provides specific and comprehensive guidance to improve data demand and use. It can be used to design, monitor and evaluate interventions, and to improve demand for, and use of, data in decision making. As more interventions are implemented to improve use of health data, those efforts need to be evaluated.

  5. Assessment of Coastal Vulnerability to Sea Level Rise of Bolinao, Pangasinan Using Remote Sensing and Geographic Information Systems

    Science.gov (United States)

    Reyes, S. R. C.; Blanco, A. C.

    2012-07-01

    A number of studies assessing the vulnerability of Southeast Asia to climate change have classified the Philippines as one of the vulnerable countries in the region. Bolinao, Pangasinan is a municipality located in northwestern Luzon, situated in the western part of the Lingayen Gulf and is bounded on the north and west by the South China Sea (West Philippine Sea). Recent studies have verified the varying trends in sea level across the South China Sea, which is considered as one of the largest, semi-enclosed marginal seas in the northwest Pacific Ocean. Three barangays (villages) were included in the study: (1) Luciente 1.0, (2) Concordia and (3) Germinal. The Socioeconomic Vulnerability Index (SVI) was computed based on population, age, gender, employment, source of income and household size, which were gathered through a qualitative survey in the selected barangays. The Coastal Vulnerability Index (CVI) described the physical vulnerability of these coastal communities based on recorded sea level anomalies and significant wave heights of multiple satellite altimetry missions, coastal topography derived from the 25-m SRTM digital elevation model (DEM), bathymetry from WorldView-2 and additional elevation data from terrestrial laser scanning surveys. The research utilized merged satellite altimetry data downloaded from the Radar Altimetry Database System (RADS), which covered the period from 1991-2010. The SVI and CVI were calculated and evaluated in ArcGIS. The SVI and CVI were integrated to determine the Total Vulnerability Index (TVI), which characterized the vulnerability of the three barangays in five classes, from very low to very high vulnerability.

  6. ASSESSMENT OF COASTAL VULNERABILITY TO SEA LEVEL RISE OF BOLINAO, PANGASINAN USING REMOTE SENSING AND GEOGRAPHIC INFORMATION SYSTEMS

    Directory of Open Access Journals (Sweden)

    S. R. C. Reyes

    2012-07-01

    Full Text Available A number of studies assessing the vulnerability of Southeast Asia to climate change have classified the Philippines as one of the vulnerable countries in the region. Bolinao, Pangasinan is a municipality located in northwestern Luzon, situated in the western part of the Lingayen Gulf and is bounded on the north and west by the South China Sea (West Philippine Sea. Recent studies have verified the varying trends in sea level across the South China Sea, which is considered as one of the largest, semi-enclosed marginal seas in the northwest Pacific Ocean. Three barangays (villages were included in the study: (1 Luciente 1.0, (2 Concordia and (3 Germinal. The Socioeconomic Vulnerability Index (SVI was computed based on population, age, gender, employment, source of income and household size, which were gathered through a qualitative survey in the selected barangays. The Coastal Vulnerability Index (CVI described the physical vulnerability of these coastal communities based on recorded sea level anomalies and significant wave heights of multiple satellite altimetry missions, coastal topography derived from the 25-m SRTM digital elevation model (DEM, bathymetry from WorldView-2 and additional elevation data from terrestrial laser scanning surveys. The research utilized merged satellite altimetry data downloaded from the Radar Altimetry Database System (RADS, which covered the period from 1991–2010. The SVI and CVI were calculated and evaluated in ArcGIS. The SVI and CVI were integrated to determine the Total Vulnerability Index (TVI, which characterized the vulnerability of the three barangays in five classes, from very low to very high vulnerability.

  7. Reusable Rocket Engine Turbopump Health Management System

    Science.gov (United States)

    Surko, Pamela

    1994-01-01

    A health monitoring expert system software architecture has been developed to support condition-based health monitoring of rocket engines. Its first application is in the diagnosis decisions relating to the health of the high pressure oxidizer turbopump (HPOTP) of Space Shuttle Main Engine (SSME). The post test diagnostic system runs off-line, using as input the data recorded from hundreds of sensors, each running typically at rates of 25, 50, or .1 Hz. The system is invoked after a test has been completed, and produces an analysis and an organized graphical presentation of the data with important effects highlighted. The overall expert system architecture has been developed and documented so that expert modules analyzing other line replaceable units may easily be added. The architecture emphasizes modularity, reusability, and open system interfaces so that it may be used to analyze other engines as well.

  8. Environmental health surveillance system; Kankyo hoken surveillance system

    Energy Technology Data Exchange (ETDEWEB)

    Ono, M. [National Inst. for Environmental Studies, Tsukuba (Japan)

    1998-02-01

    The Central Environmental Pollution Prevention Council pointed out the necessity to establish an environmental health surveillance system (hereinafter referred to as System) in its report `on the first type district specified by the Environmental Pollution Caused Health Damages Compensation Act,` issued in 1986. A study team, established in Environment Agency, has been discussing to establish System since 1986. This paper outlines System, and some of the pilot surveillance results. It is not aimed at elucidation of the cause-effect relationships between health and air pollution but at discovery of problems, in which the above relationships in a district population are monitored periodically and continuously from long-term and prospective viewpoints, in order to help take necessary measures in the early stage. System is now collecting the data of the chronic obstructive lung diseases on a nation-wide scale through health examinations of 3-year-old and preschool children and daily air pollution monitoring. 6 refs., 3 figs., 1 tab.

  9. Requirements and Solutions for Personalized Health Systems.

    Science.gov (United States)

    Blobel, Bernd; Ruotsalainen, Pekka; Lopez, Diego M; Oemig, Frank

    2017-01-01

    Organizational, methodological and technological paradigm changes enable a precise, personalized, predictive, preventive and participative approach to health and social services supported by multiple actors from different domains at diverse level of knowledge and skills. Interoperability has to advance beyond Information and Communication Technologies (ICT) concerns, including the real world business domains and their processes, but also the individual context of all actors involved. The paper introduces and compares personalized health definitions, summarizes requirements and principles for pHealth systems, and considers intelligent interoperability. It addresses knowledge representation and harmonization, decision intelligence, and usability as crucial issues in pHealth. On this basis, a system-theoretical, ontology-based, policy-driven reference architecture model for open and intelligent pHealth ecosystems and its transformation into an appropriate ICT design and implementation is proposed.

  10. Digital health and the challenge of health systems transformation

    Science.gov (United States)

    Gagnon, Marie-Pierre; Fortin, Jean-Paul

    2017-01-01

    Information and communication technologies have transformed all sectors of society. The health sector is no exception to this trend. In light of “digital health”, we see multiplying numbers of web platforms and mobile health applications, often brought by new unconventional players who produce and offer services in non-linear and non-hierarchal ways, this by multiplying access points to services for people. Some speak of a “uberization” of healthcare. New realities and challenges have emerged from this paradigm, which question the abilities of health systems to cope with new business and economic models, governance of data and regulation. Countries must provide adequate responses so that digital health, based increasingly on disruptive technologies, can benefit for all. PMID:28894741

  11. Data liquidity in health information systems.

    Science.gov (United States)

    Courtney, Paul K

    2011-01-01

    In 2001, the Institute of Medicine report Crossing the Quality Chasm and the National Committee on Vital and Health Statistics report Information for Health were released, and they provided the context for the development of information systems used to support health-supporting processes. Both had as their goals, implicit or explicit, to ensure the right data are provided to the right person at the right time, which is one definition of "data liquidity." This concept has had some traction in recent years as a shorthand way to express a system property for health information technology, but there is not a well-defined characterization of what properties of a system or of its components give it better or worse data liquidity. This article looks at some recent work that help to identify those properties and perhaps can help to ground the concept with metrics that are assessable.

  12. Health Care Performance Indicators for Health Information Systems.

    Science.gov (United States)

    Hyppönen, Hannele; Ronchi, Elettra; Adler-Milstein, Julia

    2016-01-01

    Health Information Systems (HISs) are expected to have a positive impact on quality and efficiency of health care. Rapid investment in and diffusion of HISs has increased the importance of monitoring the adoption and impacts of them in order to learn from the initiatives, and to provide decision makers evidence on the role of HISs in improving health care. However, reliable and comparable data across initiatives in various countries are rarely available. A four-phase approach is used to compare different HIS indicator methodologies in order to move ahead in defining HIS indicators for monitoring effects of HIS on health care performance. Assessed approaches are strong on different aspects, which provide some opportunities for learning across them but also some challenges. As yet, all of the approaches do not define goals for monitoring formally. Most focus on health care structural and process indicators (HIS availability and intensity of use). However, many approaches are generic in description of HIS functionalities and context as well as their impact mechanisms on health care for HIS benchmarking. The conclusion is that, though structural and process indicators of HIS interventions are prerequisites for monitoring HIS impacts on health care outputs and outcomes, more explicit definition is needed of HIS contexts, goals, functionalities and their impact mechanisms in order to move towards common process and outcome indicators. A bottom-up-approach (participation of users) could improve development and use of context-sensitive HIS indicators.

  13. Health systems around the world - a comparison of existing health system rankings.

    Science.gov (United States)

    Schütte, Stefanie; Acevedo, Paula N Marin; Flahault, Antoine

    2018-06-01

    Existing health systems all over the world are different due to the different combinations of components that can be considered for their establishment. The ranking of health systems has been a focal points for many years especially the issue of performance. In 2000 the World Health Organization (WHO) performed a ranking to compare the Performance of the health system of the member countries. Since then other health system rankings have been performed and it became an issue of public discussion. A point of contention regarding these rankings is the methodology employed by each of them, since no gold standard exists. Therefore, this review focuses on evaluating the methodologies of each existing health system performance ranking to assess their reproducibility and transparency. A search was conducted to identify existing health system rankings, and a questionnaire was developed for the comparison of the methodologies based on the following indicators: (1) General information, (2) Statistical methods, (3) Data (4) Indicators. Overall nine rankings were identified whereas six of them focused rather on the measurement of population health without any financial component and were therefore excluded. Finally, three health system rankings were selected for this review: "Health Systems: Improving Performance" by the WHO, "Mirror, Mirror on the wall: How the Performance of the US Health Care System Compares Internationally" by the Commonwealth Fund and "the Most efficient Health Care" by Bloomberg. After the completion of the comparison of the rankings by giving them scores according to the indicators, the ranking performed the WHO was considered the most complete regarding the ability of reproducibility and transparency of the methodology. This review and comparison could help in establishing consensus in the field of health system research. This may also help giving recommendations for future health rankings and evaluating the current gap in the literature.

  14. Public health systems under attack in Canada: Evidence on public health system performance challenges arbitrary reform.

    Science.gov (United States)

    Guyon, Ak'ingabe; Perreault, Robert

    2016-10-20

    Public health is currently being weakened in several Canadian jurisdictions. Unprecedented and arbitrary cuts to the public health budget in Quebec in 2015 were a striking example of this. In order to support public health leaders and citizens in their capacity to advocate for evidence-informed public health reforms, we propose a knowledge synthesis of elements of public health systems that are significantly associated with improved performance. Research consistently and significantly associates four elements of public health systems with improved productivity: 1) increased financial resources, 2) increased staffing per capita, 3) population size between 50,000 and 500,000, and 4) specific evidence-based organizational and administrative features. Furthermore, increased financial resources and increased staffing per capita are significantly associated with improved population health outcomes. We contend that any effort at optimization of public health systems should at least be guided by these four evidence-informed factors. Canada already has existing capacity in carrying out public health systems and services research. Further advancement of our academic and professional expertise on public health systems will allow Canadian public health jurisdictions to be inspired by the best public health models and become stronger advocates for public health's resources, interventions and outcomes when they need to be celebrated or defended.

  15. Strengthening health systems through linking research evidence to ...

    African Journals Online (AJOL)

    informed policies. Accordingly, a critical way of addressing these challenges facing health systems in the region is through the linking of health research findings to policy. Keywords: Evidence; Sub-Saharan Africa; Health Policy; Health Systems ...

  16. Institutional analysis of health system governance.

    Science.gov (United States)

    Abimbola, Seye; Negin, Joel; Martiniuk, Alexandra L; Jan, Stephen

    2017-11-01

    It is important that researchers who study health system governance have a set of collective understandings of the meanings of governance, which can then inform the methods used in research. We present an institutional framing and definition of health system governance; that is, governance refers to making, changing, monitoring and enforcing the rules that govern the demand and supply of health services. This pervasive, relational view of governance is to be preferred to approaches that focus primarily on structures of governments and health care organizations, because health system governance involves communities and service users, and because governments in many low- and middle-income countries tend to under-govern. Therefore, the study of health system governance requires institutional analysis; an approach that focuses not only on structures, but also on the rules (both formal and informal) governing demand and supply relations. Using this 'structure-relations' lens, and based on our field experience, we discuss how this focus could be applied to the three approaches to framing and studying health system governance that we identified in the literature. In order of decreasing focus on structures ('hardware') and increasing focus on relations ('software'), they are: (1) the government-centred approach, which focuses on the role of governments, above or to the exclusion of non-government health system actors; (2) the building-block approach, which focuses on the internal workings of health care organizations, and treats governance as one of the several building blocks of organizations; and (3) the institutional approach, which focuses on how the rules governing social and economic interactions are made, changed, monitored and enforced. Notably, either or both qualitative and quantitative methods may be used by researchers in efforts to incorporate the analysis of how rules determine relations among health system actors into these three approaches to health system

  17. Medical tourism and its impact on the US health care system.

    Science.gov (United States)

    Forgione, Dana A; Smith, Pamela C

    2007-01-01

    The health care industry within the United States continues to face unprecedented increases in costs, along with the task of providing care to an estimated 46 million uninsured or underinsured patients. These patients, along with both insurers and employers, are seeking to reduce the costs of treatment through international outsourcing of medical and surgical care. Knows as medical tourism, this trend is on the rise, and the US health care system has not fully internalized the effects this will have on its economic structure and policies. The demand for low-cost health care services is driving patients to seek treatment on a globally competitive basis, while balancing important quality of care issues. In this article, we outline some of the issues facing legislators, health care policy makers, providers, and health service researchers regarding the impact of medical tourism on the US health care system.

  18. X-33/RLV System Health Management/Vehicle Health Management

    Science.gov (United States)

    Mouyos, William; Wangu, Srimal

    1998-01-01

    To reduce operations costs, Reusable Launch Vehicles (RLVS) must include highly reliable robust subsystems which are designed for simple repair access with a simplified servicing infrastructure, and which incorporate expedited decision-making about faults and anomalies. A key component for the Single Stage To Orbit (SSTO) RLV system used to meet these objectives is System Health Management (SHM). SHM incorporates Vehicle Health Management (VHM), ground processing associated with the vehicle fleet (GVHM), and Ground Infrastructure Health Management (GIHM). The primary objective of SHM is to provide an automated and paperless health decision, maintenance, and logistics system. Sanders, a Lockheed Martin Company, is leading the design, development, and integration of the SHM system for RLV and for X-33 (a sub-scale, sub-orbit Advanced Technology Demonstrator). Many critical technologies are necessary to make SHM (and more specifically VHM) practical, reliable, and cost effective. This paper will present the X-33 SHM design which forms the baseline for the RLV SHM, and it will discuss applications of advanced technologies to future RLVs. In addition, this paper will describe a Virtual Design Environment (VDE) which is being developed for RLV. This VDE will allow for system design engineering, as well as program management teams, to accurately and efficiently evaluate system designs, analyze the behavior of current systems, and predict the feasibility of making smooth and cost-efficient transitions from older technologies to newer ones. The RLV SHM design methodology will reduce program costs, decrease total program life-cycle time, and ultimately increase mission success.

  19. Systems Thinking for Transformational Change in Health

    Science.gov (United States)

    Willis, Cameron D.; Best, Allan; Riley, Barbara; Herbert, Carol P.; Millar, John; Howland, David

    2014-01-01

    Incremental approaches to introducing change in Canada's health systems have not sufficiently improved the quality of services and outcomes. Further progress requires 'large system transformation', considered to be the systematic effort to generate coordinated change across organisations sharing a common vision and goal. This essay draws on…

  20. The Child Health Care System in Italy.

    Science.gov (United States)

    Corsello, Giovanni; Ferrara, Pietro; Chiamenti, Gianpietro; Nigri, Luigi; Campanozzi, Angelo; Pettoello-Mantovani, Massimo

    2016-10-01

    Pediatric care in Italy has been based during the last 40 years on the increased awareness of the importance of meeting the psychosocial and developmental needs of children and of the role of families in promoting the health and well-being of their children. The pediatric health care system in Italy is part of the national health system. It is made up of 3 main levels of intervention: first access/primary care, secondary care/hospital care, and tertiary care based on specialty hospital care. This overview will also include a brief report on neonatal care, pediatric preventive health care, health service accreditation programs, and postgraduate training in pediatrics. The quality of the Italian child health care system is now considered to be in serious danger because of the restriction of investments in public health caused both by the 2008 global and national economic crisis and by a reduction of the pediatric workforce as a result of progressively insufficient replacement of specialists in pediatrics. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Managing interoperability and complexity in health systems.

    Science.gov (United States)

    Bouamrane, M-M; Tao, C; Sarkar, I N

    2015-01-01

    In recent years, we have witnessed substantial progress in the use of clinical informatics systems to support clinicians during episodes of care, manage specialised domain knowledge, perform complex clinical data analysis and improve the management of health organisations' resources. However, the vision of fully integrated health information eco-systems, which provide relevant information and useful knowledge at the point-of-care, remains elusive. This journal Focus Theme reviews some of the enduring challenges of interoperability and complexity in clinical informatics systems. Furthermore, a range of approaches are proposed in order to address, harness and resolve some of the many remaining issues towards a greater integration of health information systems and extraction of useful or new knowledge from heterogeneous electronic data repositories.

  2. Child Poverty and the Health Care System.

    Science.gov (United States)

    Racine, Andrew D

    2016-04-01

    The persistence of child poverty in the United States and the pervasive health consequences it engenders present unique challenges to the health care system. Human capital theory and empirical observation suggest that the increased disease burden experienced by poor children originates from social conditions that provide suboptimal educational, nutritional, environmental, and parental inputs to good health. Faced with the resultant excess rates of pediatric morbidity, the US health care system has developed a variety of compensatory strategies. In the first instance, Medicaid, the federal-state governmental finance system designed to assure health insurance coverage for poor children, has increased its eligibility thresholds and expanded its benefits to allow greater access to health services for this vulnerable population. A second arm of response involves a gradual reengineering of health care delivery at the practice level, including the dissemination of patient-centered medical homes, the use of team-based approaches to care, and the expansion of care management beyond the practice to reach deep into the community. Third is a series of recent experiments involving the federal government and state Medicaid programs that includes payment reforms of various kinds, enhanced reporting, concentration on high-risk populations, and intensive case management. Fourth, pediatric practices have begun to make use of specific tools that permit the identification and referral of children facing social stresses arising from poverty. Finally, constituencies within the health care system participate in enhanced advocacy efforts to raise awareness of poverty as a distinct threat to child health and to press for public policy responses such as minimum wage increases, expansion of tax credits, paid family leave, universal preschool education, and other priorities focused on child poverty. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights

  3. THE E-HEALTH SYSTEMS IN POLAND

    Directory of Open Access Journals (Sweden)

    Zdzisław PÓLKOWSKI

    2013-11-01

    Full Text Available Information Technologies are disruptive technologies that have caused major changes in health system in Poland. Current digital economy is driven by modern information and new IT tools, which offer hospitals, doctors and patient access to any type of information, regardless of its form of existence, storage type or geographical location. These tools encourage the development of new activities, health services. The purpose of this article is to analyze the the current state of development of e-services in Poland in the context of nowadays health system. In the first part of the paper, the authors present various programmes, which enable the access to the medical services and patients’ data online. The next part of the paper is devoted to examining the technical aspects of the said programmes and presenting their advantages as well as the areas which might be improved.The last part of the work will be focused on the websites of the selected health institutions. According to the authors, WWW services provide much information on how the process of computer systems are being implemented, what data the services include and the capacity of the equipment as well as the software, human resources and the knowledge in this sphere. Moreover this section highlights the latest trends in e-health with particular emphasis on aspects such as the use of private and public cloud computer and t heir integration with web sites of health institutions. This study brings its contribution to the understanding of the change of health system in Poland behavior by using a new perspective e-health systems and IT tools above by doctors, officers and patients.

  4. Strengthening Rehabilitation in Health Systems Worldwide by Integrating Information on Functioning in National Health Information Systems.

    Science.gov (United States)

    Stucki, Gerold; Bickenbach, Jerome; Melvin, John

    2017-09-01

    A complete understanding of the experience of health requires information relevant not merely to the health indicators of mortality and morbidity but also to functioning-that is, information about what it means to live in a health state, "the lived experience of health." Not only is functioning information relevant to healthcare and the overall objectives of person-centered healthcare but to the successful operation of all components of health systems.In light of population aging and major epidemiological trends, the health strategy of rehabilitation, whose aim has always been to optimize functioning and minimize disability, will become a key health strategy. The increasing prominence of the rehabilitative strategy within the health system drives the argument for the integration of functioning information as an essential component in national health information systems.Rehabilitation professionals and researchers have long recognized in WHO's International Classification of Functioning, Disability and Health the best prospect for an internationally recognized, sufficiently complete and powerful information reference for the documentation of functioning information. This paper opens the discussion of the promise of integrating the ICF as an essential component in national health systems to secure access to functioning information for rehabilitation, across health systems and countries.

  5. Social determinants of health inequalities: towards a theoretical perspective using systems science.

    Science.gov (United States)

    Jayasinghe, Saroj

    2015-08-25

    A systems approach offers a novel conceptualization to natural and social systems. In recent years, this has led to perceiving population health outcomes as an emergent property of a dynamic and open, complex adaptive system. The current paper explores these themes further and applies the principles of systems approach and complexity science (i.e. systems science) to conceptualize social determinants of health inequalities. The conceptualization can be done in two steps: viewing health inequalities from a systems approach and extending it to include complexity science. Systems approach views health inequalities as patterns within the larger rubric of other facets of the human condition, such as educational outcomes and economic development. This anlysis requires more sophisticated models such as systems dynamic models. An extension of the approach is to view systems as complex adaptive systems, i.e. systems that are 'open' and adapt to the environment. They consist of dynamic adapting subsystems that exhibit non-linear interactions, while being 'open' to a similarly dynamic environment of interconnected systems. They exhibit emergent properties that cannot be estimated with precision by using the known interactions among its components (such as economic development, political freedom, health system, culture etc.). Different combinations of the same bundle of factors or determinants give rise to similar patterns or outcomes (i.e. property of convergence), and minor variations in the initial condition could give rise to widely divergent outcomes. Novel approaches using computer simulation models (e.g. agent-based models) would shed light on possible mechanisms as to how factors or determinants interact and lead to emergent patterns of health inequalities of populations.

  6. The health production function of oral health services systems

    DEFF Research Database (Denmark)

    Vlad, R.S.; Petersen, P.E.

    2000-01-01

    Attitudes, dental status, socioeconomic factors, oral health care, production of oral health, health status, quality of life......Attitudes, dental status, socioeconomic factors, oral health care, production of oral health, health status, quality of life...

  7. Techno-economic analysis of a wind-solar hybrid renewable energy system with rainwater collection feature for urban high-rise application

    International Nuclear Information System (INIS)

    Chong, W.T.; Naghavi, M.S.; Poh, S.C.; Mahlia, T.M.I.; Pan, K.C.

    2011-01-01

    Graphical abstract: This wind-solar hybrid renewable energy system is a new concept of the utilization, integration and optimization of existing renewable energy and rain water harvesting technologies. It is compact and can be built on the top of high rise buildings to provide on-site green power to that building or feed into the grid line. This system utilizes the advantages of Malaysian climate, i.e. high solar radiation and rainfall for green energy generation and free water supply. It also overcomes the inferior aspect on the low wind speed by guiding and increasing the speed of the high altitude free-stream wind from all directions radially through power-augmentation-guide-vane (PAGV) before entering the wind turbine at center portion. The PAGV is an innovative design used to guide and create venturi effect to increase the wind speed before the wind-stream enters wind turbine. The system must also be designed to provide optimum surface area for solar panel (solar thermal or photovoltaic or solar PV/T)) installation and battery compartment for power storage. In addition; rain water collection feature must be built-into the system design. The system is recommended to be sited on the top of high rise buildings or structures with its appearance or outer design can be blended into the building architecture without negative visual impact. With this system, the size of wind turbine can be reduced for a given power output and the noise is also reduced since it is contained in the PAGV. The design is also safer and suitable to be used in populated area. Mesh can be mounted at the entrance of the PAGV to prevent the bird-strike. This system can eliminate or minimize the current problems concerning public acceptance of wind energy, i.e. poor starting behavior in low wind speed, noise, visual impact, electromagnetic interference, safety and environmental factors. Highlights: → This wind, solar and rain harvester integrates existing renewable energy and rain water

  8. On certain development aspects of an ipsas-based system-target approach to evaluation of net asset sustainability level projects in high-rise construction

    Directory of Open Access Journals (Sweden)

    Kazaryan Ruben

    2018-01-01

    Full Text Available Problems of accounting and reporting of net assets and the procedure of their formation taking into account the specifics of the economic and legal status of property of a non-commercial autonomous institution are some of the most controversial in the accounting for entities of the public sector. The study focuses on justification of accounting rules for net assets of public sector entities. The methods used in the study are as follows: comparison, synthesis, analysis, logical approach, and system approach. The article examines legal aspects and specifics of recognition of assets of public sector entities in accordance with IPSAS standards (International Public Sector Accounting Standards are a set of accounting standards issued by IPSASB (Council for International Financial Reporting Standards for Public Sector Organizations used by state-owned enterprises worldwide in preparation of financial statements as of the 31st of August, 2015. The most crucial factor in the modeling of key performance indicators of the system-target approach to estimation of the sustainability level of net assets on the basis of IPSAS is a multicriterial evaluation of the basic management strategy for quality system elements used in operational and strategic planning projects operations in high-rise construction. We offer an alternative evaluation of assets due to be returned to the right holder (the state controller in the event of liquidation of a public sector entity.

  9. On certain development aspects of an ipsas-based system-target approach to evaluation of net asset sustainability level projects in high-rise construction

    Science.gov (United States)

    Kazaryan, Ruben

    2018-03-01

    Problems of accounting and reporting of net assets and the procedure of their formation taking into account the specifics of the economic and legal status of property of a non-commercial autonomous institution are some of the most controversial in the accounting for entities of the public sector. The study focuses on justification of accounting rules for net assets of public sector entities. The methods used in the study are as follows: comparison, synthesis, analysis, logical approach, and system approach. The article examines legal aspects and specifics of recognition of assets of public sector entities in accordance with IPSAS standards (International Public Sector Accounting Standards are a set of accounting standards issued by IPSASB (Council for International Financial Reporting Standards for Public Sector Organizations) used by state-owned enterprises worldwide in preparation of financial statements as of the 31st of August, 2015. The most crucial factor in the modeling of key performance indicators of the system-target approach to estimation of the sustainability level of net assets on the basis of IPSAS is a multicriterial evaluation of the basic management strategy for quality system elements used in operational and strategic planning projects operations in high-rise construction. We offer an alternative evaluation of assets due to be returned to the right holder (the state controller) in the event of liquidation of a public sector entity.

  10. Transformation of health system in Ecuador

    Directory of Open Access Journals (Sweden)

    Wilson Giovanni Jiménez Barbosa

    2017-05-01

    Full Text Available Objective: To describe the transformations of the structure of the health system in Ecuador, taking into account the constitutional and policy context of that country, and to reflect on the historical context in which it occurred and its implications for the welfare of the people from Ecuador. Materials and methods: A bibliographic review was made, beginning with the regulations of Ecuador since the Constitution of 1979, where health is considered as a right, passing by the Organic Law of Health, the Social Security Act, among others, including the last reform of the Constitution in 2008. Results: The transformation of the Health System of Ecuador is the result of the action of economic and political forces, both internal and external, that have affected this country throughout the studied period.

  11. Advancing Health Literacy Measurement: A Pathway to Better Health and Health System Performance

    Science.gov (United States)

    Pleasant, Andrew

    2014-01-01

    The concept of health literacy initially emerged and continues to gain strength as an approach to improving health status and the performance of health systems. Numerous studies clearly link low levels of education, literacy, and health literacy with poor health, poor health care utilization, increased barriers to care, and early death. However, theoretical understandings and methods of measuring the complex social construct of health literacy have experienced a continual evolution that remains incomplete. As a result, the seemingly most-cited definition of health literacy proposed in the now-decade-old Institute of Medicine report on health literacy is long overdue for updating. Such an effort should engage a broad and diverse set of health literacy researchers, practitioners, and members of the public in creating a definition that can earn broad consensus through validation testing in a rigorous scientific approach. That effort also could produce the basis for a new universally applicable measure of health literacy. Funders, health systems, and policymakers should reconsider their timid approach to health literacy. Although the field and corresponding evidence base are not perfect, health literacy—especially when combined with a focus on prevention and integrative health—is one of the most promising approaches to advancing public health. PMID:25491583

  12. Transformation of health system in Ecuador

    OpenAIRE

    Wilson Giovanni Jiménez Barbosa; María Luisa Granda Kuffo; Diana Margoth Ávila Guzmán; Leidy Johanna Cruz Díaz; Julián Camilo Flórez Parra; Luisa Silvana Mejía; Diana Carolina Vargas Suárez

    2017-01-01

    Objective: To describe the transformations of the structure of the health system in Ecuador, taking into account the constitutional and policy context of that country, and to reflect on the historical context in which it occurred and its implications for the welfare of the people from Ecuador. Materials and methods: A bibliographic review was made, beginning with the regulations of Ecuador since the Constitution of 1979, where health is considered as a right, passing by the Organic Law of Hea...

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

    Science.gov (United States)

    Vellar, Lucia; Mastroianni, Fiorina; Lambert, Kelly

    2017-12-01

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

  14. The Rise of Iran

    DEFF Research Database (Denmark)

    Rahigh-Aghsan, Ali

    Iran is viewed as a rising power that poses an increasing threat to regional and even global security. This view is wrong for three reasons. Iran's hard and soft power is exaggerated by most accounts; it is too limited to allow the Iranians to dominate the Persian Gulf let alone the Middle East...

  15. The Rise of Iran

    DEFF Research Database (Denmark)

    Rahigh-Aghsan, Ali; Jakobsen, Peter Viggo

    2010-01-01

    Iran is viewed as a rising power that poses an increasing threat to regional and even global security. This view is wrong for three reasons. Iran's hard and soft power is exaggerated by most accounts; it is too limited to allow the Iranians to dominate the Persian Gulf let alone the Middle East...

  16. Four centuries on from Bacon: progress in building health research systems to improve health systems?

    Science.gov (United States)

    Hanney, Stephen R; González-Block, Miguel A

    2014-09-23

    In 1627, Francis Bacon's New Atlantis described a utopian society in which an embryonic research system contributed to meeting the needs of the society. In this editorial, we use some of the aspirations described in New Atlantis to provide a context within which to consider recent progress in building health research systems to improve health systems and population health. In particular, we reflect on efforts to build research capacity, link research to policy, identify the wider impacts made by the science, and generally build fully functioning research systems to address the needs identified. In 2014, Health Research Policy and Systems has continued to publish one-off papers and article collections covering a range of these issues in both high income countries and low- and middle-income countries. Analysis of these contributions, in the context of some earlier ones, is brought together to identify achievements, challenges and possible ways forward. We show how 2014 is likely to be a pivotal year in the development of ways to assess the impact of health research on policies, practice, health systems, population health, and economic benefits.We demonstrate how the increasing focus on health research systems will contribute to realising the hopes expressed in the World Health Report, 2013, namely that all nations would take a systematic approach to evaluating the outputs and applications resulting from their research investment.

  17. Optimal Sensor Selection for Health Monitoring Systems

    Science.gov (United States)

    Santi, L. Michael; Sowers, T. Shane; Aguilar, Robert B.

    2005-01-01

    Sensor data are the basis for performance and health assessment of most complex systems. Careful selection and implementation of sensors is critical to enable high fidelity system health assessment. A model-based procedure that systematically selects an optimal sensor suite for overall health assessment of a designated host system is described. This procedure, termed the Systematic Sensor Selection Strategy (S4), was developed at NASA John H. Glenn Research Center in order to enhance design phase planning and preparations for in-space propulsion health management systems (HMS). Information and capabilities required to utilize the S4 approach in support of design phase development of robust health diagnostics are outlined. A merit metric that quantifies diagnostic performance and overall risk reduction potential of individual sensor suites is introduced. The conceptual foundation for this merit metric is presented and the algorithmic organization of the S4 optimization process is described. Representative results from S4 analyses of a boost stage rocket engine previously under development as part of NASA's Next Generation Launch Technology (NGLT) program are presented.

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

    NARCIS (Netherlands)

    H. Zhang (Hao)

    2017-01-01

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

  19. System impact research - increasing public health and health care system performance.

    Science.gov (United States)

    Malmivaara, Antti

    2016-01-01

    Interventions directed to system features of public health and health care should increase health and welfare of patients and population. To build a new framework for studies aiming to assess the impact of public health or health care system, and to consider the role of Randomized Controlled Trials (RCTs) and of Benchmarking Controlled Trials (BCTs). The new concept is partly based on the author's previous paper on the Benchmarking Controlled Trial. The validity and generalizability considerations were based on previous methodological studies on RCTs and BCTs. The new concept System Impact Research (SIR) covers all the studies which aim to assess the impact of the public health system or of the health care system on patients or on population. There are two kinds of studies in System Impact Research: Benchmarking Controlled Trials (observational) and Randomized Controlled Trials (experimental). The term impact covers in particular accessibility, quality, effectiveness, safety, efficiency, and equality. System Impact Research - creating the scientific basis for policy decision making - should be given a high priority in medical, public health and health economic research, and should also be used for improving performance. Leaders at all levels of health and social care can use the evidence from System Impact Research for the benefit of patients and population. Key messages The new concept of SIR is defined as a research field aiming at assessing the impacts on patients and on populations of features of public health and health and social care systems or of interventions trying to change these features. SIR covers all features of public health and health and social care system, and actions upon these features. The term impact refers to all effects caused by the public health and health and social care system or parts of it, with particular emphasis on accessibility, quality, effectiveness, adverse effects, efficiency, and equality of services. SIR creates the

  20. System impact research – increasing public health and health care system performance

    Science.gov (United States)

    Malmivaara, Antti

    2016-01-01

    Abstract Background Interventions directed to system features of public health and health care should increase health and welfare of patients and population. Aims To build a new framework for studies aiming to assess the impact of public health or health care system, and to consider the role of Randomized Controlled Trials (RCTs) and of Benchmarking Controlled Trials (BCTs). Methods The new concept is partly based on the author's previous paper on the Benchmarking Controlled Trial. The validity and generalizability considerations were based on previous methodological studies on RCTs and BCTs. Results The new concept System Impact Research (SIR) covers all the studies which aim to assess the impact of the public health system or of the health care system on patients or on population. There are two kinds of studies in System Impact Research: Benchmarking Controlled Trials (observational) and Randomized Controlled Trials (experimental). The term impact covers in particular accessibility, quality, effectiveness, safety, efficiency, and equality. Conclusions System Impact Research – creating the scientific basis for policy decision making - should be given a high priority in medical, public health and health economic research, and should also be used for improving performance. Leaders at all levels of health and social care can use the evidence from System Impact Research for the benefit of patients and population.Key messagesThe new concept of SIR is defined as a research field aiming at assessing the impacts on patients and on populations of features of public health and health and social care systems or of interventions trying to change these features.SIR covers all features of public health and health and social care system, and actions upon these features. The term impact refers to all effects caused by the public health and health and social care system or parts of it, with particular emphasis on accessibility, quality, effectiveness, adverse effects, efficiency

  1. Prognostics and health management of photovoltaic systems

    Science.gov (United States)

    Johnson, Jay; Riley, Daniel

    2018-04-10

    The various technologies presented herein relate to providing prognosis and health management (PHM) of a photovoltaic (PV) system. A PV PHM system can eliminate long-standing issues associated with detecting performance reduction in PV systems. The PV PHM system can utilize an ANN model with meteorological and power input data to facilitate alert generation in the event of a performance reduction without the need for information about the PV PHM system components and design. Comparisons between system data and the PHM model can provide scheduling of maintenance on an as-needed basis. The PHM can also provide an approach for monitoring system/component degradation over the lifetime of the PV system.

  2. Radiometric system for clinical applications in the National Health System

    International Nuclear Information System (INIS)

    Mesa Perez, G.; Arteche Diaz, R.; Camejo Batista, A.; Fonfria Bragado, C.

    2013-01-01

    In this paper it is presented the radiometric detection system SRNIC-02, manufactured at CEADEN. The system has three major components: a well-type Nal(TI) scintillator detector with its collimator, a measurement module, and the application software, which allows fixing the working parameters of the system, as well as the acquisition and processing of data. The system has two main applications in the National Health System, one for the quality control in Radiopharmacy, and in RIA/IRMA blood tests. There are 16 systems installed, in 13 provinces of the country up to this date. (Author)

  3. Marketing in Greek National Health System

    Directory of Open Access Journals (Sweden)

    Maria Tseroni

    2009-01-01

    Full Text Available Introduction: The international financial situation in combination with an aging population and the appropriation of health services imposes the management of hospital services as a necessity for the survival of hospitals.Aim: To examine the perceptions of 450 upper administrative hospital executives (Nursing, Medicine and Administrative services in the wider region of Attica, on marketing, communication, and public relations in health-care.Population study: Four hundred and fifty (450 higher health executives from the three basic fields of services in health institutions (medical, nursing, administration constituted the total sample of the research. These people are employed at 9 of the 36 hospitals in the 3 Health Regions of Attica (H.Re.Materials and method:The type of design that was chosen (to gather data for the study of attitudes and perceptions of the health personnel of the health institutions of G.S.H (Greek System of Health is a cross- sectional survey.Results: The participating subjects, even though expressed some reservations at first, formed a favorable attitude towards marketing and its application in the field of health-care. Statistically important correlations emerged between the perceptions of executives and their socio-demographic background including age, sex, education, and profession, work experience in health-care and specifically in their current position in the services as well as statistically important differences between doctors, nurses and administrators as to their perceptions of some issues in marketing.Conclusions: From the comments in the survey it appears there is a need to apply marketing correctly when providing quality care, respecting the patients’ rights and using human and not financial criteria as a guide. Based on the results of the research, important proposals are being submitted in the areas of health-care research, education and clinical practice.

  4. Health promotion and health systems: some unfinished business.

    Science.gov (United States)

    Ziglio, Erio; Simpson, Sarah; Tsouros, Agis

    2011-12-01

    One of the five action domains in the Ottawa Charter was Reorienting Health Services. In this paper, we reflect on why progress in this domain has been somewhat lethargic, particularly compared with some of the other action domains, and why now it is important to renew our commitment to this domain. Reorienting health services has been largely overlooked and opportunities missed, although good exceptions do exist. The occasion of the 25th anniversary of the Ottawa Charter represents an important opportunity for health promotion to: (i) renew its active voice in current policy debate and action and (ii) enhance achievements made to date by improving our efforts to advocate, enable and mediate for the reorientation of health services and systems. We outline six steps to reactivate and invest more in this action domain so as to be in a better position to promote health equitably and sustainably in today's fast changing world. Though our experience is mainly based in the European context, we hope that our reflections will be of some value to countries outside of this region.

  5. Changes in health expenditures in China in 2000s: has the health system reform improved affordability.

    Science.gov (United States)

    Long, Qian; Xu, Ling; Bekedam, Henk; Tang, Shenglan

    2013-06-13

    China's health system reform launched in early 2000s has achieved better coverage of health insurance and significantly increased the use of healthcare for vast majority of Chinese population. This study was to examine changes in the structure of total health expenditures in China in 2000-2011, and to investigate the financial burden of healthcare placed on its population, particularly between urban and rural areas and across different socio-economic development regions. Health expenditures data came from the China National Health Accounts study in 1990-2011, and other data used to calculate the financial burden of healthcare were from China Statistical Yearbook and China Population Statistical Yearbook. Total health expenditures were divided into government and social expenditure, and out-of-pocket payment. The financial burden of healthcare was estimated as out-of-pocket payment per capita as a percentage of annual household living consumption expenditure per capita. Between 2000 and 2011, total health expenditures in China increased from Chinese yuan 319 to 1888 (United States dollars 51 to 305), with average annual increase of 17.4%. Government and social health expenditure increased rapidly being 22.9% and 18.8% of average annual growth rate, respectively. The share of out-of-pocket payment in total health expenditure for the urban population declined from 53% in 2005 to 36% in 2011, but had only a slight decrease for the rural population from 53% to 50%. Out-of-pocket payment, as a percentage of annual household living consumption, has continued to rise, particularly in the rural population from the less developed region (6.1% in 2000 to 8.8% in 2011). The rapid increase of public funding to subsidize health insurance in China, as part of the reform strategy, did not mitigate the out-of-pocket payment for healthcare over the past decade. Financial burden of healthcare on the rural population increased. Affordability among the rural households with sick

  6. Local infection of opium poppy leaves by Peronospora somniferi sporangia can give rise to systemic infections and seed infection in resistant cultivars

    Energy Technology Data Exchange (ETDEWEB)

    Montes-Borrego, M.; Muñoz-Ledesma, F.J.; Jiménez-Díaz, R.M.; Landa, B.B.

    2017-07-01

    Downy mildew (DM) of opium poppy (Papaver somniferum) caused by Peronospora somniferi is one of the most destructive diseases of this crop due to the systemic nature of infection as compared with local infections caused by Peronospora meconopsidis, the other downy mildew pathogen of this crop. We developed an inoculation method using Peronospora somniferi sporangia as inoculum and demonstrated for the first time that local infection of leaves by sporangia give rise to systemic infections in the plant as well as of seeds. Our results also showed that this inoculation protocol was very effective in reproducing disease symptoms and assessing the resistance response to DM in opium poppy genotypes under field conditions. More interestingly, results indicate that up to 100% of seed samples from some genotypes showing a complete (symptomless) resistant phenotype were infected by the pathogen when seeds were analyzed by a P. somniferi-specific nested-PCR protocol. This latter aspect deserves further attention while breeding opium poppy for resistance to P. somniferi.

  7. Local infection of opium poppy leaves by Peronospora somniferi sporangia can give rise to systemic infections and seed infection in resistant cultivars

    International Nuclear Information System (INIS)

    Montes-Borrego, M.; Muñoz-Ledesma, F.J.; Jiménez-Díaz, R.M.; Landa, B.B.

    2017-01-01

    Downy mildew (DM) of opium poppy (Papaver somniferum) caused by Peronospora somniferi is one of the most destructive diseases of this crop due to the systemic nature of infection as compared with local infections caused by Peronospora meconopsidis, the other downy mildew pathogen of this crop. We developed an inoculation method using Peronospora somniferi sporangia as inoculum and demonstrated for the first time that local infection of leaves by sporangia give rise to systemic infections in the plant as well as of seeds. Our results also showed that this inoculation protocol was very effective in reproducing disease symptoms and assessing the resistance response to DM in opium poppy genotypes under field conditions. More interestingly, results indicate that up to 100% of seed samples from some genotypes showing a complete (symptomless) resistant phenotype were infected by the pathogen when seeds were analyzed by a P. somniferi-specific nested-PCR protocol. This latter aspect deserves further attention while breeding opium poppy for resistance to P. somniferi.

  8. Strengthening global health security by embedding the International Health Regulations requirements into national health systems.

    Science.gov (United States)

    Kluge, Hans; Martín-Moreno, Jose Maria; Emiroglu, Nedret; Rodier, Guenael; Kelley, Edward; Vujnovic, Melitta; Permanand, Govin

    2018-01-01

    The International Health Regulations (IHR) 2005, as the overarching instrument for global health security, are designed to prevent and cope with major international public health threats. But poor implementation in countries hampers their effectiveness. In the wake of a number of major international health crises, such as the 2014 Ebola and 2016 Zika outbreaks, and the findings of a number of high-level assessments of the global response to these crises, it has become clear that there is a need for more joined-up thinking between health system strengthening activities and health security efforts for prevention, alert and response. WHO is working directly with its Member States to promote this approach, more specifically around how to better embed the IHR (2005) core capacities into the main health system functions. This paper looks at how and where the intersections between the IHR and the health system can be best leveraged towards developing greater health system resilience. This merging of approaches is a key component in pursuit of Universal Health Coverage and strengthened global health security as two mutually reinforcing agendas.

  9. Current pulse: can a production system reduce medical errors in health care?

    Science.gov (United States)

    Printezis, Antonios; Gopalakrishnan, Mohan

    2007-01-01

    One of the reasons for rising health care costs is medical errors, a majority of which result from faulty systems and processes. Health care in the past has used process-based initiatives such as Total Quality Management, Continuous Quality Improvement, and Six Sigma to reduce errors. These initiatives to redesign health care, reduce errors, and improve overall efficiency and customer satisfaction have had moderate success. Current trend is to apply the successful Toyota Production System (TPS) to health care since its organizing principles have led to tremendous improvement in productivity and quality for Toyota and other businesses that have adapted them. This article presents insights on the effectiveness of TPS principles in health care and the challenges that lie ahead in successfully integrating this approach with other quality initiatives.

  10. The right to health, health systems development and public health policy challenges in Chad.

    Science.gov (United States)

    Azétsop, Jacquineau; Ochieng, Michael

    2015-02-15

    There is increasing consensus that the right to health can provide ethical, policy and practical groundings for health systems development. The goals of the right to health are congruent with those of health systems development, which are about strengthening health promotion organizations and actions so as to improve public health. The poor shape and performance of health systems in Chad question the extent of realization of the right to health. Due to its comprehensiveness and inclusiveness, the right to health has the potential of being an organizational and a normative backbone for public health policy and practice. It can then be understood and studied as an integral component of health systems development. This paper uses a secondary data analysis of existing documents by the Ministry of Public Health, Institut National de la Statistique, des Etudes Economiques et Démographiques (INSEED), the Ministry of Economy and Agence Française de Cooperation to analyze critically the shape and performance of health systems in Chad based on key concepts and components of the right to health contained in article 12 of the International Covenant on Economic, Social and Cultural Rights, and on General Comment 14. The non-realization of the right to health, even in a consistently progressive manner, raises concerns about the political commitment of state officials to public health, about the justice of social institutions in ensuring social well-being and about individual and public values that shape decision-making processes. Social justice, democratic rule, transparency, accountability and subsidiarity are important groundings for ensuring community participation in public affairs and for monitoring the performance of public institutions. The normative ideals of health systems development are essentially democratic in nature and are rooted in human rights and in ethical principles of human dignity, equality, non-discrimination and social justice. These ideals are grounded

  11. Integrating Social impacts on Health and Health-Care Systems in Systemic Seismic Vulnerability Analysis

    Science.gov (United States)

    Kunz-Plapp, T.; Khazai, B.; Daniell, J. E.

    2012-04-01

    This paper presents a new method for modeling health impacts caused by earthquake damage which allows for integrating key social impacts on individual health and health-care systems and for implementing these impacts in quantitative systemic seismic vulnerability analysis. In current earthquake casualty estimation models, demand on health-care systems is estimated by quantifying the number of fatalities and severity of injuries based on empirical data correlating building damage with casualties. The expected number of injured people (sorted by priorities of emergency treatment) is combined together with post-earthquake reduction of functionality of health-care facilities such as hospitals to estimate the impact on healthcare systems. The aim here is to extend these models by developing a combined engineering and social science approach. Although social vulnerability is recognized as a key component for the consequences of disasters, social vulnerability as such, is seldom linked to common formal and quantitative seismic loss estimates of injured people which provide direct impact on emergency health care services. Yet, there is a consensus that factors which affect vulnerability and post-earthquake health of at-risk populations include demographic characteristics such as age, education, occupation and employment and that these factors can aggravate health impacts further. Similarly, there are different social influences on the performance of health care systems after an earthquake both on an individual as well as on an institutional level. To link social impacts of health and health-care services to a systemic seismic vulnerability analysis, a conceptual model of social impacts of earthquakes on health and the health care systems has been developed. We identified and tested appropriate social indicators for individual health impacts and for health care impacts based on literature research, using available European statistical data. The results will be used to

  12. FAILSAFE Health Management for Embedded Systems

    Science.gov (United States)

    Horvath, Gregory A.; Wagner, David A.; Wen, Hui Ying; Barry, Matthew

    2010-01-01

    The FAILSAFE project is developing concepts and prototype implementations for software health management in mission- critical, real-time embedded systems. The project unites features of the industry-standard ARINC 653 Avionics Application Software Standard Interface and JPL s Mission Data System (MDS) technology (see figure). The ARINC 653 standard establishes requirements for the services provided by partitioned, real-time operating systems. The MDS technology provides a state analysis method, canonical architecture, and software framework that facilitates the design and implementation of software-intensive complex systems. The MDS technology has been used to provide the health management function for an ARINC 653 application implementation. In particular, the focus is on showing how this combination enables reasoning about, and recovering from, application software problems.

  13. Integrated Systems Health Management (ISHM) Toolkit

    Science.gov (United States)

    Venkatesh, Meera; Kapadia, Ravi; Walker, Mark; Wilkins, Kim

    2013-01-01

    A framework of software components has been implemented to facilitate the development of ISHM systems according to a methodology based on Reliability Centered Maintenance (RCM). This framework is collectively referred to as the Toolkit and was developed using General Atomics' Health MAP (TM) technology. The toolkit is intended to provide assistance to software developers of mission-critical system health monitoring applications in the specification, implementation, configuration, and deployment of such applications. In addition to software tools designed to facilitate these objectives, the toolkit also provides direction to software developers in accordance with an ISHM specification and development methodology. The development tools are based on an RCM approach for the development of ISHM systems. This approach focuses on defining, detecting, and predicting the likelihood of system functional failures and their undesirable consequences.

  14. Public policy, health system, and community actions against illness as platforms for response to NCDs in Tanzania : a narrative review

    NARCIS (Netherlands)

    Metta, Emmy; Msambichaka, Beverly; Mwangome, Mary; Nyato, Daniel J; Dieleman, Marjolein; Haisma, Hinke; Klatser, Paul; Geubbels, Eveline

    2014-01-01

    BACKGROUND: Most low- and middle- income countries are facing a rise of the burden of non-communicable diseases (NCDs) alongside the persistent burden of infectious diseases. This narrative review aims to provide an inventory of how the existing policy environment, health system, and communities are

  15. Public policy, health system, and community actions against illness as platforms for response to NCDs in Tanzania: a narrative review

    NARCIS (Netherlands)

    Metta, Emmy; Msambichaka, Beverly; Mwangome, Mary; Nyato, Daniel J.; Dieleman, Marjolein; Haisma, Hinke; Klatser, Paul; Geubbels, Eveline

    2014-01-01

    Most low- and middle- income countries are facing a rise of the burden of non-communicable diseases (NCDs) alongside the persistent burden of infectious diseases. This narrative review aims to provide an inventory of how the existing policy environment, health system, and communities are addressing

  16. Understanding The Resistance to Health Information Systems

    OpenAIRE

    David Ackah; Angelito E Alvarado; Heru Santoso Wahito Nugroho; Sanglar Polnok; Wiwin Martiningsih

    2017-01-01

    User resistance is users’ opposition to system implementation. Resistance often occurs as a result of a mismatch between management goals and employee preferences. There are two types of resistance to health iformation system namely active resistance and passive resistance. The manifestation of active resistance are being critical,  blaming/accusing, blocking, fault finding, sabotaging, undermining, ridiculing, intimidating/threatening, starting rumors, appealing to fear, manipulating arguing...

  17. A Critique of Health System Performance Measurement.

    Science.gov (United States)

    Lynch, Thomas

    2015-01-01

    Health system performance measurement is a ubiquitous phenomenon. Many authors have identified multiple methodological and substantive problems with performance measurement practices. Despite the validity of these criticisms and their cross-national character, the practice of health system performance measurement persists. Theodore Marmor suggests that performance measurement invokes an "incantatory response" wrapped within "linguistic muddle." In this article, I expand upon Marmor's insights using Pierre Bourdieu's theoretical framework to suggest that, far from an aberration, the "linguistic muddle" identified by Marmor is an indicator of a broad struggle about the representation and classification of public health services as a public good. I present a case study of performance measurement from Alberta, Canada, examining how this representational struggle occurs and what the stakes are. © The Author(s) 2015.

  18. Scaling Health Information Systems in Developing Countries

    DEFF Research Database (Denmark)

    Mengiste, Shegaw Anagaw; Neilsen, Petter

    2006-01-01

    This article addresses the issues of scaling health information system in the context of developing countries by taking a case study from Ethiopia. Concepts of information infrastructure have been used as an analytical lens to better understand scaling of Health Information systems. More...... specifically, we question the fruitfulness of focusing on not being installed base hostile and suggest focusing on how to be installed base “friendly” by underscoring how the installed base can also be draw upon and shaped by human agents. The paper conceptualizes health information infrastructure (HII......) building as an intertwined process of the evolution of the installed base and the construction activities of human agents. Overall, we argue that it is not only the adverse situation that determines how things develop, but HII builders need to navigate and take into account a wide range of issues related...

  19. Designing and Conducting Health Systems Research Projects ...

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

    Home · Resources · Publications. Designing and Conducting Health Systems Research Projects Volume 1: Proposal Development and Fieldwork ... IDRC and the United Kingdom's Global AMR Innovation Fund—managed by the ... New website will help record vital life events to improve access to services for all.

  20. Health Occupations Module. The Integumentary System.

    Science.gov (United States)

    Temple Univ., Philadelphia, PA. Div. of Vocational Education.

    This module on the integumentary system is one of eight modules designed for individualized instruction in health occupations education programs at both the secondary and postsecondary levels. This module contains an introduction to the module topic, objectives (e.g., list and describe the types of glands formed in the skin, and explain the…

  1. Activity monitoring systems in health care

    NARCIS (Netherlands)

    Kröse, B.; van Oosterhout, T.; van Kasteren, T.; Salah, A.A.; Gevers, T.

    2011-01-01

    This chapter focuses on activity monitoring in a home setting for health care purposes. First the most current sensing systems are described, which consist of wearable and ambient sensors. Then several approaches for the monitoring of simple actions are discussed, like falls or therapies. After

  2. Governance for Equity in Health Systems Deadline

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

    Jean-Claude Dumais

    2012-09-12

    Sep 12, 2012 ... of training and mentorship in research, research management, and grant administration allows awardees to pursue their research goals in a dynamic team environment in one of the world's leaders in generating new knowledge to meet global challenges. IDRC's Governance for Equity in Health Systems ...

  3. Consumerism and wellness: rising tide, falling cost.

    Science.gov (United States)

    Domaszewicz, Alexander

    2008-01-01

    Annual employer-sponsored health plan cost increases have been slowing incrementally due to slowing health care utilization--a phenomenon very likely tied to the proliferation of health management activities, wellness programs and other consumerism strategies. This article describes the sharp rise in recent years of consumer-directed health plans (CDHPs) and explains what developments must happen for genuine consumer-directed health care to realize its full potential. These developments include gathering transparent health care information, increasing consumer demand for that information and creating truly intuitive data solutions that allow consumers to easily access information in order to make better health care decisions.

  4. The Rise of Iran

    DEFF Research Database (Denmark)

    Jakobsen, Peter Viggo; Rahigh-Aghsan, Ali

    2010-01-01

    Iran is viewed by many as a rising power that poses an increasing threat to regional and even global security. This view is wrong for three reasons. Iran's hard and soft power is exaggerated by most accounts; it is too limited to allow the Iranians to dominate the Persian Gulf let alone the Middle...... East, and its brand of Shi‘ism has very limited appeal outside of Iran. Second, growing internal political and economic instability will seriously limit Iran's bid for regional dominance. Third, the failure to stop the Iranian nuclear program has led analysts to underestimate the ability of the other...... regional powers and the West to balance Iran and contain its influence, even if it acquires nuclear weapons. If these limitations on Iranian power are taken into account the rise seems destined to be a short one....

  5. Integrated Systems Health Management for Space Exploration

    Science.gov (United States)

    Uckun, Serdar

    2005-01-01

    Integrated Systems Health Management (ISHM) is a system engineering discipline that addresses the design, development, operation, and lifecycle management of components, subsystems, vehicles, and other operational systems with the purpose of maintaining nominal system behavior and function and assuring mission safety and effectiveness under off-nominal conditions. NASA missions are often conducted in extreme, unfamiliar environments of space, using unique experimental spacecraft. In these environments, off-nominal conditions can develop with the potential to rapidly escalate into mission- or life-threatening situations. Further, the high visibility of NASA missions means they are always characterized by extraordinary attention to safety. ISHM is a critical element of risk mitigation, mission safety, and mission assurance for exploration. ISHM enables: In-space maintenance and repair; a) Autonomous (and automated) launch abort and crew escape capability; b) Efficient testing and checkout of ground and flight systems; c) Monitoring and trending of ground and flight system operations and performance; d) Enhanced situational awareness and control for ground personnel and crew; e) Vehicle autonomy (self-sufficiency) in responding to off-nominal conditions during long-duration and distant exploration missions; f) In-space maintenance and repair; and g) Efficient ground processing of reusable systems. ISHM concepts and technologies may be applied to any complex engineered system such as transportation systems, orbital or planetary habitats, observatories, command and control systems, life support systems, safety-critical software, and even the health of flight crews. As an overarching design and operational principle implemented at the system-of-systems level, ISHM holds substantial promise in terms of affordability, safety, reliability, and effectiveness of space exploration missions.

  6. Procurement performance measurement system in the health care industry.

    Science.gov (United States)

    Kumar, Arun; Ozdamar, Linet; Ng, Chai Peng

    2005-01-01

    The rising operating cost of providing healthcare is of concern to health care providers. As such, measurement of procurement performance will enable competitive advantage and provide a framework for continuous improvement. The objective of this paper is to develop a procurement performance measurement system. The paper reviews the existing literature in procurement performance measurement to identify the key areas of purchasing performance. By studying the three components in the supply chain collectively with the resources, procedures and output, a model is been developed. Additionally, a balanced scorecard is proposed by establishing a set of generic measures and six perspectives. A case study conducted at the Singapore Hospital applies the conceptual model to describe the purchasing department and the activities within and outside the department. The results indicate that the material management department has already made a good start in measuring the procurement process through the implementation of the balanced scorecard. There are many data that are collected but not properly collated and utilized. Areas lacking measurement include cycle time of delivery, order processing time, effectiveness, efficiency and reliability. Though a lot of hard work was involved, the advantages of establishing a measurement system outweigh the costs and efforts involved in its implementation. Results of balanced scorecard measurements provide decision-makers with critical information on efficiency and effectiveness of the purchasing department's work. The measurement model developed could be used for any hospital procurement system.

  7. Active Wireless System for Structural Health Monitoring Applications.

    Science.gov (United States)

    Perera, Ricardo; Pérez, Alberto; García-Diéguez, Marta; Zapico-Valle, José Luis

    2017-12-11

    The use of wireless sensors in Structural Health Monitoring (SHM) has increased significantly in the last years. Piezoelectric-based lead zirconium titanate (PZT) sensors have been on the rise in SHM due to their superior sensing abilities. They are applicable in different technologies such as electromechanical impedance (EMI)-based SHM. This work develops a flexible wireless smart sensor (WSS) framework based on the EMI method using active sensors for full-scale and autonomous SHM. In contrast to passive sensors, the self-sensing properties of the PZTs allow interrogating with or exciting a structure when desired. The system integrates the necessary software and hardware within a service-oriented architecture approach able to provide in a modular way the services suitable to satisfy the key requirements of a WSS. The framework developed in this work has been validated on different experimental applications. Initially, the reliability of the EMI method when carried out with the proposed wireless sensor system is evaluated by comparison with the wireless counterpart. Afterwards, the performance of the system is evaluated in terms of software stability and reliability of functioning.

  8. Active Wireless System for Structural Health Monitoring Applications

    Directory of Open Access Journals (Sweden)

    Ricardo Perera

    2017-12-01

    Full Text Available The use of wireless sensors in Structural Health Monitoring (SHM has increased significantly in the last years. Piezoelectric-based lead zirconium titanate (PZT sensors have been on the rise in SHM due to their superior sensing abilities. They are applicable in different technologies such as electromechanical impedance (EMI-based SHM. This work develops a flexible wireless smart sensor (WSS framework based on the EMI method using active sensors for full-scale and autonomous SHM. In contrast to passive sensors, the self-sensing properties of the PZTs allow interrogating with or exciting a structure when desired. The system integrates the necessary software and hardware within a service-oriented architecture approach able to provide in a modular way the services suitable to satisfy the key requirements of a WSS. The framework developed in this work has been validated on different experimental applications. Initially, the reliability of the EMI method when carried out with the proposed wireless sensor system is evaluated by comparison with the wireless counterpart. Afterwards, the performance of the system is evaluated in terms of software stability and reliability of functioning.

  9. Contemporary sea level rise.

    Science.gov (United States)

    Cazenave, Anny; Llovel, William

    2010-01-01

    Measuring sea level change and understanding its causes has considerably improved in the recent years, essentially because new in situ and remote sensing observations have become available. Here we report on most recent results on contemporary sea level rise. We first present sea level observations from tide gauges over the twentieth century and from satellite altimetry since the early 1990s. We next discuss the most recent progress made in quantifying the processes causing sea level change on timescales ranging from years to decades, i.e., thermal expansion of the oceans, land ice mass loss, and land water-storage change. We show that for the 1993-2007 time span, the sum of climate-related contributions (2.85 +/- 0.35 mm year(-1)) is only slightly less than altimetry-based sea level rise (3.3 +/- 0.4 mm year(-1)): approximately 30% of the observed rate of rise is due to ocean thermal expansion and approximately 55% results from land ice melt. Recent acceleration in glacier melting and ice mass loss from the ice sheets increases the latter contribution up to 80% for the past five years. We also review the main causes of regional variability in sea level trends: The dominant contribution results from nonuniform changes in ocean thermal expansion.

  10. Outcome mapping for health system integration

    Directory of Open Access Journals (Sweden)

    Tsasis P

    2013-03-01

    Full Text Available Peter Tsasis,1 Jenna M Evans,2 David Forrest,3 Richard Keith Jones4 1School of Health Policy and Management, Faculty of Health, York University, Toronto, Canada; 2Institute of Health Policy, Management and Evaluation, Faculty of Medicine, University of Toronto, Canada; 3Global Vision Consulting Ltd, Victoria, Canada; 4R Keith Jones and Associates, Victoria, Canada Abstract: Health systems around the world are implementing integrated care strategies to improve quality, reduce or maintain costs, and improve the patient experience. Yet few practical tools exist to aid leaders and managers in building the prerequisites to integrated care, namely a shared vision, clear roles and responsibilities, and a common understanding of how the vision will be realized. Outcome mapping may facilitate stakeholder alignment on the vision, roles, and processes of integrated care delivery via participative and focused dialogue among diverse stakeholders on desired outcomes and enabling actions. In this paper, we describe an outcome-mapping exercise we conducted at a Local Health Integration Network in Ontario, Canada, using consensus development conferences. Our preliminary findings suggest that outcome mapping may help stakeholders make sense of a complex system and foster collaborative capital, a resource that can support information sharing, trust, and coordinated change toward integration across organizational and professional boundaries. Drawing from the theoretical perspectives of complex adaptive systems and collaborative capital, we also outline recommendations for future outcome-mapping exercises. In particular, we emphasize the potential for outcome mapping to be used as a tool not only for identifying and linking strategic outcomes and actions, but also for studying the boundaries, gaps, and ties that characterize social networks across the continuum of care. Keywords: integrated care, integrated delivery systems, complex adaptive systems, social capital

  11. The Rise and Fall of Universal Salt Iodization in Vietnam: Lessons Learned for Designing Sustainable Food Fortification Programs With a Public Health Impact.

    Science.gov (United States)

    Codling, Karen; Quang, Nguyen Vinh; Phong, Le; Phuong, Do Hong; Quang, Nguyen Dinh; Bégin, France; Mathisen, Roger

    2015-12-01

    In 2005, more than 90% of Vietnamese households were using adequately iodized salt, and urinary iodine concentration among women of reproductive age was in the optimal range. However, household coverage declined thereafter to 45% in 2011, and urinary iodine concentration levels indicated inadequate iodine intake. To review the strengths and weaknesses of the Vietnamese universal salt iodization program from its inception to the current day and to discuss why achievements made by 2005 were not sustained. Qualitative review of program documents and semistructured interviews with national stakeholders. National legislation for mandatory salt iodization was revoked in 2005, and the political importance of the program was downgraded with consequential effects on budget, staff, and authority. The Vietnamese salt iodization program, as it was initially designed and implemented, was unsustainable, as salt iodization was not practiced as an industry norm but as a government-funded activity. An effective and sustainable salt iodization program needs to be reestablished for the long-term elimination of iodine deficiency, building upon lessons learned from the past and programs in neighboring countries. The new program will need to include mandatory legislation, including salt for food processing; industry responsibility for the cost of fortificant; government commitment for enforcement through routine food control systems and monitoring of iodine status through existing health/nutrition assessments; and intersectoral collaboration and management of the program. Many of the lessons would apply equally to universal salt iodization programs in other countries and indeed to food fortification programs in general. © The Author(s) 2015.

  12. Rocket Testing and Integrated System Health Management

    Science.gov (United States)

    Figueroa, Fernando; Schmalzel, John

    2005-01-01

    Integrated System Health Management (ISHM) describes a set of system capabilities that in aggregate perform: determination of condition for each system element, detection of anomalies, diagnosis of causes for anomalies, and prognostics for future anomalies and system behavior. The ISHM should also provide operators with situational awareness of the system by integrating contextual and timely data, information, and knowledge (DIaK) as needed. ISHM capabilities can be implemented using a variety of technologies and tools. This chapter provides an overview of ISHM contributing technologies and describes in further detail a novel implementation architecture along with associated taxonomy, ontology, and standards. The operational ISHM testbed is based on a subsystem of a rocket engine test stand. Such test stands contain many elements that are common to manufacturing systems, and thereby serve to illustrate the potential benefits and methodologies of the ISHM approach for intelligent manufacturing.

  13. Internet infrastructures and health care systems: a qualitative comparative analysis on networks and markets in the British National Health Service and Kaiser Permanente.

    Science.gov (United States)

    Séror, Ann C

    2002-12-01

    The Internet and emergent telecommunications infrastructures are transforming the future of health care management. The costs of health care delivery systems, products, and services continue to rise everywhere, but performance of health care delivery is associated with institutional and ideological considerations as well as availability of financial and technological resources. to identify the effects of ideological differences on health care market infrastructures including the Internet and telecommunications technologies by a comparative case analysis of two large health care organizations: the British National Health Service and the California-based Kaiser Permanente health maintenance organization. A qualitative comparative analysis focusing on the British National Health Service and the Kaiser Permanente health maintenance organization to show how system infrastructures vary according to market dynamics dominated by health care institutions ("push") or by consumer demand ("pull"). System control mechanisms may be technologically embedded, institutional, or behavioral. The analysis suggests that telecommunications technologies and the Internet may contribute significantly to health care system performance in a context of ideological diversity. The study offers evidence to validate alternative models of health care governance: the national constitution model, and the enterprise business contract model. This evidence also suggests important questions for health care policy makers as well as researchers in telecommunications, organizational theory, and health care management.

  14. Formation of production structural units within a construction company using the systemic integrated method when implementing high-rise development projects

    Directory of Open Access Journals (Sweden)

    Lapidus Azary

    2018-01-01

    Full Text Available Development of efficient algorithms for designing future operations is a vital element in construction business. This paper studies various aspects of a methodology required to determine the integration index for construction crews performing various process-related jobs. The main objective of the study outlined in this paper is to define the notion of integration in respect to a construction crew that performs complete cycles of construction and assembly works in order to find the optimal organizational solutions, using the integrated crew algorithm built specifically for that purpose. As seen in the sequence of algorithm elements, it was designed to focus on the key factors affecting the level of integration of a construction crew depending on the value of each of those elements. The multifactor modelling approach is used to assess the KPI of integrated construction crews involved in large-sale high-rise construction projects. The purpose of this study is to develop a theoretical recommendation and a scientific methodological provision of organizational and technological nature to ensure qualitative formation of integrated construction crews to increase their productivity during integrated implementation of multi-task construction phases. The key difference of the proposed solution from the already existing ones is that it requires identification of the degree of impact of each factor, including the change in the qualification level, on the integration index of each separate element in the organizational and technological system in construction (integrated construction crew.

  15. Formation of production structural units within a construction company using the systemic integrated method when implementing high-rise development projects

    Science.gov (United States)

    Lapidus, Azary; Abramov, Ivan

    2018-03-01

    Development of efficient algorithms for designing future operations is a vital element in construction business. This paper studies various aspects of a methodology required to determine the integration index for construction crews performing various process-related jobs. The main objective of the study outlined in this paper is to define the notion of integration in respect to a construction crew that performs complete cycles of construction and assembly works in order to find the optimal organizational solutions, using the integrated crew algorithm built specifically for that purpose. As seen in the sequence of algorithm elements, it was designed to focus on the key factors affecting the level of integration of a construction crew depending on the value of each of those elements. The multifactor modelling approach is used to assess the KPI of integrated construction crews involved in large-sale high-rise construction projects. The purpose of this study is to develop a theoretical recommendation and a scientific methodological provision of organizational and technological nature to ensure qualitative formation of integrated construction crews to increase their productivity during integrated implementation of multi-task construction phases. The key difference of the proposed solution from the already existing ones is that it requires identification of the degree of impact of each factor, including the change in the qualification level, on the integration index of each separate element in the organizational and technological system in construction (integrated construction crew).

  16. Creating a 21st-century intelligent health system.

    Science.gov (United States)

    Newt, Gingrich; Nancy, Desmond

    2008-02-01

    In most areas of life, Americans enjoy the ease and convenience offered by advances in technology, communications, and transportation. Every day we experience the 21st-century model of America, which is one of effectiveness, accuracy, speed, flexibility, efficiency, lower cost, more choices, and greater achievement. We can shop online, compare prices for goods and services, and when decisions need to be made, we have access to a wide array of information sources to assist in making those decisions. In short, Americans enjoy great latitude in our power to determine what is best for us. This is not, however, the case when it comes to health and healthcare. In our current healthcare system, individuals are dependent on a structure that has resisted the natural progress and modernization achieved by market-oriented, 21st-century industries. The information age has been leaving health behind. Although it is the nature of a science- and technology-based entrepreneurial free market to provide more choices of higher quality at lower cost, in the healthcare sector, prices continue to rise, quality is inconsistent, and individuals lack the information, incentives, and power to make choices.

  17. THE QATAR HEALTH SYSTEM: CHALLENGES AND OPPORTUNITIES

    Directory of Open Access Journals (Sweden)

    Shaher ALSHAMARI

    2017-06-01

    Full Text Available Qatar’s healthcare system is comparatively new and has experienced noteworthy developments over its brief history. In this paper, our aim is to look at the unique challenges this small nation has faced in building that system. This paper will describe the accomplishments of Qatar’s medical authorities and the challenges they faced. It will also compare public and private healthcare providers. Today, the government of Qatar has financed all the health care for this rapidly-developing, multicultural nation, but it is now planning to introduce medical insurance. This report of its experience will benefit other nations wanting to develop their own healthcare systems.

  18. Utilization of Health Information System at District Level in Jimma ...

    African Journals Online (AJOL)

    Therefore, in-service training and updating of staff involved in health information system (HIS) at district, strengthening health information system inputs, timely and concrete feedbacks with establishment of functional health management information system (HMIS). KEY WORDS: Health Management Information System, ...

  19. Sustainable quality systems for every Health Service

    International Nuclear Information System (INIS)

    Touzet, Rodolfo; Pittaluga, Roberto R.

    2008-01-01

    The implementation of a Quality system is an indispensable requirement to assure the protection and the radiological safety, especially in those facilities where the potential risks are important. One of the 'general conclusions' of the Conference of Malaga (to achieve the RPP) is also the implementation of quality systems. Lamentably the great majority of the Services of Health in the world, more than 95 %, has not nowadays any formal quality system but only any elements what can be named a 'natural quality system' that includes protocols of work, records of several processes, certified of training of the personnel and diverse practices that are realized in systematic form but that not always are documented. Most health services do not have the necessary means available to adhere quickly to international standards. At the same time the health services do not have either qualified or trained personnel to lead a certification or accreditation project and most of them do not have the resources available to hire external consultants, especially the public hospitals. The scenario described represents a challenge for the Regulatory Authorities who must determine 'how to ensure that installations comply with an acceptable standard of quality without it placing an impossible strain on their budget?' Due to these circumstances a 'Basic Guide' has developed for the implementation of a quality system in every Health Service that takes the elements as a foundation of the standard ISO - 9000:2000 and the standard for systems management GSR-3 of the IAEA. The criteria and the methodologies are showed in the presentation. (author)

  20. Health system challenges of NCDs in Tunisia.

    Science.gov (United States)

    Ben Romdhane, Habiba; Tlili, Faten; Skhiri, Afef; Zaman, Shahaduz; Phillimore, Peter

    2015-01-01

    The objective of this study was to present a qualitative 'situation analysis' of the healthcare system in Tunisia, as it applies to management of cardiovascular disease (CVD) and diabetes. A primary concern was the institutional capacity to manage non-communicable diseases (NCDs). Research took place during 2010 (analysis of official documents, semi-structured interviews with key informants, and case studies in four clinics). Walt and Gilson's framework (1994) for policy analysis was used: content, actors, context, and process. Problems of integration and coordination have compounded funding pressures. Despite its importance in Tunisian healthcare, primary health is ill-equipped to manage NCDs. With limited funds, and no referral or health information system, staff morale in the public sector was low. Private healthcare has been the main development filling the void. This study highlights major gaps in the implementation of a comprehensive approach to NCDs, which is an urgent task across the region. In strategic planning, research on the health system is vital; but the capacity within Ministries of Health to use research has first to be built, with a commitment to grounding policy change in evidence.

  1. Investigation of Health Risks and Their Prevention in the Rapid Climate Changes and the Rise of Pollution of the Atmosphere in the Mountain Region of the North Caucasus

    Science.gov (United States)

    Babyakin, Alexander; Polozkov, Igor; Golitsyn, Georgy; Efimenko, Natalia; Zherlitsina, Liubov; Povolotskaya, Nina; Senik, Irina; Chalaya, Elena; Artamonova, Maria; Pogarski, Fedor

    2010-05-01

    atmospheric pollution making by Obukhov Institute of Atmospheric Physics RAS. The average weighted WPI forms the basis of weather type number, synoptic weather forecast allows you to define a subtype of the weather. This classification is used in the system of MWF in the resorts of Caucasian Mineral Waters (mountainous region of Northern Caucasus), making for the purpose of timely warnings of medical personnel of medical institutions to strengthen health surveillance and, if necessary, conduct prevention of MPR. MPR to changing weather conditions are most manifest in connection with resettlement of patients from their places of permanent residence to the unusual climatic conditions of the resort. In this regard, in order to enhance the spa rehabilitation of meteosensitive patients with coronary artery disease at PSRIC a physiological method was developed for early and routine prophylaxis of maladaptive pathological and, above all, MPR using the method of transcranial electric-pulse meso-diencephalic modulation by MDMK-4 apparatus with a frontooccipital location of the electrodes. Clinical manifestation of the MPR in adverse weather conditions in patients with coronary artery disease, hypertension with dysadaptation syndrome is characterized by frequent recurrences of angina, rhythm disorders, cerebral symptoms, vascular crisis, violations in the field of psycho-emotional area and other disorders. These meteopathies are eliminated with high efficiency using the MDMK-4 apparatus in individually selected modes at the planned rate of prophylaxis for 10 procedures. In order to urgent MPR prevention the procedures can be used situationally. The high preventive and curative effects of transcranial electric-pulse meso-diencephalic modulation of the MDMK-4 apparatus is shown by positive dynamics of the clinical status of patients, including data on the MPR test survey, the Kerdem vegetative index, rheoencephalography indicators, electrocardiography, neurovascular reactivity, Holter

  2. Health systems research in the time of health system reform in India: a review.

    Science.gov (United States)

    Rao, Krishna D; Arora, Radhika; Ghaffar, Abdul

    2014-08-09

    Research on health systems is an important contributor to improving health system performance. Importantly, research on program and policy implementation can also create a culture of public accountability. In the last decade, significant health system reforms have been implemented in India. These include strengthening the public sector health system through the National Rural Health Mission (NRHM), and expansion of government-sponsored insurance schemes for the poor. This paper provides a situation analysis of health systems research during the reform period. We reviewed 9,477 publications between 2005 and 2013 in two online databases, PubMed and IndMED. Articles were classified according to the WHO classification of health systems building blocks. Our findings indicate the number of publications on health systems progressively increased every year from 92 in 2006 to 314 in 2012. The majority of papers were on service delivery (40%), with fewer on information (16%), medical technology and vaccines (15%), human resources (11%), governance (5%), and financing (8%). Around 70% of articles were lead by an author based in India, the majority by authors located in only four states. Several states, particularly in eastern and northeastern India, did not have a single paper published by a lead author located in a local institution. Moreover, many of these states were not the subject of a single published paper. Further, a few select institutions produced the bulk of research. Of the foreign author lead papers, 77% came from five countries (USA, UK, Canada, Australia, and Switzerland). The growth of published research during the reform period in India is a positive development. However, bulk of this research is produced in a few states and by a few select institutions Further strengthening health systems research requires attention to neglected health systems domains like human resources, financing, and governance. Importantly, research capacity needs to be strengthened in

  3. [Organization development of the public health system].

    Science.gov (United States)

    Pfaff, Holger; Klein, Jürgen

    2002-05-15

    Changes in the German health care system require changes in health care institutions. Organizational development (OD) techniques can help them to cope successfully with their changing environment. OD is defined as a collective process of learning aiming to induce intended organizational change. OD is based on social science methods and conducted by process-oriented consultants. In contrast to techniques of organizational design, OD is characterized by employee participation. One of the most important elements of OD is the so-called "survey-feedback-technique". Five examples illustrate how the survey-feedback-technique can be used to facilitate organisational learning. OD technique supports necessary change in health care organizations. It should be used more frequently.

  4. Operating health analysis of electric power systems

    Science.gov (United States)

    Fotuhi-Firuzabad, Mahmud

    The required level of operating reserve to be maintained by an electric power system can be determined using both deterministic and probabilistic techniques. Despite the obvious disadvantages of deterministic approaches there is still considerable reluctance to apply probabilistic techniques due to the difficulty of interpreting a single numerical risk index and the lack of sufficient information provided by a single index. A practical way to overcome difficulties is to embed deterministic considerations in the probabilistic indices in order to monitor the system well-being. The system well-being can be designated as healthy, marginal and at risk. The concept of system well-being is examined and extended in this thesis to cover the overall area of operating reserve assessment. Operating reserve evaluation involves the two distinctly different aspects of unit commitment and the dispatch of the committed units. Unit commitment health analysis involves the determination of which unit should be committed to satisfy the operating criteria. The concepts developed for unit commitment health, margin and risk are extended in this thesis to evaluate the response well-being of a generating system. A procedure is presented to determine the optimum dispatch of the committed units to satisfy the response criteria. The impact on the response wellbeing being of variations in the margin time, required regulating margin and load forecast uncertainty are illustrated. The effects on the response well-being of rapid start units, interruptible loads and postponable outages are also illustrated. System well-being is, in general, greatly improved by interconnection with other power systems. The well-being concepts are extended to evaluate the spinning reserve requirements in interconnected systems. The interconnected system unit commitment problem is decomposed into two subproblems in which unit scheduling is performed in each isolated system followed by interconnected system evaluation

  5. The health and health system of South Africa: historical roots of current public health challenges.

    Science.gov (United States)

    Coovadia, Hoosen; Jewkes, Rachel; Barron, Peter; Sanders, David; McIntyre, Diane

    2009-09-05

    The roots of a dysfunctional health system and the collision of the epidemics of communicable and non-communicable diseases in South Africa can be found in policies from periods of the country's history, from colonial subjugation, apartheid dispossession, to the post-apartheid period. Racial and gender discrimination, the migrant labour system, the destruction of family life, vast income inequalities, and extreme violence have all formed part of South Africa's troubled past, and all have inexorably affected health and health services. In 1994, when apartheid ended, the health system faced massive challenges, many of which still persist. Macroeconomic policies, fostering growth rather than redistribution, contributed to the persistence of economic disparities between races despite a large expansion in social grants. The public health system has been transformed into an integrated, comprehensive national service, but failures in leadership and stewardship and weak management have led to inadequate implementation of what are often good policies. Pivotal facets of primary health care are not in place and there is a substantial human resources crisis facing the health sector. The HIV epidemic has contributed to and accelerated these challenges. All of these factors need to be addressed by the new government if health is to be improved and the Millennium Development Goals achieved in South Africa.

  6. Toward systems epidemiology of coffee and health.

    Science.gov (United States)

    Cornelis, Marilyn C

    2015-02-01

    Coffee is one of the most widely consumed beverages in the world and has been associated with many health conditions. This review examines the limitations of the classic epidemiological approach to studies of coffee and health, and describes the progress in systems epidemiology of coffee and its correlated constituent, caffeine. Implications and applications of this growing body of knowledge are also discussed. Population-based metabolomic studies of coffee replicate coffee-metabolite correlations observed in clinical settings but have also identified novel metabolites of coffee response, such as specific sphingomyelin derivatives and acylcarnitines. Genome-wide analyses of self-reported coffee and caffeine intake and serum levels of caffeine support an overwhelming role for caffeine in modulating the coffee consumption behavior. Interindividual variation in the physiological exposure or response to any of the many chemicals present in coffee may alter the persistence and magnitude of their effects. It is thus imperative that future studies of coffee and health account for this variation. Systems epidemiological approaches promise to inform causality, parse the constituents of coffee responsible for health effects, and identify the subgroups most likely to benefit from increasing or decreasing coffee consumption.

  7. Capital investment strategies in health care systems.

    Science.gov (United States)

    Reiter, K L; Smith, D G; Wheeler, J R; Rivenson, H L

    2000-01-01

    Capital investment decisions are among the most important decisions made by firms. They determine the firm's capacity for providing services and commit the firm's cash for an extended period of time. Interviews with chief financial officers of leading health care systems reveal capital investment strategies that generally follow the recommendations of modern finance theory. Still, there is substantial variation in capital budgeting techniques, methods of risk adjustment, and the importance of qualitative considerations in investment decision making. There is also variation in delegation of investment decision making to operating units and methods of performance evaluation. Health care systems face the same challenges as other organizations in developing and implementing capital investment strategies that use consistent methods for evaluation of projects that have inconsistent aims and outcomes.

  8. Making Technology Ready: Integrated Systems Health Management

    Science.gov (United States)

    Malin, Jane T.; Oliver, Patrick J.

    2007-01-01

    This paper identifies work needed by developers to make integrated system health management (ISHM) technology ready and by programs to make mission infrastructure ready for this technology. This paper examines perceptions of ISHM technologies and experience in legacy programs. Study methods included literature review and interviews with representatives of stakeholder groups. Recommendations address 1) development of ISHM technology, 2) development of ISHM engineering processes and methods, and 3) program organization and infrastructure for ISHM technology evolution, infusion and migration.

  9. Integrated System Health Management (ISHM) and Autonomy

    Science.gov (United States)

    Figueroa, Fernando; Walker, Mark G.

    2018-01-01

    Systems capabilities on ISHM (Integrated System Health Management) and autonomy have traditionally been addressed separately. This means that ISHM functions, such as anomaly detection, diagnostics, prognostics, and comprehensive system awareness have not been considered traditionally in the context of autonomy functions such as planning, scheduling, and mission execution. One key reason is that although they address systems capabilities, both ISHM and autonomy have traditionally individually been approached as independent strategies and models for analysis. Additionally, to some degree, a unified paradigm for ISHM and autonomy has been difficult to implement due to limitations of hardware and software. This paper explores a unified treatment of ISHM and autonomy in the context of distributed hierarchical autonomous operations.

  10. Coal prices rise

    International Nuclear Information System (INIS)

    McLean, A.

    2001-01-01

    Coking and semi hard coking coal price agreements had been reached, but, strangely enough, the reaching of common ground on semi soft coking coal, ultra low volatile coal and thermal coal seemed some way off. More of this phenomenon later, but suffice to say that, traditionally, the semi soft and thermal coal prices have fallen into place as soon as the hard, or prime, coking coal prices have been determined. The rise and rise of the popularity of the ultra low volatile coals has seen demand for this type of coal grow almost exponentially. Perhaps one of the most interesting facets of the coking coal settlements announced to date is that the deals appear almost to have been preordained. The extraordinary thing is that the preordination has been at the prescience of the sellers. Traditionally, coking coal price fixing has been the prerogative of the Japanese Steel Mills (JSM) cartel (Nippon, NKK, Kawasaki, Kobe and Sumitomo) who presented a united front to a somewhat disorganised force of predominantly Australian and Canadian sellers. However, by the time JFY 2001 had come round, the rules of the game had changed

  11. Security for decentralized health information systems.

    Science.gov (United States)

    Bleumer, G

    1994-02-01

    Health care information systems must reflect at least two basic characteristics of the health care community: the increasing mobility of patients and the personal liability of everyone giving medical treatment. Open distributed information systems bear the potential to reflect these requirements. But the market for open information systems and operating systems hardly provides secure products today. This 'missing link' is approached by the prototype SECURE Talk that provides secure transmission and archiving of files on top of an existing operating system. Its services may be utilized by existing medical applications. SECURE Talk demonstrates secure communication utilizing only standard hardware. Its message is that cryptography (and in particular asymmetric cryptography) is practical for many medical applications even if implemented in software. All mechanisms are software implemented in order to be executable on standard-hardware. One can investigate more or less decentralized forms of public key management and the performance of many different cryptographic mechanisms. That of, e.g. hybrid encryption and decryption (RSA+DES-PCBC) is about 300 kbit/s. That of signing and verifying is approximately the same using RSA with a DES hash function. The internal speed, without disk accesses etc., is about 1.1 Mbit/s. (Apple Quadra 950 (MC 68040, 33 MHz, RAM: 20 MB, 80 ns. Length of RSA modulus is 512 bit).

  12. Organizational Structure and Management in Romanian Health System

    OpenAIRE

    Boldureanu Daniel; Boldureanu Gabriela

    2010-01-01

    The health system in Romania in a continuous transformation from a centralized system (type Semashko) exists before 1989 year to one based on social health insurance (type Bismark). This paper examines the management and the organizational structure of the health system in Romania, and the relations between them in the context of the Health Reform Law.

  13. 42 CFR 438.242 - Health information systems.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Health information systems. 438.242 Section 438.242... Measurement and Improvement Standards § 438.242 Health information systems. (a) General rule. The State must ensure, through its contracts, that each MCO and PIHP maintains a health information system that collects...

  14. Contributions of Global Health Diplomacy to Health Systems in Sub ...

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

    New research will help boost Africa's bargaining power in global health diplomacy, ... need to assert their public health interests in global health diplomacy from an ... Brazil, and India; and 3) the involvement of African actors in getting universal ...

  15. Towards 5G communication systems: Are there health implications?

    Science.gov (United States)

    Di Ciaula, Agostino

    2018-04-01

    The spread of radiofrequency electromagnetic fields (RF-EMF) is rising and health effects are still under investigation. RF-EMF promote oxidative stress, a condition involved in cancer onset, in several acute and chronic diseases and in vascular homeostasis. Although some evidences are still controversial, the WHO IARC classified RF-EMF as "possible carcinogenic to humans", and more recent studies suggested reproductive, metabolic and neurologic effects of RF-EMF, which are also able to alter bacterial antibiotic resistance. In this evolving scenario, although the biological effects of 5G communication systems are very scarcely investigated, an international action plan for the development of 5G networks has started, with a forthcoming increment in devices and density of small cells, and with the future use of millimeter waves (MMW). Preliminary observations showed that MMW increase skin temperature, alter gene expression, promote cellular proliferation and synthesis of proteins linked with oxidative stress, inflammatory and metabolic processes, could generate ocular damages, affect neuro-muscular dynamics. Further studies are needed to better and independently explore the health effects of RF-EMF in general and of MMW in particular. However, available findings seem sufficient to demonstrate the existence of biomedical effects, to invoke the precautionary principle, to define exposed subjects as potentially vulnerable and to revise existing limits. An adequate knowledge of pathophysiological mechanisms linking RF-EMF exposure to health risk should also be useful in the current clinical practice, in particular in consideration of evidences pointing to extrinsic factors as heavy contributors to cancer risk and to the progressive epidemiological growth of noncommunicable diseases. Copyright © 2018 Elsevier GmbH. All rights reserved.

  16. BRIC Health Systems and Big Pharma: A Challenge for Health Policy and Management.

    Science.gov (United States)

    Rodwin, Victor G; Fabre, Guilhem; Ayoub, Rafael F

    2018-01-02

    BRIC nations - Brazil, Russia, India, and China - represent 40% of the world's population, including a growing aging population and middle class with an increasing prevalence of chronic disease. Their healthcare systems increasingly rely on prescription drugs, but they differ from most other healthcare systems because healthcare expenditures in BRIC nations have exhibited the highest revenue growth rates for pharmaceutical multinational corporations (MNCs), Big Pharma. The response of BRIC nations to Big Pharma presents contrasting cases of how governments manage the tensions posed by rising public expectations and limited resources to satisfy them. Understanding these tensions represents an emerging area of research and an important challenge for all those who work in the field of health policy and management (HPAM). © 2018 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

  17. Defining Health in the Era of Value-based Care: Lessons from England of Relevance to Other Health Systems.

    Science.gov (United States)

    Gentry, Sarah; Badrinath, Padmanabhan

    2017-03-06

    The demand for healthcare is rising due to aging populations, rising chronic disease prevalence, and technological innovations. There are currently more effective and cost-effective interventions available than can be afforded within limited budgets. A new way of thinking about the optimal use of resources is needed. Ensuring that available resources are used for interventions that provide outcomes that patient's most value, rather than a focus just on effectiveness and cost-effectiveness, may help to ensure that resources are used optimally. Value-based healthcare puts what patients value at the center of healthcare. It helps ensure that they receive the care that can provide them with outcomes they think are important and that limited resources are focused on high-value interventions. In order to do this, we need flexible definitions of 'health', personalized and tailored to patient values. We review the current status of value-based health care in England and identify lessons applicable to a variety of health systems. For this, we draw upon the work of the National Institute for Health and Care Excellence (NICE), the National Health Service (NHS), Right Care Initiative, and our local experience in promoting value-based health care for specific conditions in our region. Combining the best available evidence with open and honest dialogue between patients, clinicians, and others, whilst requiring considerable time and resources are essential to building a consensus around the value that allows the best use of limited budgets. Values have been present in healthcare since its beginnings. Placing value and values at the center of healthcare could help to ensure available resources are used to provide the greatest possible benefit to patients.

  18. Occupational Safety and Health Management System (OSHMS)

    International Nuclear Information System (INIS)

    Shyen, A.K.S.; Mohd Khairul Hakimin; Manisah Saedon

    2011-01-01

    Safe work environment has always been one of the major concerns at workplace. For this, Occupational Safety and Health Act 1994 has been promulgated for all workplaces to ensure the Safety, Health and Welfare of its employees and any person at workplaces. Malaysian Nuclear Agency therefore has started the initiative to review and improve the current Occupational Safety and Health Management System (OSHMS) by going for OHSAS 18001:2007 and MS 1722 standards certification. This would also help in our preparation to bid as the TSO (Technical Support Organization) for the NPP (Nuclear Power Plant) when it is established. With a developed and well maintained OSHMS, it helps to create a safe working condition and thus enhancing the productivity, quality and good morale. Ultimately, this will lead to a greater organization profit. However, successful OSHMS requires full commitment and support from all level of the organization to work hand in hand in implementing the safety and health policy. Therefore it is essential for all to acknowledge the progress of the implementation and be part of it. (author)

  19. The role of health system governance in strengthening the rural health insurance system in China.

    Science.gov (United States)

    Yuan, Beibei; Jian, Weiyan; He, Li; Wang, Bingyu; Balabanova, Dina

    2017-05-23

    Systems of governance play a key role in the operation and performance of health systems. In the past six decades, China has made great advances in strengthening its health system, most notably in establishing a health insurance system that enables residents of rural areas to achieve access to essential services. Although there have been several studies of rural health insurance schemes, these have focused on coverage and service utilization, while much less attention has been given to the role of governance in designing and implementing these schemes. Information from publications and policy documents relevant to the development of two rural health insurance policies in China was obtained, analysed, and synthesise. 92 documents on CMS (Cooperative Medical Scheme) or NCMS (New Rural Cooperative Medical Scheme) from four databases searched were included. Data extraction and synthesis of the information were guided by a framework that drew on that developed by the WHO to describe health system governance and leadership. We identified a series of governance practices that were supportive of progress, including the prioritisation by the central government of health system development and certain health policies within overall national development; strong government commitment combined with a hierarchal administrative system; clear policy goals coupled with the ability for local government to adopt policy measures that take account of local conditions; and the accumulation and use of the evidence generated from local practices. However these good practices were not seen in all governance domains. For example, poor collaboration between different government departments was shown to be a considerable challenge that undermined the operation of the insurance schemes. China's success in achieving scale up of CMS and NCMS has attracted considerable interest in many low and middle income countries (LMICs), especially with regard to the schemes' designs, coverage, and funding

  20. Plume rise predictions

    International Nuclear Information System (INIS)

    Briggs, G.A.

    1976-01-01

    Anyone involved with diffusion calculations becomes well aware of the strong dependence of maximum ground concentrations on the effective stack height, h/sub e/. For most conditions chi/sub max/ is approximately proportional to h/sub e/ -2 , as has been recognized at least since 1936 (Bosanquet and Pearson). Making allowance for the gradual decrease in the ratio of vertical to lateral diffusion at increasing heights, the exponent is slightly larger, say chi/sub max/ approximately h/sub e/ - 2 . 3 . In inversion breakup fumigation, the exponent is somewhat smaller; very crudely, chi/sub max/ approximately h/sub e/ -1 . 5 . In any case, for an elevated emission the dependence of chi/sub max/ on h/sub e/ is substantial. It is postulated that a really clever ignorant theoretician can disguise his ignorance with dimensionless constants. For most sources the effective stack height is considerably larger than the actual source height, h/sub s/. For instance, for power plants with no downwash problems, h/sub e/ is more than twice h/sub s/ whenever the wind is less than 10 m/sec, which is most of the time. This is unfortunate for anyone who has to predict ground concentrations, for he is likely to have to calculate the plume rise, Δh. Especially when using h/sub e/ = h/sub s/ + Δh instead of h/sub s/ may reduce chi/sub max/ by a factor of anywhere from 4 to infinity. Factors to be considered in making plume rise predictions are discussed

  1. Pilot Implementation of Health Information Systems

    DEFF Research Database (Denmark)

    Bansler, Jørgen P.; Havn, Erling C.

    2009-01-01

    Pilot implementation is a powerful and widely used approach in identifying design flaws and implementation issues before the full-scale deployment of new health information systems. However, pilot implementations often fail in the sense that they say little about the usability and usefulness...... of the proposed system designs. This calls for studies that seek to uncover and analyze the reasons for failure, so that guidelines for conducting such pilots can be developed. In this paper, we present a qualitative field study of an ambitious, but unsuccessful pilot implementation of a Danish healthcare...... information system. Based on the findings from this study, we identify three main challenges: (1) defining an appropriate scope for pilot implementation, (2) managing the implementation process, and (3) ensuring commitment to the pilot. Finally, recommendations for future research and implications...

  2. Health system challenges in organizing quality diabetes care for urban poor in South India.

    Science.gov (United States)

    Bhojani, Upendra; Devedasan, Narayanan; Mishra, Arima; De Henauw, Stefaan; Kolsteren, Patrick; Criel, Bart

    2014-01-01

    Weak health systems in low- and middle-income countries are recognized as the major constraint in responding to the rising burden of chronic conditions. Despite recognition by global actors for the need for research on health systems, little attention has been given to the role played by local health systems. We aim to analyze a mixed local health system to identify the main challenges in delivering quality care for diabetes mellitus type 2. We used the health system dynamics framework to analyze a health system in KG Halli, a poor urban neighborhood in South India. We conducted semi-structured interviews with healthcare providers located in and around the neighborhood who provide care to diabetes patients: three specialist and 13 non-specialist doctors, two pharmacists, and one laboratory technician. Observations at the health facilities were recorded in a field diary. Data were analyzed through thematic analysis. There is a lack of functional referral systems and a considerable overlap in provision of outpatient care for diabetes across the different levels of healthcare services in KG Halli. Inadequate use of patients' medical records and lack of standard treatment protocols affect clinical decision-making. The poor regulation of the private sector, poor systemic coordination across healthcare providers and healthcare delivery platforms, widespread practice of bribery and absence of formal grievance redress platforms affect effective leadership and governance. There appears to be a trust deficit among patients and healthcare providers. The private sector, with a majority of healthcare providers lacking adequate training, operates to maximize profit, and healthcare for the poor is at best seen as charity. Systemic impediments in local health systems hinder the delivery of quality diabetes care to the urban poor. There is an urgent need to address these weaknesses in order to improve care for diabetes and other chronic conditions.

  3. Health system challenges in organizing quality diabetes care for urban poor in South India.

    Directory of Open Access Journals (Sweden)

    Upendra Bhojani

    Full Text Available BACKGROUND: Weak health systems in low- and middle-income countries are recognized as the major constraint in responding to the rising burden of chronic conditions. Despite recognition by global actors for the need for research on health systems, little attention has been given to the role played by local health systems. We aim to analyze a mixed local health system to identify the main challenges in delivering quality care for diabetes mellitus type 2. METHODS: We used the health system dynamics framework to analyze a health system in KG Halli, a poor urban neighborhood in South India. We conducted semi-structured interviews with healthcare providers located in and around the neighborhood who provide care to diabetes patients: three specialist and 13 non-specialist doctors, two pharmacists, and one laboratory technician. Observations at the health facilities were recorded in a field diary. Data were analyzed through thematic analysis. RESULT: There is a lack of functional referral systems and a considerable overlap in provision of outpatient care for diabetes across the different levels of healthcare services in KG Halli. Inadequate use of patients' medical records and lack of standard treatment protocols affect clinical decision-making. The poor regulation of the private sector, poor systemic coordination across healthcare providers and healthcare delivery platforms, widespread practice of bribery and absence of formal grievance redress platforms affect effective leadership and governance. There appears to be a trust deficit among patients and healthcare providers. The private sector, with a majority of healthcare providers lacking adequate training, operates to maximize profit, and healthcare for the poor is at best seen as charity. CONCLUSIONS: Systemic impediments in local health systems hinder the delivery of quality diabetes care to the urban poor. There is an urgent need to address these weaknesses in order to improve care for diabetes

  4. Social health insurance in Nepal: A health system departure toward the universal health coverage.

    Science.gov (United States)

    Pokharel, Rajani; Silwal, Pushkar Raj

    2018-04-10

    The World Health Organization has identified universal health coverage (UHC) as a key approach in reducing equity gaps in a country, and the social health insurance (SHI) has been recommended as an important strategy toward it. This article aims to analyze the design, expected benefits and challenges of realizing the goals of UHC through the recently launched SHI in Nepal. On top of the earlier free health-care policy and several other vertical schemes, the SHI scheme was implemented in 2016 and has reached population coverage of 5% in the implemented districts in just within a year of implementation. However, to achieve UHC in Nepal, in addition to operationalizing the scheme, several other requirements must be dealt simultaneously such as efficient health-care delivery system, adequate human resources for health, a strong information system, improved transparency and accountability, and a balanced mix of the preventive, health promotion, curative, and rehabilitative services including actions to address the social determinants of health. The article notes that strong political commitment and persistent efforts are the key lessons learnt from countries achieving progressive UHC through SHI. Copyright © 2018 John Wiley & Sons, Ltd.

  5. Beyond the bench and the bedside: economic and health systems dimensions of global childhood cancer outcomes.

    Science.gov (United States)

    Denburg, Avram E; Knaul, Felicia M; Atun, Rifat; Frazier, Lindsay A; Barr, Ronald D

    2014-03-01

    Globally, the number of new cases of childhood cancer continues to rise, with a widening gulf in outcomes across countries, despite the availability of effective cure options for many pediatric cancers. Economic forces and health system realities are deeply embedded in the foundation of disparities in global childhood cancer outcomes. A truly global effort to close the childhood cancer divide therefore requires systemic solutions. Analysis of the economic and health system dimensions of childhood cancer outcomes is essential to progress in childhood cancer survival around the globe. The conceptual power of this approach is significant. It provides insight into how and where pediatric oncology entwines with broader political and economic conditions, and highlights the mutual benefit derived from systems-oriented solutions. © 2013 Wiley Periodicals, Inc.

  6. Health and environmental risks of energy systems

    International Nuclear Information System (INIS)

    Hamilton, L.D.

    1984-01-01

    This paper gives four examples of health risk assessments of energy systems: (1) Comparative risk assessment of the health effects of the coal and nuclear fuel cycles. Estimates differ from previous values chiefly by inclusion of ranges of uncertainty, but some coal-cycle numbers were re-estimated. Upper-boundary public disease risks of air pollution from coal-fired plants dominate. Reactors probably account for most of the potential effect of major nuclear accidents. Accidental death rates in electricity generation are low for reactors and higher for coal. (2) Upper boundary air pollution health risks of existing fossil-based energy technologies in the United States. Preliminary mortality estimates were obtained combining potential impacts of three index pollutants - SO 4 , NO 2 , and CO - as independent measures of risk. Four fuel cycle trajectories leading to three end-uses were analyzed. Example results: domestic wood burning has substantial potential impact, with an upper boundary exceeding that of coal; upper-boundary air pollution impacts of gas can exceed those of oil, because of NO 2 . (3) Health risks of acid deposition and other transported air pollutants, carried out as part of an assessment of the US Congress Office of Technology Assessment (OTA) Acid Rain and Transported Air Pollutants - Implications for Public Policy. Three scenarios were examined, leading to estimates of 40,000 to 50,000 annual premature deaths, depending on year (1978 vs 2000) and scenario (holding total emissions constant vs 30% reduction). (4) health effects of uranium mill tailings piles. Mortality risk is estimated to be minuscule (8.7 x 10 -9 average individual lifetime cancer risk from a model mill, compared with 9.5 x 10 -4 for background radiation). Methods that sum risks over the indefinite future are shown to be to be unrealistic. 39 references, 7 figures, 15 tables

  7. Health and environmental risks of energy systems

    International Nuclear Information System (INIS)

    Hamilton, L.D.

    1984-01-01

    The paper gives four examples of health risk assessments of energy systems: (1) Comparative risk assessment of the health effects of the coal and nuclear fuel cycles. Estimates differ from previous values chiefly by inclusion of ranges of uncertainty, but some coal-cycle numbers were re-estimated. Upper-boundary public disease risks of air pollution from coal-fired plants dominate. Reactors probably account for most of the potential effect of major nuclear accidents. Accidental death rates in electricity generation are low for reactors and higher for coal. (2) Upper-boundary air pollution health risks of existing fossil-fuel-based energy technologies in the United States of America. Preliminary mortality estimates were obtained combining potential impacts of three index pollutants - SO 4 , NO 2 , and CO - as independent measures of risk. Four fuel cycle trajectories leading to three end-uses were analysed. (3) Health risks of acid deposition and other transported air pollutants, carried out as part of an assessment of the US Congress Office of Technology Assessment (OTA) 'Acid Rain and Transported Air Pollutants. (4) Health effects of uranium mill tailings piles. Mortality risk is estimated to be minuscule (8.7x10 -9 average individual lifetime cancer risk from a model mill, compared with 9.5x10 -4 for background radiation). Methods that sum risks over the indefinite future are shown to be unrealistic. As a final example of risk analysis, the cost-effectiveness analysis for proposed EPA standards for radionuclides is shown to be deficient by an analysis concluding that the cost per potential cancer avoided could range from US $70 million to US $140 billion

  8. Highlight: Improving health systems research in West Africa | IDRC ...

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

    2016-04-15

    Apr 15, 2016 ... ... by the University of Ghana School of Public Health, in partnership with WAHO and IDRC. Health systems research experts and partners from across the ... adopted direct payment for health services as the primary means.

  9. Privacy, confidentiality and automated health information systems.

    Science.gov (United States)

    Vuori, H

    1977-12-01

    Professor Vuori's paper, first presented at the fourth Medico-legal Conference in Prague in the spring of this year, deals with the problem of the maintenance of confidentiality in computerized health records. Although more and more information is required, the hardware of the computer systems is so sophisticated that it would be very expensive indeed to 'break in' and steal from a modern data bank. Those concerned with programming computers are becoming more aware of their responsibilities concerning confidentiality and privacy, to the extent that a legal code of ethics for programmers is being formulated. They are also aware that the most sensitive of all relationships--the doctor-patient relationship--could be in danger if they failed to maintain high standards of integrity. An area of danger is where administrative boundaries between systems must be crossed--say between those of health and employment. Protection of privacy must be ensured by releasing full information about the type of data being stored, and by maintaining democratic control over the establishment of information systems.

  10. Biosecurity through Public Health System Design.

    Energy Technology Data Exchange (ETDEWEB)

    Beyeler, Walter E. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Finley, Patrick D. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Arndt, William [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Walser, Alex Christian [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Mitchell, Michael David [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2016-11-01

    We applied modeling and simulation to examine the real-world tradeoffs between developingcountry public-health improvement and the need to improve the identification, tracking, and security of agents with bio-weapons potential. Traditionally, the international community has applied facility-focused strategies for improving biosecurity and biosafety. This work examines how system-level assessments and improvements can foster biosecurity and biosafety. We modeled medical laboratory resources and capabilities to identify scenarios where biosurveillance goals are transparently aligned with public health needs, and resource are distributed in a way that maximizes their ability to serve patients while minimizing security a nd safety risks. Our modeling platform simulates key processes involved in healthcare system operation, such as sample collection, transport, and analysis at medical laboratories. The research reported here extends the prior art by provided two key compone nts for comparative performance assessment: a model of patient interaction dynamics, and the capability to perform uncertainty quantification. In addition, we have outlined a process for incorporating quantitative biosecurity and biosafety risk measures. Two test problems were used to exercise these research products examine (a) Systemic effects of technological innovation and (b) Right -sizing of laboratory networks.

  11. Social Workers' Role in the Canadian Mental Health Care System

    Science.gov (United States)

    Towns, Ashley M.; Schwartz, Karen

    2012-01-01

    Objective: Using Canadian survey data this research provides social workers in Canada with a better understanding of their role in the Canadian mental health care system. Methods: By analyzing data from the Canadian Community Health Survey, Cycle 1.2 Mental Health and Well-being, the role of social workers in the Canadian mental health system was…

  12. Understanding The Resistance to Health Information Systems

    Directory of Open Access Journals (Sweden)

    David Ackah

    2017-07-01

    Full Text Available User resistance is users’ opposition to system implementation. Resistance often occurs as a result of a mismatch between management goals and employee preferences. There are two types of resistance to health iformation system namely active resistance and passive resistance. The manifestation of active resistance are being critical,  blaming/accusing, blocking, fault finding, sabotaging, undermining, ridiculing, intimidating/threatening, starting rumors, appealing to fear, manipulating arguing, using facts selectively, distorting facts and  raising objections. The manifestation of passive resistance are agreeing verbally but not following through, failing to implement change, procrastinating/dragging feet, feigning ignorance, withholding information, suggestions, help or support, and standing by and allowing the change to fail.

  13. A VME based health monitoring system

    International Nuclear Information System (INIS)

    Huang Yiming; Wang Chunhong

    2011-01-01

    It introduces a VME based health system for monitoring the working status of VME crates in the BEPCⅡ. It consists of a PC and a VME crate where a CMM (Classic Monitor System) is installed. The CMM module is responsible for collecting data from the power supply and temperature as well as fan speed inside the VME crate and send these data to the PC via the serial port. The author developed EPICS asynchronous driver by using a character-based device protocol StreamDevice. The data is saved into EPICS IOC database in character. Man-machine interface which is designed by BOY displays the running status of the VME crate including the power supply and temperature as well as fan speed. If the value of records display unusual, the color of the value will be changed into red. This can facilitate the maintenance of the VME crates. (authors)

  14. Canadian initiative leading the way for equitable health systems and ...

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

    2016-04-27

    Apr 27, 2016 ... Home · Resources · Publications ... The field of health systems research has grown into a vibrant community. IDRC grantees are actively involved in Health Systems Global, a newinternational agency that gathers researchers, ...

  15. Health financing: Who pays for equitable health systems? | IDRC ...

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

    2012-10-24

    Oct 24, 2012 ... Countries rich and poor face difficult choices in funding quality health care for ... while 31 member states of the World Health Organization pay less than ... on how poor families are benefiting from services – or being excluded.

  16. Health information systems: failure, success and improvisation.

    Science.gov (United States)

    Heeks, Richard

    2006-02-01

    The generalised assumption of health information systems (HIS) success is questioned by a few commentators in the medical informatics field. They point to widespread HIS failure. The purpose of this paper was therefore to develop a better conceptual foundation for, and practical guidance on, health information systems failure (and success). Literature and case analysis plus pilot testing of developed model. Defining HIS failure and success is complex, and the current evidence base on HIS success and failure rates was found to be weak. Nonetheless, the best current estimate is that HIS failure is an important problem. The paper therefore derives and explains the "design-reality gap" conceptual model. This is shown to be robust in explaining multiple cases of HIS success and failure, yet provides a contingency that encompasses the differences which exist in different HIS contexts. The design-reality gap model is piloted to demonstrate its value as a tool for risk assessment and mitigation on HIS projects. It also throws into question traditional, structured development methodologies, highlighting the importance of emergent change and improvisation in HIS. The design-reality gap model can be used to address the problem of HIS failure, both as a post hoc evaluative tool and as a pre hoc risk assessment and mitigation tool. It also validates a set of methods, techniques, roles and competencies needed to support the dynamic improvisations that are found to underpin cases of HIS success.

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

    Science.gov (United States)

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

    2007-01-01

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

  18. HEALTH CARE SYSTEM AS AN OBJECT OF STATISTICAL RESEARCH

    Directory of Open Access Journals (Sweden)

    Pavel A. Smelov

    2015-01-01

    Full Text Available The article describes the health care system of the Russian Federation as anobject of statistical analysis. The features of accounting of the health system in Russia. The article highlights the key aspects of the health system, which is characterized as fully as possible the object of study.

  19. Systems Thinking and the Leadership Conundrum in Health Care

    Science.gov (United States)

    Marchildon, Gregory P.; Fletcher, Amber J.

    2016-01-01

    The ability to think in terms of a system is critical to achieving common direction, alignment, and commitment in highly distributed health systems. In Canada, provincial and territorial ministries of health provide leadership on the direction of health reform while leadership to align system levels is determined by a far more distributed group of…

  20. Intelligent Integrated Health Management for a System of Systems

    Science.gov (United States)

    Smith, Harvey; Schmalzel, John; Figueroa, Fernando

    2008-01-01

    An intelligent integrated health management system (IIHMS) incorporates major improvements over prior such systems. The particular IIHMS is implemented for any system defined as a hierarchical distributed network of intelligent elements (HDNIE), comprising primarily: (1) an architecture (Figure 1), (2) intelligent elements, (3) a conceptual framework and taxonomy (Figure 2), and (4) and ontology that defines standards and protocols. Some definitions of terms are prerequisite to a further brief description of this innovation: A system-of-systems (SoS) is an engineering system that comprises multiple subsystems (e.g., a system of multiple possibly interacting flow subsystems that include pumps, valves, tanks, ducts, sensors, and the like); 'Intelligent' is used here in the sense of artificial intelligence. An intelligent element may be physical or virtual, it is network enabled, and it is able to manage data, information, and knowledge (DIaK) focused on determining its condition in the context of the entire SoS; As used here, 'health' signifies the functionality and/or structural integrity of an engineering system, subsystem, or process (leading to determination of the health of components); 'Process' can signify either a physical process in the usual sense of the word or an element into which functionally related sensors are grouped; 'Element' can signify a component (e.g., an actuator, a valve), a process, a controller, an actuator, a subsystem, or a system; The term Integrated System Health Management (ISHM) is used to describe a capability that focuses on determining the condition (health) of every element in a complex system (detect anomalies, diagnose causes, prognosis of future anomalies), and provide data, information, and knowledge (DIaK) not just data to control systems for safe and effective operation. A major novel aspect of the present development is the concept of intelligent integration. The purpose of intelligent integration, as defined and

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

    Science.gov (United States)

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

    2017-01-01

    and GDP growth rate, and high OOPS pose serious challenges for universal health coverage. Using multi-sector interventions, countries should develop and implement evidence-informed health system financing roadmaps to address these obstacles and move forward toward universal health coverage.

  2. Public health system - current status and world experience

    Directory of Open Access Journals (Sweden)

    Andreyeva І.А.

    2016-09-01

    Full Text Available In the review, the evolution of Public Health and global development tendencies of Public Health system have been discussed. Stages of formation of the updated concept, principles of Public Health organization and the role of various organizations have been shown in the connection with development of the global concept of "Health for All". A well-functioning public health system is primarily the result of multisectoral cooperation. The aim of modern Public Health is to provide conditions of access to appropriate and cost-effective health care for all population groups, including health promotion and disease prevention.

  3. MOTIVATION AND COMPENSATION IN HEALTH SYSTEM

    Directory of Open Access Journals (Sweden)

    K. N. Borisov

    2015-01-01

    Full Text Available By the definition accepted by WHO, «health» it is not simple absence of an illness, but a condition of full physical, moral, mental and social wellbeing. By this definition forms of behavior and a way of life of the people, allowing prolonging the period of active, creative and happy life are meant. Health of each person – the main value for modern society. A crisis state of population as open social system, it is shown by its indignation in reply to stressful influences of negative socio-economic factors. It is accompanied by change of a condition of the public health which level refl ects depth of occurring changes. In the conditions of market managing also, the policy in the field of compensation, material encouragement and social support of medical workers essentially changes. A certain level of compensation regardless of should be guaranteed to the medical worker, whether mechanisms of economic incentives of its work are used or not. At the same time, the desire of the worker to hold a position with higher salary and desire to work on it is productive and is qualitative – far not same. Increase of material compensation not always leads to increase of labor motivation and aspiration it is better to work. Socially psychological bases of labor motivation of medical workers are those new approaches that will allow solving problems of increase of labor motivation more effectively. In article the assessment of labor motivation is analyzed by medical workers, measures for increase of labor motivation and according to improvement of quality of medical care are off ered. The majority of the western experts inefficiency of management recognize as the main problem of health care ofRussia. The conclusion that medical institutes, academies and institutes of a post degree obrazoyovaniye, professional development faculties, and, probably, and institutes an upravleyoniya, should adapt foreign experience (motivational, conceptual, technological and

  4. MOTIVATION AND COMPENSATION IN HEALTH SYSTEM

    Directory of Open Access Journals (Sweden)

    K. N. Borisov

    2014-01-01

    Full Text Available By the defi nition accepted by WHO, «health» it is not simple absence of an illness, but a condition of full physical, moral, mental and social wellbeing. By this defi nition forms of behavior and a way of life of the people, allowing prolonging the period of active, creative and happy life are meant. Health of each person – the main value for modern society. A crisis state of population as open social system, it is shown by its indignation in reply to stressful infl uences of negative socio-economic factors. It is accompanied by change of a condition of the public health which level refl ects depth of occurring changes. In the conditions of market managing also, the policy in the fi eld of compensation, material encouragement and social support of medical workers essentially changes. A certain level of compensation regardless of should be guaranteed to the medical worker, whether mechanisms of economic incentives of its work are used or not. At the same time, the desire of the worker to hold a position with higher salary and desire to work on it is productive and is qualitative – far not same. Increase of material compensation not always leads to increase of labor motivation and aspiration it is better to work. Socially psychological bases of labor motivation of medical workers are those new approaches that will allow solving problems of increase of labor motivation more eff ectively. In article the assessment of labor motivation is analyzed by medical workers, measures for increase of labor motivation and according to improvement of quality of medical care are off ered. The majority of the western experts ineffi ciency of management recognize as the main problem of health care ofRussia. The conclusion that medical institutes, academies and institutes of a post degree obrazoyovaniye, professional development faculties, and, probably, and institutes an upravleyoniya, should adapt foreign experience (motivational, conceptual, technological

  5. Ambivalent implications of health care information systems: a study in the Brazilian public health care system

    Directory of Open Access Journals (Sweden)

    João Porto de Albuquerque

    2011-01-01

    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.

  6. Advantages of Information Systems in Health Services

    Directory of Open Access Journals (Sweden)

    MARIA MALLIAROU & SOFIA ZYGA

    2009-01-01

    Full Text Available Nursing Information System (NIS has been defined as “a part of a health care information system that deals with nursing aspects, particularly the maintenance of the nursing record”. Nursing Uses of Information Systems in order to assess patient acuity and condition, prepare a plan of care or critical pathway, specify interventions, document care, track outcomes and control quality in the given patient care. Patient care processes, Communication, research, education and ward management can be easily delivered using NIS. There is a specific procedure that should be followed when implementing NISs. The electronic databases CINAHL and Medline were used to identify studies for review. Studies were selected from a search that included the terms ‘nursing information systems’, ‘clinical information systems’, ‘hospital information systems’, ‘documentation’, ‘nursing records’, combined with ‘electronic’ and ‘computer’. Journal articles, research papers, and systematic reviews from 1980 to 2007 were included. In Greek Hospitals there have been made many trials and efforts in order to develop electronic nursing documentation with little results. There are many difficulties and some of them are different levels of nursing education, low nurse to patient ratios, not involvement of nurses in the phases of their implementation, resistance in change. Today’s nursing practice in Greece needs to follow others counties paradigm and phase its controversies and problems in order to follow the worldwide changes in delivering nursing care.

  7. Structure health assessment and warning system (SHAWS)

    Science.gov (United States)

    Bock, Daniel M.; Kim, Keehoon; Mapar, Jalal

    2008-03-01

    We are developing a Structure Health Assessment and Warning System (SHAWS) based on building displacement measurements and wireless communication. SHAWS will measure and predict the stability/instability of a building, determine whether it is safe for emergency responders to enter during an emergency, and provide individual warnings on the condition of the structure. SHAWS incorporates remote sensing nodes (RSNs) installed on the exterior frame of a building. Each RSN includes a temperature sensor, a three-axis accelerometer making static-acceleration measurements, and a ZigBee wireless system (IEEE 802.15.4). The RSNs will be deployed remotely using an air cannon delivery system, with each RSN having an innovative adhesive structure for fast (<10 min) and strong installation under emergency conditions. Once the building has moved past a threshold (~0.25 in./building story), a warning will be issued to emergency responders. In addition to the RSNs, SHAWS will include a base station located on an emergency responder's primary vehicle, a PDA for mobile data display to guide responders, and individual warning modules that can be worn by each responder. The individual warning modules will include visual and audio indicators with a ZigBee receiver to provide the proper degree of warning to each responder.

  8. Reforms are needed to increase public funding and curb demand for private care in Israel's health system.

    Science.gov (United States)

    Chernichovsky, Dov

    2013-04-01

    Historically, the Israeli health care system has been considered a high-performance system, providing universal, affordable, high-quality care to all residents. However, a decline in the ratio of physicians to population that reached a modern low in 2006, an approximate ten-percentage-point decline in the share of publicly financed health care between 1995 and 2009, and legislative mandates that favored private insurance have altered Israel's health care system for the worse. Many Israelis now purchase private health insurance to supplement the state-sponsored universal care coverage, and they end up spending more out of pocket even for services covered by the entitlement. Additionally, many publicly paid physicians moonlight at private facilities to earn more money. In this article I recommend that Israel increase public funding for health care and adopt reforms to address the rising demand for privately funded care and the problem of publicly paid physicians who moonlight at private facilities.

  9. A Case for Open Network Health Systems: Systems as Networks in Public Mental Health.

    Science.gov (United States)

    Rhodes, Michael Grant; de Vries, Marten W

    2017-01-08

    Increases in incidents involving so-called confused persons have brought attention to the potential costs of recent changes to public mental health (PMH) services in the Netherlands. Decentralized under the (Community) Participation Act (2014), local governments must find resources to compensate for reduced central funding to such services or "innovate." But innovation, even when pressure for change is intense, is difficult. This perspective paper describes experience during and after an investigation into a particularly violent incident and murder. The aim was to provide recommendations to improve the functioning of local PMH services. The investigation concluded that no specific failure by an individual professional or service provider facility led to the murder. Instead, also as a result of the Participation Act that severed communication lines between individuals and organizations, information sharing failures were likely to have reduced system level capacity to identify risks. The methods and analytical frameworks employed to reach this conclusion, also lead to discussion as to the plausibility of an unconventional solution. If improving communication is the primary problem, non-hierarchical information, and organizational networks arise as possible and innovative system solutions. The proposal for debate is that traditional "health system" definitions, literature and narratives, and operating assumptions in public (mental) health are 'locked in' constraining technical and organization innovations. If we view a "health system" as an adaptive system of economic and social "networks," it becomes clear that the current orthodox solution, the so-called integrated health system, typically results in a "centralized hierarchical" or "tree" network. An overlooked alternative that breaks out of the established policy narratives is the view of a 'health systems' as a non-hierarchical organizational structure or 'Open Network.' In turn, this opens new technological and

  10. [eHealth in Peru: implementation of policies to strengthen health information systems].

    Science.gov (United States)

    Curioso, Walter H

    2014-01-01

    Health information systems play a key role in enabling high quality, complete health information to be available in a timely fashion for operational and strategic decision-making that makes it possible to save lives and improve the health and quality of life of the population. In many countries, health information systems are weak, incomplete, and fragmented. However, there is broad consensus in the literature of the need to strengthen health information systems in countries around the world. The objective of this paper is to present the essential components of the conceptual framework to strengthen health information systems in Peru. It describes the principal actions and strategies of the Ministry of Health of Peru during the process of strengthening health information systems. These systems make it possible to orient policies for appropriate decision-making in public health.

  11. The Rising Burden of Diabetes and Hypertension in Southeast Asian and African Regions: Need for Effective Strategies for Prevention and Control in Primary Health Care Settings

    Directory of Open Access Journals (Sweden)

    Viswanathan Mohan

    2013-01-01

    Full Text Available Aim. To review the available literature on burden of diabetes mellitus (DM and hypertension (HTN and its coexistence in Southeast Asian (SEA and the African (AFR regions and to suggest strategies to improve DM and HTN prevention and control in primary health care (PHC in the two regions. Methods. A systematic review of the papers published on DM, HTN, and prevention/control of chronic diseases in SEA and AFR regions between 1980 and December 2012 was included. Results. In the year 2011, SEA region had the second largest number of people with DM (71.4 million, while the AFR region had the smallest number (14.7 million. Screening studies identified high proportions (>50% of individuals with previously undiagnosed HTN and DM in both of the SEA and AFR regions. Studies from both regions have shown that DM and HTN coexist in type 2 DM ranging from 20.6% in India to 78.4% in Thailand in the SEA region and ranging from 9.7% in Nigeria to 70.4% in Morocco in the AFR region. There is evidence that by lifestyle modification both DM and HTN can be prevented. Conclusion. To meet the twin challenge of DM and HTN in developing countries, PHCs will have to be strengthened with a concerted and multipronged effort to provide promotive, preventive, curative, and rehabilitative services.

  12. Mental health care system optimization from a health-economics perspective: where to sow and where to reap?

    Science.gov (United States)

    Lokkerbol, Joran; Weehuizen, Rifka; Mavranezouli, Ifigeneia; Mihalopoulos, Cathrine; Smit, Filip

    2014-06-01

    Health care expenditure (as % of GDP) has been rising in all OECD countries over the last decades. Now, in the context of the economic downturn, there is an even more pressing need to better guarantee the sustainability of health care systems. This requires that policy makers are informed about optimal allocation of budgets. We take the Dutch mental health system in the primary care setting as an example of new ways to approach optimal allocation. To demonstrate how health economic modelling can help in identifying opportunities to improve the Dutch mental health care system for patients presenting at their GP with symptoms of anxiety, stress, symptoms of depression, alcohol abuse/dependence, anxiety disorder or depressive disorder such that changes in the health care system have the biggest leverage in terms of improved cost-effectiveness. Investigating such scenarios may serve as a starting point for setting an agenda for innovative and sustainable health care policies. A health economic simulation model was used to synthesize clinical and economic evidence. The model was populated with data from GPs' national register on the diagnosis, treatment, referral and prescription of their patients in the year 2009. A series of `what-if' analyses was conducted to see what parameters (uptake, adherence, effectiveness and the costs of the interventions) are associated with the most substantial impact on the cost-effectiveness of the health care system overall. In terms of improving the overall cost-effectiveness of the primary mental health care system, substantial benefits could be derived from increasing uptake of psycho-education by GPs for patients presenting with stress and when low cost interventions are made available that help to increase the patients' compliance with pharmaceutical interventions, particularly in patients presenting with symptoms of anxiety. In terms of intervention costs, decreasing the costs of antidepressants is expected to yield the biggest

  13. Priority-setting in health systems

    DEFF Research Database (Denmark)

    Byskov, Jens

    2013-01-01

    improvements work similarly in the vast array of social and other local contextual factors. Local, fair and accountable priority setting processes are neccessary to make the best of ever shifting national level strategies and priorities. An approach is described, which can assist in the involvement......DBL - under core funding from Danish International Development Agency (Danida) 2013 WHY HAVE HEALTH SYSTEMS WHEN EFFECTIVE INTERVENTIONS ARE KNOWN? Case: A teenage mother lives in a poor sub-Saharan village next to a big lake. The area is known to have malaria transmission all year around......, and surveys in nearby villages have shown a high prevalence of intestinal helminthiasis and schistosomiasis. The HIV prevalence in similar rural settings is about 10% in her age group. She has been losing weight over the last months and now her one-year-old child feels hot and is not eating well. She has...

  14. Sustainable food systems for optimal planetary health.

    Science.gov (United States)

    Canavan, Chelsey R; Noor, Ramadhani A; Golden, Christopher D; Juma, Calestous; Fawzi, Wafaie

    2017-06-01

    Sustainable food systems are an important component of a planetary health strategy to reduce the threat of infectious disease, minimize environmental footprint and promote nutrition. Human population trends and dietary transition have led to growing demand for food and increasing production and consumption of meat, amid declining availability of arable land and water. The intensification of livestock production has serious environmental and infectious disease impacts. Land clearing for agriculture alters ecosystems, increases human-wildlife interactions and leads to disease proliferation. Context-specific interventions should be evaluated towards optimizing nutrition resilience, minimizing environmental footprint and reducing animal and human disease risk. © The Author 2017. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.

  15. Accidents Preventive Practice for High-Rise Construction

    Directory of Open Access Journals (Sweden)

    Goh Kai Chen

    2016-01-01

    Full Text Available The demand of high-rise projects continues to grow due to the reducing of usable land area in Klang Valley, Malaysia. The rapidly development of high-rise projects has leaded to the rise of fatalities and accidents. An accident that happened in a construction site can cause serious physical injury. The accidents such as people falling from height and struck by falling object were the most frequent accidents happened in Malaysian construction industry. The continuous growth of high-rise buildings indicates that there is a need of an effective safety and health management. Hence, this research aims to identify the causes of accidents and the ways to prevent accidents that occur at high-rise building construction site. Qualitative method was employed in this research. Interview surveying with safety officers who are involved in highrise building project in Kuala Lumpur were conducted in this research. Accidents were caused by man-made factors, environment factors or machinery factors. The accidents prevention methods were provide sufficient Personal Protective Equipment (PPE, have a good housekeeping, execute safety inspection, provide safety training and execute accidents investigation. In the meanwhile, interviewees have suggested the new prevention methods that were develop a proper site layout planning and de-merit and merit system among sub-contractors, suppliers and even employees regarding safety at workplace matters. This research helps in explaining the causes of accidents and identifying area where prevention action should be implemented, so that workers and top management will increase awareness in preventing site accidents.

  16. Recent progress in sensor-enhanced health information systems - slowly but sustainably.

    Science.gov (United States)

    Marschollek, Michael

    2009-12-01

    The use of health-enabling technologies is regarded as one important means to face some of the challenges which accompany the demographic change with an expected rise in multi-morbidity and an increased need of care. A precondition for the sensible use of these technologies is their integration in existing information system structures, and - preferably - the enhancement of these into sensor-enhanced health information systems (seHIS). The aim of this review is to report on recent progress in seHIS, and thus to identify relevant areas of research that have to be addressed to provide patient-centered services in a semantically interoperable environment. A literature search in PubMed/Medline was combined with a manual search of papers (n = 1004) in three prominent health/medical informatics journals and one biomedical engineering journal starting from the year 2007. Despite a multitude of papers that present advanced systems using health-enabling technologies, only few papers could be identified that explicitly describe the design of seHIS or the integration of health-enabling technologies into health information systems. Recurring statements emphasise the importance of the following areas of research: patient-centered care using all available sources of information, data security, the stringent use of data representation and device connectivity standards, and adequate methods for data fusion and diagnostic analysis. There is a broad range of research in health-enabling technologies, often focused on specific diseases. The transition from current institution-centered health information systems to person-centered seHIS will be gradual, yet unavoidable for tapping the full potential of health-enabling technologies. seHIS is a growing field of research, and many ambitious challenges are still open. This literature review gives a brief outline of the most frequently mentioned research foci.

  17. Oral health information systems--towards measuring progress in oral health promotion and disease prevention

    DEFF Research Database (Denmark)

    Petersen, Poul Erik; Bourgeois, Denis; Bratthall, Douglas

    2005-01-01

    and the general public. WHO has developed global and regional oral health databanks for surveillance, and international projects have designed oral health indicators for use in oral health information systems for assessing the quality of oral health care and surveillance systems. Modern oral health information...... been designed by WHO and used by countries worldwide for the surveillance of oral disease and health. Global, regional and national oral health databanks have highlighted the changing patterns of oral disease which primarily reflect changing risk profiles and the implementation of oral health...... programmes oriented towards disease prevention and health promotion. The WHO Oral Health Country/Area Profile Programme (CAPP) provides data on oral health from countries, as well as programme experiences and ideas targeted to oral health professionals, policy-makers, health planners, researchers...

  18. Application of ubiquitous computing in personal health monitoring systems.

    Science.gov (United States)

    Kunze, C; Grossmann, U; Stork, W; Müller-Glaser, K D

    2002-01-01

    A possibility to significantly reduce the costs of public health systems is to increasingly use information technology. The Laboratory for Information Processing Technology (ITIV) at the University of Karlsruhe is developing a personal health monitoring system, which should improve health care and at the same time reduce costs by combining micro-technological smart sensors with personalized, mobile computing systems. In this paper we present how ubiquitous computing theory can be applied in the health-care domain.

  19. Are there differences in health information exchange by health system type?

    Science.gov (United States)

    Opoku-Agyeman, William; Menachemi, Nir

    2016-01-01

    Despite the potential of health information exchange (HIE) to improve safety and reduce cost, hospitals have been slow to adopt HIE with only 30% of U.S. hospitals doing so in 2012. The aim of this study was to explore the relationship between different health system types and how they engage in HIE. Data on health system types and engagement in HIE activity were combined with secondary hospital characteristics. Ordinal logistic regression analyses were used to examine the relationship between a scale measuring the level of HIE engagement and health system type controlling for hospital and market characteristics. Data from 1552 hospitals were available for analyses. Overall, hospital in a health system of any kind exchanged more patient data elements (e.g., patient demographics, clinical summaries, laboratory results, medication history, and radiology report) compared with stand-alone hospitals (3.82 vs. 1.80, p centralized health systems, 75 (4.8%) were in centralized physician/insurance health system, 284 (18.3%) were in moderately centralized health system, 391 (25.2%) were in decentralized health system, and 91 (5.9%) were in independent health system. In regression analyses, hospitals belonging to a health system were more likely to exchange patient health data with other hospitals in the same system (OR = 3.94, p < .001) but not with hospitals outside their system (OR = 1.89, p = .445). Across health system types, there was no significant difference in the exchange of patient health data. Hospital engagement in HIE is associated with health system membership. These findings will assist hospital leaders and managers to better understand how the structure and nature of their system may influence what their individual hospital can and cannot do in their decision to engage in HIE and other decisions that support the overall system objectives.

  20. Socioecological Aspects of High-rise Construction

    Science.gov (United States)

    Eichner, Michael; Ivanova, Zinaida

    2018-03-01

    In this article, the authors consider the socioecological problems that arise in the construction and operation of high-rise buildings. They study different points of view on high-rise construction and note that the approaches to this problem are very different. They also analyse projects of modern architects and which attempts are made to overcome negative impacts on nature and mankind. The article contains materials of sociological research, confirming the ambivalent attitude of urban population to high-rise buildings. In addition, one of the author's sociological survey reveals the level of environmental preparedness of the university students, studying in the field of "Construction of unique buildings and structures", raising the question of how future specialists are ready to take into account socioecological problems. Conclusion of the authors: the construction of high-rise buildings is associated with huge social and environmental risks, negative impact on the biosphere and human health. This requires deepened skills about sustainable design methods and environmental friendly construction technologies of future specialists. Professor M. Eichner presents in the article his case study project results on implementation of holistic eco-sustainable construction principles for mixed-use high-rise building in the metropolis of Cairo.

  1. Socioecological Aspects of High-rise Construction

    Directory of Open Access Journals (Sweden)

    Eichner Michael

    2018-01-01

    Full Text Available In this article, the authors consider the socioecological problems that arise in the construction and operation of high-rise buildings. They study different points of view on high-rise construction and note that the approaches to this problem are very different. They also analyse projects of modern architects and which attempts are made to overcome negative impacts on nature and mankind. The article contains materials of sociological research, confirming the ambivalent attitude of urban population to high-rise buildings. In addition, one of the author’s sociological survey reveals the level of environmental preparedness of the university students, studying in the field of "Construction of unique buildings and structures", raising the question of how future specialists are ready to take into account socioecological problems. Conclusion of the authors: the construction of high-rise buildings is associated with huge social and environmental risks, negative impact on the biosphere and human health. This requires deepened skills about sustainable design methods and environmental friendly construction technologies of future specialists. Professor M. Eichner presents in the article his case study project results on implementation of holistic eco-sustainable construction principles for mixed-use high-rise building in the metropolis of Cairo.

  2. Exploring models for the roles of health systems' responsiveness and social determinants in explaining universal health coverage and health outcomes.

    Science.gov (United States)

    Valentine, Nicole Britt; Bonsel, Gouke J

    2016-01-01

    Intersectoral perspectives of health are present in the rhetoric of the sustainable development goals. Yet its descriptions of systematic approaches for an intersectoral monitoring vision, joining determinants of health, and barriers or facilitators to accessing healthcare services are lacking. To explore models of associations between health outcomes and health service coverage, and health determinants and health systems responsiveness, and thereby to contribute to monitoring, analysis, and assessment approaches informed by an intersectoral vision of health. The study is designed as a series of ecological, cross-country regression analyses, covering between 23 and 57 countries with dependent health variables concentrated on the years 2002-2003. Countries cover a range of development contexts. Health outcome and health service coverage dependent variables were derived from World Health Organization (WHO) information sources. Predictor variables representing determinants are derived from the WHO and World Bank databases; variables used for health systems' responsiveness are derived from the WHO World Health Survey. Responsiveness is a measure of acceptability of health services to the population, complementing financial health protection. Health determinants' indicators - access to improved drinking sources, accountability, and average years of schooling - were statistically significant in particular health outcome regressions. Statistically significant coefficients were more common for mortality rate regressions than for coverage rate regressions. Responsiveness was systematically associated with poorer health and health service coverage. With respect to levels of inequality in health, the indicator of responsiveness problems experienced by the unhealthy poor groups in the population was statistically significant for regressions on measles vaccination inequalities between rich and poor. For the broader determinants, the Gini mattered most for inequalities in child

  3. Strengthening the Health System to Better Confront Noncommunicable Diseases in India

    Directory of Open Access Journals (Sweden)

    Antonio Duran

    2011-01-01

    Full Text Available The paper emphasizes the vital need to address the rising burden of noncommunicable diseases (NCDs in India with a health systems approach. The authors argue that adoption of such approach may soon be imperative. Applying the health systems framework developed by the WHO in 2000 to NCDs means in summary re-examining the planning and organization of the entire health system, from service provision to financing, from information generation to ensuring adequate supply of pharmaceuticals/technologies or human resources, from improving facility management to performance monitoring. Using this framework the authors seek to highlight core issues and identify possible policy actions required. The challenge is to ensure the best implementation of what works, aligning the service provision function with the financial incentives, ensuring leadership/stewardship by the government across local/municipal, state or regional and national level while involving stakeholders. A health system perspective would also ensure that action against NCD goes hand in hand with tackling the remaining burden from communicable diseases, maternal, child health and nutrition issues.

  4. [Framework for the strengthening of health information systems in Peru].

    Science.gov (United States)

    Curioso, Walter H; Espinoza-Portilla, Elizabeth

    2015-01-01

    In this article we present the essential components and policies that are most relevant regarding the conceptual framework to strengthen the health information systems in Peru. The article also presents the main policies, actions and strategies made in the field of electronic health in Peru that are most significant. The health information systems in Peru play a key role and are expected to achieve an integrated and interoperable information system. This will allow health information to be complete, efficient, of good quality and available in a timely manner to achieve better quality of life for people and allow meaningful modernization of public health in the context of health reform in Peru.

  5. Consultation on the Libyan health systems: towards patient-centred ...

    African Journals Online (AJOL)

    To start the planning process to re-engineer the health sector, the Libyan Ministry of Health in collaboration with the World Health Organisation (WHO) and other international experts in the field sponsored the National Health Systems Conference in Tripoli, Libya, between the 26th and the 30th of August 2012. The aim of ...

  6. The Role of Education in Health System Performance

    Science.gov (United States)

    Grignon, Michel

    2008-01-01

    I investigate the role of education on health, using country-level data and the production frontier framework suggested by the World Health Organization (WHO) to assess performances of health care systems. I find that the impact of human capital on health is much smaller than suggested by the WHO frontier model, and the relationship exhibits…

  7. Implementing a routine health management information system in ...

    African Journals Online (AJOL)

    South Sudan has recently acquired statehood. Planning and management of the health care system, based on evidence, requires a constant flow of information from health services. The Division of Monitoring and Evaluation (M&E) of the Ministry of Health developed the framework for the health sector of the country in 2008.

  8. The Rise of the Professional Field of Medicine in Sweden

    Directory of Open Access Journals (Sweden)

    Carina Carlhed

    2013-12-01

    Full Text Available This article is an analysis of conditions enabling the rise of the professional field of medicine in Sweden. The analysis is based mainly on second- ary data, while the use of primary data is restricted to official statistics. Primarily, it aims to study the conditions promoting professionalization in medicine. Important exogenous conditions were derived from early emerging nation state administration structures concerning policy and governance of public health, as well as a delegated supervision of professional health activities to the medical profession and the organization of a public national health care system. Professionalization strategies such as social organization of the medical profession and their use of a variety of legitimizing resources as tools for jurisdictional claims are considered as endogenous conditions. Broadly, the analysis shows a close relationship between the growth of professionalization in the field of medicine and the development of state prosperity in the Swedish welfare state. 

  9. Performance of community health workers:situating their intermediary position within complex adaptive health systems

    OpenAIRE

    Kok, Maryse. C; Broerse, Jacqueline E.W; Theobald, Sally; Ormel, Hermen; Dieleman, Marjolein; Taegtmeyer, Miriam

    2017-01-01

    Health systems are social institutions, in which health worker performance is shaped by transactional processes between different actors. This analytical assessment unravels the complex web of factors that influence the performance of community health workers (CHWs) in low- and middle-income countries. It examines their unique intermediary position between the communities they serve and actors in the health sector, and the complexity of the health systems in which they operate. The assessment...

  10. Hydrogeology of, simulation of groundwater flow in, and potential effects of sea-level rise on the Kirkwood-Cohansey aquifer system in the vicinity of Edwin B. Forsythe National Wildlife Refuge, New Jersey

    Science.gov (United States)

    Fiore, Alex R.; Voronin, Lois M.; Wieben, Christine M.

    2018-03-19

    The Edwin B. Forsythe National Wildlife Refuge encompasses more than 47,000 acres of New Jersey coastal habitats, including salt marshes, freshwater wetlands, tidal wetlands, barrier beaches, woodlands, and swamps. The refuge is along the Atlantic Flyway and provides breeding habitat for fish, migratory birds, and other wildlife species. The refuge area may be threatened by global climate change, including sea-level rise (SLR).The Kirkwood-Cohansey aquifer system underlies the Edwin B. Forsythe National Wildlife Refuge. Groundwater is an important source of freshwater flow into the refuge, but information about the interaction of surface water and groundwater in the refuge area and the potential effects of SLR on the underlying aquifer system is limited. The U.S. Geological Survey (USGS), in cooperation with the U.S. Fish and Wildlife Service (USFWS), conducted a hydrologic assessment of the refuge in New Jersey and developed a groundwater flow model to improve understanding of the geohydrology of the refuge area and to serve as a tool to evaluate changes in groundwater-level altitudes that may result from a rise in sea level.Groundwater flow simulations completed for this study include a calibrated baseline simulation that represents 2005–15 hydraulic conditions and three SLR scenarios―20, 40, and 60 centimeters (cm) (0.656, 1.312, and 1.968 feet, respectively). Results of the three SLR simulations indicate that the water table in the unconfined Kirkwood-Cohansey aquifer system in the refuge area will rise, resulting in increased discharge of fresh groundwater to freshwater wetlands and streams. As sea level rises, simulated groundwater discharge to the salt marsh, bay, and ocean is projected to decrease. Flow from the salt marsh, bay, and ocean to the overlying surface water is projected to increase as sea level rises.The simulated movement of the freshwater-seawater interface as sea level rises depends on the hydraulic-head gradient. In the center of the

  11. Guidelines for Psychological Practice in Health Care Delivery Systems

    Science.gov (United States)

    American Psychologist, 2013

    2013-01-01

    Psychologists practice in an increasingly diverse range of health care delivery systems. The following guidelines are intended to assist psychologists, other health care providers, administrators in health care delivery systems, and the public to conceptualize the roles and responsibilities of psychologists in these diverse contexts. These…

  12. ISWHM: Tools and Techniques for Software and System Health Management

    Science.gov (United States)

    Schumann, Johann; Mengshoel, Ole J.; Darwiche, Adnan

    2010-01-01

    This presentation presents status and results of research on Software Health Management done within the NRA "ISWHM: Tools and Techniques for Software and System Health Management." Topics include: Ingredients of a Guidance, Navigation, and Control System (GN and C); Selected GN and C Testbed example; Health Management of major ingredients; ISWHM testbed architecture; and Conclusions and next Steps.

  13. Global Health Systems and Policy Development: Implications for Health Literacy Research, Theory and Practice.

    Science.gov (United States)

    Rowlands, Gillian; Dodson, Sarity; Leung, Angela; Levin-Zamir, Diane

    2017-01-01

    Accessible and responsive health systems are critical to population health and human development. While progress has been made toward global health and development targets, significant inequities remain within and between countries. Expanding health inequities suggest a widespread and systemic neglect of vulnerable citizens, and a failure to enshrine within policies a responsibility to tailor care to the variable capabilities of citizens. Implementation of health and social policies that drive the design of accessible health systems, services, products and infrastructure represents the next frontier for health reform. Within this chapter we argue the need to consider health and health literacy across policy domains, to operationalize the intent to address inequities in health in meaningful and pragmatic ways, and to actively monitor progress and impact within the context of the Sustainable Development Goals (SDGs). We contend that viewing and developing policies and systems within a health literacy framework will assist in placing citizens and equity considerations at the center of development efforts. In this chapter, we explore the relationship between health literacy and equitable access to health care, and the role of health system and policy reform. We first explore international policies, health literacy, and the SDGs. We then explore national policies and the role that national and local services and systems play in building health literacy, and responding to the health literacy challenges of citizens. We discuss the World Health Organization's (WHO) Framework for Integrated People-Centered Health Services and the way in which health services are being encouraged to understand and respond to citizen health literacy needs. Each section of the chapter ends with a summary and a review of health literacy research and practice. Throughout, we illustrate our points through 'vignettes' from around the world.

  14. Thinking shift on health systems: from blueprint health programmes towards resilience of health systems Comment on "Constraints to applying systems thinking concepts in health systems: A regional perspective from surveying stakeholders in Eastern Mediterranean countries".

    Science.gov (United States)

    Blanchet, Karl

    2015-03-03

    International health is still highly dominated by equilibrium approaches. The emergence of systems thinking in international health provides a great avenue to develop innovative health interventions adapted to changing contexts. The public health community, nevertheless, has the responsibility to translate concepts related to systems thinking and complexity into concrete research methods and interventions. One possibility is to consider the properties of systems such as resilience and adaptability as entry points to better understand how health systems react to shocks. © 2015 by Kerman University of Medical Sciences.

  15. Viewpoint: Re-instating a 'public health' system under universal health care in India.

    Science.gov (United States)

    George, Mathew

    2015-02-01

    I examine possibilities for strengthening essential public health functions in the context of India's drive to implement universal health care. In a country where population health outcomes are rooted in social, political, economic, cultural, and ecological conditions, it is important to have a state mediated public health system that can modify the causes of the major public health problems. This calls for strengthening the social epidemiological approach in public health by demarcating public health functions distinct from medical care. This will be a prerequisite for the growth of the public health profession in the country, because it can offer avenues for newly trained professionals within the country to work in 'core' public health.

  16. Principles and core functions of integrated child health information systems.

    Science.gov (United States)

    Hinman, Alan R; Atkinson, Delton; Diehn, Tonya Norvell; Eichwald, John; Heberer, Jennifer; Hoyle, Therese; King, Pam; Kossack, Robert E; Williams, Donna C; Zimmerman, Amy

    2004-11-01

    Infants undergo a series of preventive and therapeutic health interventions and activities. Typically, each activity includes collection and submission of data to a dedicated information system. Subsequently, health care providers, families, and health programs must query each information system to determine the child's status in a given area. Efforts are underway to integrate information in these separate information systems. This requires specifying the core functions that integrated information systems must perform.

  17. Increment 23/24 Critical Readiness Review Health Maintenance System

    Science.gov (United States)

    Nieschwitz, Linda

    2010-01-01

    This slide presentation reviews the Health Maintenance System. It includes information on the carbon dioxide (CO2) and moisture removal system (CMRS), the variable oxygen system,rendevous station panels, and the crew contamination protection kit (CCPK).

  18. Rationing in health systems: A critical review.

    Science.gov (United States)

    Keliddar, Iman; Mosadeghrad, Ali Mohammad; Jafari-Sirizi, Mehdi

    2017-01-01

    Background: It is difficult to provide health care services to all those in need of such services due to limited resources and unlimited demands. Thus, priority setting and rationing have to be applied. This study aimed at critically examining the concept of rationing in health sector and identifying its purposes, influencing factors, mechanisms, and outcomes. Methods: The critical interpretive synthesis methodology was used in this study. PubMed, Cochrane, and Proquest databases were searched using the related key words to find related documents published between 1970 and 2015. In total, 161 published reports were reviewed and included in the study. Thematic content analysis was applied for data analysis. Results: Health services rationing means restricting the access of some people to useful or potentially useful health services due to budgetary limitation. The inherent features of the health market and health services, limited resources, and unlimited needs necessitate health services rationing. Rationing can be applied in 4 levels: health care policy- makers, health care managers, health care providers, and patients. Health care rationing can be accomplished through fixed budget, benefit package, payment mechanisms, queuing, copayments, and deductibles. Conclusion: This paper enriched our understanding of health services rationing and its mechanisms at various levels and contributed to the literature by broadly conceptualizing health services rationing.

  19. Health system resilience: Lebanon and the Syrian refugee crisis

    Science.gov (United States)

    Ammar, Walid; Kdouh, Ola; Hammoud, Rawan; Hamadeh, Randa; Harb, Hilda; Ammar, Zeina; Atun, Rifat; Christiani, David; Zalloua, Pierre A

    2016-01-01

    Background Between 2011 and 2013, the Lebanese population increased by 30% due to the influx of Syrian refugees. While a sudden increase of such magnitude represents a shock to the health system, threatening the continuity of service delivery and destabilizing governance, it also offers a unique opportunity to study resilience of a health system amidst ongoing crisis. Methods We conceptualized resilience as the capacity of a health system to absorb internal or external shocks (for example prevent or contain disease outbreaks and maintain functional health institutions) while sustaining achievements. We explored factors contributing to the resilience of the Lebanese health system, including networking with stakeholders, diversification of the health system, adequate infrastructure and health human resources, a comprehensive communicable disease response and the integration of the refugees within the health system. Results In studying the case of Lebanon we used input–process–output–outcome approach to assess the resilience of the Lebanese health system. This approach provided us with a holistic view of the health system, as it captured not only the sustained and improved outcomes, but also the inputs and processes leading to them. Conclusion Our study indicates that the Lebanese health system was resilient as its institutions sustained their performance during the crisis and even improved. PMID:28154758

  20. A Case for Open Network Health Systems: Systems as Networks in Public Mental Health

    Directory of Open Access Journals (Sweden)

    Michael Grant Rhodes

    2017-03-01

    Full Text Available Increases in incidents involving so-called confused persons have brought attention to the potential costs of recent changes to public mental health (PMH services in the Netherlands. Decentralized under the (Community Participation Act (2014, local governments must find resources to compensate for reduced central funding to such services or “innovate.” But innovation, even when pressure for change is intense, is difficult. This perspective paper describes experience during and after an investigation into a particularly violent incident and murder. The aim was to provide recommendations to improve the functioning of local PMH services. The investigation concluded that no specific failure by an individual professional or service provider facility led to the murder. Instead, also as a result of the Participation Act that severed communication lines between individuals and organizations, information sharing failures were likely to have reduced system level capacity to identify risks. The methods and analytical frameworks employed to reach this conclusion, also lead to discussion as to the plausibility of an unconventional solution. If improving communication is the primary problem, non-hierarchical information, and organizational networks arise as possible and innovative system solutions. The proposal for debate is that traditional “health system” definitions, literature and narratives, and operating assumptions in public (mental health are ‘locked in’ constraining technical and organization innovations. If we view a “health system” as an adaptive system of economic and social “networks,” it becomes clear that the current orthodox solution, the so-called integrated health system, typically results in a “centralized hierarchical” or “tree” network. An overlooked alternative that breaks out of the established policy narratives is the view of a ‘health systems’ as a non-hierarchical organizational structure or

  1. On Capillary Rise and Nucleation

    Science.gov (United States)

    Prasad, R.

    2008-01-01

    A comparison of capillary rise and nucleation is presented. It is shown that both phenomena result from a balance between two competing energy factors: a volume energy and a surface energy. Such a comparison may help to introduce nucleation with a topic familiar to the students, capillary rise. (Contains 1 table and 3 figures.)

  2. HiRISE: The People's Camera

    Science.gov (United States)

    McEwen, A. S.; Eliason, E.; Gulick, V. C.; Spinoza, Y.; Beyer, R. A.; HiRISE Team

    2010-12-01

    The High Resolution Imaging Science Experiment (HiRISE) camera, orbiting Mars since 2006 on the Mars Reconnaissance Orbiter (MRO), has returned more than 17,000 large images with scales as small as 25 cm/pixel. From it’s beginning, the HiRISE team has followed “The People’s Camera” concept, with rapid release of useful images, explanations, and tools, and facilitating public image suggestions. The camera includes 14 CCDs, each read out into 2 data channels, so compressed images are returned from MRO as 28 long (up to 120,000 line) images that are 1024 pixels wide (or binned 2x2 to 512 pixels, etc.). This raw data is very difficult to use, especially for the public. At the HiRISE operations center the raw data are calibrated and processed into a series of B&W and color products, including browse images and JPEG2000-compressed images and tools to make it easy for everyone to explore these enormous images (see http://hirise.lpl.arizona.edu/). Automated pipelines do all of this processing, so we can keep up with the high data rate; images go directly to the format of the Planetary Data System (PDS). After students visually check each image product for errors, they are fully released just 1 month after receipt; captioned images (written by science team members) may be released sooner. These processed HiRISE images have been incorporated into tools such as Google Mars and World Wide Telescope for even greater accessibility. 51 Digital Terrain Models derived from HiRISE stereo pairs have been released, resulting in some spectacular flyover movies produced by members of the public and viewed up to 50,000 times according to YouTube. Public targeting began in 2007 via NASA Quest (http://marsoweb.nas.nasa.gov/HiRISE/quest/) and more than 200 images have been acquired, mostly by students and educators. At the beginning of 2010 we released HiWish (http://www.uahirise.org/hiwish/), opening HiRISE targeting to anyone in the world with Internet access, and already more

  3. Information technology law and health systems in the European Union.

    Science.gov (United States)

    Mossialos, Elias; Thomson, Sarah; Ter Linden, Annemarie

    2004-01-01

    This study aims to examine the impact of European Union (EU) law relating to information technology (IT) on health systems. The study identifies EU directives relating to IT, analyzes them in terms of their impact on the use of IT in health systems, and outlines their implications for health technology assessment (HTA). Analysis is based on a review of literature identified through relevant databases and Internet searches. Developments in IT have serious implications for EU health systems, presenting policy makers with new challenges. The European Commission has adopted a range of legal measures to protect consumers in the "information society" However, as few of them are health-specific, it is not evident that they have implications for health, health systems, or HTA, and they may not be effective in protecting consumers in the health sector. In light of the growing importance of IT in the health sector, legal and nonlegal measures need to be further developed at EU and international level. Where possible, future initiatives should pay attention to the particular characteristics of health goods and services and health systems. Although definitions of HTA usually recognize the importance of evaluating both the indirect, unintended consequences of health technologies and the legal aspects of their application, it seems that, in practice, HTA often overlooks or underestimates legislative matters. Those involved in HTA should be aware of the legal implications of using IT to provide health goods and services and compile, store, transfer, and disseminate health information electronically.

  4. Integrating ICTs within health systems | IDRC - International ...

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

    2016-06-10

    Jun 10, 2016 ... ... to help improve service delivery, build local capacity for primary health care, and address the ... There is limited evidence on how electronic health (eHealth) technologies can be ... The world is now home to the greatest num.

  5. Plume rise from multiple sources

    International Nuclear Information System (INIS)

    Briggs, G.A.

    1975-01-01

    A simple enhancement factor for plume rise from multiple sources is proposed and tested against plume-rise observations. For bent-over buoyant plumes, this results in the recommendation that multiple-source rise be calculated as [(N + S)/(1 + S)]/sup 1/3/ times the single-source rise, Δh 1 , where N is the number of sources and S = 6 (total width of source configuration/N/sup 1/3/ Δh 1 )/sup 3/2/. For calm conditions a crude but simple method is suggested for predicting the height of plume merger and subsequent behavior which is based on the geometry and velocity variations of a single buoyant plume. Finally, it is suggested that large clusters of buoyant sources might occasionally give rise to concentrated vortices either within the source configuration or just downwind of it

  6. Collaboration for Health Systems Analysis and Innovation (CHESAI ...

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

    Adding a social science perspective to the field of health policy and systems research ... Other expected outcomes include publications, teaching material, podcasts, ... implementation of a primary health care reform in a South African province.

  7. Implementing a routine health management information system in ...

    African Journals Online (AJOL)

    combination of appropriate tools, training and support resulted in health facilities, counties ... database for the South Sudan information system was developed in the District Health .... if operating at State level they send reports to the SMOH.

  8. Sensor Area Network for Integrated Systems Health Management, Phase II

    Data.gov (United States)

    National Aeronautics and Space Administration — The term Integrated Systems Health Management (ISHM) is used to describe a capability that focuses on determining the condition (health) of every element in a...

  9. National healthcare systems and the need for health information governance.

    Science.gov (United States)

    Hovenga, Evelyn J S

    2013-01-01

    This chapter gives an overview of health data, information and knowledge governance needs and associated generic principles so that information systems are able to automate such data collections from point-of-care operational systems. Also covered are health information systems' dimensions and known barriers to the delivery of quality health services, including environmental, technology and governance influences of any population's health status within the context of national health systems. This is where health information managers and health informaticians need to resolve the many challenges associated with eHealth implementations where data are assets, efficient information flow is essential, the ability to acquire new knowledge desirable, and where the use of data and information needs to be viewed from a governance perspective to ensure reliable and quality information is obtained to enhance decision making.

  10. Measuring health systems strength and its impact: experiences from the African Health Initiative.

    Science.gov (United States)

    Sherr, Kenneth; Fernandes, Quinhas; Kanté, Almamy M; Bawah, Ayaga; Condo, Jeanine; Mutale, Wilbroad

    2017-12-21

    Health systems are essential platforms for accessible, quality health services, and population health improvements. Global health initiatives have dramatically increased health resources; however, funding to strengthen health systems has not increased commensurately, partially due to concerns about health system complexity and evidence gaps demonstrating health outcome improvements. In 2009, the African Health Initiative of the Doris Duke Charitable Foundation began supporting Population Health Implementation and Training Partnership projects in five sub-Saharan African countries (Ghana, Mozambique, Rwanda, Tanzania, and Zambia) to catalyze significant advances in strengthening health systems. This manuscript reflects on the experience of establishing an evaluation framework to measure health systems strength, and associate measures with health outcomes, as part of this Initiative. Using the World Health Organization's health systems building block framework, the Partnerships present novel approaches to measure health systems building blocks and summarize data across and within building blocks to facilitate analytic procedures. Three Partnerships developed summary measures spanning the building blocks using principal component analysis (Ghana and Tanzania) or the balanced scorecard (Zambia). Other Partnerships developed summary measures to simplify multiple indicators within individual building blocks, including health information systems (Mozambique), and service delivery (Rwanda). At the end of the project intervention period, one to two key informants from each Partnership's leadership team were asked to list - in rank order - the importance of the six building blocks in relation to their intervention. Though there were differences across Partnerships, service delivery and information systems were reported to be the most common focus of interventions, followed by health workforce and leadership and governance. Medical products, vaccines and technologies, and

  11. Local health systems in 21st century: who cares?-An exploratory study on health system governance in Amsterdam.

    Science.gov (United States)

    Plochg, T; Delnoij, D M J; Hogervorst, W V G; van Dijk, P; Belleman, S; Klazinga, N S

    2006-10-01

    There is a growing awareness that there should be a public health perspective to health system governance. Its intrinsic population health orientation provides the ultimate ground for determining the health needs and governing collaborative care arrangements within which these needs can be met. Notwithstanding differences across countries, population health concerns are not central to European health reforms. Governments currently withdraw leaving governance roles to care providers and/or financiers. Thereby, incentives that trigger the uptake of a public health perspective are often ignored. In this study we addressed this issue in the city of Amsterdam. Using a qualitative study design, we explored whether there is a public health perspective to the governance practices of the municipality and the major sickness fund in Amsterdam. And if so, what the scope of this perspective is. And if not, why not. Findings indicate that the municipality has a public health perspective to local health system governance, but its scope is limited. The municipality facilitates rather than governs health care provision in Amsterdam. Furthermore, the sickness fund runs major financial risks when adapting a public health perspective. It covers an insured population that partly overlaps the Amsterdam population. Returns on investments in population health are therefore uncertain, as competitors would also profit from the sickness fund's investments. The local health system in Amsterdam is not consistently aligned to the health needs of the Amsterdam population. The Amsterdam case is not unique and general consequences for local health system governance are discussed.

  12. Fellowship Program in Health System Improvement: A novel approach integrating leadership development and patient-centred health system transformation.

    Science.gov (United States)

    Philippon, Donald J; Montesanti, Stephanie; Stafinski, Tania

    2018-03-01

    This article highlights a novel approach to professional development, integrating leadership, development and patient-centred health system transformation in the new Fellowship Program in Health System Improvement offered by the School of Public Health at the University of Alberta. Early assessment of the program is also provided.

  13. Reforming the reform: the Greek National Health System in transition.

    Science.gov (United States)

    Tountas, Yannis; Karnaki, Panagiota; Pavi, Elpida

    2002-10-01

    The National Health System (ESY) in Greece, which was established in 1983, is in a state of continuous crisis. This situation is caused mainly by the system's problematic administration, low productivity and inadequate Primary Health Care. These have led the re-elected PASOK government to introduce by the end of 2000 a radical reform of the health system. The 200 reform measures announced by the new Minister of Health and Welfare include changes aiming at: the decentralization of the ESY, the creation of a unified financing system for the social insurance funds, a new management structure in public hospitals, the organization of a Primary Health System in urban areas, and the strengthening of Public Health and Health Promotion. These changes are presented and discussed in this paper.

  14. A complex-systems approach to predicting effects of sea level rise and nitrogen loading on nitrogen cycling in coastal wetland ecosystems

    Science.gov (United States)

    Larsen, Laurel G.; Moseman, Serena; Santoro, Alyson; Hopfensperger, Kristine; Burgin, Amy

    2010-01-01

    To effectively manage coastal ecosystems, we need an improvedunderstanding of how tidal marsh ecosystem services will respond to sea-level rise and increased nitrogen (N) loading to coastal areas. Here we review existing literature to better understand how these interacting perturbations s will likely impact N removal by tidal marshes. We propose that the keyy factors controlling long-term changes in N removal are plant-community changes, soil accretion rates, surface-subsurface flow paths, marsh geomorphology microbial communities, and substrates for microbial reactions. Feedbacks affecting relative elevations and sediment accretion ratess will serve as dominant controls on future N removal throughout the marsh. Given marsh persistence, we hypothesize that the processes dominating N removal will vary laterally across the marsh and longitudinallyalong the estuarine gradient. In salt marsh interiors, where nitrate reduction rates are often limited by delivery of nitrate to bacterial communities, reductions in groundwater discharge due to sea level rise may trigger a net reduction in N removal. In freshwater marshes, we expect a decreasee in N removal efficiency due to increased sulfide concentrations. Sulfide encroachment will increase the relative importance of dissimilatory nitrate reduction to ammonium and lead to greater bacterial nitrogen immobilization, ultimately resulting in an ecosystem that retains more N and is less effective at permanent N removal from the watershed. In contrast, we predict that sealevel–driven expansion of the tidal creek network and the degree of surface-subsurface exchange flux through tidal creek banks will result in greater N-removal efficiency from these locations.

  15. The rise of Chrome

    OpenAIRE

    Jonathan Tamary; Dror G. Feitelson

    2015-01-01

    Since Chrome’s initial release in 2008 it has grown in market share, and now controls roughly half of the desktop browsers market. In contrast with Internet Explorer, the previous dominant browser, this was not achieved by marketing practices such as bundling the browser with a pre-loaded operating system. This raises the question of how Chrome achieved this remarkable feat, while other browsers such as Firefox and Opera were left behind. We show that both the performance of Chrome and its co...

  16. The impact of mHealth interventions on health systems: a systematic review protocol.

    Science.gov (United States)

    Fortuin, Jill; Salie, Faatiema; Abdullahi, Leila H; Douglas, Tania S

    2016-11-25

    Mobile health (mHealth) has been described as a health enabling tool that impacts positively on the health system in terms of improved access, quality and cost of health care. The proposed systematic review will examine the impact of mHealth on health systems by assessing access, quality and cost of health care as indicators. The systematic review will include literature from various sources including published and unpublished/grey literature. The databases to be searched include: PubMed, Cochrane Library, Google Scholar, NHS Health Technology Assessment Database and Web of Science. The reference lists of studies will be screened and conference proceedings searched for additional eligible reports. Literature to be included will have mHealth as the primary intervention. Two authors will independently screen the search output, select studies and extract data; discrepancies will be resolved by consensus and discussion with the assistance of the third author. The systematic review will inform policy makers, investors, health professionals, technologists and engineers about the impact of mHealth in strengthening the health system. In particular, it will focus on three metrics to determine whether mHealth strengthens the health system, namely quality of, access to and cost of health care services. Systematic review registration: PROSPERO CRD42015026070.

  17. Overcoming Barriers to Rural Children's Mental Health: An Interconnected Systems Public Health Model

    Science.gov (United States)

    Huber, Brenda J.; Austen, Julie M.; Tobin, Renée M.; Meyers, Adena B.; Shelvin, Kristal H.; Wells, Michael

    2016-01-01

    A large, Midwestern county implemented a four-tiered public health model of children's mental health with an interconnected systems approach involving education, health care, juvenile justice and community mental health sectors. The community sought to promote protective factors in the lives of all youth, while improving the capacity,…

  18. System of Health Accounts and Health Satellite Accounts : Application in Low- and Middle-Income Countries

    NARCIS (Netherlands)

    Nakhimovsky, S.; Hernandez-Peña, P.; van Mosseveld, C.; Palacios, A.

    2014-01-01

    Health accounting data that show economic and financial resource flows within a health system are critical to informing health and economic policy – at both national and international levels. However, countries vary widely in their health accounting histories as well as the demand for and capacity

  19. Paying for and receiving benefits from health services in South Africa: is the health system equitable?

    Science.gov (United States)

    Ataguba, John E; McIntyre, Di

    2012-03-01

    There is a global challenge for health systems to ensure equity in both the delivery and financing of health care. However, many African countries still do not have equitable health systems. Traditionally, equity in the delivery and the financing of health care are assessed separately, in what may be termed 'partial' analyses. The current debate on countries moving toward universal health systems, however, requires a holistic understanding of equity in both the delivery and the financing of health care. The number of studies combining these aspects to date is limited, especially in Africa. An assessment of overall health system equity involves assessing health care financing in relation to the principles of contributing to financing according to ability to pay and benefiting from health services according to need for care. Currently South Africa is considering major health systems restructuring toward a universal system. This paper examines together, for both the public and the private sectors, equity in the delivery and financing of health care in South Africa. Using nationally representative datasets and standard methodologies for assessing progressivity in health care financing and benefit incidence, this paper reports an overall progressive financing system but a pro-rich distribution of health care benefits. The progressive financing system is driven mainly by progressive private medical schemes that cover a small portion of the population, mainly the rich. The distribution of health care benefits is not only pro-rich, but also not in line with the need for health care; richer groups receive a far greater share of service benefits within both public and private sectors despite having a relatively lower share of the ill-health burden. The importance of the findings for the design of a universal health system is discussed.

  20. Vitamin D in ocular and systemic health

    Directory of Open Access Journals (Sweden)

    Solani D. Mathebula

    2015-06-01

    Vitamin D is produced in skin exposed to sunlight UVB radiation and is then metabolised by the kidney into calciferol, which is an active form. The main function of vitamin D is to promote calcium and phosphorus absorption, and studies have shown that a lack of itplays an important role in ocular conditions, such as age-related macular degeneration and diabetic retinopathy. Recent studies have suggested that vitamin D may protect the diabetic retina; however, other vitamin D-associated conditions (diabetes, hypertension and cardiovascular diseases may result in secondary ocular manifestations and the potential forsight-threatening complications. The purpose of this review is to describe the current literature on the role of vitamin D in ocular and systemic wellness. However, more research is needed to determine if increasing levels of this vitamin can assist in preventing age-related macular degeneration or diabetic retinopathy. Since vitamin D is a circulating steroid hormone, its receptors are found in almost every cell in the human body, and this suggests that vitamin D might have a very broad role for overall health. However, there is still demand for further research to clarify the clinical use of vitamin D in the prevention and treatment of various chronic diseases.

  1. Health Rights and Equity-oriented Health System Change in ...

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

    The private sector is the largest health provider in India, and unregulated private ... and girls in the last two decades, yet gender inequality and gender-based ... View moreIWRA/IDRC webinar on climate change and adaptive water ... Socially equitable climate action is essential to strengthen the resilience of all people, ...

  2. Contributions of Global Health Diplomacy to Health Systems in Sub ...

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

    African policymakers and other relevant actors will be exposed to the arguments, methods, and challenges of global health diplomacy so they can engage more ... L'Association internationale de ressources en eau (IWRA), en étroite collaboration avec le CRDI, organise un webinaire intitulé "Changements climatiques et ...

  3. Development of blood extraction system for health monitoring system

    Science.gov (United States)

    Tsuchiya, Kazuyoshi; Nakanishi, Naoyuki; Nakamachi, Eiji

    2004-03-01

    The purpose of this research is to develop the compact human blood sampling device applied for a health monitoring system(HMS), which is called "Mobile Hospital". The HMS consists of (1) a micro electrical pumping system for blood extraction, (2) a bio-sensor to detect and evaluate an amount of Glucose, Cholesterol and Urea in extracted blood, by using enzyme such as Glucoseoxidase (GOD), Cholesteroloxidase and Urease. The mechanical design elements of the device are bio-compatible microneedle, indentation unit using a shape memory alloy(SMA) actuator and pumping unit using a piezoelectric microactuator. The design concept is the biomimetic micromachine of female mosquito"s blood sampling mechanism. The performances of the main mechanical elements such as indentation force of the microneedle, actual stroke of the indentation unit using a SMA actuator and liquid sampling ability of the pumping unit using PZT piezoelectric microactuator were measured. The 3 mm stroke of the indentation load generated by SMA actuator was 0.8mN. The amount of imitation blood extracted by using bimorph PZT actuators was about 0.5 microliters for 10 sec. A 60-micrometer outer diameter and 25-micrometer inner diameter Titanium microneedle, which size is same as female mosquito"s labium, was produced by sputter deposition.

  4. Point systems in Games for Health: A bibliometric scoping study

    OpenAIRE

    Kokol, Peter

    2018-01-01

    Very few details about point systems used in games for health are reported in scientific literature. To shed some light on this topic a bibliometric study, analyzing the papers containing terms related to games for health and point systems was performed and a mini taxonomy was derived. The search string game* AND health AND (point* OR score) AND system* in a Scopus bibliographic database was used to produce the corpus. We limited the search to articles, reviews and conference papers written i...

  5. Health at the center of health systems reform: how philosophy can inform policy.

    Science.gov (United States)

    Sturmberg, Joachim P; Martin, Carmel M; Moes, Mark M

    2010-01-01

    Contemporary views hold that health and disease can be defined as objective states and thus should determine the design and delivery of health services. Yet health concepts are elusive and contestable. Health is neither an individual construction, a reflection of societal expectations, nor only the absence of pathologies. Based on philosophical and sociological theory, empirical evidence, and clinical experience, we argue that health has simultaneously objective and subjective features that converge into a dynamic complex-adaptive health model. Health (or its dysfunction, illness) is a dynamic state representing complex patterns of adaptation to body, mind, social, and environmental challenges, resulting in bodily homeostasis and personal internal coherence. The "balance of health" model-emergent, self-organizing, dynamic, and adaptive-underpins the very essence of medicine. This model should be the foundation for health systems design and also should inform therapeutic approaches, policy decision-making, and the development of emerging health service models. A complex adaptive health system focused on achieving the best possible "personal" health outcomes must provide the broad policy frameworks and resources required to implement people-centered health care. People-centered health systems are emergent in nature, resulting in locally different but mutually compatible solutions across the whole health system.

  6. Rise of a cold plume

    International Nuclear Information System (INIS)

    Kakuta, Michio

    1977-06-01

    The rise of smoke from the stacks of two research reactors in normal operation was measured by photogrametric method. The temperature of effluent gas is less than 20 0 C higher than that of the ambient air (heat emission of the order 10 4 cal s -1 ), and the efflux velocity divided by the wind speed is between 0.5 and 2.8 in all 16 smoke runs. The field data obtained within downwind distance of 150m are compared with those by plume rise formulas presently available. Considering the shape of bending-over plume, the Briggs' formula for 'jet' gives a reasonable explanation of the observed plume rise. (auth.)

  7. [European health systems and the integration problem of modern societies].

    Science.gov (United States)

    Lüschen, G

    2000-04-01

    With reference to the national health systems in Germany and the UK we must acknowledge that it was in particular Bismarck's Reform, originally directed toward a solidarity among the socially weak, which entailed in its development a marked redistribution via progressive health fees and standardized health services. In view of Alfred Marshall's original expectations this has resulted in a specific integration of the socially weak and with some difference for nationally tax-financed and social security financed health systems to a genuine contribution towards integration of modern society. An open research question is whether as a consequence of solidarity and integration through health systems there is a decline of social inequality for health. Equally open is the question as to the socio-structural and economic consequences the expansion of modern health systems has.

  8. Corruption in the health care system: the circumstantial evidence.

    Science.gov (United States)

    Ibrahim, Joseph; Majoor, Jennifer

    2002-01-01

    Health care systems are under intense scrutiny, and there is an increasing emphasis on patient safety and quality of care in general. Evidence continues to emerge demonstrating that health systems are performing at sub-optimal levels. The evidence includes the under-use, over-use and mis-use of health care services; new standards asking for respect, dignity, honesty and transparency; the corporatization of health; and the existing inequalities in power and health outcomes. Recommendations for improving health care often refer to increasing the level of collaboration and consultation. These strategies are unlikely to remedy the root causes of our ailing health systems if we accept the circumstantial evidence that suggests the system is rotten.

  9. [The Mexican health system: does it require a transformation?].

    Science.gov (United States)

    Chertorivski Woldenberg, Salomón; Fajardo Dolci, German

    2012-01-01

    National health systems represent an organized social response that enables countries to improve, maintain and enhance the health status of their citizens. These evolve and are transformed according to changes in the biological, economic, political and social components of health. In Mexico there is currently a segmented health system, consisting of a bismarckian model of social security and a social protection in health model. The latter developed to comply with the fourth constitutional article by which health is no longer described as a right linked to the employment status of the individual. Given this reality at least three alternatives seem to emerge for the future: the permanence of a mixed health system with social security and social protection institutions with a similar weight within the national health system, or its opposite, the extension of social protection as a mechanism for widespread access. Given the challenges we face, it is desirable to establish a unified health system, the aim should be that health care is universally protected, as currently happens, but is guaranteed through a much more efficient and based in primary care health care system.

  10. Enhancing the Effectiveness of Consumer-Focused Health Information Technology Systems Through eHealth Literacy

    DEFF Research Database (Denmark)

    Kayser, Lars; Kushniruk, Andre; Osborne, Richard H

    2015-01-01

    BACKGROUND: eHealth systems and applications are increasingly focused on supporting consumers to directly engage with and use health care services. Involving end users in the design of these systems is critical to ensure a generation of usable and effective eHealth products and systems. Often...... the end users engaged for these participatory design processes are not actual representatives of the general population, and developers may have limited understanding about how well they might represent the full range of intended users of the eHealth products. As a consequence, resulting information...... model with the domains of a new concept of eHealth literacy. METHODS: This approach expands an existing method for supporting health IT system development, which advocates use of a three-dimensional user-task-context matrix to comprehensively identify the users of health IT systems, and what their needs...

  11. HealthStyles: a new psychographic segmentation system for health care marketers.

    Science.gov (United States)

    Endresen, K W; Wintz, J C

    1988-01-01

    HealthStyles is a new psychographic segmentation system specifically designed for the health care industry. This segmentation system goes beyond traditional geographic and demographic analysis and examines health-related consumer attitudes and behaviors. Four statistically distinct "styles" of consumer health care preferences have been identified. The profiles of the four groups have substantial marketing implications in terms of design and promotion of products and services. Each segment of consumers also has differing expectations of physician behavior.

  12. Efficiency performance of China's health care delivery system.

    Science.gov (United States)

    Zhang, Luyu; Cheng, Gang; Song, Suhang; Yuan, Beibei; Zhu, Weiming; He, Li; Ma, Xiaochen; Meng, Qingyue

    2017-07-01

    Improving efficiency performance of the health care delivery system has been on the agenda for the health system reform that China initiated in 2009. This study examines the changes in efficiency performance and determinants of efficiency after the reform to provide evidence to assess the progress of the reform from the perspective of efficiency. Descriptive analysis, Data Envelopment Analysis, the Malmquist Index, and multilevel regressions are used with data from multiple sources, including the World Bank, the China Health Statistical Yearbook, and routine reports. The results indicate that over the last decade, health outcomes compared with health investment were relatively higher in China than in most other countries worldwide, and the trend was stable. The overall efficiency and total factor productivity increased after the reform, indicating that the reform was likely to have had a positive impact on the efficiency performance of the health care delivery system. However, the health care delivery structure showed low system efficiency, mainly attributed to the weakened primary health care system. Strengthening the primary health care system is central to enhancing the future performance of China's health care delivery system. Copyright © 2017 John Wiley & Sons, Ltd.

  13. A decision technology system for health care electronic commerce.

    Science.gov (United States)

    Forgionne, G A; Gangopadhyay, A; Klein, J A; Eckhardt, R

    1999-08-01

    Mounting costs have escalated the pressure on health care providers and payers to improve decision making and control expenses. Transactions to form the needed decision data will routinely flow, often electronically, between the affected parties. Conventional health care information systems facilitate flow, process transactions, and generate useful decision information. Typically, such support is offered through a series of stand-alone systems that lose much useful decision knowledge and wisdom during health care electronic commerce (e-commerce). Integrating the stand-alone functions can enhance the quality and efficiency of the segmented support, create synergistic effects, and augment decision-making performance and value for both providers and payers. This article presents an information system that can provide complete and integrated support for e-commerce-based health care decision making. The article describes health care e-commerce, presents the system, examines the system's potential use and benefits, and draws implications for health care management and practice.

  14. [The need of transforming the health system in Mexico].

    Science.gov (United States)

    López-Cervantes, Malaquías; Durán Arenas, Juan Luis; Villanueva Lozano, Marcia

    2011-01-01

    In this article we review the need for the transformation of the Mexican health care system given the deformities that the system developed in the last 60 years. We start by the discussion of two main deformities: the segmented answer to the health right, and the development of a segmented health care system based on the method of payment (formal workers contributions); and the development of a health care model based on specialties and hospital care. These deformities have resulted in a health care system characterized by high costs and low effectiveness. Even though the correction of the deformities imply complex modifications that involve political economic and legal aspects, in the short term we have the conditions in Mexico for the creation of a universal primary health care system, given the human and financial resources available in the country.

  15. Purchasing to improve health systems performance

    National Research Council Canada - National Science Library

    Robinson, Ray; Jakubowski, Elke; Figueras, Josep

    2005-01-01

    ... as they formulate purchasing strategies so that they can increase effectiveness and improve performance in their own national context An assessment of the intersecting roles of citizens, the government and the providers * * * Written by leading health policy analysts, this book is essential reading for health policy makers, planners and managers as well as resear...

  16. Strengthening health systems | IDRC - International Development ...

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

    2013-04-03

    Apr 3, 2013 ... ... maternal health risks and make better, more informed decisions about care. .... Corps examines a woman patient at a mobile health clinic in Pakistan. ... With the support of IDRC, Lehmann has studied the role of nurses in ...

  17. Mental Health Mobile Apps: From Infusion to Diffusion in the Mental Health Social System.

    Science.gov (United States)

    East, Marlene Lynette; Havard, Byron C

    2015-01-01

    The roles of mental health educators and professionals in the diffusion of mental health mobile apps are addressed in this viewpoint article. Mental health mobile apps are emerging technologies that fit under the broad heading of mobile health (mHealth). mHealth, encompassed within electronic health (eHealth), reflects the use of mobile devices for the practice of public health. Well-designed mental health mobile apps that present content in interactive, engaging, and stimulating ways can promote cognitive learning, personal growth, and mental health enhancement. As key influencers in the mental health social system, counselor educators and professional associations may either help or hinder diffusion of beneficial mHealth technologies. As mental health mobile apps move towards ubiquity, research will continue to be conducted. The studies published thus far, combined with the potential of mental health mobile apps for learning and personal growth, offer enough evidence to compel mental health professionals to infuse these technologies into education and practice. Counselor educators and professional associations must use their influential leadership roles to train students and practitioners in how to research, evaluate, and integrate mental health mobile apps into practice. The objectives of this article are to (1) increase awareness of mHealth and mental health mobile apps, (2) demonstrate the potential for continued growth in mental health mobile apps based on technology use and acceptance theory, mHealth organizational initiatives, and evidence about how humans learn, (3) discuss evidence-based benefits of mental health mobile apps, (4) examine the current state of mHealth diffusion in the mental health profession, and (5) offer solutions for impelling innovation diffusion by infusing mental health mobile apps into education, training, and clinical settings. This discussion has implications for counselor educators, mental health practitioners, associations

  18. Health financing for universal coverage and health system performance: concepts and implications for policy.

    Science.gov (United States)

    Kutzin, Joseph

    2013-08-01

    Unless the concept is clearly understood, "universal coverage" (or universal health coverage, UHC) can be used to justify practically any health financing reform or scheme. This paper unpacks the definition of health financing for universal coverage as used in the World Health Organization's World health report 2010 to show how UHC embodies specific health system goals and intermediate objectives and, broadly, how health financing reforms can influence these. All countries seek to improve equity in the use of health services, service quality and financial protection for their populations. Hence, the pursuit of UHC is relevant to every country. Health financing policy is an integral part of efforts to move towards UHC, but for health financing policy to be aligned with the pursuit of UHC, health system reforms need to be aimed explicitly at improving coverage and the intermediate objectives linked to it, namely, efficiency, equity in health resource distribution and transparency and accountability. The unit of analysis for goals and objectives must be the population and health system as a whole. What matters is not how a particular financing scheme affects its individual members, but rather, how it influences progress towards UHC at the population level. Concern only with specific schemes is incompatible with a universal coverage approach and may even undermine UHC, particularly in terms of equity. Conversely, if a scheme is fully oriented towards system-level goals and objectives, it can further progress towards UHC. Policy and policy analysis need to shift from the scheme to the system level.

  19. The Economics of Public Health: Missing Pieces to the Puzzle of Health System Reform.

    Science.gov (United States)

    Mays, Glen P; Atherly, Adam J; Zaslavsky, Alan M

    2017-12-01

    The United States continues to experiment with health care delivery and financing innovations, but relatively little attention is given to the public health system and its capacity for improving health status in the U.S. population at large. The public health system operates as a multisector enterprise in which government agencies work in conjunction with private and voluntary organizations to identify health risks in the population and to mobilize community-wide actions that prevent and contain these risks. The Affordable Care Act and related health reform initiatives are generating new interest in the question of how best to expand and integrate public health approaches into the larger U.S. health system. The research articles featured in this issue of Health Services Research cluster around two broad topics: how public health agencies can deliver services efficiently and how public health agencies can interact productively with other elements of the health system. The results suggest promising avenues for aligning medical care and public health practices. © Health Research and Educational Trust.

  20. Taking Her Breath Away: The Rise of COPD in Women

    Science.gov (United States)

    ... Disparities Taking Her Breath Away: The Rise of COPD in Women Disparities in Lung Health Series More ... the U.S. live with chronic obstructive pulmonary disease (COPD), which includes chronic bronchitis and emphysema. Millions more ...

  1. Big things come in bundled packages: implications of bundled payment systems in health care reimbursement reform.

    Science.gov (United States)

    Delisle, Dennis R

    2013-01-01

    With passage of the Affordable Care Act, the ever-evolving landscape of health care braces for another shift in the reimbursement paradigm. As health care costs continue to rise, providers are pressed to deliver efficient, high-quality care at flat to minimally increasing rates. Inherent systemwide inefficiencies between payers and providers at various clinical settings pose a daunting task for enhancing collaboration and care coordination. A change from Medicare's fee-for-service reimbursement model to bundled payments offers one avenue for resolution. Pilots using such payment models have realized varying degrees of success, leading to the development and upcoming implementation of a bundled payment initiative led by the Center for Medicare and Medicaid Innovation. Delivery integration is critical to ensure high-quality care at affordable costs across the system. Providers and payers able to adapt to the newly proposed models of payment will benefit from achieving cost reductions and improved patient outcomes and realize a competitive advantage.

  2. Home birth integration into the health care systems of eleven international jurisdictions.

    Science.gov (United States)

    Comeau, Amanda; Hutton, Eileen K; Simioni, Julia; Anvari, Ella; Bowen, Megan; Kruegar, Samantha; Darling, Elizabeth K

    2018-02-13

    The purpose of this study was to develop assessment criteria that could be used to examine the level of integration of home birth within larger health care systems in developed countries across 11 international jurisdictions. An expert panel developed criteria and a definition to assess home birth integration within health care systems. We selected jurisdictions based on the publications that were eligible for inclusion in our systematic review and meta-analysis on planned place of birth. We sent the authors of the included publications a questionnaire about home birth practitioners and practices in their respective health care system at the time of their studies. We searched published peer-reviewed, non-peer-reviewed, and gray literature, and the websites of professional bodies to document information about home birth integration in each jurisdiction based on our criteria. Where information was lacking, we contacted experts in the field from the relevant jurisdiction. Home birth is well integrated into the health care system in British Columbia (Canada), England, Iceland, the Netherlands, New Zealand, Ontario (Canada), and Washington State (USA). Home birth is less well integrated into the health care system in Australia, Japan, Norway, and Sweden. This paper is the first to propose criteria for the evaluation of home birth integration within larger maternity care systems. Application of these criteria across 11 international jurisdictions indicates differences in the recognition and training of home birth practitioners, in access to hospital facilities, and in the supplies and equipment available at home births, which give rise to variation in the level of integration across different settings. Standardized criteria for the evaluation of systems integration are essential for interpreting planned home birth outcomes that emerge from contextual differences. © 2018 Wiley Periodicals, Inc.

  3. Multiplicity in public health supply systems: a learning agenda.

    Science.gov (United States)

    Bornbusch, Alan; Bates, James

    2013-08-01

    Supply chain integration-merging products for health programs into a single supply chain-tends to be the dominant model in health sector reform. However, multiplicity in a supply system may be justified as a risk management strategy that can better ensure product availability, advance specific health program objectives, and increase efficiency.

  4. Sensor Area Network for Integrated Systems Health Management, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — The term Integrated Systems Health Management (ISHM) is used to describe a capability that focuses on determining the condition of every element in a complex System...

  5. Distributed Rocket Engine Testing Health Monitoring System, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — The on-ground and Distributed Rocket Engine Testing Health Monitoring System (DiRETHMS) provides a system architecture and software tools for performing diagnostics...

  6. Distributed Rocket Engine Testing Health Monitoring System, Phase II

    Data.gov (United States)

    National Aeronautics and Space Administration — Leveraging the Phase I achievements of the Distributed Rocket Engine Testing Health Monitoring System (DiRETHMS) including its software toolsets and system building...

  7. A Structural Model Decomposition Framework for Systems Health Management

    Data.gov (United States)

    National Aeronautics and Space Administration — Systems health management (SHM) is an impor- tant set of technologies aimed at increasing system safety and reliability by detecting, isolating, and identifying...

  8. Highlight: Kenya selects first research chair on health systems ...

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

    14 avr. 2016 ... Research will focus on a systems approach to improving maternal and child ... and at the same time, endeavour to bridge the gap between universities ... health systems research is grounded in political realities and have real ...

  9. Building equitable health systems in Latin America | IDRC ...

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

    The region's segmented health systems make it difficult to provide equal access to ... to reorganize healthcare systems in Argentina, Brazil, Paraguay, and Uruguay. ... Involving urban communities in controlling dengue fever in Latin America.

  10. Strategic information systems planning for health service providers.

    Science.gov (United States)

    Moriarty, D D

    1992-01-01

    There is significant opportunity for health service providers to gain competitive advantage through the innovative use of strategic information systems. This analysis presents some key strategic information systems issues that will enable managers to identify opportunities within their organizations.

  11. Integrated environment, safety, and health management system description

    International Nuclear Information System (INIS)

    Zoghbi, J. G.

    2000-01-01

    The Integrated Environment, Safety, and Health Management System Description that is presented in this document describes the approach and management systems used to address integrated safety management within the Richland Environmental Restoration Project

  12. Sources of project financing in health care systems.

    Science.gov (United States)

    Smith, D G; Wheeler, J R; Rivenson, H L; Reiter, K L

    2000-01-01

    Through discussions with chief financial officers of leading health care systems, insights are offered on preferences for project financing and development efforts. Data from these same systems provide at least anecdotal evidence in support of pecking-order theory.

  13. INFORMATION SOCIETY AND FINANCIAL SUSTAINABILITY OF THE ROMANIAN HEALTH SYSTEM

    Directory of Open Access Journals (Sweden)

    TATIANA BOGDAN

    2016-06-01

    Full Text Available The financial sustainability of the health systems often reveals the ability of policy makers to finance healthcare in the face of growing cost pressures, with populations ageing, new technologies and increased patient expectations for healthcare coverage and quality. Thus, the healthcare systems need to reinvent themselves by using innovative financing mechanisms coupled with electronic information and communication systems, while offering greater transparency, flexibility and choice and increasing access to the services available. The paper analyses the healthcare financing models: the national health system, the social insurance or the private insurance model so that the Romanian health care reform should preserve the best elements of its existing system while selectively adapt techniques and processes that seemed to have been successful in other countries. Moreover, the application of information and communication technologies – eHealth offers new possibilities for improving almost every aspect of healthcare, from making medical systems more powerful and responsive to providing better health information to all.

  14. Smart health monitoring systems: an overview of design and modeling.

    Science.gov (United States)

    Baig, Mirza Mansoor; Gholamhosseini, Hamid

    2013-04-01

    Health monitoring systems have rapidly evolved during the past two decades and have the potential to change the way health care is currently delivered. Although smart health monitoring systems automate patient monitoring tasks and, thereby improve the patient workflow management, their efficiency in clinical settings is still debatable. This paper presents a review of smart health monitoring systems and an overview of their design and modeling. Furthermore, a critical analysis of the efficiency, clinical acceptability, strategies and recommendations on improving current health monitoring systems will be presented. The main aim is to review current state of the art monitoring systems and to perform extensive and an in-depth analysis of the findings in the area of smart health monitoring systems. In order to achieve this, over fifty different monitoring systems have been selected, categorized, classified and compared. Finally, major advances in the system design level have been discussed, current issues facing health care providers, as well as the potential challenges to health monitoring field will be identified and compared to other similar systems.

  15. Regulatory system reform of occupational health and safety in China.

    Science.gov (United States)

    Wu, Fenghong; Chi, Yan

    2015-01-01

    With the explosive economic growth and social development, China's regulatory system of occupational health and safety now faces more and more challenges. This article reviews the history of regulatory system of occupational health and safety in China, as well as the current reform of this regulatory system in the country. Comprehensive, a range of laws, regulations and standards that promulgated by Chinese government, duties and responsibilities of the regulatory departments are described. Problems of current regulatory system, the ongoing adjustments and changes for modifying and improving regulatory system are discussed. The aim of reform and the incentives to drive forward more health and safety conditions in workplaces are also outlined.

  16. Building a durable response to HIV/AIDS: implications for health systems.

    Science.gov (United States)

    Atun, Rifat; Bataringaya, Jacqueline

    2011-08-01

    The remarkable rise in investments for HIV control programs in 2003-2010 enabled an unprecedented expansion of access to HIV services in low-income and middle-income countries. By the end of 2010, more than 5.2 million people were receiving antiretroviral therapy (ART), which transformed HIV infection, once a death sentence, into a long-term illness. The rapid expansion in the number of persons receiving ART means that health systems must continue to provide acute life-saving care for those with advanced HIV/AIDS although also providing chronic care services to expanding cohorts of more stable patients who are doing well on ART. This expansion also means a transition from an emergency response to the epidemic, characterized by a public health approach, to a more integrated and durable approach to HIV prevention, care, and treatment services that fosters individualized care for those requiring long-term antiretroviral treatment. Yet most low-income and middle-income countries, which have weak health systems, are poorly prepared to make this transition. In this article, we highlight the challenges health systems face in developing a sustained and durable response to HIV/AIDS. The article analyses the readiness of health systems to combine rapid expansion of ART access with long-term treatment and continuity of care for a growing cohort of patients. We argue that effective management of a transition from an emergency AIDS response to long-term programatic strategies will require a paradigm shift that enables leveraging investments in HIV to build sustainable health systems for managing large cohorts of patients receiving ART although meeting the immediate needs of those who remain without access to HIV treatment and care.

  17. Mobile technology in health information systems - a review.

    Science.gov (United States)

    Zhang, X-Y; Zhang, P-Y

    2016-05-01

    Mobile technology is getting involved in every sphere of life including medical health care. There has been an immense upsurge in mobile phone-based health innovations these days. The expansion of mobile phone networks and the proliferation of inexpensive mobile handsets have made the digital information and communication technology capabilities very handy for the people to exploit if for any utility including health care. The mobile phone based innovations are able to transform weak and under performing health information system into more modern and efficient information system. The present review article will enlighten all these aspects of mobile technology in health care.

  18. The former Yugoslav Republic of Macedonia: Health System Review.

    Science.gov (United States)

    Milevska Kostova, Neda; Chichevalieva, Snezhana; Ponce, Ninez A; van Ginneken, Ewout; Winkelmann, Juliane

    2017-05-01

    This analysis of the health system of the former Yugoslav Republic of Macedonia reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. The country has made important progress during its transition from a socialist system to a market-based system, particularly in reforming the organization, financing and delivery of health care and establishing a mix of private and public providers. Though total health care expenditure has risen in absolute terms in recent decades, it has consistently fallen as share of GDP, and high levels of private health expenditure remain. Despite this, the health of the population has improved over the last decades, with life expectancy and mortality rates for both adults and children reaching similar levels to those in ex-communist EU countries, though death rates caused by unhealthy behaviour remain high. Inheriting a large health infrastructure, good public health services and well-distributed health service coverage after independence in 1991, the country re-built a social health insurance system with a broad benefit package. Primary care providers were privatized and new private hospitals were allowed to enter the market. In recent years, the country reformed the organization of care delivery to better incorporate both public and private providers in an integrated system. Significant efficiency gains were reached with a pioneering health information system that has reduced waiting times and led to a better coordination of care. This multi-modular e-health system has the potential to further reduce existing inefficiencies and to generate evidence for assessment and research. Despite this progress, satisfaction with health care delivery is very mixed with low satisfaction levels with public providers. The public hospital sector in particular is characterized by inefficient organization, financing and provision of health care; and many professionals

  19. Health Information System in a Cloud Computing Context.

    Science.gov (United States)

    Sadoughi, Farahnaz; Erfannia, Leila

    2017-01-01

    Healthcare as a worldwide industry is experiencing a period of growth based on health information technology. The capabilities of cloud systems make it as an option to develop eHealth goals. The main objectives of the present study was to evaluate the advantages and limitations of health information systems implementation in a cloud-computing context that was conducted as a systematic review in 2016. Science direct, Scopus, Web of science, IEEE, PubMed and Google scholar were searched according study criteria. Among 308 articles initially found, 21 articles were entered in the final analysis. All the studies had considered cloud computing as a positive tool to help advance health technology, but none had insisted too much on its limitations and threats. Electronic health record systems have been mostly studied in the fields of implementation, designing, and presentation of models and prototypes. According to this research, the main advantages of cloud-based health information systems could be categorized into the following groups: economic benefits and advantages of information management. The main limitations of the implementation of cloud-based health information systems could be categorized into the 4 groups of security, legal, technical, and human restrictions. Compared to earlier studies, the present research had the advantage of dealing with the issue of health information systems in a cloud platform. The high frequency of studies conducted on the implementation of cloud-based health information systems revealed health industry interest in the application of this technology. Security was a subject discussed in most studies due to health information sensitivity. In this investigation, some mechanisms and solutions were discussed concerning the mentioned systems, which would provide a suitable area for future scientific research on this issue. The limitations and solutions discussed in this systematic study would help healthcare managers and decision

  20. [Health system reforms, economic constraints and ethical and legal values].

    Science.gov (United States)

    Caillol, Michel; Le Coz, Pierre; Aubry, Régis; Bréchat, Pierre-Henri

    2010-01-01

    Health system and hospital reforms have led to important and on-going legislative, structural and organizational changes. Is there any logic at work within the health system and hospitals that could call into question the principle of solidarity, the secular values of ethics that govern the texts of law and ethics? In order to respond, we compared our experiences to a review of the professional and scientific literature from 1992 to 2010. Over the course of the past eighteen years, health system organization was subjected to variations and significant tensions. These variations are witnesses to a paradigm shift: although a step towards the regionalization of the health system integrating the choice of public health priorities, consultation and participatory democracy has been implemented, nevertheless the system was then re-oriented towards the trend of returning to centralization on the basis of uniting economics, technical modernization and contracting. This change of doctrine may undermine the social mission of hospitals and the principle of solidarity. Progress, the aging population and financial constraints would force policy-makers to steer the health system towards more centralized control. Hospitals, health professionals and users may feel torn within a system that tends to simplify and minimize what is becoming increasingly complex and global. Benchmarks on values, ethics and law for the hospitals, healthcare professionals and users are questioned. These are important elements to consider when the law on the reform of hospitals, patients, health care and territories and regional health agencies is implemented.