Malone, Mary; Whittaker, Karen A; Cowley, Sarah; Ezhova, Ivanka; Maben, Jill
This paper draws on a narrative review of the literature, commissioned to support the Health Visitor Implementation Plan, and aimed at identifying messages about the knowledge, skills, and abilities needed by health visitors to work within the current system of health care provision. The scoping study and narrative review used three complementary approaches: a broad search, a structured search, and a seminal paper search to identify empirical papers from the health visitor literature for review. The key inclusion criteria were messages of relevance for practice. 378 papers were reviewed. These included empirical papers from the United Kingdom (UK) from 2004 to February 2012, older research identified in the seminal paper search and international literature from 2000 to January 2016. The review papers were read by members of the multidisciplinary research team which included health visitor academics, social scientists, and a clinical psychologist managed the international literature. Thematic content analysis was used to identify main messages. These were tabulated and shared between researchers in order to compare emergent findings and to confirm dominant themes. The analysis identified an 'orientation to practice' based on salutogenesis (health creation), human valuing (person-centred care), and viewing the person in situation (human ecology) as the aspirational core of health visitors' work. This was realised through home visiting, needs assessment, and relationship formation at different levels of service provision. A wide range of knowledge, skills, and abilities were required, including knowledge of health as a process and skills in engagement, building trust, and making professional judgments. These are currently difficult to impart within a 45week health visitor programme and are facilitated through ad hoc post-registration education and training. The international literature reported both similarities and differences between the working practices of health
Kendrick, Denise; Illingworth, Rachel; Hapgood, Rhydian; Woods, Amanda J; Collier, Jacqueline
Baby walkers are a commonly used item of nursery equipment. Between 12% and 50% of parents whose infant uses a walker report that their child has suffered a walker-related injury. Health visitors' knowledge, attitudes and practice with regard to walkers and related health education has not been explored so far. The aim of the study was to describe health visitors' knowledge of walkers and walker-related injuries, their attitudes towards walkers and current practice with regard to walker health education, and to examine the relationship between knowledge and attitudes and knowledge and practice. A survey was carried out with 64 health visitors prior to participation in a randomized controlled trial assessing the effectiveness of an educational package in reducing baby walker use. The response rate was 95%. Half of the health visitors always discussed walkers postnatally, most frequently at the 6-9 month check. Most did not usually discuss the frequency of walker-related injuries. Most had negative attitudes towards walkers, but believed that parents hold positive attitudes to them and that it is hard to persuade parents not to use them. Health visitors had a limited knowledge of walker use and walker-related injuries. Those giving advice on walkers most often had higher knowledge scores than those giving advice less often (P = 0.03). Those with higher knowledge scores held more negative attitudes towards walkers (rs = 0.29, P = 0.023) and believed parents to have more positive attitudes towards walkers (rs = -0.49, P negotiating alternatives to their use. The provision of audio-visual aids for discussing walkers might also be helpful.
Cullinane Thomas, Catherine; Koontz, Lynne
The National Park Service (NPS) manages the Nation’s most iconic destinations that attract millions of visitors from across the Nation and around the world. Trip-related spending by NPS visitors generates and supports a considerable amount of economic activity within park gateway communities. This economic effects analysis measures how NPS visitor spending cycles through local economies, generating business sales and supporting jobs and income. In 2016, the National Park System received an estimated 330,971,689 recreation visits. Visitors to National Parks spent an estimated $18.4 billion in local gateway regions (defined as communities within 60 miles of a park). The contribution of this spending to the national economy was 318 thousand jobs, $12.0 billion in labor income, $19.9 billion in value added, and $34.9 billion in economic output. The lodging sector saw the highest direct contributions with $5.7 billion in economic output directly contributed to local gateway economies nationally. The sector with the next greatest direct contributions was the restaurants and bars sector, with $3.7 billion in economic output directly contributed to local gateway economies nationally. Results from the Visitor Spending Effects report series are available online via an interactive tool. Users can view year-by-year trend data and explore current year visitor spending, jobs, labor income, value added, and economic output effects by sector for national, state, and local economies. This interactive tool is available at https://www.nps.gov/subjects/socialscience/vse.htm.
Cullinane Thomas, Catherine M.; Koontz, Lynne
The National Park Service (NPS) manages the Nation’s most iconic destinations that attract millions of visitors from across the Nation and around the world. Trip-related spending by NPS visitors generates and supports a considerable amount of economic activity within park gateway communities. This economic effects analysis measures how NPS visitor spending cycles through local economies, generating business sales and supporting jobs and income.In 2015, the National Park System received over 307.2 million recreation visits. NPS visitors spent \\$16.9 billion in local gateway regions (defined as communities within 60 miles of a park). The contribution of this spending to the national economy was 295 thousand jobs, \\$11.1 billion in labor income, \\$18.4 billion in value added, and \\$32.0 billion in economic output. The lodging sector saw the highest direct contributions with \\$5.2 billion in economic output directly contributed to local gateway economies nationally. The sector with the next greatest direct contributions was the restaurants and bar sector, with \\$3.4 billion in economic output directly contributed to local gateway economies nationally.Results from the Visitor Spending Effects report series are available online via an interactive tool. Users can view year-by-year trend data and explore current year visitor spending, jobs, labor income, value added, and economic output effects by sector for national, state, and local economies. This interactive tool is available at http://go.nps.gov/vse.
Cullinane Thomas, Catherine M.; Koontz, Lynne; Cornachione, Egan
The National Park Service (NPS) manages the Nation’s most iconic destinations that attract millions of visitors from across the Nation and around the world. Trip-related spending by NPS visitors generates and supports a considerable amount of economic activity within park gateway communities. This economic effects analysis measures how NPS visitor spending cycles through local economies, generating business sales and supporting jobs and income. In 2017, the National Park System received an estimated 331 million recreation visits. Visitors to National Parks spent an estimated \\$18.2 billion in local gateway regions (defined as communities within 60 miles of a park). The contribution of this spending to the national economy was 306 thousand jobs, \\$11.9 billion in labor income, \\$20.3 billion in value added, and \\$35.8 billion in economic output. The lodging sector saw the highest direct contributions with \\$5.5 billion in economic output directly contributed to local gateway economies nationally. The sector with the next greatest direct contributions was the restaurants and bars sector, with \\$3.7 billion in economic output directly contributed to local gateway economies nationally. Results from the Visitor Spending Effects report series are available online via an interactive tool. Users can view year-by-year trend data and explore current year visitor spending, jobs, labor income, value added, and economic output effects by sector for national, state, and local economies. This interactive tool is available at https://www.nps.gov/subjects/socialscience/vse.htm.
Hogg, R; de Kok, B; Netto, G; Hanley, J; Haycock-Stuart, E
In the UK, public health nurses (health visitors) provide support and advice to families with young children, including those from minority ethnic communities. While the need for cultural sensitivity is being increasingly recognized, the factors which contribute to this sensitivity are poorly understood. The Pakistani and Chinese communities constitute the two largest minority ethnic groups in Scotland. This study explored Pakistani and Chinese women's experience of motherhood and of the health visiting service and public health nurses' experiences of working with Chinese and Pakistani mothers. Semi-structured individual interviews were carried out with 16 Pakistani and 15 Chinese mothers. Eight health visitors took part in two focus groups. The study was undertaken in an urban area of Scotland. Data were analysed thematically. Chinese and Pakistani mothers negotiate complex processes in order to ensure that their children maintain their own ethnic identity while fitting in with their peers in their adopted country. Health visitors were seen as supportive, although sometimes advice and information given was culturally inappropriate, and their role was often poorly understood. Health visitors were anxious to be sensitive to families' religious and cultural beliefs. Cultural sensitivity is an important factor in providing appropriate advice and help to Pakistani and Chinese families, and involves health visitors in considering views and practices on parenting which may differ across cultures, including their own. Family characteristics need to be understood on an individual basis, rather than making assumptions about clients' cultural norms and lifestyles. This is best achieved by exploring with mothers if they understand the advice and information they are being offered and also if it is appropriate to their cultural and religious beliefs. © 2014 John Wiley & Sons Ltd.
Wright, C M; Jeffrey, S K; Ross, M K; Wallis, L; Wood, R
UK child health promotion guidelines expect health visitors to assess family needs before new babies are aged 4 months and offer targeted care on that basis thereafter. Data from an intensive family support programme were used to assess how accurately family needs can be predicted at this stage. A population based cohort of 1202 families with new babies receiving an intensive health visiting programme. Analysis of routinely recorded data. Starting Well project, Glasgow, UK. Health visitor rating of family needs. Families receiving high visiting rates or referred to social work services. Of 302 families rated high need, only 143 (47%) were identified by age 4 months. Visiting rates in the first year for those initially rated high need were nearly double those for the remainder, but around two thirds of those with high contact rates/referred to social work were not initially rated high need. Six family characteristics (no income, baby born preterm, multiple pregnancy, South Asian, prior social work/criminal justice involvement, either parent in care as a child) were identified as the commonest/strongest predictors of contact rates; 1003 (83%) families had one such characteristics and/or lived in a highly deprived area, including 228 (93%) of those with high contact rates and 157 (96%) of those referred to social work. Most families at risk will not be identified on an individual basis in the early weeks. Most families in deprived areas need continued input if the most vulnerable families are to be reliably identified.
Pape-Haugaard, Louise; Haugaard, Karin; Carøe, Per
show redundant records. This redundancy can be explained by multiple transmissions conducted by end users or systems, or a lack of validation methods in the National CDB. In our results three types of cases are presented: from health visitors at school, from health visitors visiting families and from...
Greenway, Julie Catherine; Entwistle, Vikki Ann; terMeulen, Ruud
To explore whether and how health visitors experience ethical tensions between the public health agenda and the need to be responsive to individual clients. Current health policy in England gives health visitors a key role in implementing the government's public health agenda. Health visitors are also required by their Professional Code to respond to the health-related concerns and preferences of their individual clients. This may generate tensions. A total of 17 semi-structured individual interviews covering participants' experiences of implementing public health interventions and perceptions of the ethical tensions involved were conducted. Interviews were audio-recorded, transcribed and analysed thematically using a Framework approach. Health visitors raised a number of ethical concerns, which they attributed to organisational resource allocation and the introduction of protocols and targets relating to public health goals. They did not always regard it as appropriate to raise topics that employing organisations had identified as public health priorities with particular clients for whom they were not priorities, or who had other more pressing needs. They noted that resources that were allocated towards reaching public health targets were unavailable for clients who needed support in other areas. Organisational protocols designed to monitor performance put pressure on health visitors to prioritise achieving targets and undermined their ability to exercise professional judgement when supporting individual clients. This had implications for health visitors' sense of professionalism. Health visitors saw trusting relationships as key to effective health visiting practice, but the requirement to implement public health priorities, combined with a lack of resources in health visiting, eroded their ability to form these. Policies need to be evaluated with regard to their impact upon a broader range of processes and outcomes than public health goals. The erosion of health
Appleton, Jane V; Cowley, Sarah
Assessment of family health need is a central feature of health visiting practice in which a range of skills, knowledge and judgements are used. These assessments are pivotal in uncovering need, safeguarding children and in determining levels of health intervention to be offered to children and their families by the health visiting service in the UK. The central focus of this paper is to outline the critical attributes of the basic principles that underpin health visiting assessment practice that emerged as part of a case study enquiry. A case study design informed by a constructivist methodology was used to examine health visitors' professional judgements and use of formal guidelines in identifying health needs and prioritising families requiring extra health visiting support. The main study was conducted in three community Trust case sites in England, UK, with pilot work being undertaken in a fourth site. Fifteen health visitors participated in the main study and data were collected during 56 observed home visits to families receiving extra health visiting support. Separate in-depth interviews were conducted with the health visitors, pre- and post-home contacts, while 53 client interviews also took place. The analysis suggests that there are certain fundamental elements associated with the majority of health visitor assessments and these have been termed assessment principles. These characteristics are integral to, and provide the basis upon which health visitors' assessments are conducted and professional judgement is formed. They reflect the basic principles of health visiting assessment practice, which exist despite the constraints and realities of the practice context and can be differentiated from the activity centred methods of assessment processes.
Atopic eczema affects up to 20% of children in the UK. It is a disease of varying severity, and health visitors and school nurses have a vital role in educating and supporting children and their parents and carers in its management. Diagnosis and assessment needs to consider atopic eczema severity, effect on quality of life and contributing trigger factors. Treatment should be tailored to the individual child and should include education on emollient therapy, the use of topical corticosteroids and other measures. A case study is included to highlight practical issues and the support of the child and family in coping with atopic eczema at home and in school.
Aquino, Maria Raisa Jessica Ryc V; Olander, Ellinor K; Needle, Justin J; Bryar, Rosamund M
Interprofessional collaboration between midwives and health visitors working in maternal and child health services is widely encouraged. This systematic review aimed to identify existing and potential areas for collaboration between midwives and health visitors; explore the methods through which collaboration is and can be achieved; assess the effectiveness of this relationship between these groups, and ascertain whether the identified examples of collaboration are in line with clinical guidelines and policy. A narrative synthesis of qualitative and quantitative studies. Fourteen electronic databases, research mailing lists, recommendations from key authors and reference lists and citations of included papers. Papers were included if they explored one or a combination of: the areas of practice in which midwives and health visitors worked collaboratively; the methods that midwives and health visitors employed when communicating and collaborating with each other; the effectiveness of collaboration between midwives and health visitors; and whether collaborative practice between midwives and health visitors meet clinical guidelines. Papers were assessed for study quality. Eighteen papers (sixteen studies) met the inclusion criteria. The studies found that midwives and health visitors reported valuing interprofessional collaboration, however this was rare in practice. Findings show that collaboration could be useful across the service continuum, from antenatal care, transition of care/handover, to postnatal care. Evidence for the effectiveness of collaboration between these two groups was equivocal and based on self-reported data. In relation, multiple enablers and barriers to collaboration were identified. Communication was reportedly key to interprofessional collaboration. Interprofessional collaboration was valuable according to both midwives and health visitors, however, this was made challenging by several barriers such as poor communication, limited resources, and
Kronborg, Hanne; Væth, Michael; Olsen, Jørn
BACKGROUND: Little is known about what influences health visitors' breastfeeding support. The objective was to describe health visitors' breastfeeding experiences, beliefs, knowledge and self-efficacy in breastfeeding guidance and determine the impact of a training course on these factors, and how...... to learn the mechanisms of breastfeeding. Data were collected through self-administered questionnaires before the intervention and after the follow-up period. One hundred and six (97%) health visitors and 1302 (82%) mothers responded. RESULTS: At baseline no substantial differences were seen between...... the two groups on years since education, own breastfeeding experiences, beliefs or self-efficacy in breastfeeding guidance except that health visitors in the intervention group, who had completed the course, demonstrated significantly higher scores on knowledge questions (P
Drennan, Vari M; Porter, Elizabeth M J; Grant, Robert L
Educationalists and managers internationally are challenged to find ways of preparing, recruiting early in their careers, and retaining nurses into public health roles in primary care. Public health nursing qualifications are post-initial nurse registration in the United Kingdom as in some other countries. In the mid twentieth century there were a number of innovative programmes of dual qualification: registered nurse and health visitor (the United Kingdom term for public health nurse). To investigate the career histories of graduates from courses integrating both nursing and health visitor qualifications. An observational, survey study. The United Kingdom. A purposive sample of graduates from integrated registered nurse and health visitor programmes, 1959-1995, from one University. Self completed, anonymous, survey sent to graduates, with contact details known to the University and through snowballing techniques, in 2011. Forty five women (56%), graduates in all four decades, returned the survey. A significant majority (82%) had taken up health visitor posts on completing the course. Over their careers, 42% of all jobs held were as health visitors. Only four never worked in a post that required a health visiting qualification. Most had undertaken paid work throughout their careers that focused on aspects of public health, often linked to child, maternal and/or family wellbeing. Many held teaching/lecturing and management posts at some point in their career. Those holding management posts were more likely to report leaving them as a result of organisational re-structuring or redundancy than those in non-management posts. Courses that prepare students to be both nurses and health visitors result in a majority of graduates who take up posts as health visitors on qualification and subsequently. Nurse education planners may find this evidence of value in determining ways of providing a future workforce for public health nursing. Copyright © 2012 Elsevier Ltd. All
Wattoo, F.H.; Memon, M.S.; Memon, A.N.; Wattoo, M.H.S.; Tirmizi, S.A.; Iqbal, J.
To study the effects of stress among lady health visitors and housewives in regard to their serum total cholesterol, HDL cholesterol, and LDL cholesterol and triglyceride levels. The study was performed at the Institute of Biochemistry, University of Sindh, Jamshoro, Pakistan during the years 2003 to 2005. Seventy lady health visitor and housewives aged between 25-40 years participated in this study and were selected from Hyderabad and its adjoining areas. Environmental, psychological and physiological stress levels were measured with likert scale. Total cholesterol, LDL cholesterol and HDL cholesterol and triglyceride levels were measured. Environmental, psychological and physiological stresses were significantly higher in housewives as compared to lady health visitors. A low level of HDL cholesterol was observed in housewives as compared to lady health visitors. The levels of total cholesterol, LDL cholesterol and triglyceride were found higher in housewives than lady health visitors. Housewives are under more stress than lady health visitors. The levels of total cholesterol, LDL cholesterol and triglyceride increases but HDL cholesterol decrease with stress. (author)
Cullinane Thomas, Catherine; Huber, Christopher; Koontz, Lynne
The National Park System covers more than 84 million acres and is comprised of more than 401 sites across the Nation. These lands managed by the National Park Service (NPS) serve as recreational destinations for visitors from across the Nation and around the world. On vacations or on day trips, NPS visitors spend time and money in the gateway communities surrounding NPS sites. Spending by NPS visitors generates and supports a considerable amount of economic activity within park gateway economies. The NPS has been measuring and reporting visitor spending and economic effects for the past 25 years. The 2012 analysis marked a major revision to the NPS visitor spending effects analyses, with the development of the Visitor Spending Effects model (VSE model) which replaced the previous Money Generation Model (see Cullinane Thomas et al. (2014) for a description of how the VSE model differs from the previous model). This report provides updated VSE estimates associated with 2014 NPS visitation.
Cullinane Thomas, Catherine; Huber, Christopher C.; Koontz, Lynne
The National Park Service (NPS) manages the nation's most iconic destinations that attract millions of visitors from across the nation and around the world. Trip-related spending by NPS visitors generates and supports a considerable amount of economic activity within park gateway communities. This economic effects analysis measures how NPS visitor spending cycles through local economies, generating business sales and supporting jobs and income.
Glatt, Kevin; Okunseri, Christopher; Flanagan, Diane; Simpson, Pippa; Cao, Yumei; Willis, Earnestine
Home visiting programs promote the education and health of Early Head Start (EHS) children and pregnant women. However, EHS's oral health component is unevenly implemented. We conducted an educational intervention to improve oral health knowledge and motivational interviewing techniques among Wisconsin EHS home visitors. A questionnaire assessing oral health-related knowledge and confidence was administered to home visitors before and after an educational session. Changes between pre/post-responses were analyzed with McNemar's test and Wilcoxon Signed Rank test. After the intervention there were increases in both knowledge and confidence related to oral health communication. Knowledge increases were observed in such topics as fluoridation, dental caries, and caregivers' role in assisting and supervising children's tooth brushing. A brief educational intervention was associated with increased home visitor knowledge and confidence in communicating oral health messages to EHS caregivers and pregnant women. © 2016 American Association of Public Health Dentistry.
Nishikawa, Mariko; Yamanaka, Masaaki; Kiriya, Junko; Jimba, Masamine
Over 24 million international visitors came to Japan in 2016 and the number is expected to increase. Visitors could be at a risk of illness or injury that may result in hospitalization in Japan. We assessed the effects of a four-minute digital animation titled Mari Info Japan on the level of anxiety experienced by international visitors to Japan. We conducted a non-randomized, controlled study at Narita International Airport outside Tokyo in December 2014. On the first day, we recruited international visitors for the intervention group at predetermined departure gates and, the following day, we sampled visitors for the control group at the same gates. We repeated this procedure twice over 4 days. The intervention group watched the digital animation and the control group read a standard travel guidebook in English. After receiving either intervention, they completed a questionnaire on their level of anxiety. The outcome was assessed using the Mari Meter-X, The State-Trait Anxiety Inventory Form Y (STAI-Y), and a face scale, before and immediately after the intervention. We analyzed data with Wilcoxon rank sum tests. We recruited 265 international visitors (134 in the intervention group, 131 in the control group), 241 (91%) of whom completed the questionnaire. Most of them had no previous Japanese health information before arrival in Japan. The level of anxiety about health services in Japan was significantly reduced in the intervention group (Mari Meter-X median: - 5 and 0, p animation is more effective in reducing anxiety among international visitors to Japan compared with reading a standard brochure or guidebook. Such effective animations of health information should be more widely distributed to international visitors. UMIN-CTR (University Hospital Medical Information Network Center Clinical Trials Registry), UMIN000015023 , September 3, 2014.
Dean, Janet G.; And Others
Discusses the role of the health visitor in the prediction of early childhood injuries, abuse, and failure to thrive--based on a three-year study of the relationship between early maternal attitudes and subsequent child health. Journal availability: Pergamon Press Ltd., Headington Hill Hall, Oxford, OX3 OBW England. (DLS)
Lewis, Anne; Ilot, Irene; Lekka, Chrysanthi; Oluboyede, Yemi
The mental health of mothers is of significant concern to community practitioners. This paper reports on a case study exploring the success factors of a well established, health visitor-led protocol to identify and treat women with mild to moderate depression. Data were collected through interviews with a purposive sample of 12 community practitioners, a focus group of four health visitors and observation of a multidisciplinary steering group meeting. The protocol was described as an evidence-based tool and safety net that could be used flexibly to support clinical judgments and tailored to individual needs. Success factors included frontline clinician engagement and ownership, continuity of leadership to drive development and maintain momentum, comprehensive and on-going staff training, and strategic support for the protocol as a quality indicator at a time of organisational change. Quality and clinical leadership are continuing policy priorities. The protocol enabled frontline staff to lead a service innovation, providing a standardised multiprofessional approach to women's mental health needs through effective support, advice and treatment that can be measured and quality assured.
Drennan, Vari M; Porter, Elizabeth M J; Grant, Robert L
BACKGROUND: Educationalists and managers internationally are challenged to find ways of preparing, recruiting early in their careers, and retaining nurses into public health roles in primary care. Public health nursing qualifications are post-initial nurse registration in the United Kingdom as in some other countries. In the mid twentieth century there were a number of innovative programmes of dual qualification: registered nurse and health visitor (the United Kingdom term for public health n...
Donald B.K. English; Warren Kriesel; Vernon R Leeworthy; Peter C. Wiley
This report provides estimates of the economic impact that visitors to the Florida Keys have on both the Monroe County and larger South Florida regional economies. Estimates are made for output/sales, income, and employment and include both direct and secondary economic impacts. This report provides the basis for demonstrating the income-producing asset value of the...
Eynon, Julia; Carrier, Judith; Rees, Sally; Cartwright, Annie
Domestic violence has been described as a public health epidemic, with victims of domestic violence encountered in all health care settings. Within the United Kingdom the role of the health visitor (specialist community public health nurse) is to promote health in the whole community; every family with a child under five years has a named health visitor. Preparation for the health visitor role is unique to the United Kingdom. Health visitors are particularly well placed to identify and support mothers who are experiencing domestic violence. The objective of this review was to synthesise the best available evidence relating to support provided by UK health visitors for mothers who have experienced domestic violence, from both the mothers and the health visitors' perspectives. The participants of interest were mothers who have experienced domestic violence and health visitors who offer support to those mothers.The self reported experiences of health visitor support provided to mothers who have experienced domestic violence, from the perspective of both the mothers and the health visitors providing the support.This review considered studies that focus on qualitative data including, but not limited to, designs such as ethnography, phenomenology, grounded theory, action research and feminist research. Studies published up to April 2011 were included in the review. The search was restricted to English language studies. The databases searched were: Medline, CINAHL, PsycINFO, PsycARTICLES, EMBASE, British Nursing Index and Archive, ASSIA and TRIP. Studies were assessed for methodological quality using the standardised critical appraisal instruments from the Joanna Briggs Institute. Data were extracted using standardised data extraction tools from the Joanna Briggs Institute. Data synthesis used the Joanna Briggs Institute approach for meta-synthesis by meta-aggregation. Findings were synthesised into categories, which were aggregated into synthesised findings. Four
This Issue Brief discusses the emerging issue of "defined contribution" (DC) health benefits. The term "defined contribution" is used to describe a wide variety of approaches to the provision of health benefits, all of which have in common a shift in the responsibility for payment and selection of health care services from employers to employees. DC health benefits often are mentioned in the context of enabling employers to control their outlay for health benefits by avoiding increases in health care costs. DC health benefits may also shift responsibility for choosing a health plan and the associated risks of choosing a plan from employers to employees. There are three primary reasons why some employers currently are considering some sort of DC approach. First, they are once again looking for ways to keep their health care cost increases in line with overall inflation. Second, some employers are concerned that the public "backlash" against managed care will result in new legislation, regulations, and litigation that will further increase their health care costs if they do not distance themselves from health care decisions. Third, employers have modified not only most employee benefit plans, but labor market practices in general, by giving workers more choice, control, and flexibility. DC-type health benefits have existed as cafeteria plans since the 1980s. A cafeteria plan gives each employee the opportunity to determine the allocation of his or her total compensation (within employer-defined limits) among various employee benefits (primarily retirement or health). Most types of DC health benefits currently being discussed could be provided within the existing employment-based health insurance system, with or without the use of cafeteria plans. They could also allow employees to purchase health insurance directly from insurers, or they could drive new technologies and new forms of risk pooling through which health care services are provided and financed. DC health
Tandon, S. Darius; Mercer, Constance D.; Saylor, Elizabeth L.; Duggan, Anne K.
This research was conducted to understand paraprofessional home visitors' perceptions of their training in addressing poor mental health, substance abuse, and domestic violence, and their actions in working with families in addressing these issues. Five focus groups were conducted with a total of 28 paraprofessional home visitors. Three main…
Kronborg, Hanne; Væth, Michael; Kristensen, Ingeborg
Objective: To assess if the absence of early home visits influenced the mothers’ breastfeeding duration and use of medical services. Design: Data from mothers who had given birth during a strike period were compared to data from a reference period with usual work practice. Sample: The study...... included 3834 newborn and 375 health visitors, 75 of whom worked during the strike period. Intervention: All families were offered non- standardized home visits after discharge in the reference period. During the strike, the service was based on individual risk assessment. Results: Overall, no difference....... The mothers’ needs for postnatal visits differed depending on parity: primiparae underlined uncertainty, multiparae underlined previous breastfeeding experience. Mothers had missed out on guidance on all areas of the health visitors’ service. Conclusion: Non-standardized home visits by health visitors were...
Domestic abuse is a serious problem across the world and it is considered a public health issue. Nurses play a crucial role in recognising and responding to domestic abuse but they sometimes lack confidence in dealing with the issue. In this article, two recently completed studies are used to extract lessons for health visiting practice. The first study investigated primary healthcare professionals' beliefs about domestic abuse. Many healthcare professionals were confident in dealing with domestic abuse. However, there was disinclination among some to discuss the issue. People who experience abuse rarely discuss it unless asked. So the study highlighted a potential dynamic of silence between health professionals and abused people in their care. The second study investigated student nurses and student midwives experiences of learning about domestic abuse. The student nurses had learned less than the student midwives. They had not been taught about domestic abuse in university and many had not had the opportunity to learn about it in clinical placement. They reported reluctance among some mentors to discuss the issue with them, with a resulting silencing of the issue. Both of these studies have important lessons for health visiting practice regarding opening up crucial conversations about domestic abuse.
Nakamura, Sachiko; Wada, Koji; Yanagisawa, Naoki; Smith, Derek R
In 2020, Japan will host the Tokyo Olympic and Paralympic Games in 2020 (Tokyo 2020) which will involve a large population influx from various countries to Tokyo, the most populated city in Japan. We summarize the potential health risks for visitors to Tokyo 2020, related to communicable disease risks and other health threats, based on recent national and local surveillance reports. We reviewed up-to-date surveillance reports published by the National Institute of Infectious Diseases and Tokyo Metropolitan Infectious Disease Surveillance Center. Communicable disease risks for vaccine-preventable illnesses such as measles and rubella, as well as food and waterborne diseases represent the most likely risks. The risk of acquiring vector-borne diseases is considered low in Japan. On the other hand, however, heat-related illness represents a potential risk, as Tokyo 2020 is scheduled during the hottest season in Japan, with temperatures generally expected to exceed 30 °C. Maintaining an up-to-date routine vaccination schedule is highly recommended for visitors attending the Tokyo 2020 and appropriate hygiene measures for food and waterborne diseases as well as health promotion for heat-related illness. It may also be useful to increase the number of multilingual triage clinicians whom can be placed within emergency departments during the Tokyo 2020 to provide first contact services and coordination of emergency care among non-Japanese speaking visitors to Tokyo. Copyright © 2018. Published by Elsevier Ltd.
Jackson, Cath; Coe, Anne; Cheater, Francine M; Wroe, Stephen
This paper is a report of an exploratory study to evaluate the effectiveness and acceptability of a specialist health visitor-led weight management clinic in primary care. Tackling obesity is a global health priority. Whilst there is evidence to support a role for primary healthcare professionals in its management, provision in England varies widely. Using designated 'obesity specialists' is an approach warranting further investigation. In 2003-2004, patients with a body mass index of 30 or more received a specialist health visitor-led intervention based on the Jan Felgens 'I2E2' model. Clinical outcome data and self-reported dietary consumption data were collected at weeks 1, 13, 27 and 52. Quantitative and qualitative data on patient acceptability of the clinic were collected at week 26. Eighty-nine patients attended the clinic. Mean body weight and body mass index and systolic and diastolic blood pressure decreased over time by statistically significant amounts. There was a non-significant decrease in fasting blood sugar over time, but approximately one in 10 patients with undiagnosed diabetes were identified. No statistically significant change was evident for cholesterol levels. Mean self-reported weekly consumption of cakes, desserts and snacks decreased and that of fruit and vegetables increased, each by statistically significant amounts. Participants found the clinic highly acceptable and identified the specialist health visitor as fundamental to its success. A partnership approach to weight management through which patients are empowered to make sustainable lifestyle changes now needs to be tested in a multi-centre randomized controlled trial.
Brooks, Christina; Khatau, Tejas
Prescribing is an essential element of health visiting practice. This initiative used the payment framework of Commissioning for Quality and Innovation (CQUIN) to develop health visiting practice across a large health visiting workforce in the East Midlands. A focus on emollient prescribing practice was agreed and a guidance booklet regarding preferred emollient products was produced, based on the local formulary Each health visitor benefitted from receiving additional training and was given a guidance booklet to inform their practice. Targets were set for each quarter to demonstrate an improved prescribing adherence to the preferred product list.The targets were achieved for each quarter. Prescribing rates and confidence improved across the service. Therefore, it was demonstrated that specific guidance and ongoing support can improve prescribing practice within the health visiting service.
Barten, M; Noordhuizen, J P M; Lipman, L J A
An increasing number of Dutch dairy farmers have diversified their activities, often opening their farm up to visitors (tourist accommodation, farm shop, contact with livestock, etc). It is essential to prevent these visitors from having accidents or becoming ill, which could result in financial claims and might harm the reputation of the agricultural sector. This article describes how the hazard analysis critical control points concept and principles (HACCP) can be applied to these activities and integrated with on-farm operational herd health and production management programmes.
Haynes, Clare F.; And Others
The paper describes the characteristics of thriving and failure to thrive (FTT) children and their mothers and examines the effect of short-term lay health visitor intervention in cases of nonorganic failure to thrive. Three patients of interaction were identified in the FTT group, benign neglect, incoordination, over hostility. (Author/DB)
Pritchard, A; Kendrick, D
To evaluate practice nurse (PN) and health visitor (HV) management of patients with acute minor illnesses, monitor the effect on general practitioner (GP) workload, and describe the range of conditions seen by nurses. Patients requesting 'urgent' appointments (within 24 hours) were offered consultations with a PN or HV trained in the management of acute minor illness. Comparative data were collected before and after the establishment of the acute minor illness service. A general practice in Nottingham, England. Patient satisfaction, consultation rate, prescriptions, investigations, referrals and urgent re-consultations for the same condition within 2 weeks. About 2056 urgent consultations were recorded in the study period, of which 332 (16.1%) were seen by PNs and 46 (2.2%) by a HV. High levels of patient satisfaction were reported for all health professionals. Patients seeing the HV reported higher levels of satisfaction than those consulting GPs (P=0.033) and PNs (P=0.010). There was no difference by health professional for prescription rates (P=0.76), re-consultations (P=0.14), or referrals to secondary care (P=0.07). General practitioners were more likely to initiate further investigations than the PNs or HV (P manage patients with a range of conditions. General practitioner workload can be reduced while maintaining high patient satisfaction levels.
Druce, Maralyn; Howden, Stella
The growth of e-learning in health professional education reflects expansion of personal use of online resources. Understanding the user perspective in a fast-changing digital world is essential to maintain the currency of our approach. Mixed methods were used to investigate a cohort of postgraduate, e-learning healthcare students' perspectives on their use of online resources for personal and/or professional roles, via questionnaire and student-constructed diagrams, capturing use of online resources (underpinned by White's model of "resident" and "visitor" online engagement). Semistructured interviews explored the use and value of resources afforded via the online environment. The 45 study participants described a range of prior experiences with online resources in personal and professional capacities, but overall students tended to use online "tools" ("visitor" mode) rather than highly collaborative networks ("resident" mode). In relation to e-learning, the dominant interview theme was valuing knowledge transfer from the tutor and using "visitor" behaviors to maximize knowledge acquisition. Peer-learning opportunities were less valued and barriers to collaborative "resident" modes were identified. These findings help to inform e-learning course design to promote engagement. The results enable recommendations for use of the "Visitor and Residents" model and for planning activities that learners might utilize effectively.
Dong, Xiaoxin; Liu, Ling; Cao, Shiyi; Yang, Huajie; Song, Fujian; Yang, Chen; Gong, Yanhong; Wang, Yunxia; Yin, Xiaoxu; Xu, Xing; Xie, Jun; Sun, Yi; Lu, Zuxun
Community health service in China is designed to provide a convenient and affordable primary health service for the city residents, and to promote health equity. Based on data from a large national study of 35 cities across China, we examined the characteristics of the patients and the utilization of community health institutions (CHIs), and assessed the role of community health service in promoting equity in health service utilization for community residents. Multistage sampling method was applied to select 35 cities in China. Four CHIs were randomly chosen in every district of the 35 cities. A total of 88,482 visitors to the selected CHIs were investigated by using intercept survey method at the exit of the CHIs in 2008, 2009, 2010, and 2011. Descriptive analyses were used to analyze the main characteristics (gender, age, and income) of the CHI visitors, and the results were compared with that from the National Health Services Survey (NHSS, including CHIs and higher levels of hospitals). We also analyzed the service utilization and the satisfactions of the CHI visitors. The proportions of the children (2.4%) and the elderly (about 22.7%) were lower in our survey than those in NHSS (9.8% and 38.8% respectively). The proportion of the low-income group (26.4%) was apparently higher than that in NHSS (12.5%). The children group had the lowest satisfaction with the CHIs than other age groups. The satisfaction of the low-income visitors was slightly higher than that of the higher-income visitors. The utilization rate of public health services was low in CHIs. The CHIs in China appears to fulfill the public health target of uptake by vulnerable populations, and may play an important role in promoting equity in health service utilization. However, services for children and the elderly should be strengthened.
Sayer, Lynn; Barriball, K Louise; Bliss, Julie; Bakhshi, Savita; While, Alison E
Fast tracking is one strategy that organizations use to ameliorate workforce shortfalls by attracting new recruits, and accelerating their skills development and experience. In response to the Government's target of rapidly expanding the number of health visitors in England's National Health Service, the fast track initiative was launched to recruit newly qualified (fast track) as well as experienced (standard entry) nurses and midwives onto health visiting programmes. This paper evaluates the fast track initiative, from the perspective of fast track and standard entry students, practice teachers and health visitor managers. A mixed methods design was used comprising a questionnaire survey (n = 71 students), semi-structured interviews (n = 37 students), telephone interviews (n = 13 managers) and six focus groups (n = 24 practice teachers). Data were collected between April 2012 and July 2013. Descriptive statistics, t-tests and the Pearson Chi-square test were used to analyse the quantitative data. The qualitative data were analysed thematically. Motivations for health visiting as a career choice were similar for fast track and standard entry students, with career progression and interest in health promotion being key motivators. There was consensus that personal qualities and characteristics were more important than experience or qualifications. However, fast track students were significantly less confident about their public health competencies in leadership and management (p communication (p 0.5). Fast tracking offers a useful recruitment strategy in order to expand the health visitor workforce, but longitudinal research is needed to confirm benefits such as retention and career trajectories. © The Author(s) 2015.
US Agency for International Development — Visitor Registration System (VRS) streamlines visitor check-in and check-out process for expediting visitors into USAID. The system captures visitor information...
Donetto, Sara; Malone, Mary; Sayer, Lynn; Robert, Glenn
In response to a policy-driven workforce expansion in England new models of preparing health visitors for practice have been implemented. 'Community of Learning hubs' (COLHs) are one such model, involving different possible approaches to student support in clinical practice placements (for example, 'long arm mentoring' or 'action learning set' sessions). Such models present opportunities for studying the possible effects of spatiality on the learning experiences of students and newly qualified health visitors, and on team relationships more broadly. To explore a 'community of learning hub' model in health visitor education and reflect on the role of space and place in the learning experience and professional identity development of student health visitors. Qualitative research conducted during first year of implementation. Three 'community of learning hub' projects based in two NHS community Trusts in London during the period 2013-2015. Managers and leads (n=7), practice teachers and mentors (n=6) and newly qualified and student health visitors (n=16). Semi-structured, audio-recorded interviews analysed thematically. Participants had differing views as to what constituted a 'hub' in their projects. Two themes emerged around the spaces that shape the learning experience of student and newly qualified health visitors. Firstly, a generalised need for a 'quiet place' which allows pause for reflection but also for sharing experiences and relieving common anxieties. Secondly, the role of physical arrangements in open-plan spaces to promote access to support from more experienced practitioners. Attention to spatiality can shed light on important aspects of teaching and learning practices, and on the professional identities these practices shape and support. New configurations of time and space as part of educational initiatives can surface new insights into existing practices and learning models. Copyright © 2017. Published by Elsevier Ltd.
Bruun, Signe; Buhl, Susanne; Husby, Steffen
compared. DESIGN: The study population was part of the Odense Child Cohort. The four methods used were: (a) self-administered questionnaire 3 months postpartum, (b) self-administered questionnaire 18 months postpartum, (c) registrations from health visitors visiting the families several times within...... weeks, and the mean age when introduced to complementary foods from 19 to 21 weeks. The mean duration of any breastfeeding was 33 weeks across methods. CONCLUSIONS: Compared with the weekly SMS questions, the self-administered questionnaires and the health visitors' reports resulted in a greater...
Hughes, Alison; Condon, Louise
Aim To explore the experiences of student and novice health visitors in implementing health visiting policy reform pre- and post-qualification. In England, public health nursing has been subject to major policy reform. The Health Visitor Implementation Plan (2011) set out a plan to recruit increasing numbers of nurses and midwives to the profession to deliver an expanded and refocussed health visiting service. Exploring this policy change from the viewpoint of those new to health visiting offers a unique perspective into how a specific policy vision is translated into nursing practice. A descriptive qualitative study in which participants were enrolled on a one-year post-graduate health visiting course at a University in South West of England. Qualitative data were collected pre- and post-qualification. A total of 16 interviews and a focus group were conducted with nine participants between September 2012 and March 2013. Findings Descriptive data were interpreted using Lipsky's theoretical framework of street-level bureaucracy. Three themes emerged which relate to this 'bottom-up' perspective on policy implementation; readiness to operationalise policy, challenges in delivering the service vision; and using discretion in delivering the vision. Community public health nurses operate as street-level bureaucrats in negotiating the demands of policy and practice, and by this means, attempt to reconcile professional values with institutional constraints. Barriers to policy implementation at a local level mediate the effects of policy reform, ultimately impacting upon outcomes for children and families.
Humphries, Heatha; Nolan, Mary
To improve engagement of Health Visitors and Community Practitioners delivering the Healthy Child Programme with fathers. To evaluate a one-day, father-focused workshop with a supporting handbook for Practitioners. To identify institutional and organisational barriers to engagement with fathers. The UK government policy encourages health professionals to engage with fathers. This derives from robust evidence that fathers' early involvement with their children impacts positively on emotional, behavioural and educational development. Yet, there is little evidence that the importance of engaging fathers is reflected in Health Visitor training or that primary-care services are wholly embracing father-inclusive practice. The Fatherhood Institute (FI), a UK charity, has developed a workshop for Practitioners delivering the Healthy Child Programme. A 'before and after' evaluation study, comprising a survey followed by telephone interviews, evaluated the impact of the FI workshop on Health Visitors' and Community Practitioners' knowledge, attitudes and behaviour in practice. A total of 134 Health Visitors and Community Practitioners from eight NHS Trusts in England attended the workshop from November 2011 to January 2014 at 12 sites. A specially constructed survey, incorporating a validated questionnaire, was administered before the workshop, immediately afterwards and three months later. Telephone interviews further explored participants' responses. Analysis of the questionnaire data showed that the workshop and handbook improved participants' knowledge, attitudes and behaviour in practice. This was sustained over a three-month period. In telephone interviews, most participants said that the workshop had raised their awareness of engaging fathers and offered them helpful strategies. However, they also spoke of barriers to engagement with fathers. NHS Trusts need to review the training and education of Health Visitors and Community Practitioners and take a more strategic
Jentes, Emily S; Davis, Xiaohong M; Macdonald, Susan; Snyman, P Johann; Nelson, Hugh; Quarry, Doug; Lai, Irene; van Vliet, Erik W N; Balaban, Victor; Marano, Cinzia; Mues, Katherine; Kozarsky, Phyllis; Marano, Nina
During the 2008 Olympic and Paralympic Games, we conducted surveillance of illnesses among travelers at six Beijing clinics. Surveys asked about demographic, pre-travel, and vaccination information, and physician-provided diagnoses. Of 807 respondents, 38% and 57% were classified as foreign visitors (FV) and expatriates, respectively. Less than one-half of FV sought pre-travel advice; sources included health-care providers and friends/family. FV vaccination rate was also low; however, most vaccines given were recommended by the Centers for Disease Control and Prevention. The most common FV diagnoses were respiratory, injury/musculoskeletal, and gastrointestinal illnesses; for expatriates, injury/musculoskeletal, respiratory, and dermatologic were the most common illnesses. Respiratory illnesses in expatriates were significantly less in 2008 than during 2004-2007 (chi(2) = 10.2; P = 0.0014), suggesting that control programs may have reduced pollutants/respiratory irritants during the 2008 Games. We found no previous studies of health outcomes among expatriates living in cities with mass travel events. These findings highlight the need to continuously disseminate information to health-care providers advising travelers.
Eskyte, Ieva; Gray-Burrows, Kara; Owen, Jenny; Sykes-Muskett, Bianca; Zoltie, Tim; Gill, Susanne; Smith, Victoria; McEachan, Rosemary; Marshman, Zoe; West, Robert; Pavitt, Sue; Day, Peter
Parental supervised brushing (PSB) when initiated in infancy can lead to long-term protective home-based oral health habits thereby reducing the risk of dental caries. However, PSB is a complex behaviour with many barriers reported by parents hindering its effective implementation. Within the UK, oral health advice is delivered universally to parents by health visitors and their wider teams when children are aged between 9 and 12 months. Nevertheless, there is no standardised intervention or training upon which health visitors can base this advice, and they often lack the specialised knowledge needed to help parents overcome barriers to performing PSB and limiting sugary foods and drinks.Working with health visitors and parents of children aged 9-24 months, we have co-designed oral health training and resources (Health Visitors delivering Advice in Britain on Infant Toothbrushing (HABIT) intervention) to be used by health visitors and their wider teams when providing parents of children aged 9-12 months with oral health advice.The aim of the study is to explore the acceptability of the HABIT intervention to parents and health visitors, to examine the mechanism of action and develop suitable objective measures of PSB. Six health visitors working in a deprived city in the UK will be provided with training on how to use the HABIT intervention. Health visitors will then each deliver the intervention to five parents of children aged 9-12 months. The research team will collect measures of PSB and dietary behaviours before and at 2 weeks and 3 months after the HABIT intervention. Acceptability of the HABIT intervention to health visitors will be explored through semi-structured diaries completed after each visit and a focus group discussion after delivery to all parents. Acceptability of the HABIT intervention and mechanism of action will be explored briefly during each home visit with parents and in greater details in 20-25 qualitative interviews after the
Káren Mendes Jorge de Souza
Full Text Available ABSTRACT Objective: Analyze the perceptions of undergraduate nursing students about the contributions of public health to nursing practice in the Unified Health System. Method: Qualitative Descriptive Study. Data collection was carried out through semi-directed interviews with 15 students. The language material was analyzed according to content and thematic analysis. Results: Thematic categories were established, namely: "Perceptions about Public Health" and "Contribution of Public Health to nursing practice in the Unified Health System". Final considerations: Perceptions about Public Health are diversified, but converge to the recognition of this field as the basis for training nurses qualified to work in the SUS with technical competence, autonomy and focusing on the integrality in health care.
Visitor's Computer Guidelines Network Connection Request Instruments Instruments by Telescope IR Instruments Guidelines Library Facilities Outreach NOAO-S EPO Program team Art of Darkness Image Gallery EPO/CADIAS â¹âº You are here CTIO Home Â» Astronomers Â» Visitor's Computer Guidelines Visitor's Computer
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Affected by the salary adjustments on 1 January 2001 and the evolution of the staff members and fellows population, the average reference salary, which is used as an index for fixed contributions and reimbursement maxima, has changed significantly. An adjustment of the amounts of the reimbursement maxima and the fixed contributions is therefore necessary, as from 1 January 2001. Reimbursement maxima The revised reimbursement maxima will appear on the leaflet summarizing the benefits for the year 2001, which will be sent out with the forthcoming issue of the CHIS Bull'. This leaflet will also be available from the divisional secretariats and from the UNIQA office at CERN. Fixed contributions The fixed contributions, applicable to some categories of voluntarily insured persons, are set as follows (amounts in CHF for monthly contributions) : voluntarily insured member of the personnel, with normal health insurance cover : 910.- (was 815.- in 2000) voluntarily insured member of the personnel, with reduced heal...
Poole Wilson, Tiffany; Davis, Kermit G
The aim of this study was to assess the contributions of Thomas Waters's work in the field of health care ergonomics and beyond. Waters's research of safe patient handling with a focus on reducing musculoskeletal disorders (MSDs) in health care workers contributed to current studies and prevention strategies. He worked with several groups to share his research and assist in developing safe patient handling guidelines and curriculum for nursing students and health care workers. The citations of articles that were published by Waters in health care ergonomics were evaluated for quality and themes of conclusions. Quality was assessed using the Mixed Methods Appraisal Tool and centrality to original research rating. Themes were documented by the type of population the citing articles were investigating. In total, 266 articles that referenced the top seven cited articles were evaluated. More than 95% of them were rated either medium or high quality. The important themes of these citing articles were as follows: (a) Safe patient handling is effective in reducing MSDs in health care workers. (b) Shift work has negative impact on nurses. (c) There is no safe way to manually lift a patient. (d) Nurse curriculums should contain safe patient handling. The research of Waters has contributed significantly to the health care ergonomics and beyond. His work, in combination with other pioneers in the field, has generated multiple initiatives, such as a standard safe patient-handling curriculum and safe patient-handling programs. © 2016, Human Factors and Ergonomics Society.
Peckover, Sue; Aston, Megan
To critically examine surveillance practices of health visitors (HV) in the UK and public health nurses (PHNs) in Canada. The practice and meaning of surveillance shifts and changes depending on the context and intent of relationships between mothers and HVs or PHNs. We present the context and practice of HVs in the UK and PHNs in Canada and provide a comprehensive literature review regarding surveillance of mothers within public health systems. We then present our critique of the meaning and practice of surveillance across different settings. Concepts from Foucault and discourse analysis are used to critically examine and discuss the meaning of surveillance. Surveillance is a complex concept that shifts meaning and is socially and institutionally constructed through relations of power. Healthcare providers need to understand the different meanings and practices associated with surveillance to effectively inform practice. Healthcare providers should be aware of how their positions of expert and privilege within healthcare systems affect relationships with mothers. A more comprehensive understanding of personal, social and institutional aspects of surveillance will provide opportunities to reflect upon and change practices that are supportive of mothers and their families. © 2017 John Wiley & Sons Ltd.
This issue of the IAEA Bulletin edition considers the ideas and innovations that led to the IAEA’s formation and influenced its evolution. In this issue of the IAEA Bulletin, you will learn more about how countries use nuclear technology to improve health and prosperity and protect the environment through the technical cooperation programme. Together, the Member States and the IAEA are making a lasting contribution to achieving the Millennium Development Goals that challenge us to significantly reduce hunger, poverty and disease
Bruun, Signe; Buhl, Susanne; Husby, Steffen; Jacobsen, Lotte Neergaard; Michaelsen, Kim F; Sørensen, Jan; Zachariassen, Gitte
Studies on prevalence and effects of breastfeeding call for reliable and precise data collection to optimize infant nutrition, growth, and health. Data on breastfeeding and infant nutrition are at risk of, for example, recall bias or social desirability bias. The aim of the present analysis was to compare data on infant nutrition, that is, breastfeeding, use of infant formula, and introduction to complementary foods, obtained by four different methods. We assumed that weekly short message service (SMS) questions were the most reliable method, to which the other methods were compared. The study population was part of the Odense Child Cohort. The four methods used were: (a) self-administered questionnaire 3 months postpartum, (b) self-administered questionnaire 18 months postpartum, (c) registrations from health visitors visiting the families several times within the first year of life, and (d) weekly SMS questions introduced shortly after birth. In total, 639 singleton mothers with data from all four methods were included. The proportion of mothers initiating breastfeeding varied from 86% to 97%, the mean duration of exclusive breastfeeding from 12 to 19 weeks, and the mean age when introduced to complementary foods from 19 to 21 weeks. The mean duration of any breastfeeding was 33 weeks across methods. Compared with the weekly SMS questions, the self-administered questionnaires and the health visitors' reports resulted in a greater proportion of mothers with an unknown breastfeeding status, a longer duration of exclusive breastfeeding and later introduction to complementary foods, while the duration of any breastfeeding did not differ.
Penney, R. W.
This article describes the Fellowship and Visitor Programme as it is at present, detailing the various headings under which the visitors come and indicating the methods by which they are chosen. The way in which their work is integrated into the general scientific activity of CERN is discussed briefly.
Bryans, Alison; Cornish, Flora; McIntosh, Jean
In line with recent UK and Scottish policy imperatives, there is increasing pressure for the health visiting service to assume an enhanced role in improving public health. Although health visiting has so far maintained its unique position as a primarily preventive service within the UK health service, its distinctive contribution now appears under threat. The continuing absence of a comprehensive and integrated conceptual basis for practice has a negative impact on the profession's ability to respond to current challenges. Establishing an integrative framework to conceptualise health visiting practice would enable more sensitive, focused and appropriate research, education and evaluation in relation to practice. Work in this area could thus usefully contribute to the future development of the service at a difficult time. Our paper aims to make such a contribution. In support of our conceptual aims, we draw on a study of health visiting practice undertaken within a large conurbation in central Scotland. The study used a mixed method, collaborative approach involving 12 audio-recorded and observed health visitor-client interactions, semi-structured interviews with the 12 HVs and 12 clients, examination of related documentation and workshops with the HV participants. We critically consider prevalent models of health visiting practice and describe the more integrative conceptual approach provided by Bronfenbrenner's ecological, 'person-in-context' framework. The paper subsequently explores relationships between this framework and understandings of need demonstrated by health visitors who participated in our study. Current policy emphasises the need to focus on public health and social inclusion in order to improve health. However, if this policy is to be translated into practice, we must develop a more adequate understanding of how practitioners work effectively with families and individuals in a sensitive and context-specific manner. Bronfenbrenner's framework appears
INTERFACING INFANT MENTAL HEALTH KNOWLEDGE SYSTEMS: REFLECTIONS ON THE NARRATIVES OF LAY HOME VISITORS' EXPERIENCES OF LEARNING AND APPLYING RELATIONAL CONCEPTS OF DEVELOPMENT IN A SOUTH AFRICAN INTERVENTION PROGRAM.
Baradon, Tessa; Bain, Katherine
The question of interfacing research and clinically generated knowledge in the field of infant mental health (IMH) with local cultural knowledge and belief systems has provoked extended discussion in recent years. This article explores convergences and divergences between current research-based, relational IMH mental health models and "community" knowledge held by a group of South African lay home visitors from a socioeconomically deprived township. These women were trained in a psychoanalytic and attachment-informed infant mental health program that promotes a relational model of infant development. They provide an intervention that supports high risk mother-infant relationships in the same locality. A two-tiered approach was taken to the analysis of the home visitor interviews and focused on the home visitors' constructed narratives of infant development posttraining as well as the personal impact of the training and work on the home visitors themselves. The study found that psychoanalytic and attachment-informed thinking about development makes sense to those operating within the local South African cultural context, but that the accommodation of this knowledge is a complex and challenging process. © 2016 Michigan Association for Infant Mental Health.
Steven, Alison; Larkin, Valerie; Stewart, Jane; Bateman, Belinda
Continuing Professional Development is important for maintaining and developing knowledge and skills. Evidence regarding direct impact on practice is limited. Existing literature often lacks sufficient detail regarding the initiative or its evaluation, making transferability problematic. To explore the impact and perceived value of multi-disciplinary Continuing Professional Development workshops for Health Visitors who support families with children with complex health needs. Realistic Evaluation principles guided the research. Workshop attendees were invited to participate (n.21), 81% (n.17) agreed. Data collection included a questionnaire and semi-structured interviews. Data analysis included descriptive statistics and qualitative thematic analysis. One North of England Health Service Trust. Interrelated temporal themes emerged. Before the workshop expectations included, uncertainty regarding content and ambiguity regarding attendance. During workshops comments focused on networking opportunities, the detail, content and facilitation of the learning experience. 'Emotional safety' enabled interaction, sharing and absorption of information, and potentially increased trust, confidence and social capital. Participants viewed the workshop as informative, enhancing insight regarding roles, services and processes. Post-workshop participants reported examples of practice enhancements attributed to workshop attendance including: confidence building; improved team working; facilitation of early referral and accessing additional support for families. Findings suggest initiative developers aiming CPD at new or existing teams need to consider nurturing social capital and to pay attention to the context and mechanisms, which can prompt attendance, engagement and subsequent practice application. Copyright © 2018 Elsevier Ltd. All rights reserved.
ATLAS Visitors Centre has opened its shiny new doors to the public. Officially launched on Monday February 23rd, 2009, the permanent exhibition at Point 1 was conceived as a tour resource for ATLAS guides, and as a way to preserve the public’s opportunity to get a close-up look at the experiment in action when the cavern is sealed.
Affected by both the salary adjustment index on 1.1.2000 and the evolution of the staff members and fellows population, the average reference salary, which is used as an index for fixed contributions and reimbursement maximal, has changed significantly. An adjustment of the amounts of the reimbursement maximal and the fixed contributions is therefore necessary, as from 1 January 2000.Reimbursement maximalThe revised reimbursement maximal will appear on the leaflet summarising the benefits for the year 2000, which will soon be available from the divisional secretariats and from the AUSTRIA office at CERN.Fixed contributionsThe fixed contributions, applicable to some categories of voluntarily insured persons, are set as follows (amounts in CHF for monthly contributions):voluntarily insured member of the personnel, with complete coverage:815,- (was 803,- in 1999)voluntarily insured member of the personnel, with reduced coverage:407,- (was 402,- in 1999)voluntarily insured no longer dependent child:326,- (was 321...
When local government considers future land-use plans, the local health authorities are not always included as a key partner. In Cambridgeshire, England, the former Cambridgeshire Health Authority formed a partnership with local government to address this issue. The relationship that developed and the subsequent health impact review provided an opportunity to influence strategic policy and ensure that health objectives are taken into account. Through partnership working, lessons were learned about how to incorporate health issues into a strategic land-use planning document to the overall benefit of the community
Yiyan Liu; Ginger Zhe Jin
We study whether employer premium contribution schemes could impact the pricing behavior of health plans and contribute to rising premiums. Using 1991-2011 data before and after a 1999 premium subsidy policy change in the Federal Employees Health Benefits Program (FEHBP), we find that the employer premium contribution scheme has a differential impact on health plan pricing based on two market incentives: 1) consumers are less price sensitive when they only need to pay part of the premium incr...
Resolute large scale mining company contribution to health services of Lusu ... in terms of socio economic, health, education, employment, safe drinking water, ... The data were analyzed using Scientific Package for Social Science (SPSS).
de Siqueira, Soraia Lemos; Kruse, Maria Henriqueta Luce
This paper focuses on the scientific production of health professionals, especially nurses, about agrochemicals and human health. The essay combines and presents information by means of literature review, with a view to acknowledge the contribution of each author and their use for the human health field. Thirty-two research articles, published in Brazilian journals, were located. The analysis of these articles highlights that healthcare professionals' contributions focus on human health, especially, workers' health and food quality. With a view to minimize the effects from agrochemicals on human and environmental health, the authors exposes action suggestions both for health professionals and for the institutions associated.
Alzahrani, Abdullah G; Choudhry, Abdul Jamil; Al Mazroa, Mohammad A; Turkistani, Abdul Hafiz M; Nouman, Ghassan S; Memish, Ziad A
While performing the Hajj, hajjis face different risks related to the environment, their behaviors and their health conditions that can result in a variety of diseases. The objective of this study was to determine the pattern of diseases among pilgrims seeking medical services in Mina primary health care centers (PHCCs) during the Hajj season in 1429 (2008). This is a descriptive study based on the medical records of a random sample of 4136 patients who attended 13 randomly selected Mina PHCCs from 8 to 12 Dhu-Alhijja, 1429 H (6-10 December 2008). The majority of the patients were men (70.7%), and most of the patients were between 45 and 64 years of age (42.8%). One-fifth (20.2%) of the patients suffered from multiple diseases. Respiratory diseases were the most common (60.8%), followed by musculoskeletal (17.6%), skin (15.0%) and gastrointestinal (13.1%) diseases. Diabetes, asthma and hypertension each constituted less than 3% of the total diseases. Respiratory diseases were the most common independent of nationality or the day of visit, while the frequency of the other diseases varied according to nationality and the day of visit. The most frequently prescribed drugs were analgesics, antipyretics, antibiotics and cough syrups. This study describes the pattern of diseases among pilgrims attending Mina PHCCs, which may aid in providing the best possible health care services to pilgrims. Copyright Â© 2011 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.
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 ...
Full Text Available This article proposes a process framework for developing and managing visitor attractions (VA in small island developing states with Trinidad and Tobago, a two-island state in the Caribbean, as the case study. An extensive literature review was conducted, supported by field observations, individual depth interviews, and small and large focus group meetings. The process framework identified four sets of processes: national policy formulation and legislation; inventory, classification, evaluation, and ranking of VA; general operations management involving project management activities; and site specific activities of development, operations, and maintenance. The value of the framework lies in the fact that no similar framework applicable to small islands was covered in the literature and validation was obtained from a panel of experts and a cross section of tourism stakeholders in Tobago.
Dong, Xiaoxin; liu, Ling; Cao, Shiyi; Yang, Huajie; Song, Fujian; Yang, Chen; Gong, Yanhong; Wang, Yunxia; Yin, Xiaoxu; Xie, Jun; Sun, Yi; Lu, Zuxun
Background Community health service in China is designed to provide a convenient and affordable primary health service for the city residents, and to promote health equity. Based on data from a large national study of 35 cities across China, we examined the characteristics of the patients and the utilization of community health institutions (CHIs), and assessed the role of community health service in promoting equity in health service utilization for community residents. Methods Multistage sa...
Liu, Yiyan; Jin, Ginger Zhe
We study whether employer premium contribution schemes could impact the pricing behavior of health plans and contribute to rising premiums. Using 1991-2011 data before and after a 1999 premium subsidy policy change in the Federal Employees Health Benefits Program (FEHBP), we find that the employer premium contribution scheme has a differential impact on health plan pricing based on two market incentives: 1) consumers are less price sensitive when they only need to pay part of the premium increase, and 2) each health plan has an incentive to increase the employer's premium contribution to that plan. Both incentives are found to contribute to premium growth. Counterfactual simulation shows that average premium would have been 10% less than observed and the federal government would have saved 15% per year on its premium contribution had the subsidy policy change not occurred in the FEHBP. We discuss the potential of similar incentives in other government-subsidized insurance systems such as the Medicare Part D and the Health Insurance Marketplace under the Affordable Care Act. Copyright © 2014 Elsevier B.V. All rights reserved.
This dissertation describes the creation of a new integrated Information Technology (IT) system that assisted in the collection of data about the behaviour of website visitors as well as sales and marketing data for those visitors who turned into customers. A key contribution to knowledge was the creation of a method to predict the outcome of visits to a website from visitors’ browsing behaviour. A new Online Tracking Module (OTM) was created that monitored visitors’ behaviour while they brow...
Full Text Available This study investigates the role of prior experience on the impact of actual self and ideal self-congruity on tourists’ intention to visit Turkey for leisure purposes. The study draws from an empirical study with 648 subjects conducted in cooperation with the Turkish Ministry of Culture and Tourism. Results suggest that the effect of actual self-congruity on intention to visit differs according to different levels of tourist experience. While self-congruity has a positive effect on intenti on to visit for the non-visitors and first-time visitors --implying that the relationship between self-congruity and intention does not vary between non-visitors and first-time visitors --this effect loses its significance for repeat visitors. These findings partially support the previous proposed moderating role of prior experience on the impact of self congruity on intention to visit a destination and expand the discussion on this topic raising new questions
Hobbs, Mary A; Robinson, Susan; Neyens, David M; Steed, Connie
Hospital visitors' hand hygiene (HH) is an important aspect of preventing health care-associated infections, but little is known about visitors' use of alcohol-based hand sanitizers (AHS). The study aim was to examine if use of AHS is influenced by visitor characteristics and the location of AHS within the lobby of a large hospital. An observational study was conducted with AHS placed in 3 different locations. The data included visitor characteristics and if AHS were used. The results suggest that visitors are 5.28 times (95% confidence interval [CI], 3.68-7.82) more likely to use AHS when dispensers are located in the middle of the lobby with limited landmarks or barriers, 1.35 times more likely to use the AHS in the afternoon compared with the morning, or when they are younger visitors (adjusted odds ratio, 1.47; 95% CI, 1.09-1.97). Individuals in a group are more likely (adjusted odds ratio, 1.39; 95% CI, 1.06-1.84) to use AHS. In addition to location, time of day, and age, there is a group effect that results in visitors being more likely to use AHS when in a group. The increased use related to groups may serve as a mechanism to encourage visitor HH. The results suggest future research opportunities to investigate the effect of group dynamics and social pressure on visitor AHS use and to identify strategies for improving visitor HH. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
Following the 2010 five-yearly review of financial and social conditions, which included the CERN Health Insurance Scheme (CHIS), the CERN Council decided in December 2010 to progressively increase the level of contributions over the period 2011-2015. For 2012, the contribution rate of active and retired CHIS members will be 4.41%. The amounts of the fixed premiums for voluntarily insured members (e.g. users and associates) as well as the supplementary contributions for spouses with income from a professional activity increase accordingly : Voluntary contributions The full contribution based on Reference Salary II is now 1094 CHF per month. This fixed amount contribution is applied to voluntarily affiliated users and associates with normal coverage. Half of this amount (547 CHF) is applied to apprentices as well as to voluntarily affiliated users and associates with reduced coverage. Finally, an amount of 438 CHF is applied to children maintaining their insurance cover on a voluntary and tempo...
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 ...
... by the experiences of managing the WIRHE scholarship programme, which highlighted the challenges faced by students from rural communities who try to gain access to institutions of higher education. This report describes the Wits CRH experience of organising a student-led rural health careers day as a pilot project, ...
To be a success, a website has to attract-and keep--visitors. This Mini Missing Manual shows you how to attract new and return visitors and use the power of keywords and Web search engines to rise up in the rankings of search results. You'll also learn how to use a powerful-and free--service that tracks visitor activity on your site so you know which of your Web pages they love, and-just as important--which pages don't work for them. Using this information, you can fine-tune your site to keep the visitors coming. This Mini Missing Manual is excerpted from Creating a Web Site: The Missing Man
de Maria, Florence; Grémy, Isabelle
Local authorities in France are key players in shaping public health policy by their action on the determinants of health and through their actions aimed at specific population groups. Since the public health act of 9 August 2004 establishing the first regional public health plans, their level of involvement and role continues to grow as coordinators, funders and project managers within the greater Paris metropolitan region. Their active participation in regional policy to improve population health and reduce inequalities in health has led to a better organization of the public health programs implemented (in terms of visibility, dialogue, coordination, transparency, and better awareness of context and integration of local issues). Their participation is also a source of innovation resulting in the proposal and use of new approaches (such as the development of health surveillance and observation for advising the local decision-making process). Within the current context of the "Hospitals, patients, health and territories" bill, which entrusts the governance of regional health policy to a specific agency, the role given to local authorities in this new organizational structure must be clearly defined to take into account all of their existing and potential contributions to public health policy.
... 22 Foreign Relations 1 2010-04-01 2010-04-01 false International visitors. 62.28 Section 62.28 Foreign Relations DEPARTMENT OF STATE PUBLIC DIPLOMACY AND EXCHANGES EXCHANGE VISITOR PROGRAM Specific Program Provisions § 62.28 International visitors. (a) Purpose. The international visitor category is for...
Mauritz, Walter; Brazinova, Alexandra; Majdan, Marek; Leitgeb, Johannes
The goal was to compare epidemiology of hospital admissions for traumatic brain injury (TBI) in Austrian residents vs. visitors to Austria. Data on all hospital admissions due to TBI (ICD-10 codes S06.0-S06.9; years 2009-2011) was provided by the Austrian Statistical Office. Data on Austrian population and on tourism (visitor numbers, nights spent) was retrieved from www.statistik.at . Age, sex, mechanism of injury, season and mortality was analysed for Austrian residents vs. visitors. Visitors contributed 3.9% to the total population and 9.2% of all TBI cases. Incidence of hospital admissions was 292/100,000/year in Austrian residents and was 727/100,000/year in visitors. Male:female ratio was 1.39:1 in Austrian residents and 1.55:1 in visitors. Austrian cases were older than visitors' cases (mean age 41 vs. 28 years). Austrian cases were distributed evenly over the seasons, while 75% of the visitors' cases happened during winter and spring. The most frequently observed causes of TBI in Austrian residents were private accidents, while sports caused almost half of the visitors' cases. Hospital mortality was lower in visitors than in Austrian residents (0.8 vs. 2.1%). Sports-related TBI of visitors causes a significant workload for Austrian hospitals. Better prevention is warranted.
Langdon, Esther Jean
In order to examine the development of anthropological paradigms and their dialogue with medicine, I divide the discussion into two general, but non-exclusive, approaches: one that focuses on health and disease as social and cultural experience and construction, and another that examines health from an interactional and political perspective. For the first approach, I focus on North American and French theories that find resonance in the anthropological dialogue in Brazil. For the second political approach, the discussion originates in the dialogue among anthropologists in Latin America who have been developing models to contribute to an interdisciplinary approach necessary for health policies and intervention in health. The concepts of practices in self-care and intermedicality, among others, are explored due to their contribution in anthropology to public policies in health. These anthropologists have argued that health practices should be understood through the notions of autonomy, collectivity, agency and praxis, as opposed to the notions of the biomedical perspective characterized as being universalist, biological, individualist and a-historical.
Full Text Available Purpose: The aim of this research is to segment visitors at the Kruger National Park based on the frequency of visitation in order to distinguish between first-time and repeat park visitors. Problem investigated: The Kruger National Park (KNP in South Africa is one of the world’s most renowned wildlife reserves. The KNP is in great demand because it is regarded as anall-inclusive holiday destination that provides tourists with a unique nature and leisure experience. As a result, the park attracts over one million visitors per annum and is one of the top five international tourist destinations in the country. For the KNP to sustain its visitor numbers, park managers should realise that both first-time and repeat visitor groups play a fundamental role in the overall competitiveness and success of the park, and they should strive to achieve a balance between first-time and repeat visitors. Therefore, the park management should know which attributes of the park attract first-time visitors group and which attract repeat visitors. Design and methodology and approach: A research survey was done at various rest camps inthe KNP from 26 December 2010 to 03 January 2011; a total of 436 visitor questionnaires were completed. Two-way frequency tables and chi-square tests as well as analysis of variance and Tukey’s multiple comparisons were used to analyse the data and segment first-time and repeat visitors based on socio-demographics and behavioural characteristics as well as travel motivations. Findings and implications: The results indicated that first-time visitors are long-haul visitors, are younger and pay for fewer people whilst repeat visitors are mainly motivated by escape and plan their trips well in advance. These differences indicate that the KNP should follow a two pronged marketing approach aimed at both visitor markets. This would greatly contribute to the long-term sustainability and competitiveness of the KNP.
Dudden, Rosalind F; Protzko, Shandra L
While the role of the librarian as an expert searcher in the systematic review process is widely recognized, librarians also can be enlisted to help systematic review teams with other challenges. This article reviews the contributions of librarians to systematic reviews, including communicating methods of the review process, collaboratively formulating the research question and exclusion criteria, formulating the search strategy on a variety of databases, documenting the searches, record keeping, and writing the search methodology. It also discusses challenges encountered such as irregular timelines, providing education, communication, and learning new technologies for record keeping. Rewards include building relationships with researchers, expanding professional expertise, and receiving recognition for contributions to health care outcomes.
Current and potential future contributions of social workers to health practice are considered at the three levels of direct service to patients, influence on the processes and procedures of the health setting and influence on its future planning and service development. The capacity of U.S.A. and U.K. social work to contribute at these levels is compared in the light of their contrasting relationships to the health system. U.S.A. social work in health care is practised as employees of the health setting or as private practitioners and contains the majority of U.S.A. social workers. It remains a specialism that sustains a major body of published work, commitment to knowledge-building, standard setting and performance review, and a psycho-social orientation shared by a growing number of medical and nursing professionals. Its approach to the health system is that of the pursuit of professional credibility in the secondary setting by adopting the professional-technical practice model of the clinician. U.K. social work since the early 1970s has been committed to generic education and practice and to the development of its own primary setting in social services departments which now employ almost all U.K. social workers. Area team social work in these departments, typified by statutory work with the most deprived sections of the population, has become the dominant culture of British social work, with implications for the occupational identity and career prospects of those social workers who are outposted or attached to health settings but no longer employed by them. British social work and its management now approach the health system from a position of organizational independence which should strengthen their capacity to influence the health system. The cultural differences between social work and medicine, however, are experienced more keenly than ever as many social workers adopt a socio-political practice model that is at odds with the professional-technical model
Birhan, Wubet; Giday, Mirutse; Teklehaymanot, Tilahun
Ethiopian people have been using traditional medicine since time immemorial with 80% of its population dependent on traditional medicines. However, the documentation of traditional healers' clinics contribution to modern public health system in cosmopolitan cities is scanty. Studies conducted so far are limited and focused on the perceptions and practices of modern and traditional health practitioners about traditional medicine. Thus, a cross sectional study was conducted from February to May 2010 to assess the contribution of traditional healers' clinics to public health care system in Addis Ababa. Ten traditional healers who were willing to participate in the study and 306 patients who were visiting these traditional healers' clinics were interviewed using two types of semi-structured questionnaires. Data were summarized using percentages, tables and bar chart. The diseases mostly treated by traditional healers were wound, inflammation, herpes zoster, hemorrhoids, fracture, paralysis, back-pain, liver diseases, cancer and eczema. This study showed that traditional healers' clinics considerably contribute to public health care in Addis Ababa. Fifty two percent of patients reported that traditional healers' clinics were their first choice when they faced health problems. The reasons for visiting these clinics were 175 (57.2%) efficacy, 109 (35.6%) dissatisfaction with modern medicine, 10 (3.3%) dissatisfaction with modern medicine and efficacy, 6 (2.0%) cost and 6 (2.0%) dissatisfaction and cost. Females (55.2%), young age (20-40 years, 65.0%), never married (56.9%), orthodox (73.9%), Amhara (52.3%), educational status above grade 12 (34.6%) and government employees (29.4%) were frequent visitors. Healers reported that there was no form of cooperation with modern health professionals. The reasons were lack of motivation to collaborate and communicate with modern health service workers. Family based apprenticeship was the sources of knowledge for majority of the
Full Text Available Abstract Background Ethiopian people have been using traditional medicine since time immemorial with 80% of its population dependent on traditional medicines. However, the documentation of traditional healers' clinics contribution to modern public health system in cosmopolitan cities is scanty. Studies conducted so far are limited and focused on the perceptions and practices of modern and traditional health practitioners about traditional medicine. Thus, a cross sectional study was conducted from February to May 2010 to assess the contribution of traditional healers' clinics to public health care system in Addis Ababa. Materials and methods Ten traditional healers who were willing to participate in the study and 306 patients who were visiting these traditional healers' clinics were interviewed using two types of semi-structured questionnaires. Data were summarized using percentages, tables and bar chart. Results The diseases mostly treated by traditional healers were wound, inflammation, herpes zoster, hemorrhoids, fracture, paralysis, back-pain, liver diseases, cancer and eczema. This study showed that traditional healers' clinics considerably contribute to public health care in Addis Ababa. Fifty two percent of patients reported that traditional healers' clinics were their first choice when they faced health problems. The reasons for visiting these clinics were 175 (57.2% efficacy, 109 (35.6% dissatisfaction with modern medicine, 10 (3.3% dissatisfaction with modern medicine and efficacy, 6 (2.0% cost and 6 (2.0% dissatisfaction and cost. Females (55.2%, young age (20-40 years, 65.0%, never married (56.9%, orthodox (73.9%, Amhara (52.3%, educational status above grade 12 (34.6% and government employees (29.4% were frequent visitors. Healers reported that there was no form of cooperation with modern health professionals. The reasons were lack of motivation to collaborate and communicate with modern health service workers. Family based
Drea, Clare; Lumsden, Virginia; Bourne, James
This paper presents the findings of a survey of practitioners within a health visiting service. This service was an Early Implementer site for the Health Visitor Implementation Plan. The survey was administered in the context of training all practitioners in the Solihull Approach. It aimed to gather information from practitioners about factors they thought could help them do their work with families more effectively. Practitioners' responses were analysed using thematic analysis. The principal needs identified were: more knowledge, skills and training; increased time to support families; increased supervision and support; and improved communication and partnership working. Practitioners' needs identified through the analysis were subsequently taken into account during development of the service.
Veitch, Jennifer A
People spend much of their waking time in their workplaces (approximately 33% on a weekly basis), which raises the possibility that the conditions they experience at work influence their health and well-being. The workplace design literature has given scant attention to mental health outcomes, instead focusing on healthy populations. Conversely, the mental health literature gives scant attention to the potential contribution of workplace design in preventing mental health problems; nor does it provide much insight into facilitating return to work. Taken together, however, the literature does suggest both lines of research and possible interventions. Existing knowledge proposes that workplace design can influence mental health via the effects of light exposure on circadian regulation, social behaviour and affect; the effects of aesthetic judgement on at-work mood and physical well-being and at-home sleep quality; access to nature and recovery from stressful experiences; and privacy regulation and stimulus control. This paper includes a short review of the literature in this area, proposals for new research directions and consideration of the implications of this information on the design choices made by business owners, designers and facility managers. Providing suitable working conditions for all employees avoids stigmatizing employees who have mental health problems, while facilitating prevention and return to work among those who do. Copyright © 2011 Longwoods Publishing.
Visitors to CERN will now be able to appreciate first-hand the sheer scale of the computing challenge associated with the LHC, during guided visits to the Computing Centre. Two more of CERN's experimental facilities have recently been added to the itineraries offered to the public by the Visits Service. The general public will now be able to see the COMPASS experiment and CERN's Computing Centre. Over the past few years, there has been an increasing demand for visits. Last year, 25 000 visitors came to see sites at CERN. 'Visitors to CERN are impressed by the sheer scale of the experiments, interested to find out how they work and amazed at how they are often located underground,' says Dominique Bertola, Head of the CERN Visits Service. COMPASS is the first fixed-target experiment available for viewing to the general public. The linear structure of the detector makes it an ideal exhibit for the visitors, because it permits them to see the different stages of the experiment and intuitively appreciate how it ...
Sadoughi, Farahnaz; Azadi, Tania; Azadi, Tannaz
Implementation of eHealth strategy in Iran has a history less than 17 years. Iran's eHealth strategy is developed in 2011 and is called "Iran' 2025 Health Map: Health Information Technology". Considering the important role of nurses in providing healthcare services as well as in future long term plans such as sustainable development, it is of high value to pay attention to nurses' contribution in developing eHealth strategies. Thus the purpose of this study was to investigate nurses' contribution to health information technology of Iran's 2025 health map. This study was a qualitative study conducted in 2015 through reviewing the "Iran' 2025 Health Map: Health Information Technology" official report. The strategy published in three volumes and in Persian language was downloaded through the official website of the office of Statistics and Information Technology of Iranian Ministry of Health and Medical Education (MOHME). Two main themes were identified in the report indicating areas which nurses' roles were clearly stated. The findings revealed that nurses' contribution is not clearly stated in the strategy. However, there are a few areas highlighting nurses' involvement such as "determining beneficiary groups" and "information dissemination". It is suggested that more attention needs to be paid in contribution of nurses in further actions to revise the Iran's eHealth strategy.
Olson, Linda G
This study compares pre- and posttest Leadership Practices Inventory (LPI-Self) scores for public health leaders who completed the Regional Institute for Health and Environmental Leadership (RIHEL) training program at least 2 years earlier; it seeks to identify factors contributing to changes in practices and overall leadership development for public health and environment leaders. Sixty-seven alumni who completed the yearlong RIHEL program between 1999 and 2002 participated through mailed surveys and phone interviews. The Leadership Practices Inventory, an alumni leadership development survey, and interviews provided evidence for positive change in leadership practices. Alumni experienced significant increases in pre- to post-LPI scores, collaborative leadership practices, and communication skills consistent with those taught in the RIHEL program. Women presented higher Encourage the Heart scores than men. Years of public health service negatively correlated with Total Change scores of LPI. The RIHEL program as a training intervention was credited significantly with changes in leadership practices for alumni studied. Nine influencing factors were identified for leadership development and are embedded in a Leadership Development Influence Model. These include self-awareness, a leadership development framework, and skills important in multiple leadership situations. Confidence was both an encouraging factor and a resulting factor to the increased exemplary leadership practices. Leadership development in public health must include multiple factors to create consistent increases in exemplary leadership practices. While the study focused on the leadership development process itself, RIHEL training was reported as having a positive, significant impact overall in participant leadership development. This study adds research data as a foundation for training content areas of focus. Studies to further test the Leadership Development Influence Model will allow public health
Staff members, fellows and pensioners are reminded that any change in their marital status, as well as any change in their spouse or registered partner’s income or health insurance cover, must be reported to CERN in writing within 30 calendar days, in accordance with Articles III 6.01 to 6.03 of the Rules of the CERN Health Insurance Scheme (CHIS). Such changes may affect the conditions of the spouse or registered partner’s membership of the CHIS or the payment of the supplementary contribution to it for the spouse or registered partner’s insurance cover. For more information see: http://cern.ch/chis/contribsupp.asp From 1.1.2008, the indexed amounts of the supplementary monthly contribution for the different monthly income brackets are as follows, expressed in Swiss francs: more than 2500 CHF and up to 4250 CHF: 134.- more than 4250 CHF and up to 7500 CHF: 234.- more than 7500 CHF and up to 10,000 CHF: 369.- more than 10,000 CHF: 470.- It is in the member of the ...
White, Judy; Woodward, Jenny; South, Jane
The role that members of the public (non-professional lay people) can play in improving health is being increasingly recognised in research and policy. This paper explores what contribution lay people employed as health trainers are making to addressing health inequalities in England. Data from eight local evaluations of health trainer services were synthesised using a data-extraction framework to find out about client populations, any lifestyle changes made, health trainers' background and community engagement activities. These data were compared with national data to assess how findings relating to addressing inequalities compared with the national picture. Local data largely matched national data and showed that health trainers are reaching people living with disadvantage and enabling them to make lifestyle changes. The data suggest that they do this by engaging with communities and taking a person-centred approach. Being non-clinical peers is also important. However, no evidence was found that health trainers were impacting on health inequalities at a population level. Health trainers are contributing to addressing health inequalities but the services evaluated were small and had been operating for a limited time, so to expect reductions in inequalities at a population level within districts would be unrealistic. The findings of this synthesis present a challenge to primary care and public health to employ health trainers in order to engage marginalised communities as one element of plans to address health inequalities.
Background Within Canada, many public health leaders have long identified the importance of improving the health of all Canadians especially those who face social and economic disadvantages. Future improvements in population health will be achieved by promoting health equity through action on the social determinants of health. Many Canadian documents, endorsed by government and public health leaders, describe commitments to improving overall health and promoting health equity. Public health has an important role to play in strengthening action on the social determinants and promoting health equity. Currently, public health services in British Columbia are being reorganized and there is a unique opportunity to study the application of an equity lens in public health and the contribution of public health to reducing health inequities. Where applicable, we have chosen mental health promotion, prevention of mental disorders and harms of substance use as exemplars within which to examine specific application of an equity lens. Methods/design This research protocol is informed by three theoretical perspectives: complex adaptive systems, critical social justice, and intersectionality. In this program of research, there are four inter-related research projects with an emphasis on both integrated and end of grant knowledge translation. Within an overarching collaborative and participatory approach to research, we use a multiple comparative case study research design and are incorporating multiple methods such as discourse analysis, situational analysis, social network analysis, concept mapping and grounded theory. Discussion An important aim of this work is to help ensure a strong public health system that supports public health providers to have the knowledge, skills, tools and resources to undertake the promotion of health equity. This research will contribute to increasing the effectiveness and contributions of public health in reducing unfair and inequitable differences
There are four nuclear power plant units in Finland, two of which are PWR's owned by Imatran Voima Oy. The two BWR units are located at Olkiluoto and owned by Teollisuuden Voima Oy. This presentation tells about TVO's concept of informing the visitors at Olkiluoto. At the site there are located, in addition to the two nuclear power plant units, the intermediate storage for spent fuel, the repository for low and medium-active waste as well as the training centre. At the Olkiluoto Visitor's Centre all the activities of the company are presented using varied audio-visual aids. The centre has several exhibits and there are also different installations to show how the plant works. (author)
Smith, Sarah L; DeGrace, Beth; Ciro, Carrie; Bax, Ami; Hambrick, Andrea; James, Jennifer; Evans, Alexandra
Child health and developmental outcomes are influenced by the health of the family and the context created. Research suggests symptoms of poor family health (e.g. suboptimal family interactions, parenting stress) yet there is limited understanding of the factors which contribute to robust family health which may unveil opportunities for targeted intervention and family health promotion. The present study examined families' experiences of family health and factors contributing to family health. We performed a qualitative study using constructivist grounded theory methods to guide our understanding of family health for families with typically developing children aged 5-18. Interviews were conducted in family homes and all members were invited to participate. Data from interviews were transcribed, coded, thematically analyzed, and verified with select families. Ten families, including 10 mothers, 8 fathers, and 15 children participated in the study. Participants described family health as a process of balance, living purposefully, and sharing experiences together in alignment with family identity. Mediating family health were processes of awareness and reflection, and adapting, adjusting, and changing in response to family life including external stress factors. Results highlight the possibility for healthcare practitioners to facilitate families' self-reflection and awareness about their health in order to mediate family health development.
27 February 2012 - Director of the Health Directorate at the Research DG European Commission R. Draghia-Akli in the ATLAS visitor centre with ATLAS Former Collaboration Spokesperson P. Jenni and Head of CERN EU Projects Office S. Stavrev; in the LHC superconducting magnet test hall with E. Todesco; and signing the guest book with CERN Director-General R. Heuer.
27 February 2012 - Director of the Health Directorate at the Research DG European Commission R. Draghia-Akli in the ATLAS visitor centre with ATLAS Former Collaboration Spokesperson P. Jenni and Head of CERN EU Projects Office S. Stavrev; in the LHC superconducting magnet test hall with E. Todesco; and signing the guest book with CERN Director-General R. Heuer.
Ottrey, Ella; Palermo, Claire; Huggins, Catherine E; Porter, Judi
To explore multiple perspectives and experiences of volunteer and visitor involvement and interactions at hospital mealtimes. In addition, to understand how the volunteer and visitor role at mealtimes is perceived within the hospital system. Mealtime assistance can improve patients' food intake and mealtime experience. Barriers to providing mealtime assistance include time pressures, staff availability and inadequate communication. Volunteers and visitors can encourage and assist patients at mealtimes. There is a lack of evidence on the relationship between hospital staff, volunteers and visitors. A qualitative, ethnographic approach. Sixty-seven hours of fieldwork were conducted on two subacute wards within an Australian healthcare network in 2015. Mealtime practices and interactions of hospital staff, volunteers and visitors were observed. Sixty-one staff, volunteers and visitors were interviewed in 75 ethnographic and semi-structured interviews. Data were inductively and thematically analysed. Three key themes emerged as follows: "help"-volunteers and visitors were considered helpful when they assisted patients at mealtimes, supported well-being and aided staff-patient communication; "hindrance"-staff perceived visitors as negative presences when they inhibited patient progress and impacted staff work practices; and "reality of practice"-visiting hours, visitor engagement in patient therapy and communication between staff, volunteers and visitors were important practical considerations of mealtime involvement. The findings show how and why volunteers and visitors can be helpful and unhelpful at hospital mealtimes on subacute wards. More research on the role and contribution of volunteers and visitors on hospital wards will inform future practice in healthcare settings. This healthcare organisation should continue to encourage volunteer and visitor involvement at hospital mealtimes. More effort is needed to educate visitors about patients' therapeutic goals and
Salinas, Judith; Muñoz, Carolina; Albagli, Andrea; Araya, Gloria; Vio, Fernando
The objective of this paper is to present the distance education's contribution to developing health promotion in Chile, through evaluation of a postgraduate certificate program for professionals, and a training course for nurse technicians working in primary healthcare, with an 8-month follow-up after program completion. The program methodology was participatory, interactive and reflective, with mentoring support, exercises, group work and discussions as well as content pertinent to the needs of practice. The evaluation was quali-quantitative with an analysis of the student profile, the implementation process, outcomes at the end of the training and impacts on workplace changes. The results showed a high rate of student approval (87 and 76%), good academic performance and a high level of satisfaction with the methodology and knowledge delivered. The participants' final projects were adapted to local work places realities and were implemented by 62.6% of technicians and 43% of professionals, in addition to changes in work practices that favor health promotion. The level of fulfillment of participants' expectations was very high and the most frequent barriers to implementing the final project were lack of time and personnel, along with minimal support from management and low prioritization of health promotion. This study shows the effectiveness of a distance training model for professionals and technicians that can reach the most remote parts of the country, where there is no access to presencial training, with an educational program centered on work activities and current health challenges. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: email@example.com.
Ho, Hao Chih; Speck, Cora S R; Kumasaki, Jennifer
Over seven million tourists visit the Hawaiian Islands each year. Popular visitor activities such as surfing, scuba diving, ocean kayaking, parasailing, bicycle tours and hiking each have risks of serious injury. This study reviews visitors' activities that led to serious injuries requiring treatment at the state's only trauma center while vacationing in Hawai'i. A retrospective electronic medical record review was conducted of all visitor and resident trauma patients admitted to The Queen's Medical Center (QMC) from January 2002-December 2006. Patient demographics, injury type and severity, mechanism of injury, and discharge status were collected and analyzed. A total of 8244 patients were admitted to QMC for major traumatic injuries over the five year study period. Of these, 466 (5.7%) were visitors. The most common mechanisms of visitor injuries were falls (23.6%), water-related injuries (22.8%), motor vehicle crashes (18.7%), motorcycle, moped, and recreational vehicle crashes (12.2%), assaults (7.3%), and bicycle crashes (4.0%). A disproportionate number of visitors sustained serious injuries while engaging in water-related activities: Visitors account for only 12.6% of the population on any given day, yet comprise 44.2% of the total admissions for Hawai'i's water-related injuries. Head and spine injuries make up over two-thirds (68.2%) of these water-related visitor injuries. As a general category, falls were responsible for the highest number of visitor trauma admissions. Of the recreational activities leading to high numbers of trauma admissions, water-related activities are the leading causes of serious injuries among visitors to Hawai'i. Water-related injury rates are significantly higher for Hawai'i's visitors than residents. Water safety education for visitors should be developed in multiple languages to educate and protect Hawai'i's visitors and visitor industry.
Global gaps in health care The World Health Organization's Health for All ... Making the invisible visible: gender, data, and evidence for development ... Strengthening Governance in Health Systems for Reproductive Health and Rights in ...
Vincent, Charles; Wearden, Alison; French, David P
While health care brings great benefits, all treatments, and many investigations, carry some risk. As patients, we should be told of the risks of specific treatments but we are also at risk from failings in the health care system itself. We suggest that, while there are many examples of individual health psychologists who have made important contributions, this has not yet translated into a broader disciplinary engagement. Health psychologists have devoted much more attention to patients and devoted much less attention to the potentially huge impact of studying and intervening with staff, clinical practice, and organizations. We believe that there are considerable opportunities for health psychology to engage more closely with patient safety and, more importantly, that this would be of great benefit to both patients and staff. Statement of contribution What is already known on this subject? While health care brings great benefits, all treatments, and many investigations, carry some risk. Patients are also at risk from failings in the health care system itself. Studies using review of medical records in many countries have found that between 8% and 12% of patients in hospital suffer an unintended harm due to health care. What does this study add? There are many examples of individual psychologists who have made important contributions, but this has not yet translated into a broader disciplinary engagement. There are considerable opportunities for health psychology to engage more closely with patient safety. These include health behaviour change, teamwork, communication after medical error, diagnosis and decision making, organisational culture, and improving compliance with rules and standards. Psychologists providing a clinical service to specialist services in any area could expand their remit from supporting patients to a more general support and engagement with safety and quality initiatives. Health psychologists have models to understand the behaviour of people
Yuasa, Motoyuki; Yamaguchi, Yoshie; Imada, Mihoko
The Japan International Cooperation Agency (JICA) has focused its attention on appraising health development assistance projects and redirecting efforts towards health system strengthening. This study aimed to describe the type of project and targets of interest, and assess the contribution of JICA health-related projects to strengthening health systems worldwide. We collected a web-based Project Design Matrix (PDM) of 105 JICA projects implemented between January 2005 and December 2009. We developed an analytical matrix based on the World Health Organization (WHO) health system framework to examine the PDM data and thereby assess the projects' contributions to health system strengthening. The majority of JICA projects had prioritized workforce development, and improvements in governance and service delivery. Conversely, there was little assistance for finance or medical product development. The vast majority (87.6%) of JICA projects addressed public health issues, for example programs to improve maternal and child health, and the prevention and treatment of infectious diseases such as AIDS, tuberculosis and malaria. Nearly 90% of JICA technical healthcare assistance directly focused on improving governance as the most critical means of accomplishing its goals. Our study confirmed that JICA projects met the goals of bilateral cooperation by developing workforce capacity and governance. Nevertheless, our findings suggest that JICA assistance could be used to support financial aspects of healthcare systems, which is an area of increasing concern. We also showed that the analytical matrix methodology is an effective means of examining the component of health system strengthening to which the activity and output of a project contributes. This may help policy makers and practitioners focus future projects on priority areas.
Kafyri, Andriani; Hovardas, Tasos; Poirazidis, Konstantinos
A relatively under-researched question is whether there is a possibility of influencing environmentally aware tourists regarding ecotourism at destinations that continue to develop under a pattern of mass `seaside' tourism. Our objective was to assess the pro-environmental intentions of visitors at two small Greek islands, which are within a Natura 2000 site, specifically Paxoi and Antipaxoi. Intentions involved willingness to receive information about the protected area, willingness to accept pro-environmental limitations on recreational experience, and willingness-to-pay a conditional environmental conservation value added tax. In addition, we aimed to identify determinants of visitor pro-environmental intentions among visitor and visit characteristics, visitor satisfaction, and self-reported environmental knowledge, as well as anticipated outcomes of tourism development and suggestions for protected area management. We randomly collected 324 usable questionnaires during the summer season; 242 (74.69 %) by Greek visitors and 82 (25.31 %) by foreign visitors. Visitor satisfaction was quite high; however, visitors reported low levels of environmental knowledge. Our findings showed that the unique characteristics of the destination were not salient among visitors and that there is a lack of effective outreach campaigns, interpretation, and on-site environmental education programs. However, our study revealed high levels of visitor pro-environmental intentions that might support the promotion of ecotourism on the two islands. We provide recommendations based on determinants of visitor pro-environmental intentions, which might assist towards advancing visitor participation in environmental education projects, environmentally responsible behavior among visitors, and financial contribution to environmental conservation by visitors.
Kafyri, Andriani; Hovardas, Tasos; Poirazidis, Konstantinos
A relatively under-researched question is whether there is a possibility of influencing environmentally aware tourists regarding ecotourism at destinations that continue to develop under a pattern of mass 'seaside' tourism. Our objective was to assess the pro-environmental intentions of visitors at two small Greek islands, which are within a Natura 2000 site, specifically Paxoi and Antipaxoi. Intentions involved willingness to receive information about the protected area, willingness to accept pro-environmental limitations on recreational experience, and willingness-to-pay a conditional environmental conservation value added tax. In addition, we aimed to identify determinants of visitor pro-environmental intentions among visitor and visit characteristics, visitor satisfaction, and self-reported environmental knowledge, as well as anticipated outcomes of tourism development and suggestions for protected area management. We randomly collected 324 usable questionnaires during the summer season; 242 (74.69 %) by Greek visitors and 82 (25.31 %) by foreign visitors. Visitor satisfaction was quite high; however, visitors reported low levels of environmental knowledge. Our findings showed that the unique characteristics of the destination were not salient among visitors and that there is a lack of effective outreach campaigns, interpretation, and on-site environmental education programs. However, our study revealed high levels of visitor pro-environmental intentions that might support the promotion of ecotourism on the two islands. We provide recommendations based on determinants of visitor pro-environmental intentions, which might assist towards advancing visitor participation in environmental education projects, environmentally responsible behavior among visitors, and financial contribution to environmental conservation by visitors.
Avila, R; Pinheiro, M; Sazima, M
Inga species are characterised by generalist or mixed pollination system. However, this feature does not enhance reproductive rates in species with very low fruit set under natural conditions. Some ecological and genetic factors are associated with this feature, and to test the effect of massive visits on pollination success in Inga subnuda subsp. luschnathiana, we studied the efficacy of polyads deposited on stigmas of flowers isolated from visitors and polyads exposed to visitors. The proportion of polyads fixed in stigmas decreased after exposure to visitors (24 h) in comparison to stigmas isolated from visitors (hummingbirds, bees, wasps, hawkmoths and bats), and fruit set was very low. Furthermore, nectar production, sugar composition and other floral biology traits were evaluated. Increased nectar production, sugar availability and sucrose dominance during the night indicates adaptation to nocturnal visitors and supports their role as main pollinators; although the brush-flower morphology, time of anthesis, nectar dynamics and chemical composition also allow daytime visitors. Thus the species is an important resource for a diverse group of floral visitors. We conclude that excess visits (diurnal and nocturnal) are responsible for the decrease in fixed polyads in stigmas of I. subnuda subsp. luschnathiana flowers, thus contributing, with others factors, to its low fruit set. Therefore, the generalist pollination system does not result in reproductive advantages because the low fruit set in natural conditions could be the result of a negative effect of visitors/pollinators. © 2014 German Botanical Society and The Royal Botanical Society of the Netherlands.
Nguyen, Mai Phuong; Mirzoev, Tolib; Le, Thi Minh
In Vietnam, a lower-middle income country, while the overall skill- and knowledge-based quality of health workforce is improving, health workers are disproportionately distributed across different economic regions. A similar trend appears to be in relation to health outcomes between those regions. It is unclear, however, whether there is any relationship between the distribution of health workers and the achievement of health outcomes in the context of Vietnam. This study examines the statistical relationship between the availability of health workers and health outcomes across the different economic regions in Vietnam. We constructed a panel data of six economic regions covering 8 years (2006-2013) and used principal components analysis regressions to estimate the impact of health workforce on health outcomes. The dependent variables representing the outcomes included life expectancy at birth, infant mortality, and under-five mortality rates. Besides the health workforce as our target explanatory variable, we also controlled for key demographic factors including regional income per capita, poverty rate, illiteracy rate, and population density. The numbers of doctors, nurses, midwives, and pharmacists have been rising in the country over the last decade. However, there are notable differences across the different categories. For example, while the numbers of nurses increased considerably between 2006 and 2013, the number of pharmacists slightly decreased between 2011 and 2013. We found statistically significant evidence of the impact of density of doctors, nurses, midwives, and pharmacists on improvement to life expectancy and reduction of infant and under-five mortality rates. Availability of different categories of health workforce can positively contribute to improvements in health outcomes and ultimately extend the life expectancy of populations. Therefore, increasing investment into more equitable distribution of four main categories of health workforce
For 2016, the contribution rate for active and retired CHIS members will be 4.86%. The amounts of the fixed contributions for voluntarily insured members (e.g. users and other associates), as well as the supplementary contributions for spouses with income from a professional activity or with a retirement pension (including a CERN pension), are thus as follows: 1. Voluntary contributions The full contribution based on Reference Salary II is 1218 CHF per month. This fixed contribution is applied to voluntarily affiliated users and other associates with normal coverage. Half of this amount, 609 CHF, is applied to voluntarily affiliated users and other associates with reduced coverage. Finally, an amount of 487 CHF is applied to children maintaining their insurance cover on a voluntary and temporary basis. 2. Supplementary contributions The supplementary contribution for the spouse or registered partner of a staff member, fellow or pensioner is now as follows, according to the spouse’s month...
From vision to reality--managing change in the provision of library and information services to nurses, midwives, health visitors and PAMs: (professions allied to medicine) a case study of the North Thames experience with the Inner London Consortium.
Godbolt, S; Williamson, J; Wilson, A
One of the North Thames' pioneering consortia, the Inner London Consortium (ILC) is a complex body which includes NHS Trusts with teaching hospital university connections, community-based Trusts and general hospital acute Trusts. Within the consortium there are 12,000 trained nurses, midwives, health visitors and other professional staff working in the professions allied to medicine (PAMs), all of whom require access to and provision of appropriate library information services. In 1994, taking into account experiences elsewhere in the Region and nationally, it became clear that library issues were complex and would become acute with the move of nursing libraries from ILC Trust sites over a very short timescale. A report on the issues commissioned by the Consortium recommended that a library project, which built on existing NHS Trust PGMDE funded library resources and moved these to a multidisciplinary base to serve the consortium membership, be implemented. The objective of providing access to library information services for nurses and PAMs was achieved. Successes that emerged from the implementation included: The registration in Trust libraries of almost 12 000 new members within the initial 6-month monitoring period. The development of service level agreements and standards for the delivery of services to these new user groups. This paper describes the processes behind these significant and complex changes.
Frequent visitors at the psychiatric emergency room (PER) constitute a small subgroup of patients, yet they are responsible for a disproportionate number of visits and thus claim considerable resources. Their needs are often left unmet and their repetitive visits reflect their dissatisfaction as well as that of PERs' staff. Motivated by these dilemmas, this study systematically reviews the literature about frequent visitors at PER and seeks to answer two questions: What characterizes frequent visitors at PER in the literature? and What characterizes PER in the literature? Based on 29 studies, this paper offers answers to the two questions based on a strength weakness opportunities and threats (SWOT) analysis. The results of the review and subsequent analysis of the literature revealed the multiplicity and complexity of frequent visitors' characteristics and how they appear to converge. Commonalities were more difficult to identify in PER characteristics. In some cases, this happened because the characteristics were poorly described or were context specific. As a result, it was not easy to compare the studies on PER. Based on SWOT and the findings of the analysis, the paper proposes new venues of research and suggests how the field of mental health might develop by taking into account its opportunities and threats.
visitors pursuing a long-standing interest or hobby. The second part of the talk will present preliminary findings from a study of user motivation in the context of Europeana.eu. The talk will invite to reflections and a discussion of how we can explore and evaluate motivation of virtual museum visitors....
Hartl, Ann; Rassing, Charlotte
The overall objective was to provide a comprehensive description of visitors to Bornholm that was in keeping with the standard analysis of destination surveys.......The overall objective was to provide a comprehensive description of visitors to Bornholm that was in keeping with the standard analysis of destination surveys....
Miller, Jane; Lee, Amanda; Obersky, Natalie; Edwards, Rachael
The present paper reports on a quality improvement activity examining implementation of A Better Choice Healthy Food and Drink Supply Strategy for Queensland Health Facilities (A Better Choice). A Better Choice is a policy to increase supply and promotion of healthy foods and drinks and decrease supply and promotion of energy-dense, nutrient-poor choices in all food supply areas including food outlets, staff dining rooms, vending machines, tea trolleys, coffee carts, leased premises, catering, fundraising, promotion and advertising. An online survey targeted 278 facility managers to collect self-reported quantitative and qualitative data. Telephone interviews were sought concurrently with the twenty-five A Better Choice district contact officers to gather qualitative information. Public sector-owned and -operated health facilities in Queensland, Australia. One hundred and thirty-four facility managers and twenty-four district contact officers participated with response rates of 48.2% and 96.0%, respectively. Of facility managers, 78.4% reported implementation of more than half of the A Better Choice requirements including 24.6% who reported full strategy implementation. Reported implementation was highest in food outlets, staff dining rooms, tea trolleys, coffee carts, internal catering and drink vending machines. Reported implementation was more problematic in snack vending machines, external catering, leased premises and fundraising. Despite methodological challenges, the study suggests that policy approaches to improve the food and drink supply can be implemented successfully in public-sector health facilities, although results can be limited in some areas. A Better Choice may provide a model for improving food supply in other health and workplace settings.
Macaskill, Ann; Denovan, Andrew
Balanced assessment of mental health involves assessing well-being and strengths as well as psychopathology. The character strengths of curiosity, gratitude, hope, optimism and forgiveness are assessed in 214 new undergraduates and their relationships to mental health, subjective well-being and self-esteem explored. Scoring the mental health scale…
Pritchard, Daryl; Petrilla, Allison; Hallinan, Shawn; Taylor, Donald H; Schabert, Vernon F; Dubois, Robert W
U.S. health care spending nearly doubled in the decade from 2000-2010. Although the pace of increase has moderated recently, the rate of growth of health care costs is expected to be higher than the growth in the economy for the near future. Previous studies have estimated that 5% of patients account for half of all health care costs, while the top 1% of spenders account for over 27% of costs. The distribution of health care expenditures by type of service and the prevalence of particular health conditions for these patients is not clear, and is likely to differ from the overall population. To examine health care spending patterns and what contributes to costs for the top 5% of managed health care users based on total expenditures. This retrospective observational study employed a large administrative claims database analysis of health care claims of managed care enrollees across the full age and care spectrum. Direct health care expenditures were compared during calendar year 2011 by place of service (outpatient, inpatient, and pharmacy), payer type (commercially insured, Medicare Advantage, and Medicaid managed care), and therapy area between the full population and high resource patients (HRP). The mean total expenditure per HRP during calendar year 2011 was $43,104 versus $3,955 per patient for the full population. Treatment of back disorders and osteoarthritis contributed the largest share of expenditures in both HRP and the full study population, while chronic renal failure, heart disease, and some oncology treatments accounted for disproportionately higher expenditures in HRP. The share of overall expenditures attributed to inpatient services was significantly higher for HRP (40.0%) compared with the full population (24.6%), while the share of expenditures attributed to pharmacy (HRP = 18.1%, full = 21.4%) and outpatient services (HRP = 41.9%, full = 54.1%) was reduced. This pattern was observed across payer type. While the use of physician
Emma F. Gray
Conservation implications: The results pointed to potentially significant economic consequences for conservation efforts as visitors become less satisfied with their experience. Perceptions of visitors are important for management decisions as park fees contribute significantly to conservation efforts. This could ultimately result in a reduced capacity for African conservation areas to conserve their biodiversity effectively. The results suggest that management may need to re-evaluate their approach to controlling woody plant encroachment.
Due, Pernille; Krølner, Rikke; Rasmussen, Mette
useful for providing an overview of what elements and mechanisms in adolescence may be of special importance for adult health inequalities. There is a lack of knowledge of how social patterns of health, health behaviours, and social relations in adolescence transfer into adulthood and to what extent...... vulnerability. METHODS: We conducted literature searches in English-language peer-reviewed journals using PubMed (from 1966 to May 2009) and PsycINFO, and combined these with hand-searches of reference lists, journals, and authors of particular relevance. RESULTS: Most health indicators are socially patterned...
May 20, 2004 ... health insurance, which will ensure that families of all people in formal employment have ... parent and does not harm the health services of the source country. Bilateral ... On-going research and dialogue has ensured that we have better ... South Africa has ample evidence of genetic make-up plus social-.
Habibian, M; Gelbier, S; Munday, B A
The aims of this study were: to explore: (i) the knowledge and views regarding orthodontics of a group of 11-12-year-old girls attending a school in Southeast London and (ii) the terms that they used to obtain the information. The study used Dental Health Education sessions to investigate the aims of the study. Eight DHE sessions at a secondary school for girls were tape recorded. In order to raise the issue of orthodontics and trigger the formation of questions during health education session, a worksheet containing true/false questions, a crossword puzzle regarding orthodontics and some open ended questions was designed and sent to students. They were required to read and complete the worksheet before each session. They were not required to return the completed worksheets to the investigators but did return them to their teachers. The sessions were tape recorded and supplemented by notes taken at the sessions by the investigator. A total of eight DHE sessions, attended by 14 girls each, were tape-recorded. Each tape recording was immediately transcribed verbatim. The next stage was to organize the data and to single out the orthodontic questions and discussions and categorize them. A total of 117 girls aged 11-12-year-old comprised the study group: 77% were white and 23% black children. After reading the transcripts several times, certain themes on orthodontics emerged. The results showed that children questioned different aspects of orthodontics. Nine themes emerged from their questions and discussions. They wanted to know why orthodontic treatment was carried out and when was the right time to start treatment. They were very keen to find out the differences between different orthodontic appliances. The psychosocial impacts of wearing an orthodontic appliance, i.e., experience of pain as well as the need for extraction of some permanent teeth as part of the treatment were of concern. They asked some questions on the need for repair, adjustment and taking care of
Conill, E M; Mendonça, M H; da Silva, R A; Gawryszewski, V
This article discusses about a recent procedure in health care studies, the comparison as a methodology of analysis. The different analytical currents refer to a particular method of understanding health-disease process. They are: functionalism, the historical-materialism and the new currents. Their phylosophical and sociological basis, concepts, analysis instruments and purposes are showed here by a review of the principal works from representative authors as Navarro, Terris, Roemer, Fry, Illich, Capra and others. The paper suggests that comparative analysis can take two directions: the first is a operational approach for analysing the concrete situations of health's service organization, the second, a more conceptual one, aimed at identifying critical questions and international tendencies in health's systems. The recent discussion search for the overcoming of these dichotomies toward the progress of the production of knowledge and its effects in health's services organization.
Lozowski Boisvert, Dorothy; Jochums Slez, Brenda
As informal educational institutions, science museums must do more than entertain and amaze visitors. Museum educators must design exhibits that attract and hold the attention of visitors long enough so that the visitors become engaged with the exhibits and learn from them. In order for museum educators to develop such exhibits, more information is needed about the variables associated with learning in museums. This study contributes to the growing body of knowledge on informal education by examining the relationship between visitor characteristics and attraction, holding power, and visitor engagement.One hundred fifty-four visitors to a science museum discovery space were observed as they interacted freely with the exhibits. Trained volunteers recorded the subjects' movements including the exhibits at which they stopped (attraction), the amount of time spent at each exhibit (holding power), and behaviors indicative of subjects' engagement levels with the exhibits. Data indicated significant differences between age group and the holding power of exhibits. Though not significant statistically, a similar trend was noted between age group and attraction and visitor engagement level. No significant differences were found between gender or social grouping and attraction, holding power, or engagement levels.
L du Plessis
Full Text Available Emotions constitute a crucial element in understanding a service experience. When a service experience is evaluated by airport visitors, their evaluation is influenced by their emotional reactions. Furthermore, since emotions represent a primary source of human motivation, positive emotions are likely to lead to positive responses, increased satisfaction and favourable behaviour. These introductory statements give rise to the aim of this article, which is to explore those service elements influencing visitors' emotions and, consequently, also their experiences at an international airport. In order to achieve the aim, a questionnaire survey (N=490 was conducted at an international airport in South Africa after which a factor analysis was performed to identify the primary elements of the airport service environment that influence the emotions of visitors. Structural equation modelling was then employed to test the significance of the relationship between the service elements and the emotions of visitors. Five distinct service elements were identified, namely Physical comfort, Amenities, Visitor facilities, Passenger services and Accessibility. These elements further showed significant correlations with the emotions of visitors. This research was the first of its kind conducted at an international airport in South Africa and contributes significantly to management practices regarding specific elements of an international airport environment, i.e. the emotions, experiences and behaviour of international airport visitors.
Bundhamcharoen, Kanitta; Limwattananon, Supon; Kusreesakul, Khanitta; Tangcharoensathien, Viroj
The millennium development goals triggered an increased demand for data on child and maternal mortalities for monitoring progress. With the advent of the sustainable development goals and growing evidence of an epidemiological transition toward non-communicable diseases, policymakers need data on mortality and disease trends and distribution to inform effective policies and support monitoring progress. Where there are limited capacities to produce national health estimates (NHEs), global health estimates (GHEs) can fill gaps for global monitoring and comparisons. This paper discusses lessons learned from Thailand's burden of disease (BOD) study on capacity development on NHEs and discusses the contributions and limitations of GHEs in informing policies at the country level. Through training and technical support by external partners, capacities are gradually strengthened and institutionalized to enable regular updates of BOD at national and subnational levels. Initially, the quality of cause-of-death reporting in death certificates was inadequate, especially for deaths occurring in the community. Verbal autopsies were conducted, using domestic resources, to determine probable causes of deaths occurring in the community. This method helped to improve the estimation of years of life lost. Since the achievement of universal health coverage in 2002, the quality of clinical data on morbidities has also considerably improved. There are significant discrepancies between the Global Burden of Disease 2010 study estimates for Thailand and the 1999 nationally generated BOD, especially for years of life lost due to HIV/AIDS, and the ranking of priority diseases. National ownership of NHEs and an effective interface between researchers and decision-makers contribute to enhanced country policy responses, whereas subnational data are intended to be used by various subnational partners. Although GHEs contribute to benchmarking country achievement compared with global health
Gerritsen, Annette; Bocquier, Philippe; White, Michael; Mbacké, Cheikh; Alam, Nurul; Beguy, Donatien; Odhiambo, Frank; Sacoor, Charfudin; Phuc, Ho Dang; Punpuing, Sureeporn; Collinson, Mark A.
Background Migration is difficult to measure because it is highly repeatable. Health and Demographic Surveillance Systems (HDSSs) provide a unique opportunity to study migration as multiple episodes of migration are captured over time. A conceptual framework is needed to show the public health implications of migration. Objective/design Research conducted in seven HDSS centres [International Network for the Demographic Evaluation of Populations and Their Health (INDEPTH) Network], published in a peer-reviewed volume in 2009, is summarised focussing on the age–sex profile of migrants, the relation between migration and livelihoods, and the impact of migration on health. This illustrates the conceptual structure of the implications of migration. The next phase is described, the Multi-centre Analysis of the Dynamics In Migration And Health (MADIMAH) project, consisting of workshops focussed on preparing data and conducting the analyses for comparative studies amongst HDSS centres in Africa and Asia. The focus here is on the (standardisation of) determinants of migration and the impact of migration on adult mortality. Results The findings in the volume showed a relatively regular age structure for migration among all HDSS centres. Furthermore, migration generally contributes to improved living conditions at the place of origin. However, there are potential negative consequences of migration on health. It was concluded that there is a need to compare results from multiple centres using uniform covariate definitions as well as longitudinal analysis techniques. This was the starting point for the on-going MADIMAH initiative, which has increased capacity at the participating HDSS centres to produce the required datasets and conduct the analyses. Conclusions HDSS centres brought together within INDEPTH Network have already provided strong evidence of the potential negative consequences of migration on health, which contrast with the beneficial impacts of migration on
Davis, Siona Ruth
CMS welcomed over 5500 visitors underground during the 2013 CERN Open Days and more than 4500 during the Neighbourhood Days of 2014 on the occasion of CERN’s 60th anniversary. During the latter event, visitors gave their feedback on the visit experience by answering three questions: • In one sentence, what will you tell your friends about what you saw today? • What fact or story that you heard today impressed you the most? • Describe the CMS detector in three words. This poster will show the analysis of the answers given by visitors.
Davis, Siona Ruth
CMS welcomed over 5500 visitors underground during the 2013 CERN Open Days and more than 4500 during the Neighbourhood Days of 2014 on the occasion of CERN’s 60th anniversary. During the latter event, visitors gave their feedback on the visit experience by answering three questions: • In one sentence, what will you tell your friends about what you saw today? • What fact or story that you heard today impressed you the most? • Describe the CMS detector in three words. This poster will show the analysis of the answers given by visitors.
de Vere, Amber J
The effects of visitor presence on zoo and aquarium animals have become increasingly well studied, using measures such as behavioral responses and exhibit usage. Many taxa remain underrepresented in this literature; this is the case for marine mammals, despite widespread public concern for their welfare in managed care settings. The current study therefore used behavioral activity budgets and exhibit usage to assess the responses of California sea lions (Zalophus californianus) and harbor seals (Phoca vitulina) to visitors at the Seal Cove exhibit at Six Flags Discovery Kingdom, Vallejo CA. Data was collected via focal follow video recordings over the summer season of 2016, and analyzed using MANCOVAs, discriminant analyses, and modified Spread of Participation Indices. The sea lions showed no significant changes in behavior when visitors were present, but did show greater preference for the water bordering visitor viewing areas during these times. Two sea lions gave birth during the study period, and showed greater preference for land areas both adjacent to and out of sight of visitors when nursing compared to while pregnant. In contrast, the harbor seals showed significant behavioral changes in the presence of visitors, including increased vigilance and feeding. This was associated with increased preferential use of water areas adjacent to the visitor viewing area. Visitors were able to purchase fish to throw to the animals, which likely contributed to the differences observed. Overall, this study found little evidence for negative visitor impacts on two pinniped species in a zoo setting. © 2018 Wiley Periodicals, Inc.
Full Text Available An increasing interest in organic agriculture for food production is seen throughout the world and one key reason for this interest is the assumption that organic food consumption is beneficial to public health. The present paper focuses on the background of organic agriculture, important public health related compounds from crop food and variations in the amount of health related compounds in crops. In addition, influence of organic farming on health related compounds, on pesticide residues and heavy metals in crops, and relations between organic food and health biomarkers as well as in vitro studies are also the focus of the present paper. Nutritionally beneficial compounds of highest relevance for public health were micronutrients, especially Fe and Zn, and bioactive compounds such as carotenoids (including pro-vitamin A compounds, tocopherols (including vitamin E and phenolic compounds. Extremely large variations in the contents of these compounds were seen, depending on genotype, climate, environment, farming conditions, harvest time, and part of the crop. Highest amounts seen were related to the choice of genotype and were also increased by genetic modification of the crop. Organic cultivation did not influence the content of most of the nutritional beneficial compounds, except the phenolic compounds that were increased with the amounts of pathogens. However, higher amounts of pesticide residues and in many cases also of heavy metals were seen in the conventionally produced crops compared to the organic ones. Animal studies as well as in vitro studies showed a clear indication of a beneficial effect of organic food/extracts as compared to conventional ones. Thus, consumption of organic food seems to be positive from a public health point of view, although the reasons are unclear, and synergistic effects between various constituents within the food are likely.
Uwe P. Hermann
Research purpose: This study aimed to develop a general visitor profile and to describe the motivational factors for visiting the park in order to support the development of tourism at MNP. Motivation of the study: A tourism management plan is required for the park; however, any planning associated planning requires an assessment of tourist behaviour and needs. Research design, approach and method: An online questionnaire was distributed to a database of visitors to MNP during March−April 2013. A total of 486 responses were received. Data were analysed using descriptive statistics through frequencies and means. Motivator constructs were analysed through a factor analysis. Main findings: The study both confirmed and contradicted previous findings from other national parks in terms of visitor profiles and motivations. Most crucially, this study identified a new motivational factor for visiting national parks, which advances the need to manage the heritage aspect of world heritage sites distinctly from national parks. Managerial implications: The results indicated that visitors to MNP were older and better educated compared to visitors at other national parks. These visitors included predominantly first-time visitors. In addition these visitors are mainly motivated by the need for a nature experience, although the park is not a Big 5 reserve, findings also identified heritage and education as a unique motivational factor for this park. Contribution added: The study promotes the requirement of a unique park-specific tourism management strategy for MNP as the market base of this park is demographically distinct. In addition, the park should improve the promotion of its status as a World Heritage asset in relation to its natural attributes in order to attract greater numbers of heritage tourists. Although the park features exceptional natural features, the reserve is not a Big 5 reserve and this may result in dissatisfaction with the major group of visitors seeking a
Padyšáková, Eliška; Bartoš, Michael; Tropek, Robert; Janeček, Stěpán
Many recent studies have suggested that the majority of animal-pollinated plants have a higher diversity of pollinators than that expected according to their pollination syndrome. This broad generalization, often based on pollination web data, has been challenged by the fact that some floral visitors recorded in pollination webs are ineffective pollinators. To contribute to this debate, and to obtain a contrast between visitors and pollinators, we studied insect and bird visitors to virgin flowers of Hypoestes aristata in the Bamenda Highlands, Cameroon. We observed the flowers and their visitors for 2-h periods and measured the seed production as a metric of reproductive success. We determined the effects of individual visitors using 2 statistical models, single-visit data that were gathered for more frequent visitor species, and frequency data. This approach enabled us to determine the positive as well as neutral or negative impact of visitors on H. aristata's reproductive success. We found that (i) this plant is not generalized but rather specialized; although we recorded 15 morphotaxa of visitors, only 3 large bee species seemed to be important pollinators; (ii) the carpenter bee Xylocopa cf. inconstans was both the most frequent and the most effective pollinator; (iii) the honey bee Apis mellifera acted as a nectar thief with apparent negative effects on the plant reproduction; and (iv) the close relationship between H. aristata and carpenter bees was in agreement with the large-bee pollination syndrome of this plant. Our results highlight the need for studies detecting the roles of individual visitors. We showed that such an approach is necessary to evaluate the pollination syndrome hypothesis and create relevant evolutionary and ecological hypotheses.
Full Text Available Many recent studies have suggested that the majority of animal-pollinated plants have a higher diversity of pollinators than that expected according to their pollination syndrome. This broad generalization, often based on pollination web data, has been challenged by the fact that some floral visitors recorded in pollination webs are ineffective pollinators. To contribute to this debate, and to obtain a contrast between visitors and pollinators, we studied insect and bird visitors to virgin flowers of Hypoestes aristata in the Bamenda Highlands, Cameroon. We observed the flowers and their visitors for 2-h periods and measured the seed production as a metric of reproductive success. We determined the effects of individual visitors using 2 statistical models, single-visit data that were gathered for more frequent visitor species, and frequency data. This approach enabled us to determine the positive as well as neutral or negative impact of visitors on H. aristata's reproductive success. We found that (i this plant is not generalized but rather specialized; although we recorded 15 morphotaxa of visitors, only 3 large bee species seemed to be important pollinators; (ii the carpenter bee Xylocopa cf. inconstans was both the most frequent and the most effective pollinator; (iii the honey bee Apis mellifera acted as a nectar thief with apparent negative effects on the plant reproduction; and (iv the close relationship between H. aristata and carpenter bees was in agreement with the large-bee pollination syndrome of this plant. Our results highlight the need for studies detecting the roles of individual visitors. We showed that such an approach is necessary to evaluate the pollination syndrome hypothesis and create relevant evolutionary and ecological hypotheses.
This study explicates the influence of audience factors on website credibility and the subsequent effect that credibility has on the intention to revisit a site. It does so in an experimental setting in which participants were given two health-related search tasks. Reliance on the web for health-related information positively influenced website credibility in both searches. Knowledge was a significant predictor for the search task that required more cognitive ability. Of the credibility dimensions, trust/expertise and depth were significant predictors of intention to revisit a site in both searches. Fairness and goodwill were nonsignificant predictors in both searches.
Beckfield, Jason; Morris, Katherine Ann; Bambra, Clare
In this study we aimed to analyze gender health equity as a case of how social policy contributes to population health. We analyzed three sets of social-investment policies implemented in Europe and previously hypothesized to reduce gender inequity in labor market outcomes: childcare; active labor market programs; and long-term care. We use 12 indicators of social-investment policies from the OECD Social Expenditure Database, the OECD Family Database, and the Social Policy Indicators' Parental Leave Benefit Dataset. We draw outcome data from the 2015 Global Burden of Disease for years lived with disability and all-cause mortality among men and women ages 25-54 for 18 European nations over the 1995-2010 period. We estimate 12 linear regression models each for mortality and morbidity (i.e. years lived with disability), one per social-investment indicator. All models use country fixed-effects and cluster-robust standard errors. For years lived with disability, women benefit more from social investment for most indicators. The only exception is the percentage of young children in publicly funded childcare or schooling, which equally benefits men. For all-cause mortality, men benefit more or equally from social investment for most indicators, while women benefit more from government spending on direct job creation through civil employment. Social policy contributes to the distribution of population health. Social-investment advocates argue such policies in particular enhance economic gender equity. Our results show that these polices have ambiguous effects on gender health equity and even differential improvements among men for some outcomes.
Rosenkotter, N.; Vondeling, H.; Blancquaert, I.
contribute to the systematic translation and assessment of genomic health applications by focussing at population level and on public health policy making. It is shown to what extent HTA, HNA and HIA contribute to translational research by using the continuum of translational research (T1-T4) in genomic...... into the impact on public health and health care practice of those technologies that are actually introduced. This paper aims to give an overview of the major assessment instruments in public health [ health technology assessment (HTA), health needs assessment (HNA) and health impact assessment (HIA)] which could...... medicine as an analytic framework. The selected assessment methodologies predominantly cover 2 to 4 phases within the T1-T4 system. HTA delivers the most complete set of methodologies when assessing health applications. HNA can be used to prioritize areas where genomic health applications are needed...
Patel, Kiran C R; Spilsbury, Peter; Shukla, Rashmi
The drive to address social determinants of health is gaining momentum. Appreciating that health outcomes are only partly affected by healthcare, clinicians and clinical communities can play a significant role in this crusade by action at local, regional, national and global levels. A concerted and systematic focus on integrating and industrialising upstream interventions at every healthcare encounter is essential to prevent future illness, thus enabling a paradigm shift in the healthcare service from being one of illness management to health preservation. The evidence base demonstrates the cost efficacy of upstream interventions. The challenge is how this evidence is utilised to implement these interventions in everyday healthcare. Today, with a global economic crisis and challenged public sector funding, the need to address prevention has never been more pressing. Clinical engagement at all levels, from the front line to the boardroom is vital. Clinicians must address access, communication, strategy and commissioning to fulfil a professional responsibility to become and remain the corporate memory of a health service focused on preventing illness while simultaneously delivering cost-effective healthcare.
D'Antonio, Ashley; Monz, Christopher
A variety of social and ecological factors influence the level and extent of ecological change that occurs in a park or protected area. Understanding these factors and how they are interrelated can help managers prevent undesirable ecological impacts, especially in areas without formal trails and visitor sites. This study examines the relationship between levels of visitor use and spatial patterns of visitor behavior at a variety of backcountry recreation destinations. Current assumptions in both the literature and simulation modeling efforts assume that visitor behavior either does not change with use level or that visitors are more likely to disperse at high levels of visitor use. Using visitor counts and GPS tracks of visitor behavior in locations where visitors could disperse off-trail, we found that visitors' spatial behavior does vary with visitor use level in some recreation settings, however the patterns of visitor behavior observed in this study are sometimes contrary to current generalizations. When visitor behavior does vary with use level, visitors are dispersing more at low levels of visitor use not when use level is high. Overall, these findings suggest that in certain situations the amount of visitor use at a recreation destination may be a less important driver of ecological change than visitor behavior. Copyright © 2016 Elsevier Ltd. All rights reserved.
The Virtual Visitor Center (VVC) web site (www2.slac.stanford.edu/vvc) is a ''virtual'' version of the Visitor Center, a mini science museum that opened at SLAC in 1996. The VVC was made public in December 1998. Both centers contribute to SLAC mission regarding education of the next generation and increasing scientific awareness of the public. The site is designed to mimic the real visitor center and allow a larger audience to the information. The intent was to reach the 8th-12th grade audience. Considerable effort was made to organize the content, including color-coding graphical elements for each main topic area. Tables of contents, a search tool, several photo tours, as well as graphical and non-graphical menu bars allow users many methods of navigating the site. The site was developed over almost two years using an estimated .95 FTE, split between a program manager, graphic designer, content provider (theoretical physicist), and a summer intern (high school teacher). As of November 1999, the site consists of 1,147 files, 935 images, 3,080 internal hyperlinks, and 190 external hyperlinks. The site has had over 1 million hits between January and mid-October 1999 and averages about 600 page views each day. Future plans include bringing the web site into compliance with the W3Cs Web Content Accessibility guidelines, thoroughly integrating the glossary terms, continued incorporation of current research at SLAC, and adding more interactivity.
The Virtual Visitor Center (VVC) web site (www2.slac.stanford.edu/vvc) is a ''virtual'' version of the Visitor Center, a mini science museum that opened at SLAC in 1996. The VVC was made public in December 1998. Both centers contribute to SLAC mission regarding education of the next generation and increasing scientific awareness of the public. The site is designed to mimic the real visitor center and allow a larger audience to the information. The intent was to reach the 8th-12th grade audience. Considerable effort was made to organize the content, including color-coding graphical elements for each main topic area. Tables of contents, a search tool, several photo tours, as well as graphical and non-graphical menu bars allow users many methods of navigating the site. The site was developed over almost two years using an estimated .95 FTE, split between a program manager, graphic designer, content provider (theoretical physicist), and a summer intern (high school teacher). As of November 1999, the site consists of 1,147 files, 935 images, 3,080 internal hyperlinks, and 190 external hyperlinks. The site has had over 1 million hits between January and mid-October 1999 and averages about 600 page views each day. Future plans include bringing the web site into compliance with the W3Cs Web Content Accessibility guidelines, thoroughly integrating the glossary terms, continued incorporation of current research at SLAC, and adding more interactivity
Díaz-Castro, Lina; Arredondo, Armando; Pelcastre-Villafuerte, Blanca Estela; Hufty, Marc
To analyze the conceptualization of the term governance on public mental health programs. In this systematic review, we analyzed the scientific literature published in the international scenario during 15 years (from 2000 to 2015). The databases analyzed were: Medline, CINAHL, PsycINFO and PubMed. Governance and mental health were the descriptors. We included relevant articles according to our subject of study and levels of analysis: (i) the concept of governance in mental health; (ii) process and decision spaces; (iii) strategic and pertinent actors who operate in the functioning of the health system, and (iv) social regulations. We excluded letters to the editor, news articles, comments and case reports, incomplete articles and articles whose approach did not include the object of study of this review. We have found five conceptualizations of the term governance on mental health in the area of provision policies and service organization. The agents were both those who offer and those who receive the services: we identified several social norms. The concept of governance in mental health includes standards of quality and attention centered on the patient, and incorporates the consumers of mental healthcare in the decision-making process. Analizar la conceptualización del término gobernanza en las políticas de salud mental. En esta revisión sistemática se analizó literatura científica publicada en el ámbito internacional durante 15 años (de 2000 hasta 2015). Las bases de datos analizadas fueron: Medline, CINAHL, PsycINFO y PubMed. Los descriptores fueron gobernanza y salud mental. Fueron incluidos artículos relevantes de acuerdo a nuestro objeto de estudio y niveles de análisis: (i) concepto de gobernanza en salud mental; (ii) proceso y espacios de decisión; (iii) actores estratégicos y de interés que intervienen en el funcionamiento del sistema de salud, y (iv) normas sociales. Se excluyeron cartas al editor, noticias, comentarios y reporte de caso
Beyazit, Ayşen; Inceboz, Tonay; Over, Leyla
Dogs are the most preferred pet animal in the world. Canine demodicosis is a skin disease of dogs in which there is proliferation of Demodex canis, an acarine parasite of canine hair follicles, and is typically manifested by alopecia as well as inflammation of hair follicles and sebaceous glands. Secondary bacterial infection often induces pustule and a crusting dermatitis. Two years ago, a police dog eight years old, without any previous health problem, was brought to a private veterinary clinic for edematous and inflammatory lesions on the soles of its feet. In the clinic, antibacterial and antimicotics were applied for treatment of the lesions, but ten months after completion of the therapy the lesions relapsed and the treatment was repeated. But again six months after the last treatment, the lesions spread widely and the general health status of the dog began to worsen. Finally the dog was brought for treatment to the Izmir Bornova Veterinary Research Institution. Microscopic examination of all the skin scrapings revealed the presence of 10-15 adult Demodex mites per cm(2) and the diagnosis was pododemodicosis. Treatment was performed with ivermectin, antibacterial drugs and beta-glucan. The density of Demodex was reduced after two months of therapy and there was clinical and microscopical improvement. Six months after completion of the therapy the lesions disappeared completely.
Smallpox eradication in South Asia was a result of the efforts of many grades of health-workers. Working from within the confines of international organisations and government structures, the role of the field officials, who were of various nationalities and also drawn from the cities and rural enclaves of the countries in these regions, was crucial to the development and deployment of policies. However, the role of these personnel is often downplayed in official histories and academic histories, which highlight instead the roles played by a handful of senior officials within the World Health Organization and the federal governments in the sub-continent. This article attempts to provide a more rounded assessment of the complex situation in the field. In this regard, an effort is made to underline the great usefulness of the operational flexibility displayed by field officers, wherein lessons learnt in the field were made an integral part of deploying local campaigns; careful engagement with the communities being targeted, as well as the employment of short term workers from amongst them, was an important feature of this work.
Full Text Available Abstract Background The life course approach emphasises the contribution of circumstances in childhood and youth to adult health inequalities. However, there is still a lot to know of the contribution of living conditions in childhood and youth to adult health inequalities and how later environmental and behavioural factors are connected with the effects of earlier circumstances. This study aims to assess a how much childhood circumstances, current circumstances and health behaviour contribute to educational health differences and b to which extent the effect of childhood circumstances on educational health differences is shared with the effects of later living conditions and health behaviour in young adults. Methods The data derived from the Health 2000 Survey represent the Finnish young adults aged 18–29 in 2000. The analyses were carried out on 68% (n = 1282 of the sample (N = 1894. The cross-sectional data based on interviews and questionnaires include retrospective information on childhood circumstances. The outcome measure was poor self-rated health. Results Poor self-rated health was much more common among subjects with primary education only than among those in the highest educational category (OR 4.69, 95% CI 2.63 to 8.62. Childhood circumstances contributed substantially (24% to the health differences between these educational groups. Nearly two thirds (63% of this contribution was shared with behavioural factors adopted by early adulthood, and 17% with current circumstances. Health behaviours, smoking especially, were strongly contributed to educational health differences. Conclusion To develop means for avoiding undesirable trajectories along which poor health and health differences develop, it is necessary to understand the pathways to health inequalities and know how to improve the living conditions of families with children.
It may be seen that with advent of the green revolution, the per capita availability of food has shown an increase during the past decade, although population increase during the period has been significant. Currently, the gap between estimated requirement and availability is small and gives the hope that the country can be self-sufficient in the near future. The national averages often do not tell the full story as economic factors lead to uneven distribution of total food supplies. The shortages are more severely felt by the poorer segments as they are economically unable to demand their full share; thus, economically weaker sections of most developing nations live in a chronic state of near famine. Food irradiation is one of these existing technologies. It is a physical method that can be used to preserve food from microbial and insect damage and infection, as well as from physiological deterioration. In other words, this method can extend the storage life of food considerably without noticeable change of the properties of the food commodity. The impact of food irradiation can be very great especially because of its contribution to the hygienization of food
... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Exchange Visitor Program Services, Exchange-Visitor Program Application B Appendix B to Part 62 Foreign Relations DEPARTMENT OF STATE PUBLIC DIPLOMACY... Media and Communications; 03—Education; 04—Business and Commercial; 05—Banking and Financial; 06...
..., number of dogs and number of pack and saddle stock (that is, the number of animals either carrying people... dogs, number of pack and saddle stock (that is, the number of animals either carrying people or their... people. The information collected from the Visitor's Permit (FS-2300-30) and Visitor Registration Card...
Westrich, Lisa; Sanchez, Monika; Strobel, Karen
Background: A San Francisco Bay Area school health initiative was established in fall 2010 to improve wellness programs in 4 local school districts using the Coordinated School Health (CSH) model. This study examines the role of district-wide wellness coordinators and the ways in which they contribute to intentional coordination of health and…
Tappero, Jordan W; Cassell, Cynthia H; Bunnell, Rebecca E; Angulo, Frederick J; Craig, Allen; Pesik, Nicki; Dahl, Benjamin A; Ijaz, Kashef; Jafari, Hamid; Martin, Rebecca
To achieve compliance with the revised World Health Organization International Health Regulations (IHR 2005), countries must be able to rapidly prevent, detect, and respond to public health threats. Most nations, however, remain unprepared to manage and control complex health emergencies, whether due to natural disasters, emerging infectious disease outbreaks, or the inadvertent or intentional release of highly pathogenic organisms. The US Centers for Disease Control and Prevention (CDC) works with countries and partners to build and strengthen global health security preparedness so they can quickly respond to public health crises. This report highlights selected CDC global health protection platform accomplishments that help mitigate global health threats and build core, cross-cutting capacity to identify and contain disease outbreaks at their source. CDC contributions support country efforts to achieve IHR 2005 compliance, contribute to the international framework for countering infectious disease crises, and enhance health security for Americans and populations around the world.
Cintia Poleto Buzeli
Full Text Available With this experience report of a master’s degree and two teachers of graduate Nursing School of Nursing Federal University of Mato Grosso, we sought to reflect on the Community Therapy (TC as a practice of collective care offered to students university students. Our goal is to report the experience of performing TC wheels in an academic environment, offer theoretical and methodological principles for the structuring and implementation of this practice care to college students at other universities. Was used for data collection direct observation of the wheels of TC the professional experiences as nurses and therapists community and appreciation of documents of such as the registration form filled out by the TC meetings and therapist co-therapist after each wheel TC. The reported experience has demonstrated the effectiveness of TC for the promotion of health thin this group, showing its importance as a practice for the creation and strengthening of ties between the community, the establishment of solidarity networks among students, as being a space speech and listening to their sufferings, their appreciation of life and its potential for promoting self-esteem and to encourage the development of a democract and civic consciousness.
Jinap, S; Hajeb, P
This article reviews application of glutamate in food and its benefits and role as one of the common food ingredients used. Monosodium glutamate is one of the most abundant naturally occurring amino acids which frequently added as a flavor enhancer. It produced a unique taste that cannot be provided by other basic taste (saltiness, sourness, sweetness and bitterness), referred to as a fifth taste (umami). Glutamate serves some functions in the body as well, serving as an energy source for certain tissues and as a substrate for glutathione synthesis. Glutamate has the potential to enhance food intake in older individuals and dietary free glutamate evoked a visceral sensation from the stomach, intestine and portal vein. Small quantities of glutamate used in combination with a reduced amount of table salt during food preparation allow for far less salt to be used during and after cooking. Because glutamate is one of the most intensely studied food ingredients in the food supply and has been found safe, the Joint Expert Committee on Food Additives of the United Nations Food and Agriculture Organization and World Health Organization placed it in the safest category for food additives. Despite a widespread belief that glutamate can elicit asthma, migraine headache and Chinese Restaurant Syndrome (CRS), there are no consistent clinical data to support this claim. In addition, findings from the literature indicate that there is no consistent evidence to suggest that individuals may be uniquely sensitive to glutamate. 2010 Elsevier Ltd. All rights reserved.
Koontz, Lynne; Cullinane Thomas, Catherine; Ziesler, Pamela; Olson, Jeffrey; Meldrum, Bret
This paper provides an overview of the evolution, future, and global applicability of the U.S. National Park Service's (NPS) visitor spending effects framework and discusses the methods used to effectively communicate the economic return on investment in America's national parks. The 417 parks represent many of America's most iconic destinations: in 2016, they received a record 331 million visits. Competing federal budgetary demands necessitate that, in addition to meeting their mission to preserve unimpaired natural and cultural resources for the enjoyment of the people, parks also assess and showcase their contributions to the economic vitality of their regions and the nation. Key approaches explained include the original Money Generation Model (MGM) from 1990, MGM2 used from 2001, and the visitor spending effects model which replaced MGM2 in 2012. Detailed discussion explains the NPS's visitor use statistics system, the formal program for collecting, compiling, and reporting visitor use data. The NPS is now establishing a formal socioeconomic monitoring (SEM) program to provide a standard visitor survey instrument and a long-term, systematic sampling design for in-park visitor surveys. The pilot SEM survey is discussed, along with the need for international standardization of research methods.
Mace, Britton L.; Marquit, Joshua D.; Bates, Scott C.
Transportation infrastructure in national parks has historically been designed for the automobile. With more vehicles in the parks, visitors found themselves in circumstances more reminiscent of a city than a park. Traffic jams, overcrowding, illegal parking, horn honking, and idling vehicles became common, creating stress and contributing to air and noise pollution, the very things visitors were hoping to get away from. Park managers began searching for alternatives, including shuttle systems. Many national parks have implemented optional shuttle systems, but relatively few have completely closed roads to vehicles, transporting visitors on mandatory shuttles. Zion National Park instituted a mandatory shuttle system in May 2000 to relieve crowding and congestion in the main canyon and to protect natural resources. Taking a longitudinal approach, attributes of the shuttle (e.g., crowding, accessibility, freedom, efficiency, preference, and success) were assessed with experiential park factors (e.g., scenic beauty, naturalness, solitude, tranquility, air quality, and soundscape) in 2000, 2003, and 2010 by surveying shuttle-riding park visitors. While visitors initially reported a few reservations about the shuttle system, by 2003, the majority rated the system successful. Ratings of all shuttle-related variables, except crowding, improved over the decade. Improvements were greatest for freedom, accessibility, and efficiency. Multiple regression found overall shuttle success to be mediated by preference, freedom, accessibility, efficiency, and comfort. Experiential variables assessing park conditions followed a similar pattern, with improved ratings as the decade progressed. Results provide important insights into the visitor experience with mandatory alternative shuttle systems in national parks.
Hartl, Ann; Rassing, Charlotte
In July 1995 the Research Centre of Bornholm (now: Centre for Regional and Tourism Research) began conducting a survey among visitors to Bornholm. The survey is being conducted in order to assess the nature of tourism demand in peripheral areas, using Bornholm as a case example for the purposes...... of fieldwork. During the first year people arriving and departing by ferry and plane were interviewed. Since July 1996 only people departing by ferry have been interviewed. The overall objective is to provide a comprehensive description of visitors to Bornholm that was in keeping with the standard analysis...... of destination surveys. Because the survey has been conducted for six and a half year (since July 1995) the data can also disclose trends in visitor patterns. The passenger survey carried out by the Centre for Regional and Tourism Research is, to our knowledge, the largest of its kind carried out in Denmark....
In July 1995 the Research Centre of Bornholm (now: Centre for Regional and Tourism Research) began conducting a survey among visitors to Bornholm. The survey was conducted in order to assess the nature of tourism demand in peripheral areas, using Bornholm as a case example for the purposes...... of fieldwork. During the first year people arriving and departing by ferry and plane were interviewed. From July 1996 only people departing by ferry were interviewed. The overall objective is to provide a comprehensive description of visitors to Bornholm that was in keeping with the standard analysis...... of destination surveys. Because the survey has been conducted for seven and a half year altogether, the data can also disclose trends in visitor patterns. The passenger survey carried out by the Centre for Regional and Tourism Research is, to our knowledge, the largest of its kind carried out in Denmark....
Communications strategies in the nuclear field are often based on the creation of visitor centres at nuclear facility sites. Today, the design, as well as the realization and management of such centres has become a specialized function, and its role is very complementary to the nuclear operator's. It also uses the latest technology in the field of audio-visual, experiment and interactivity. This publication contains the proceedings of an international seminar organized by the OECD Nuclear Energy Agency on the role of visitor centres at nuclear facility sites. It includes the main papers presented at this Seminar
Diehl, Eliana Elisabeth; Langdon, Esther Jean; Dias-Scopel, Raquel Paiva
Indigenous community health workers are part of a strategy developed by Brazil in the last two decades to promote a special healthcare model for indigenous peoples. Their role is designed to deal with various aspects of the special health policy, including the link between the heath team and the community and mediation between scientific and indigenous medical knowledge. Despite a significant increase in the number of indigenous community health workers in recent years, an evaluation of their responsibilities and contributions to the success of special care had not been conducted previously. This article, based on a literature review and original research by the authors, analyzes the role of the indigenous community health workers vis-à-vis their training and participation in health teams in different contexts in Brazil. Considering the importance assigned to the role of indigenous community health workers, this analysis reveals various ambiguities and contradictions that hinder both their performance and their potential contribution to the special health services.
The purpose of this report is to present the results of a review of the Clark County visitor economy and the Clark County visitor. The review, undertaken in support of NWPO's two objectives mentioned above, addressed a number of topics including performance of the Clark County visitor economy as a generator of employment, earnings and tax base; importance of the Clark County visitor economy to the Nevada economy as a whole; elements of the Clark County visitor economy outside the Las Vegas strip and downtown areas; current trends in the Clark County visitor industry; and indirect economic effects of Clark County casino/hotel purchases
Jennings, Natasha; Lutze, Matthew; Clifford, Stuart; Maw, Michael
The emergency nurse practitioner is now a well established and respected member of the healthcare team. Evaluation of the role has focused on patient safety, effectiveness and quality of care outcomes. Comparisons of the role continue to focus on cost, with findings based on incomplete and almost impossible to define, recognition of contribution to service delivery by paralleled practitioners. Currently there is no clear definition as to how nurse practitioners contribute to value in health service delivery. Robust and rigorous research needs to be commissioned taking into consideration the unique hybrid nature of the emergency nurse practitioner role and focusing on the value they contribute to health care delivery.
syndrome (15 items) • Other anxiety syndrome (6 items) • Eating disorders (4 items; binge and bulimia nervosa) Has your doctor or other health...The Millennium Cohort: a 21-Year Contribution to the Understanding of Military and Veterans’ Health Second Annual Trauma Stress Disorders ...AVAILABILITY STATEMENT Approved for public release; distribution unlimited 13. SUPPLEMENTARY NOTES Presented at The Second Annual Trauma Spectrum Disorders
Anderson, Kevin; Emmerton, Lynne M
Objective The aim of the present study was to review the contribution of mobile health applications ('apps') to consumers' self-management of chronic health conditions, and the potential for this practice to inform health policy, procedures and guidelines. Methods A search was performed on the MEDLINE, Cochrane Library, ProQuest and Global Health (Ovid) databases using the search terms 'mobile app*', 'self-care', 'self-monitoring', 'trial', 'intervention*' and various medical conditions. The search was supplemented with manual location of emerging literature and government reports. Mapping review methods identified relevant titles and abstracts, followed by review of content to determine extant research, reports addressing the key questions, and gaps suggesting areas for future research. Available studies were organised by disease state, and presented in a narrative analysis. Results Four studies describing the results of clinical trials were identified from Canada, England, Taiwan and Australia; all but the Australian study used custom-made apps. The available studies examined the effect of apps in health monitoring, reporting positive but not robust findings. Australian public policy and government reports acknowledge and support self-management, but do not address the potential contribution of mobile interventions. Conclusions There are limited controlled trials testing the contribution of health apps to consumers' self-management. Further evidence in this field is required to inform health policy and practice relating to self-management. What is known about the topic? Australian health policy encourages self-care by health consumers to reduce expenditure in health services. A fundamental component of self-care in chronic health conditions is self-monitoring, which can be used to assess progress towards treatment goals, as well as signs and symptoms of disease exacerbation. An abundance of mobile health apps is available for self-monitoring. What does this study
Santric-Milicevic, M; Vasic, V; Terzic-Supic, Z
In times of austerity, the availability of econometric health knowledge assists policy-makers in understanding and balancing health expenditure with health care plans within fiscal constraints. The objective of this study is to explore whether the health workforce supply of the public health care sector, population number, and utilization of inpatient care significantly contribute to total health expenditure. The dependent variable is the total health expenditure (THE) in Serbia from the years 2003 to 2011. The independent variables are the number of health workers employed in the public health care sector, population number, and inpatient care discharges per 100 population. The statistical analyses include the quadratic interpolation method, natural logarithm and differentiation, and multiple linear regression analyses. The level of significance is set at P Total health expenditure increased by 1.21 standard deviations, with an increase in health workforce growth rate by 1 standard deviation. Furthermore, this rate decreased by 1.12 standard deviations, with an increase in (negative) population growth rate by 1 standard deviation. Finally, the growth rate increased by 0.38 standard deviation, with an increase of the growth rate of inpatient care discharges per 100 population by 1 standard deviation (P < 0.001). Study results demonstrate that the government has been making an effort to control strongly health budget growth. Exploring causality relationships between health expenditure and health workforce is important for countries that are trying to consolidate their public health finances and achieve universal health coverage at the same time.
At the inauguration of the new CMS visitor centre. The CMS experiment inaugurated a new visitor centre at its Cessy site on 14 June. This will allow the thousands of people who come to CERN each year to follow the construction of one the Laboratory's flagship experiments first-hand. CERN receives over 20,000 visitors each year. Until recently, many of them were taken on a guided tour of one of the LEP experiments. With the closure of LEP, however, trips underground are no longer possible, and the Visits' Service has put in place a number of other itineraries (Bulletin 46/2000). Since the CMS detector will be almost entirely constructed in a surface hall, it is now taking a big share of the limelight. The CMS visitor centre has been built on a platform overlooking CMS construction. It contains a set of clear descriptive posters describing the experiment, along with a video projection showing animations and movies about CMS construction. In the coming weeks, a display of CMS detector elements will be added, as...
"Inside the Big Black Box" is a European survey of responses by visitors to five laboratories, including CERN. Its findings will be presented at a two-day meeting to be held at CERN on 29 and 30 March. Can the visits programme of a research laboratory, such as a particle physics laboratory, satisfy the public's curiosity? What are the impressions of visitors to such laboratories? "Inside the Big Black Box" (IN3B), a study sponsored by the European Commission, provides the answers to these previously unanswered questions. The results of this survey, conducted among 4000 visitors to five laboratories (CERN in Switzerland, LNGS in Italy, Demokritos in Greece and DESY and Forschungszentrum Jülich in Germany), will be presented at a meeting hosted by CERN on 29 and 30 March. The detailed programme and a registration form for those wishing to attend can be found at: http://www.cern.ch/info/IN3B. Visitors to the DESY laboratory inside the hall of the TESLA (Tera Electr...
Thomsen, Bente Dahl; Ravn, Anders Peter
In this investigation, visitors to an art and design exhibition have used an interactive computer program to express the qualities they consider important for an art or design object (artefact). They have then used the program with their individually selected qualities to assess the artefacts. In...
On Open Day, CERN was filled with visitors from around Europeâand beyondâwho toured the LHC detector sites and visited a multitude of experimental halls and workshops across the Meyrin and Prevessin sites, the vast majority in buildings normally closed to the public.
Fallahi Khoshknab, Masoud; Oskouie, Fatemeh; Ghazanfari, Nahid; Najafi, Fereshteh; Tamizi, Zahra; Afshani, Shahla; Azadi, Ghazal
Background There are high levels of sexual harassment in health care systems. Also, workplace violence occurs against ethnic and racial minorities. This study aimed to identify the frequency of and the factors contributing to and preventing sexual and racial harassment in the workplace towards health professionals in Iran. Methods This cross-sectional study was conducted on 6500 out of 57000 health workers who were selected by multistage random sampling from some teaching hospitals in Iran. D...
Apr 20, 2018 ... Relationship exists between the visitors' motivation (r = 0.23, p = 0.00) and their level of satisfaction. ... decisions which are reflected in travel behaviour. Visitors' travel ..... family holiday purchase decision-making process” ...
Full Text Available Background One common challenge to social systems is achieving equity in financial contributions and preventing financial loss. Because of the large and unpredictable nature of some costs, achieving this goal in the health system presents important and unique problems. The present study investigated the Household Financial Contributions (HFCs to the health system. Methods The study investigated 800 households in Shiraz. The study sample size was selected using stratified sampling and cluster sampling in the urban and rural regions, respectively. The data was collected using the household section of the World Health Survey (WHS questionnaire. Catastrophic health expenditures were calculated based on the ability of the household to pay and the reasons for the catastrophic health expenditures by a household were specified using logistic regression. Results The results showed that the fairness financial contribution index was 0.6 and that 14.2% of households were faced with catastrophic health expenditures. Logistic regression analysis revealed that household economic status, the basic and supplementary insurance status of the head of the household, existence of individuals in the household who require chronic medical care, use of dental and hospital care, rural location of residences, frequency of use of outpatient services, and Out-of-Pocket (OOP payment for physician visits were effective factors for determining the likelihood of experiencing catastrophic health expenditure. Conclusion It appears that the current method of health financing in Iran does not adequately protect households against catastrophic health expenditure. Consequently, it is essential to reform healthcare financing.
Cristina García Magro
Full Text Available Purpose: The aims of the paper is offers a model of analysis which allows to measure the impact on the performance of fairs, as well as the knowledge or not of the motives of participation of the visitors on the part of the exhibitors. Design/methodology: A review of the literature is established concerning two of the principal interested agents, exhibitors and visitors, focusing. The study is focused on the line of investigation referred to the motives of participation or not in a trade show. According to the information thrown by each perspectives of study, a comparative analysis is carried out in order to determine the degree of existing understanding between both. Findings: The trade shows allow to be studied from an integrated strategic marketing approach. The fit model between the reasons for participation of exhibitors and visitors offer information on the lack of an understanding between exhibitors and visitors, leading to dissatisfaction with the participation, a fact that is reflected in the fair success. The model identified shows that a strategic plan must be designed in which the reason for participation of visitor was incorporated as moderating variable of the reason for participation of exhibitors. The article concludes with the contribution of a series of proposals for the improvement of fairground results. Social implications: The fit model that improve the performance of trade shows, implicitly leads to successful achievement of targets for multiple stakeholders beyond the consideration of visitors and exhibitors. Originality/value: The integrated perspective of stakeholders allows the study of the existing relationships between the principal groups of interest, in such a way that, having knowledge on the condition of the question of the trade shows facilitates the task of the investigator in future academic works and allows that the interested groups obtain a better performance to the participation in fairs, as visitor or as
Is information about the nature, location and incidence of crimes against tourists/visitors sufficient to develop meaningful visitor safety and security policy? Are the views of key tourism stakeholder groups useful in informing and enhancing visitor safety and security policy? To answer these questions, this study analyzes 24 years of recorded crime data against visitors to Barbados and survey data of key tourism stakeholder groups and concludes: 1) that information about the nature, locatio...
Urbanos-Garrido, Rosa M
Social factors have been proved to be main determinants of individuals' health. Recent studies have also analyzed the contribution of some of those factors, such as education and job status, to socioeconomic inequalities in health. The aim of this paper is to provide new evidence about the factors driving socioeconomic inequalities in health for the Spanish population by including housing deprivation and social interactions as health determinants. Cross-sectional study based on the Spanish sample of European Statistics on Income and Living Conditions (EU-SILC) for 2006. The concentration index measuring income-related inequality in health is decomposed into the contribution of each determinant. Several models are estimated to test the influence of different regressors for three proxies of ill-health. Health inequality favouring the better-off is observed in the distribution of self-assessed health, presence of chronic diseases and presence of limiting conditions. Inequality is mainly explained, besides age, by social factors such as labour status and financial deprivation. Housing deprivation contributes to pro-rich inequality in a percentage ranging from 7.17% to 13.85%, and social interactions from 6.16% to 10.19%. The contribution of some groups of determinants significantly differs depending on the ill-health variable used. Health inequalities can be mostly reduced or shaped by policy, as they are mainly explained by social determinants such as labour status, education and other socioeconomic conditions. The major role played on health inequality by variables taking part in social exclusion points to the need to focus on the most vulnerable groups.
Petersen, Johanna; Larimer, Nicole; Kaye, Jeffrey A; Pavel, Misha; Hayes, Tamara L
With the rising age of the population, there is increased need to help elderly maintain their independence. Smart homes, employing passive sensor networks and pervasive computing techniques, enable the unobtrusive assessment of activities and behaviors of the elderly which can be useful for health state assessment and intervention. Due to the multiple health benefits associated with socializing, accurately tracking whether an individual has visitors to their home is one of the more important aspects of elders' behaviors that could be assessed with smart home technology. With this goal, we have developed a preliminary SVM model to identify periods where untagged visitors are present in the home. Using the dwell time, number of sensor firings, and number of transitions between major living spaces (living room, dining room, kitchen and bathroom) as features in the model, and self report from two subjects as ground truth, we were able to accurately detect the presence of visitors in the home with a sensitivity and specificity of 0.90 and 0.89 for subject 1, and of 0.67 and 0.78 for subject 2, respectively. These preliminary data demonstrate the feasibility of detecting visitors with in-home sensor data, but highlight the need for more advanced modeling techniques so the model performs well for all subjects and all types of visitors.
Following the 2010 five-yearly review of financial and social conditions, which included the CERN Health Insurance Scheme (CHIS), the CERN Council decided in December 2010 to progressively increase the level of contributions over the period 2011-2015. For 2015, the contribution rate of active and retired CHIS members will be 4.86%. The amounts of the fixed premiums for voluntarily insured members (e.g. users and associates) as well as the supplementary contributions for spouses with income from a professional activity or with a retirement pension (including the CERN pension) increase accordingly : 1. Voluntary contributions The full contribution based on Reference Salary II is now 1208 CHF per month. This fixed amount contribution is applied to voluntarily affiliated users and associates with normal coverage. Half of this amount (604 CHF) is applied to voluntarily affiliated users and associates with reduced coverage. Finally, an amount of 483 CHF is applied to children maintaining their insur...
Human Resources Department
Following the 2010 five-yearly review of financial and social conditions, which included the CERN Health Insurance Scheme (CHIS), the CERN Council decided in December 2010 to progressively increase the level of contributions over the period 2011-2015. For 2013, the contribution rate of active and retired CHIS members will be 4.55%. The amounts of the fixed premiums for voluntarily insured members (e.g. users and associates) as well as the supplementary contributions for spouses with income from a professional activity will increase accordingly: 1. Voluntary contributions The full contribution based on Reference Salary II is now 1116 CHF per month. This fixed amount contribution is applied to voluntarily affiliated users and associates with normal coverage. Half of this amount (558 CHF) is applied to voluntarily affiliated users and associates with reduced coverage. Finally, an amount of 446 CHF is applied to children maintaining their insurance cover on a voluntary and temporarily basis. More ...
Following the 2010 five-yearly review of financial and social conditions, which included the CERN Health Insurance Scheme (CHIS), the CERN Council decided in December 2010 to progressively increase the level of contributions over the period 2011-2015. For 2014, the contribution rate of active and retired CHIS members will be 4.7%. The amounts of the fixed premiums for voluntarily insured members (e.g. users and associates) as well as the supplementary contributions for spouses with income from a professional activity or with a retirement pension (including the CERN pension) will increase accordingly: Voluntary contributions The full contribution based on Reference Salary II is now 1161 CHF per month. This fixed amount contribution is applied to voluntarily affiliated users and associates with normal coverage. Half of this amount (580 CHF) is applied to voluntarily affiliated users and associates with reduced coverage. Finally, an amount of 464 CHF is applied to children maintaining their ins...
Zach, Florian; Xiang, Zheng; Fesenmaier, Daniel R.
Innovation has become an increasingly important issue for tourism businesses. The goal of this study was to evaluate innovation in Web marketing by American convention and visitors bureaus and the contribution of website features to the overall success of their Web marketing programs. The results...
Homer, J.; Glassmeyer, C.; Sauer, N.; Powell, J.
This paper describes the design and operation of a constructed on-site bio-treatment wetland at the Fernald Preserve Visitors Center. The use of constructed wetlands for treatment of domestic wastewater at the Fernald Preserve contributed to the award of Leadership in Energy and Environmental Design platinum certification from the U.S. Green Building Council. (authors)
Rudy M. Schuster; Laura Sullivan; Duarte Morais; Diane Kuehn
This analysis explores the differences in Affective and Cognitive Destination Image among three Hudson River Valley (New York) tourism communities. Multiple regressions were used with six dimensions of visitors' images to predict future intention to revisit. Two of the three regression models were significant. The only significantly contributing independent...
Robert G. Dvorak; Erin D. Small
This study examines visitor attitudes across the Boundary Waters Canoe Area Wilderness regarding the effects of natural disturbances on visitor planning and wilderness conditions. Visitors were intercepted at entry points and permit distribution locations during 2007. Results suggest that respondents were aware of recent wind and fire disturbances. Few respondents...
Martella, Claudio; Miraglia, Armando; Frost, Jeana; Cattani, Marco; van Steen, Maarten
Fine-arts museums design exhibitions to educate, inform and entertain visitors. Existing work leverages technology to engage, guide and interact with the visitors, neglecting the need of museum staff to understand the response of the visitors. Surveys and expensive observational studies are
This paper reviews Italian Development Assistance for Health and overall contribution to Global Health from 2001 to 2012. It analyses strategies and roles of central and decentralized authorities as well as those of private non-profit and corporate actors. The research illustrates a very low and unstable official contribution that lags far behind internationally agreed upon objectives, a highly fragmented institutional scenario, and controversial political choices favouring “vertical” global initiatives undermining national health systems, and in contrast with Italian deep-rooted principles, traditional approaches and official guidelines. Italy’s contribution to global health goes beyond official development aid, however. The raising movement toward Universal Health Coverage may offer an extraordinary opportunity for a leading role to a country whose National Health System is founded on the principles of universal and equitable access to care. At the same time, the distinctive experience of Italian decentralized cooperation, with the involvement of a multiplicity actors in a coordinated effort for cooperation in health with homologous partners in developing countries, may offer – if adequately harnessed - new opportunities for an Italian “system” of development cooperation. Nevertheless, the indispensable prerequisite of a substantial increase in public funding is challenged by the current economic crisis and domestic political situation. For a renewed Italian role in development and global health, a paradigm shift is needed, requiring both conceptual revision and deep institutional and managerial reforms to ensure an appropriate strategic direction and an efficient and effective use of resources. PMID:24708890
Wood, K.T.; Lawson, S.R.; Marion, J.L.
The rock outcrops and cliffs of Shenandoah National Park provide habitat for several rare and endangered plant and animal species, including the federally endangered Shenandoah Salamander (Plethodon shenandoah; Ludwig et al., 1993). The location of the well-known park tour road, Skyline Drive, along the ridgeline provides exceptional access to many outcrops and cliffs throughout the park for a large number of the park?s 1.2 million annual visitors. Consequently, visitor use of cliff areas has led to natural resource impacts, including marked decreases in size and vigor of known rare plant populations. Despite the clear ecological value and potential threats to the natural resources at cliff areas, managers possess little information on visitor use of cliff sites and presently have no formal planning document to guide management. Thus, a park wide study of cliff sites was initiated during the 2005 visitor use season. As part of this research effort, our study used an integrative approach to study recreational use and visitor-caused resource impacts at one of the more heavily visited cliff sites in the park: Little Stony Man Cliffs (LSMC). In particular, this study integrated data from resource impact measurements and visitor use observation to help assess the effects of recreational use on the natural resources of LSMC. Procedures derived from campsite and trail impact studies were used to measure and characterize the amount of visitor-caused resource impacts on LSMC (Marion & Leung, 2001; Marion, 1995). Visitor use observations were conducted on top of LSMC to document and characterize the type and amount of recreational use the cliffs receive and the behaviors of recreationists that may contribute to cliff-top resource impacts. Resource impact measurement data show trampling disturbance present at LSMC, characterized by vegetation loss, exposed soil, and root exposure. Documentation of informal trails, soil erosion, tree damage, and tree stumps provide further
Rosenkötter, N; Vondeling, H; Blancquaert, I; Mekel, O C L; Kristensen, F B; Brand, A
The European Union has named genomics as one of the promising research fields for the development of new health technologies. Major concerns with regard to these fields are, on the one hand, the rather slow and limited translation of new knowledge and, on the other hand, missing insights into the impact on public health and health care practice of those technologies that are actually introduced. This paper aims to give an overview of the major assessment instruments in public health [health technology assessment (HTA), health needs assessment (HNA) and health impact assessment (HIA)] which could contribute to the systematic translation and assessment of genomic health applications by focussing at population level and on public health policy making. It is shown to what extent HTA, HNA and HIA contribute to translational research by using the continuum of translational research (T1-T4) in genomic medicine as an analytic framework. The selected assessment methodologies predominantly cover 2 to 4 phases within the T1-T4 system. HTA delivers the most complete set of methodologies when assessing health applications. HNA can be used to prioritize areas where genomic health applications are needed or to identify infrastructural needs. HIA delivers information on the impact of technologies in a wider scope and promotes informed decision making. HTA, HNA and HIA provide a partly overlapping and partly unique set of methodologies and infrastructure for the translation and assessment of genomic health applications. They are broad in scope and go beyond the continuum of T1-T4 translational research regarding policy translation. Copyright © 2010 S. Karger AG, Basel.
Abstract There is general agreement on the need to integrate human rights into health policies and programmes, although there is still reluctance to go beyond rhetorical acknowledgement of their assumed significance. To determine the actual value of human rights for the effectiveness of public health efforts requires clarity about what their incorporation looks like in practice and how to assess their contribution. Despite the pervasive use of indicators in the public health field, indicators that specifically capture human rights concerns are not well developed and those that exist are inconsistently used. Even though “health and human rights indicators” are increasingly being constructed, it is often the case that health indicators are used to draw conclusions about some interaction between human rights and health; or that law and policy or other indicators, traditionally the domain of the human rights community, are used to make conclusions about health outcomes. To capture the added value that human rights bring to health, the differences in the contributions offered by these indicators need to be understood. To determine the value of different measures for advancing programme effectiveness, improving health outcomes and promoting human rights, requires questioning the intended purpose behind the construction of an indicator, who uses it, the kind of indicator it is, the extent to which it provides information about vulnerable populations, as well as how the data are collected and used. PMID:19784452
Full Text Available This paper aims to establish the link between tourists’ perceptions on cultural offers and their overall satisfaction, and explore the implication of this link for sustainable tourist destination management. Assessing online customers’ reviews, this study identifies a positive correlation between visitors’ perspectives and experiences at the on-site cultural centre and visitors’ destination satisfaction. It suggests that the on-site cultural centre plays a critical role in building up visitors’ perception on cultural attributes of the destination, and its impact on visitor satisfaction is a double-edged sword. Visitors’ positive perspectives on the cultural centre enhance visitors’ experiences and contribute to their destination satisfaction; however, not only does a negative perspective on their cultural and spiritual experience compromise visitors’ satisfaction, but also subsequent negative online reviews damage the destination image and discourage visitor return/visit. The findings help destination management organisations to better understand visitors’ preference for cultural centres and therefore to improve visitors’ cultural experience. This paper appeals for further study of on-site cultural centres’ role in forming destination cultural attributes, and of social media’s potential in enriching cultural experience.
Full text: This eight minute video demonstrates the approach taken by Nuclear Electric to exhibitions that are open to the public. The information is given both visually - with excerpts from some of the attractions on display at the centres - and in comments from interviews with visitors, the centre guides and the man responsible for many of the exhibits featured in the video. on one side are the schoolchildren who are visiting the exhibition and are seen both playing and learning as they press buttons, watch videos, 'meet' Michael Faraday, and learn about radiation - its disposal and its safe transportation. The headmaster of the school is interviewed and explains that the exhibition is helping his children understand the importance of electricity to their world. on the other side is Jackie Lucas, the visitor centre manager, explaining what the public make of the exhibition. We see her staff greeting the children and helping them to understand the show. The designer of the exhibition, Len Upton explains how you go about making an exhibition such as this both informative and fun. Also interviewed is the man behind many of the exhibitions featured at Nuclear Electric's visitor centres up and down the country, Nicholas Mullane. He explains the purpose of the exhibition and what messages it imparts. The video is presented in split-screen or composite format, whereby the interviewee and children are often presented together. Excerpts from the various videos on display are presented as both how they are seen from the floor, as well as the full screen effect of the various programmes. The video gives much of the feeling of fun to be gained at the exhibition, as well as showing the educational benefits to be gained from a couple of hours at one of Nuclear Electric's visitor centres. Copies of the video can be obtained from Bob Fenton at Nuclear Electric. (Fax: ++44 1 452 652 443). (author)
Crinson, Iain; Yuill, Chris
This article examines both the contribution and the limitations of research that has sought to develop a causal understanding of the psychosocial dimension of inequalities in health. The article seeks to revive interest in Marx's theory of alienation in developing the case for an alternative materialist conceptualization that is able to postulate the pathways from alienation as a psychosocial generative structure to social inequalities in health outcomes within late modern societies.
Renaud, Lidewij R; Huysmans, Maaike A; Speklé, Erwin M; van der Beek, Allard J; van der Ploeg, Hidde P
Sitting too much has been associated with negative health outcomes. 'The End of Sitting' is a newly developed office landscape that moves away from the traditional chair-desk setup. The landscape aims to reduce sitting time by offering a variety of (supported) standing positions. The aim of this study was to determine the usage of the landscape after being placed in the main entrance hall of the VU University in Amsterdam. We observed the number of spontaneous visitors as well as the duration of visits, changes to another location within the landscape, and adopted postures. Using questionnaires reasons (not) to visit the landscape, perceived affordances of the landscape and associations with long-term use were determined. Observed numbers of visitors were relatively low and duration of visits were short, which seemed to indicate visitors were trying out the landscape. The majority of visitors were in an upright position, reflecting the designers' intentions. Visitors indicated that long-term use would be pleasant to them. 'The End of Sitting' landscape received positive reactions but number of visits were limited in the few months that it was placed in the university main entrance hall. The landscape might be better suited for designated working or study spaces, for which it was originally intended. It might also be worth to explore the landscapes suitability for short stay environments, such as waiting rooms.
Full Text Available The inadequate supply of health workers and demand-side barriers due to clinical practice that heeds too little attention to cultural context are serious obstacles to achieving universal health coverage and the fulfillment of the human rights to health, especially for the poor and vulnerable living in remote rural areas. A number of strategies have been deployed to increase both the supply of healthcare workers and the demand for healthcare services. However, more can be done to improve service delivery as well as mitigate the geographic inequalities that exist in this field. To contribute to overcoming these barriers and increasing access to health services, especially for the most vulnerable, Partners In Health (PIH, a US non-governmental organization specializing in equitable health service delivery, has created the University of Global Health Equity (UGHE in a remote rural district of Rwanda. The act of building this university in such a rural setting signals a commitment to create opportunities where there have traditionally been few. Furthermore, through its state-of-the-art educational approach in a rural setting and its focus on cultural competency, UGHE is contributing to progress in the quest for equitable access to quality health services.
Celino, Suely Deysny de Matos; Costa, Gabriela Maria Cavalcanti; França, Inácia Sátiro Xavier de; Araújo, Ednaldo Cavalcante de
The shared management in health of the Research Program for the Unified Health System (PPSUS) has the purpose of funding research in priority areas for the health of the Brazilian population. The scope of this qualitative study is to understand the researchers' perception of the contribution of research funded by the PPSUS invitations to bid in the State of Paraiba, for resolving the priority health problems of the Paraiba population, for reducing regional inequalities in health and for bolstering the management of SUS. A documentary survey of the bids and final reports of research and a semi-structured interview with 28 coordinators of these studies was conducted. Triangulation strategy of data was used and subsequently subjected to content analysis, which converged with the categories: solving the health problems; reducing regional inequalities; contribution to management. Paraiba state needs adjustments such that the PPSUS can be fully implemented, ensuring that the knowledge generated can be converted into health policies and actions, since the research funded respond to the health needs of the population and difficulties in SUS management.
Hegger, Ingrid; Kok, Maarten O; Janssen, Susan W J; Schuit, Albertine J; van Oers, Hans A M
The Dutch Public Health Status and Forecasts report (PHSF Report) integrates research data and identifies future trends affecting public health in the Netherlands. To investigate how PHSF contributions to health policy can be enhanced, we analysed the development process whereby the PHSF Report for 2010 was produced (PHSF-2010). To collect data, a case study approach was used along the lines of Contribution Mapping including analysis of documents from the PHSF-2010 process and interviews with actors involved. All interviews were recorded and transcribed ad verbatim and coded using an inductive code list. The PHSF-2010 process included activities aimed at alignment between researchers and policy-makers, such as informal meetings. However, we identified three issues that are easily overlooked in knowledge development, but provide suggestions for enhancing contributions: awareness of divergent; continuously changing actor scenarios; vertical alignment within organizations involved and careful timing of draft products to create early adopters. To enhance the contributions made by an established public health report, such as the PHSF Report, it is insufficient to raise the awareness of potential users. The knowledge product must be geared to policy-makers' needs and must be introduced into the scenarios of actors who may be less familiar. The demand for knowledge product adaptations has to be considered. This requires continuous alignment efforts in all directions: horizontal and vertical, external and internal. The findings of this study may be useful to researchers who aim to enhance the contributions of their knowledge products to health policy. © The Author 2016. Published by Oxford University Press on behalf of the European Public Health Association.
Full Text Available Is information about the nature, location and incidence of crimes against tourists/visitors sufficient to develop meaningful visitor safety and security policy? Are the views of key tourism stakeholder groups useful in informing and enhancing visitor safety and security policy? To answer these questions, this study analyzes 24 years of recorded crime data against visitors to Barbados and survey data of key tourism stakeholder groups and concludes: 1 that information about the nature, location and incidence of crimes against visitors is necessary but not sufficient to inform visitor safety and security policy; and 2 that the views and input of key stakeholders are essential if destinations are to become more effective in enhancing visitor safety and security.
Singham, Timothy; Viding, Essi; Schoeler, Tabea; Arseneault, Louise; Ronald, Angelica; Cecil, Charlotte M.; McCrory, Eamon; Rijsdijk, Frülhing
Importance Exposure to bullying is associated with poor mental health. However, the degree to which observed associations reflect direct detrimental contributions of exposure to bullying to mental health remains uncertain, as noncausal relationships may arise from genetic and environmental confounding (eg, preexisting vulnerabilities). Determining to what extent exposure to bullying contributes to mental health is an important concern, with implications for primary and secondary interventions. Objective To characterize the concurrent and longitudinal contribution of exposure to bullying to mental health in childhood and adolescence using a twin differences design to strengthen causal inference. Design, Setting, and Participants Participants were drawn from the Twins Early Development Study, a population-based cohort recruited from population records of births in England and Wales between January 1, 1994, and December 31, 1996. Data collection took place when the participants were between 11 and 16 years of age from December 1, 2005, to January 31, 2013. Data analysis was conducted from January 1, 2016, to June 20, 2017. Exposures Participants completed the Multidimensional Peer-Victimization Scale at 11 and 14 years of age. Main Outcomes and Measures Mental health assessments at 11 and 16 years of age included anxiety, depression, hyperactivity and impulsivity, inattention, conduct problems, and psychotic-like experiences (eg, paranoid thoughts or cognitive disorganization). Results The 11 108 twins included in the final sample (5894 girls and 5214 boys) were a mean age of 11.3 years at the first assessment and 16.3 years at the last assessment. The most stringent twin differences estimates (monozygotic) were consistent with causal contribution of exposure to bullying at 11 years to concurrent anxiety, depression, hyperactivity and impulsivity, inattention, and conduct problems. Effects decreased over time; that is, substantial concurrent contributions to anxiety
Hayek, Samah; Tessler, Riki; Bord, Shiran; Endevelt, Ronit; Satran, Carmit; Livne, Irit; Khatib, Mohammed; Harel-Fisch, Yosi; Baron-Epel, Orna
The Israeli Health Promoting School Network (HPSN) is actively committed to enhancing a healthy lifestyle for the entire school population. This study aimed to explore the contribution of school participation in the HPSN and students' individual characteristics to healthy eating and physical activity habits among Israeli school children aged 10-12 years. A cross-sectional survey was conducted among 4166 students in grades 4-6 from 28 schools. The schools were selected from a sample of HPSN affiliated and non-HPSN schools. The contribution of individual characteristics (grade, gender and subjective self-reported health education activities at school) and school characteristics (school type, population group, deprivation score) to healthy eating and physical activity habits was analyzed using multi-level hierarchical models. Multi-level analysis indicated that student's individual characteristic was significantly associated with healthy eating and physical activity habits. The subjective self-reported health education received at school was statistically significant factor associated with students' health behaviors. The school's affiliation with the HPSN was not associated with higher healthy eating and physical activity scores after adjusting for individual factors. These findings suggest that Israeli HPSN schools do not contribute to children's health behaviors more than other schools. Therefore, health promoting activities in HPSN schools need to be improved to justify their recognition as members of the HPS network and to fulfill their mission. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: firstname.lastname@example.org.
David N. Cole; Stephen F. McCool; William T. Borrie; Jennifer O' Loughlin
Thirty-seven papers are presented on wilderness visitors, experiences, and visitor management. Three overview papers synthesize knowledge and research about wilderness visitors, management of visitor experiences, and wilderness recreation planning. Other papers contain the results of specific research projects on wilderness visitors, information and education, and...
Full Text Available The study aims to propose a new approach to analyse visitor perceptions and experiences in a tourism destination. The purpose is to discuss how the discrete choice models can contribute to the analysis of the tourism destination in the visitor experience perspective. The study pays particular attention to the role of food and wine supply in thetourism experience and the destination perception. This research deepens the theoretical approach to the analysis of visitor perceptions for a tourist urban destination. The proposed framework has been applied to the city of Verona. The findings concern an exploratory survey and the subsequent building of the causal analysis. The discrete choice model application and the development of the experimental design are discussed, in order to take the role of food and wine attractions into account. The exploratory survey identified seven relevant themes for visitors. Among them, food and wine specialties may play a relevant role in the assessment of a tourist destination. Attributes and levels have been outlined to apply the discrete choice models. A survey questionnaire has been developed to be submitted to a large sample of visitors or potential visitors of Verona. The methodological contribution of this study is the application of the discrete choice models to the study of tourism experiences. The empirical innovation consists in a different marketing perspective for an urban tourist destination, whose competitiveness is strengthened by the agrofood industry.
Farič, Nuša; Potts, Henry W W
Wikipedia is one of the most accessed sources of health information online. The current English-language Wikipedia contains more than 28,000 articles pertaining to health. The aim was to characterize individuals' motivations for contributing to health content on the English-language Wikipedia. A set of health-related articles were randomly selected and recent contributors invited to complete an online questionnaire and follow-up interview (by Skype, by email, or face-to-face). Interviews were transcribed and analyzed using thematic analysis and a realist grounded theory approach. A total of 32 Wikipedians (31 men) completed the questionnaire and 17 were interviewed. Those completing the questionnaire had a mean age of 39 (range 12-59) years; 16 had a postgraduate qualification, 10 had or were currently studying for an undergraduate qualification, 3 had no more than secondary education, and 3 were still in secondary education. In all, 15 were currently working in a health-related field (primarily clinicians). The median period for which they have been an active editing Wikipedia was 3-5 years. Of this group, 12 were in the United States, 6 were in the United Kingdom, 4 were in Canada, and the remainder from another 8 countries. Two-thirds spoke more than 1 language and 90% (29/32) were also active contributors in domains other than health. Wikipedians in this study were identified as health professionals, professionals with specific health interests, students, and individuals with health problems. Based on the interviews, their motivations for editing health-related content were summarized in 5 strongly interrelated categories: education (learning about subjects by editing articles), help (wanting to improve and maintain Wikipedia), responsibility (responsibility, often a professional responsibility, to provide good quality health information to readers), fulfillment (editing Wikipedia as a fun, relaxing, engaging, and rewarding activity), and positive attitude to
Reviews literature concerned with the contribution of mental health professionals to the well-being of children of divorce. Topics include effects of divorce on children, divorce prevention, predivorce counseling, custody conflicts, postdivorce counseling, and changes in social and educational practices. (Author/DB)
The paper examined the role of physical activity and fitness more especially in the area of disease prevention and control by looking at the major ways by which regular physical activity and fitness contributes to optimal health and wellness. The Surgeor General's Report (1996), stressed that physical inactivity is a national problem which…
Thackeray, Rosemary; Keller, Heidi; Heilbronner, Jennifer Messenger; Dellinger, Laura K Lee
Since its inception in 2005, articles in Health Promotion Practice's social marketing department have focused on describing social marketing's unique contributions and the application of each to the practice of health promotion. This article provides a brief review of six unique features (marketing mix, consumer orientation, segmentation, exchange, competition, and continuous monitoring) and then presents two case studies-one on reducing stigma related to mental health and the other a large-scale campaign focused on increasing HIV testing among African American youth. The two successful case studies show that social marketing principles can be applied to a wide variety of topics among various population groups.
Zach, Florian; Gretzel, Ulrike; Xiang, Zheng
, and continuity of innovation in Web marketing efforts and the perceived contribution of this investment to the overall success of the bureau's Web marketing program. The findings indicate that American convention and visitor bureaus have invested substantially in their websites and continue redesigning them...... as new technology and Web marketing trends emerge. However, it appears that there is a substantial gap between bureau investments in innovative website features and related activities and their perceived contribution to overall Web marketing success....
Ballantyne, P J
While it is established that socioeconomic status and social integration influence the distribution of health and illness among men and women, little attention has been paid to the different ways in which women and men experience socioeconomic opportunities and social attachments to others. Drawing on evidence from the literature, the position developed in this article is that gender mediates the influence of both socioeconomic status and social integration on health, and for women, these are intricately linked. Women's relationship to the labour market establishes and perpetuates their socioeconomic inequality relative to men, and may produce contradictory influences on women's health. Furthermore, for women, the marital relationship is paradoxical: marriage may at once improve economic and social support opportunities, while diminishing control over paid and unpaid work--potentially increasing as well as compromising the health status of women. The article is intended to contribute to the growing body of literature on gender and the determinants of health.
Fillipi André dos Santos Silva
Full Text Available Objective: To identify the types, purposes and the contributions of simulation in training in health. Method: This is a narrative review of the literature in its construction were used studies surveyed in databases Latin American and Caribbean Health Sciences (LILACS and Scopus, and other data sources. Results: The types of simulations and simulators are characterized by the degree of organization of landscape and simulator technology: low, medium and high fidelity. These degrees of fidelity enable the development of skills and abilities in students in the context of health education. Conclusion: Considering the scope and possibilities of its use, the simulation can be a positive tool in health education process. Descriptors: Education. Simulation. Health. Education. Formative feedback.
Okechukwu, Cassandra A.; Souza, Kerry; Davis, Kelly D.; de Castro, A. Butch
This paper synthesizes research on the contribution of workplace injustices – discrimination, harassment, abuse and bullying – to occupational health disparities. A conceptual framework is presented to illustrate the pathways through which injustices at the interpersonal and institutional level lead to differential risk of vulnerable workers to adverse occupational health outcomes. Members of demographic minority groups are more likely to be victims of workplace injustice and suffer more adverse outcomes when exposed to workplace injustice compared to demographic majority groups. A growing body of research links workplace injustice to poor psychological and physical health, and a smaller body of evidence links workplace injustice to unhealthy behaviors. Although not as well studied, studies also show that workplace injustice can influence workers’ health through effects on workers’ family life and job-related outcomes. Lastly, this paper discusses methodological limitations in research linking injustices and occupational health disparities and makes recommendations to improve the state of research. PMID:23813664
Okechukwu, Cassandra A; Souza, Kerry; Davis, Kelly D; de Castro, A Butch
This paper synthesizes research on the contribution of workplace injustices to occupational health disparities. We conducted a broad review of research and other reports on the impact of workplace discrimination, harassment, and bullying on workers' health and on family and job outcomes. Members of demographic minority groups are more likely to be victims of workplace injustice and suffer more adverse outcomes when exposed to workplace injustice compared to demographic majority groups. A growing body of research links workplace injustice to poor psychological and physical health, and a smaller body of evidence links workplace injustice to unhealthy behaviors. Although not as well studied, studies show that workplace injustice can influence workers' health through effects on workers' family life and job-related outcomes. Injustice is a key contributor to occupational health injustice and prospective studies with oversample of disadvantaged workers and refinement of methods for characterizing workplace injustices are needed. © 2013 Wiley Periodicals, Inc.
Sundari Ravindran, T K; Fonn, Sharon
A social franchise in health is a network of for-profit private health practitioners linked through contracts to provide socially beneficial services under a common brand. The early 21st century has seen considerable donor enthusiasm for promoting social franchises for the provision of reproductive health services. Based on a compendium of descriptive information on 45 clinical social franchises, located in 27 countries of Africa, Asia and Latin America, this paper examines their contribution to universal access to comprehensive reproductive health services. It finds that these franchises have not widened the range of reproductive health services, but have mainly focused on contraceptive services, and to a lesser extent, maternal health care and abortion. In many instances, coverage had not been extended to new areas. Measures taken to ensure sustainability ran counter to the objective of access for low-income groups. In almost two-thirds of the franchises, the full cost of all services had to be paid out of pocket and was unaffordable for low-income women. While standards and protocols for quality assurance were in place in all franchises, evidence on adherence to these was limited. Informal interviews with patients indicated satisfaction with services. However, factors such as difficulties in recruiting franchisees and significant attrition, franchisees' inability to attend training programmes, use of lay health workers to deliver services without support or supervision, and logistical problems with applying quality assurance tools, all raise concerns. The contribution of social franchises to universal access to reproductive health services appears to be uncertain. Continued investment in them for the provision of reproductive health services does not appear to be justified until and unless further evidence of their value is forthcoming. Copyright © 2011 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.
Lahelma, Eero; Laaksonen, Mikko; Aittomäki, Akseli
While health inequalities among employees are well documented, their variation and determinants among employee subpopulations are poorly understood. We examined variations in occupational class inequalities in health within four employment sectors and the contribution of working conditions to these inequalities. Cross-sectional data from the Helsinki Health Study in 2000-2002 were used. Each year, employees of the City of Helsinki, aged 40-60 years, received a mailed questionnaire (n = 8,960, 80% women, overall response rate for 3 years 67%). The outcome was physical health functioning measured by the overall physical component summary of SF-36. The socioeconomic indicator was occupational social class. Employment sectors studied were health care, education, social welfare and administration (n = 6,557). Physical and mental workload, and job demands and job control were explanatory factors. Inequality indices from logistic regression analysis were calculated. Occupational class inequalities in physical health functioning were slightly larger in education (1.47) than in the other sectors (1.43-1.40). Physical workload explained 95% of inequalities in social welfare and 32-36% in the other sectors. Job control also partly explained health inequalities. However, adjusting for mental workload and job demands resulted in larger health inequalities. Inequalities in physical health functioning were found within each employment sector, with minor variation in their magnitude. Physical workload was the main explanation for these inequalities, but its contribution varied between the sectors. In contrast, considering psychosocial working conditions led to wider inequalities. Improving physical working conditions among the lower occupational classes would help reduce health inequalities within different employment sectors.
Løhre, Audhild; Rise, Marit By; Steinsbekk, Aslak
The aim was to investigate characteristics of female and male visitors to practitioners of homeopathy in a large adult population in Norway. A cross-sectional adult total population health survey from Central Norway (the Nord-Trøndelag Health Study--HUNT 3) conducted in 2008. Variables included demographics, lifestyle, health status and health care use. Multivariate logistic regression models were employed to analyse the data. In total 50,827 participated (54% of the total population). The prevalence of visits to practitioners of homeopathy was 1.3%, a decline from 4.3% 10 years earlier. Both female and male visitors were 4-5 times more likely to experience recent somatic complaints. Further, female visitors were characterised by higher education, non-smoking, more chronic complaints, and visiting a physician or a chiropractor the past year whereas male visitors were characterised by seeking help for psychiatric complaints and visiting a chiropractor. There were no associations of age, marital status, physical activity, perceived global health, respiratory, skin, or musculoskeletal diseases with visiting practitioners of homeopathy. CONCLUSIONS AND PROPOSALS: There has been a marked decline in visits to practitioners of homeopathy. The results indicate a change in reasons to consult from complaints that influences the visitors' global health to less chronic complaints. Further research should compare changes in visits complementary and alternative medicine (CAM) practitioners and the characteristics of visitors to practitioners of homeopathy to characteristics of other CAM visitors. Copyright © 2012 The Faculty of Homeopathy. Published by Elsevier Ltd. All rights reserved.
Rajan, Dheepa; Kalambay, Hyppolite; Mossoko, Mathias; Kwete, Dieudonné; Bulakali, Joseph; Lokonga, Jean-Pierre; Porignon, Denis; Schmets, Gerard
This case study from DR Congo demonstrates how rational operational planning based on a health systems strengthening strategy (HSSS) can contribute to policy dialogue over several years. It explores the operationalization of a national strategy at district level by elucidating a normative model district resource plan which details the resources and costs of providing an essential health services package at district level. This paper then points to concrete examples of how the results of this exercise were used for Ministry of Health (MoH) decision-making over a time period of 5 years. DR Congo's HSSS and its accompanying essential health services package were taken as a base to construct a normative model health district comprising of 10 Health Centres (HC) and 1 District Hospital (DH). The normative model health district represents a standard set by the Ministry of Health for providing essential primary health care services. The minimum operating budget necessary to run a normative model health district is $17.91 per inhabitant per year, of which $11.86 is for the district hospital and $6.05 for the health centre. The Ministry of Health has employed the results of this exercise in 4 principal ways: 1.Advocacy and negotiation instrument; 2. Instrument to align donors; 3. Field planning; 4. Costing database to extract data from when necessary. The above results have been key in the policy dialogue on affordability of the essential health services package in DR Congo. It has allowed the MoH to provide transparent information on financing needs around the HSSS; it continues to help the MoH negotiate with the Ministry of Finance and bring partner support behind the HSSS.
Krishnaswamy, Saroja; Subramaniam, Kavitha; Low, Wah Yun; Aziz, Jemain Abdul; Indran, Tishya; Ramachandran, Padma; Hamid, Abdul Rahman Abdul; Patel, Vikram
This paper examines the factors contributing to the under utilisation of health care services in the Malaysian population. Using data derived from Malaysian Mental Health Survey (MMHS) information on utilisation of four basic health services in the previous three months, namely contact with health care professionals, ward admissions, having diagnostic or laboratory tests done and being on any medications were obtained. A total of 2202 out of 3666 or 60% of the MMHS participants were included in this study. Thirty percent of the subjects (n = 664) had contacts with health care professionals. Those with health complications, disabilities and those aged 50 years and above utilised health services more significantly as compared to those who lacked health facilities near their homes, had little family support during illnesses and were from the Chinese ethnic group. Factors leading to the under utilisation of health care services need to be further studied and needs in certain groups in the population should be addressed. Healthcare providers must be prepared to fulfil these needs.
Haller-Hayon, Orit; Korn, Liat; Magnezi, Racheli
This study examines the contribution of the Health Management Bachelor's degree program at an Israeli university to the professional development of its graduates. The aims of this study were: To examine the perceived gaps between acquired knowledge and required knowledge within the workforce; To explore the potential changes in the graduates' occupation conditions or professional status following their studies; To test the contribution of the curricula content studied by the graduates to their understanding, knowledge and integration within the healthcare system; and to examine the graduates perceptions towards required content, that should be added to the curricula. A structured, self-reported questionnaire was administered to 182 Health Management Department individuals whom have graduated from the Bachelors program between the years 2005 and 2009. The majority of the graduates reported the existance of a knowledge gap (greater among males, young and single than among females, older and married graduates). Most of the courses which were ranked as the lowest contributing ones were related to Management (e.g. Mathematics for Social Sciences, Accounting Fundamentals, Finance Theory), while the graduates recommended the inclusion of additional components to the curricula. The study demonstrates that a perceived gap exists between the acquired and the required knowledge of the Health Management Studies graduates. Various changes have been reported by the graduates (such as wage raise and role changes), following their study completion, suggesting that the program has partially contributed to their professional status. A 'Learning by Sharing' forum of academic staff, employers and graduates is recommended.
Fallahi Khoshknab, Masoud; Oskouie, Fatemeh; Ghazanfari, Nahid; Najafi, Fereshteh; Tamizi, Zahra; Afshani, Shahla; Azadi, Ghazal
There are high levels of sexual harassment in health care systems. Also, workplace violence occurs against ethnic and racial minorities. This study aimed to identify the frequency of and the factors contributing to and preventing sexual and racial harassment in the workplace towards health professionals in Iran. This cross-sectional study was conducted on 6500 out of 57000 health workers who were selected by multistage random sampling from some teaching hospitals in Iran. Data were collected using the questionnaire of "workplace violence in the health sector" developed by the International Labor Organization, International Council of Nurses, World Health Organization, and Public Services International. According to the findings, the frequencies of sexual harassment and racial harassment were, respectively, 4.7% and 12% for the 12 months prior to the study (2011). Among healthcare workers, nurses reported the highest rate of violence. The most important contributing factors in sexual and racial harassment were lack of security facilities (45.8%) and people's ignorance of employees' tasks (55.7%). The presence of security force, safety measures in the wards, and guards were noted as the most important preventive factor to harassment. Based on the results, the frequency of sexual and racial harassment is low, which can be attributed to underreporting due to cultural sensitivity or fear. So, identifying the reasons for refusal to report harassment, developing a clear mechanism for reporting and providing the necessary trainings to health workers are essential in order to deal with harassment.
Vouking, Marius Zambou; Binde, Thierry; Tadenfok, Carine Nouboudem; Ekani, Jean Marie Edengue; Ekra, Daniel
Introduction The establishment of effective community-based surveillance is an essential objective of all disease surveillance systems. Several studies and reports have found that the situation is far from optimal in several developing countries such as Cameroon. Methods We conducted a cross-sectional descriptive study to assess the contribution of community health workers to surveillance of vaccine-preventable diseases in Obala health district. The performance of community health workers was measured using: the number of cases referred to the health center, the percentage of accomplished referrals, the percentage of cases referred by community health workers confirmed by the staff of health centers. A questionnaire containing forty-seven questions (open-ended and closed-ended) was used for interviews with community health workers. The data were analyzed using SPSS 21 and Excel 2007. Counts and percentages are reported. Results The study showed that the age ranged of community health workers was from 24 to 61 years with an average of 37.9 years ± 6.7 years. The most represented age group was between 40 and 50 with a percentage of 38.6%. The male sex was more represented than the female sex (61.4% vs 38.6%) or a sex ratio male man of 1.7. Forty-five percent of community health workers were selected at a village meeting, 93.1% of community health workers were involved in the surveillance of vaccine-preventable diseases and 87% experienced at least one preventable disease. Only 45.8% of them had the case definitions of the four diseases. Analysis of community health workers attendance at organized health committee meetings showed that 79% of community health workers attended at least one health committee meeting in 2015 and only 49% were monitored in 2015. Community health workers reported 42 suspected cases of measles, 37 of which actually went to the nearest Health Center, a baseline rate of 88%. Conclusion Community health workers play a key role in the control of
Discussing the needs to be met by a visitor centre, the author develops the strategies to be adopted and defines the items to be included in the information program. The procedure in preparing the layout and design are explained and the media available to provide various levels of information are listed. Principles of selecting and mixing the media are discussed and the functions of the various sections of the centre described. Also included are examples of the costs and time requirements for the establishment of a typical centre. The importance of regular maintenance and updating is emphasized. (author)
Pratt, Bridget; Loff, Bebe
Health research has been identified as a vehicle for advancing global justice in health. However, in bioethics, issues of global justice are mainly discussed within an ongoing debate on the conditions under which international clinical research is permissible. As a result, current ethical guidance predominantly links one type of international research (biomedical) to advancing one aspect of health equity (access to new treatments). International guidelines largely fail to connect international research to promoting broader aspects of health equity - namely, healthier social environments and stronger health systems. Bioethical frameworks such as the human development approach do consider how international clinical research is connected to the social determinants of health but, again, do so to address the question of when international clinical research is permissible. It is suggested that the narrow focus of this debate is shaped by high-income countries' economic strategies. The article further argues that the debate's focus obscures a stronger imperative to consider how other types of international research might advance justice in global health. Bioethics should consider the need for non-clinical health research and its contribution to advancing global justice. © 2011 Blackwell Publishing Ltd.
Martin, Anne; Lassman, David; Whittle, Lekha; Catlin, Aaron
In 2009, US health care spending grew 4.0 percent--a historically low rate of annual increase--to $2.5 trillion, or $8,086 per person. Despite the slower growth, the share of the gross domestic product devoted to health spending increased to 17.6 percent in 2009 from 16.6 percent in 2008. The growth rate of health spending continued to outpace the growth of the overall economy, which experienced its largest drop since 1938. The recession contributed to slower growth in private health insurance spending and out-of-pocket spending by consumers, as well as a reduction in capital investments by health care providers. The recession also placed increased burdens on households, businesses, and governments, which meant that fewer financial resources were available to pay for health care. Declining federal revenues and strong growth in federal health spending increased the health spending share of total federal revenue from 37.6 percent in 2008 to 54.2 percent in 2009.
Levin, Betty Wolder; Browner, C H
In 1946, the newly formed World Health Organization boldly sought to conceptualize "health" as wellbeing in the positive sense, "not merely the absence of disease or infirmity." Yet nearly six decades later, researchers are still principally concerned with pathology and its characteristics and consequences. This special issue is the result of an effort to broaden the focus. Anthropologists working from evolutionary, biological and sociocultural perspectives and in diverse geographic regions were asked to examine meanings associated with health and/or to identify social conditions and practices that have contributed to positive physiological and psychological states in particular cultures, times, or across time. Most notable, perhaps, was discovering how difficult it is for Western social scientists to move beyond pathology-based thinking; most authors represented here regard health primarily as the absence of disease. Still, these papers articulate and address questions key to understanding health in and of itself, including: How is health conceptualized? What kinds of social conditions lead to health? And, how do social inequalities affect health? This introduction critically discusses previous work on the subject to contextualize the original research papers offered here.
James, W P; Nelson, M; Ralph, A; Leather, S
Social class differences in health are seen at all ages, with lower socioeconomic groups having greater incidence of premature and low birthweight babies, heart disease, stroke, and some cancers in adults. Risk factors including lack of breast feeding, smoking, physical inactivity, obesity, hypertension, and poor diet are clustered in the lower socioeconomic groups. The diet of the lower socioeconomic groups provides cheap energy from foods such as meat products, full cream milk, fats, sugars, preserves, potatoes, and cereals but has little intake of vegetables, fruit, and wholewheat bread. This type of diet is lower in essential nutrients such as calcium, iron, magnesium, folate, and vitamin C than that of the higher socioeconomic groups. New nutritional knowledge on the protective role of antioxidants and other dietary factors suggests that there is scope for enormous health gain if a diet rich in vegetables, fruit, unrefined cereal, fish, and small quantities of quality vegetable oils could be more accessible to poor people.
Nøhr, Christian; Botin, Lars; Zhu, Xinxin
This paper discusses how health information technologies like tele-care, tele-health and tele-medicine can improve the condition for high-need patients, specifically in relation to access. The paper addresses specifically the values of timeliness and equity and how tele technological solutions can support and enhance these values. The paper introduces to the concept of scaffolding, which constitutes the framework for dynamic, appropriate, caring and embracing approaches for engaging and involving high-need patients that are vulnerable and exposed. A number of specific considerations for designing tele-technologies for high-need patients are derived, and the paper concludes that ethical and epistemological criterions for design are needed in order to meet the needs and requirements of the weak and exposed.
Cockerham, William C
This paper examines recent trends in theory in health sociology in the United States and finds that the use of theory is flourishing. The central thesis is that the field has reached a mature state and is in the early stage of a paradigm shift away from a past focus on methodological individualism (in which the individual is the primary unit of analysis) toward a growing utilization of theories with a structural orientation This outcome is materially aided by research methods (e.g. hierarchal linear modeling, biomarkers) providing measures of structural effects on the health of the individual that were often absent or underdeveloped in the past. Structure needs to be accounted for in any social endeavor and contemporary medical sociology appears to be doing precisely that as part of the next stage of its evolution. The recent contributions to theory in the sociology of health discussed in this paper are fundamental cause, medicalization, social capital, neighborhood disadvantage, and health lifestyle theories.
Gagnon, France; Bergeron, Pierre; Clavier, Carole; Fafard, Patrick; Martin, Elisabeth; Blouin, Chantal
Written by a group of political science researchers, this commentary focuses on the contributions of political science to public health and proposes research avenues to increase those contributions. Despite progress, the links between researchers from these two fields develop only slowly. Divergences between the approach of political science to public policy and the expectations that public health can have about the role of political science, are often seen as an obstacle to collaboration between experts in these two areas. Thus, promising and practical research avenues are proposed along with strategies to strengthen and develop them. Considering the interdisciplinary and intersectoral nature of population health, it is important to create a critical mass of researchers interested in the health of populations and in healthy public policy that can thrive working at the junction of political science and public health. © 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.
García, E I; Mira Solves, J J; Guilabert Mora, M
Identifying a minimum set of efficiency indicators calculated from current information sources. Interventions adopted from the analysis of these indicators could contribute to health services sustainability. We applied the discussion group technique. A total of 23 quality coordinators from around the country and the representatives of the regional quality societies in SECA (Spanish Society for Quality in Healthcare) participated. Ten efficiency indicators useful for integrated management areas were identified and accepted, 5 in the area of primary care and 5 for hospital management. The efficiency indicators agreed upon could contribute to the sustainability of the health system without this affecting the quality of care. Copyright © 2014 SECA. Published by Elsevier Espana. All rights reserved.
Lee, Albert; Cheng, Frances F K; Fung, Yanas; St Leger, Lawrence
The Health Promoting School (HPS) is a WHO sponsored framework, compiled to enable education and health sectors to be more effective in school based initiatives. This study attempted to test the hypothesis that students from schools that had comprehensively embraced the HPS concept as indicated by the Healthy School Award, were better, in terms of health risk behaviour, self reported health status, and academic results, than students from schools that did not reach the standard of the award. The results presented came from nine schools (four primary and five secondary) applying for accreditation of the Healthy Schools Award after adopting the HPS framework for two years. Regular consultancy support and training were available to all schools. Students had completed before and after surveys to assess their health behaviours, self reported health status, and academic standing before the two year intervention, and at its end. Data from the before and after surveys of the students attending schools that reached certain level of HPS standard as indicated by the award, were compared with students whose schools did not receive the award, and the results showed differences. Some differences were found to be more significant among the primary school students than secondary schools students. This illustrated early intervention for lifestyle changes to be more effective. Students' satisfaction with life also improved if their schools adopted the concept of HPS comprehensively. The results suggest that comprehensive implementation of HPS would contribute to differences in certain behaviours and self reported health and academic status.
Ana María Molina Gómez; Angelina Roméu Escobar; Miriam Gutiérrez Escobar; María Elinor Dulzaides Iglesias
Background: the cognitive, socio-cultural and communicative language teaching approach reveals the importance of syntactic speech closely related to semantic and pragmatic dimensions and aimed at understanding, analysis and construction of discourse. Objective: to design a didactic strategy that contributes to the development of communicative competence. Methods: pedagogic research on the teaching- learning process of Spanish grammar for first year students of Health Psychology in the Univers...
Social Security Administration — The data store houses detail information pertaining to visitors' wait times, visits, calls, and other customer relationship information relating to VIPR and CHIP....
Full Text Available Abstract Background Sports and arts based services for children have positive impacts on their mental and physical health. The charity sector provides such services, often set up in response to local communities expressing a need. The present study maps resilience promoting services provided by children's charities in England. Specifically, the prominence of sports and arts activities, and types of mental health provisions including telephone help-lines, are investigated. Findings The study was a cross-sectional web-based survey of chief executives, senior mangers, directors and chairs of charities providing services for children under the age of 16. The aims, objectives and activities of participating children's charities and those providing mental health services were described overall. In total 167 chief executives, senior managers, directors and chairs of charities in England agreed to complete the survey. From our sample of charities, arts activities were the most frequently provided services (58/167, 35%, followed by counselling (55/167, 33% and sports activities (36/167, 22%. Only 13% (22/167 of charities expected their work to contribute to the health legacy of the 2012 London Olympics. Telephone help lines were provided by 16% of the charities that promote mental health. Conclusions Counselling and arts activities were relatively common. Sports activities were limited despite the evidence base that sport and physical activity are effective interventions for well-being and health gain. Few of the charities we surveyed expected a health legacy from the 2012 London Olympics.
Bhui, Kamaldeep S; Admasachew, Lul A; Persaud, Albert
Sports and arts based services for children have positive impacts on their mental and physical health. The charity sector provides such services, often set up in response to local communities expressing a need. The present study maps resilience promoting services provided by children's charities in England. Specifically, the prominence of sports and arts activities, and types of mental health provisions including telephone help-lines, are investigated. The study was a cross-sectional web-based survey of chief executives, senior mangers, directors and chairs of charities providing services for children under the age of 16. The aims, objectives and activities of participating children's charities and those providing mental health services were described overall. In total 167 chief executives, senior managers, directors and chairs of charities in England agreed to complete the survey. From our sample of charities, arts activities were the most frequently provided services (58/167, 35%), followed by counselling (55/167, 33%) and sports activities (36/167, 22%). Only 13% (22/167) of charities expected their work to contribute to the health legacy of the 2012 London Olympics. Telephone help lines were provided by 16% of the charities that promote mental health. Counselling and arts activities were relatively common. Sports activities were limited despite the evidence base that sport and physical activity are effective interventions for well-being and health gain. Few of the charities we surveyed expected a health legacy from the 2012 London Olympics.
Schneider, Maria Cristina; Tirado, Maria Cristina; Rereddy, Shruthi; Dugas, Raymond; Borda, Maria Isabel; Peralta, Eduardo Alvarez; Aldighieri, Sylvain; Cosivi, Ottorino
The consequences of natural disasters on the people living in the Americas are often amplified by socio-economic conditions. This risk may be increased by climate-related changes. The public health consequences of natural disasters include fatalities as well as an increased risk of communicable diseases. Many of these diseases are zoonotic and foodborne diseases. The aim of this article is to provide an overview of the importance of natural disasters for the Americas and to emphasise the contribution of veterinary public health (VPH) to the management of zoonotic and foodborne disease risks. An analysis was conducted of natural disasters that occurred in the Americas between 2004 and 2008. Five cases studies illustrating the contributions of VPH in situations of disaster are presented. The data shows that natural disasters, particularly storms and floods, can create very important public health problems. Central America and the Caribbean, particularly Haiti, presented a higher risk than the other areas of the Americas. Two priority areas of technical cooperation are recommended for this region, namely: reducing the risk of leptospirosis and other vector-borne disease outbreaks related to floods and hurricanes and improving food safety. The contribution of different disciplines and sectors in disaster preparedness and response is of paramount importance to minimise morbidity and mortality.
Serafin, Alina; Franklin, Sarah; Mehta, Rashesh; Crosby, Scott; Lee, Diane; Edlin, Becky; Bewick, Bridgette M
Background Smoking is a public health concern and an avoidable cause of morbidity and mortality. Widening tobacco control policies might help shift social norms, the acceptability of exposing others to second-hand smoke, and cultural attitudes towards smoking. This study explored patient, staff, and visitor viewpoints of smoking within the grounds of a National Health Service hospital. Methods Analysis of free text responses given as part of a larger repeat cross sectional questionnaire study...
Muma, John B; Mwacalimba, Kennedy K; Munang'andu, Hetron M; Matope, Gift; Jenkins, Akinbowale; Siamudaala, Victor; Mweene, Aaron S; Marcotty, Tanguy
Few studies have explicitly examined the linkages between human health, animal disease control and poverty alleviation. This paper reviews the contribution that veterinary medicine can make to poverty alleviation in sub-Saharan Africa. Our analysis attempts to explore aspects of this contribution under five themes: food production; food safety; impact and control of zoonotic infections; promotion of ecotourism; and environmental protection. While these areas of human activity have, more or less, fallen under the influence of the veterinary profession to varying degrees, we attempt to unify this mandate using a 'One Health' narrative, for the purpose of providing clarity on the linkages between the veterinary and other professions, livestock production and poverty alleviation. Future opportunities for improving health and reducing poverty in the context of developing African countries are also discussed. We conclude that veterinary science is uniquely positioned to play a key role in both poverty reduction and the promotion of health, a role that can be enhanced through the reorientation of the profession's goals and the creation of synergies with allied and related professions.
John B. Muma
Full Text Available Few studies have explicitly examined the linkages between human health, animal disease control and poverty alleviation. This paper reviews the contribution that veterinary medicine can make to poverty alleviation in sub-Saharan Africa. Our analysis attempts to explore aspects of this contribution under five themes: food production; food safety; impact and control of zoonotic infections; promotion of ecotourism; and environmental protection. While these areas of human activity have, more or less, fallen under the influence of the veterinary profession to varying degrees, we attempt to unify this mandate using a 'One Health' narrative, for the purpose of providing clarity on the linkages between the veterinary and other professions, livestock production and poverty alleviation. Future opportunities for improving health and reducing poverty in the context of developing African countries are also discussed. We conclude that veterinary science is uniquely positioned to play a key role in both poverty reduction and the promotion of health, a role that can be enhanced through the reorientation of the profession's goals and the creation of synergies with allied and related professions.
Research methods from social science, such as social network analysis, random coefficient modeling, and advanced measurement techniques, can contribute much to the health sciences. There is, however, a slow rate of transmission of social science methodology into the health sciences. This paper identifies some of the barriers for adoption and proposes ideas for the future. Commentary. Contributions of social science to the health sciences are not always recognized as such. It may help if the professional profile of social science in the health sciences would be higher and if its focus would be more on making useful predictions. Clinical epidemiologists may assume that their discipline includes all relevant methods and that social science is largely based on qualitative research. These perceptions need to be challenged in order to widen the scope of clinical epidemiology and include relevant methods from other sciences. New methods help to ask new research questions and to provide better to old questions. This paper has sketched challenges for both social science researchers and clinical epidemiologists.
MACHADO, Teresa Robichez
Full Text Available The judicialization of health generates debate in various areas of knowledge, with particular contri-butions from legal experts, doctors, and policymakers. Because of the diversity of those involved, several topics are considered. Some studies highlight positive arguments for the judicialization of health, whereas others defend the need for establishing criteria for or limitations to judicial action. Furthermore, others still report concerns over the possible negative consequences of this process. In order to offer an analysis on this topic, this study provides a review of the literature and adopts the theoretical instrument by Norman Daniels, who proposes a reflection on the needs for health and the ways in which these needs can be met, the moral importance of health and the inequalities in health to be an injustice. In conclusion, it can be affirmed that some of these studies defended in the Brazilian national debate cannot be sustained in light of the data presented herein. Throughout Norman Daniels’ thoughts on the Theory of Justice in terms of questions of health, it can be deduced that, in the Brazilian debate, there are few conflicts over the moral importance of the topic; in addition, not much is known about the second aspect of the theory, which is the reflection when inequality in health can be considered unjust. It is therefore proposed that Daniels’ theory adds two important points to the national debate. The first involves the need to place health problems within a greater reflection in public policy. The second, which involves the need to establish limits to meeting health demands, fits into a public policy that seeks to better meet the needs of the population, which is not a simple cost-benefit assessment.
Infanti, Jennifer J; Lund, Ragnhild; Muzrif, Munas M; Schei, Berit; Wijewardena, Kumudu
Domestic violence in pregnancy is a significant health concern for women around the world. Globally, much has been written about how the health sector can respond effectively and comprehensively to domestic violence during pregnancy via antenatal services. The evidence from low-income settings is, however, limited. Sri Lanka is internationally acknowledged as a model amongst low-income countries for its maternal and child health statistics. Yet, very little research has considered the perspectives and experiences of the key front line health providers for pregnant women in Sri Lanka, public health midwives (PHMs). We address this gap by consulting PHMs about their experiences identifying and responding to pregnant women affected by domestic violence in an underserved area: the tea estate sector of Badulla district. Over two months in late 2014, our interdisciplinary team of social scientists and medical doctors met with 31 estate PHMs for group interviews and a participatory workshop at health clinics across Badulla district. In the paper, we propose a modified livelihoods model to conceptualise the physical, social and symbolic assets, strategies and constraints that simultaneously enable and limit the effectiveness of community-based health care responses to domestic violence. Our findings also highlight conceptual and practical strategies identified by PHMs to ensure improvements in this complex landscape of care. Such strategies include estate-based counselling services; basic training in family counselling and mediation for PHMs; greater surveillance of abusive men's behaviours by male community leaders; and performance evaluation and incentives for work undertaken to respond to domestic violence. The study contributes to international discussions on the meanings, frameworks, and identities constructed at the local levels of health care delivery in the global challenge to end domestic violence. In turn, such knowledge adds to international debates on the roles
Bundhamcharoen, Kanitta; Limwattananon, Supon; Kusreesakul, Khanitta; Tangcharoensathien, Viroj
The Millennium Development Goals (MDGs) triggered increased demand for data on child and maternal mortality for monitoring progress. With the advent of the Sustainable Development Goals (SDGs) and growing evidence of an epidemiological transition towards non-communicable diseases, policy makers need data on mortality and disease trends and distribution to inform effective policies and support monitoring progress. Where there are limited capacities to produce national health estimates (NHEs), global health estimates (GHEs) can fill gaps for global monitoring and comparisons. This paper draws lessons learned from Thailand's burden of disease study (BOD) on capacity development for NHEs, and discusses the contributions and limitation of GHEs in informing policies at country level. Through training and technical support by external partners, capacities are gradually strengthened and institutionalized to enable regular updates of BOD at national and sub-national levels. Initially, the quality of cause of death reporting in the death certificates was inadequate, especially for deaths occurring in the community. Verbal autopsies were conducted, using domestic resources, to determine probable causes of deaths occurring in the community. This helped improve the estimation of years of life lost. Since the achievement of universal health coverage in 2002, the quality of clinical data on morbidities has also considerably improved. There are significant discrepancies between the 2010 Global Burden of Diseases (GBD) estimates for Thailand and the 1999 nationally generated BOD, especially for years of life lost due to HIV/AIDS, and the ranking of priority diseases. National ownership of NHEs and effective interfaces between researchers and decision makers contribute to enhanced country policy responses, while sub-national data are intended to be used by various sub-national-level partners. Though GHEs contribute to benchmarking country achievement compared with global health
Stephen, Craig; Dicicco, Emiliano; Munk, Brandon
Salmon farming is a significant contribution to the global seafood market to which the goal of sustainability is often applied. Diseases related to farms are perhaps the most contentious issues associated with sustainable salmon farming. We reviewed literature and policies in British Columbia, Canada, as well as interviewed key informants to examine how fish health regulations do or could support sustainability goals. We found four main obstacles to the development and application of a sustainability-based health management system. First, salmon farming faced the same challenges as other industries when trying to establish an operational definition of sustainability that captures all stakeholders' interests. Second, there was no program responsible for integrating the various regulations, responsible departments, and monitoring efforts to develop a comprehensive view of sustainability. Third, there was inadequate research base and social consensus on the criteria that should be used to track health outcomes for sustainability purposes. Fourth, the regulatory and management paradigm for salmon farming has been focused on diseases and pathogens as opposed to embracing a more inclusive health promotion model that includes biotic, abiotic, and social determinants of health. A transparent and inclusive participatory process that effectively links expert views with community and industry concerns should serve as the foundation for the next generation of health management regulations for salmon farming.
Bardach, Naomi S; Hibbard, Judith H; Greaves, Felix; Dudley, R Adams
In the context of the Affordable Care Act, there is extensive emphasis on making provider quality transparent and publicly available. Online public reports of quality exist, but little is known about how visitors find reports or about their purpose in visiting. To address this gap, we gathered website analytics data from a national group of online public reports of hospital or physician quality and surveyed real-time visitors to those websites. Websites were recruited from a national group of online public reports of hospital or physician quality. Analytics data were gathered from each website: number of unique visitors, method of arrival for each unique visitor, and search terms resulting in visits. Depending on the website, a survey invitation was launched for unique visitors on landing pages or on pages with quality information. Survey topics included type of respondent (eg, consumer, health care professional), purpose of visit, areas of interest, website experience, and demographics. There were 116,657 unique visitors to the 18 participating websites (1440 unique visitors/month per website), with most unique visitors arriving through search (63.95%, 74,606/116,657). Websites with a higher percent of traffic from search engines garnered more unique visitors (P=.001). The most common search terms were for individual hospitals (23.25%, 27,122/74,606) and website names (19.43%, 22,672/74,606); medical condition terms were uncommon (0.81%, 605/74,606). Survey view rate was 42.48% (49,560/116,657 invited) resulting in 1755 respondents (participation rate=3.6%). There were substantial proportions of consumer (48.43%, 850/1755) and health care professional respondents (31.39%, 551/1755). Across websites, proportions of consumer (21%-71%) and health care professional respondents (16%-48%) varied. Consumers were frequently interested in using the information to choose providers or assess the quality of their provider (52.7%, 225/427); the majority of those choosing a
The OECD Nuclear energy Agency, has, since 1957, been addressing issues in radiological protection through its Committee on Radiation Protection and Public Health (CRPPH). The Committee is made up of regulators and radiation protection experts, with the broad mission to provide timely identification of new and emerging issues, to analyse their possible implications and to recommend or take action to address these issues to further enhance radiation protection regulation and implementation. The regulatory and operational consensus developed by the CRPPH on these emerging issues supports policy and regulation development in Member countries, and disseminates good practice. To best serve the needs of its Member countries, the CRPPH has been focusing its work in recent years on a few key topic areas. These induce the evolution of the system of radiological protection, the advancement of preparedness for nuclear emergency accidents, and the improvement of occupational exposure management at nuclear power plants. With the International Commission on Radiological Protection about to issue new recommendations, due out in 2005, the CRPPH will take advantage of the radiological protection community's recent focus on emerging policy and strategic issues to develop a new CRPPH Collective Opinion. This document, to be published in 2005, will serve the Committee as a guide for its programme of work for the coming 5 to 10 years. (Author) 13 refs
Staff Members, Fellows and Pensioners are reminded that any change in the marital status of members of the personnel, as well as any change in the spouse's income or health insurance cover, shall be notified in writing to CERN, within 30 calendar days of the change, in accordance with Article R IV 1.17 of the Staff Regulations. Such changes may have consequences on the conditions of the spouse's affiliation to the CERN Health Insurance Scheme (CHIS) or on the payment of the supplementary contribution to the CHIS for the coverage of the spouse. In 2003, for the following income brackets, the indexed amounts in Swiss francs of the supplementary contribution are : - more than 30'000 CHF and up to 50'000 CHF: 134.- - more than 50'000 CHF and up to 90'000 CHF: 234.- - more than 90'000 CHF and up to 130'000 CHF: 369.- - more than 130'000 CHF: 468.- It is in the member of the personnel's interest to declare as soon as possible a change in the annual income of his spouse in order that the contribution is adjusted w...
Rob I. Mawby
Full Text Available Tourism has long been recognized as a crime generator. This poses a dilemma in the sustainable development context: is continued tourist expansion sustainable if it generates increased law and order problems? Using the example of Brașov, Romania, this article considers the ways in which criminal justice agencies and the tourism sector have operated in partnership to ensure the security of both local residents and visitors. We argue that the success of the initiative depends on multi-agency working at the local level, but that the involvement of local residents is also crucial. This commitment may be tested as the nature of tourism changes. The research consists of an analysis of primary and secondary data. The results revealed that among the main security issues mentioned by tourists are not only robberies and other social and situational features that contributed to tourists feeling anxious or unsafe, but also the need to have access to good health services and easy access to money changing facilities, information centers, etc. Some improvements are suggested for the local Sustainable Development Strategy of Brașov.
Gumede, Nicksy; Coulibaly, Sheick Oumar; Yahaya, Ali Ahmed; Ndihokubwayo, Jean-Bosco; Nsubuga, Peter; Okeibunor, Joseph; Dosseh, Annick; Salla, Mbaye; Mihigo, Richard; Mkanda, Pascal; Byabamazima, Charles
The laboratory has always played a very critical role in diagnosis of the diseases. The success of any disease programme is based on a functional laboratory network. Health laboratory services are an integral component of the health system. Efficiency and effectiveness of both clinical and public health functions including surveillance, diagnosis, prevention, treatment, research and health promotion are influenced by reliable laboratory services. The establishment of the African Regional polio laboratory for the Polio Eradication Initiative (PEI) has contributed in supporting countries in their efforts to strengthen laboratory capacity. On the eve of the closing of the program, we have shown through this article, examples of this contribution in two countries of the African region: Côte d'Ivoire and the Democratic Republic of Congo. Descriptive studies were carried out in Côte d'Ivoire (RCI) and Democratic Republic of Congo (DRC) from October to December 2014. Questionnaires and self-administered and in-depth interviews and group discussions as well as records and observation were used to collect information during laboratory visits and assessments. The PEI financial support allows to maintain the majority of the 14 (DRC) and 12 (RCI) staff involved in the polio laboratory as full or in part time members. Through laboratory technical staff training supported by the PEI, skills and knowledge were gained to reinforce laboratories capacity and performance in quality laboratory functioning, processes and techniques such as cell culture. In the same way, infrastructure was improved and equipment provided. General laboratory quality standards, including the entire laboratory key elements was improved through the PEI accreditation process. The Polio Eradication Initiative (PEI) is a good example of contribution in strengthening public health laboratories systems in the African region. It has established strong Polio Laboratory network that contributed to the
Ozlem Koroglu; Ozlem Guzel
Undoubtedly, development of sustainable tourism activities is closely related to the protection of natural resources. Protection of natural resources is an important issue that should be taken seriously by the communities. Natural resource management includes sharing all the necessary responsibility for the purpose of protecting natural resources, ensuring the sustainability and leaving it to the next generation. This paper aims to explore the visitor perceptions of tour guides to contribute ...
Mykhalovskiy, Eric; Weir, Lorna
The recent SARS epidemic has renewed widespread concerns about the global transmission of infectious diseases. In this commentary, we explore novel approaches to global infectious disease surveillance through a focus on an important Canadian contribution to the area--the Global Public Health Intelligence Network (GPHIN). GPHIN is a cutting-edge initiative that draws on the capacity of the Internet and newly available 24/7 global news coverage of health events to create a unique form of early warning outbreak detection. This commentary outlines the operation and development of GPHIN and compares it to ProMED-mail, another Internet-based approach to global health surveillance. We argue that GPHIN has created an important shift in the relationship of public health and news information. By exiting the pyramid of official reporting, GPHIN has created a new monitoring technique that has disrupted national boundaries of outbreak notification, while creating new possibilities for global outbreak response. By incorporating news within the emerging apparatus of global infectious disease surveillance, GPHIN has effectively responded to the global media's challenge to official country reporting of outbreak and enhanced the effectiveness and credibility of international public health.
Jinyang Deng; Maureen Young Bender
Previous studies indicate that tourists' destination choices are increasingly influenced by perceptions of sustainability but research into tourists' insights and sensitivities about sustainability is lacking. This study examines how visitors to West Virginia perceive tourism development in the state. Findings indicate that visitors' perceptions are...
Carla Barbieri; Yasuharu Katsube; Christine Tew
Festivals attract a variety of visitors driven by a complex set of motivations. The objective of this study was to identify and classify motivations for attending the South Farm Showcase (SFS), a university-based agricultural festival in Missouri. The study further developed a motivation-based segmentation of festival visitors and examined their distinct...
Stephen F. McCool; Chad P. Dawson
What information is needed to facilitate enhanced management of visitor experiences in wilderness? The final session of the workshop comprised a facilitated process with the 20 participants to identify research and information needs to support wilderness visitor experience management. The Wilderness Act and the previous presentations and discussions not only provided a...
...--Fees and Charges AGENCY: Department of State. ACTION: Final rule. SUMMARY: The Department of State is amending its regulations regarding fees and charges for Exchange Visitor Program services. The fees permit the Department to recoup the cost of providing such Exchange Visitor Program services. DATES...
... DEPARTMENT OF AGRICULTURE Forest Service Information Collection: Grey Towers Visitor Comment Card... request: (1) An extension from the Office of Management and Budget; and (2) to merge the currently approved information collection 0596- 0222, ``Grey Towers Visitor Comment Card'' with 0596-0226, ``Forest...
...] National Fire Academy Board of Visitors AGENCY: Federal Emergency Management Agency, DHS. ACTION: Committee Management; Notice of Open Teleconference Federal Advisory Committee Meeting. SUMMARY: The National Fire Academy Board of Visitors will meet by teleconference on February 2, 2010. DATES: The teleconference will...
...] National Fire Academy Board of Visitors AGENCY: Federal Emergency Management Agency, DHS. ACTION: Notice of cancellation of meeting. SUMMARY: The National Fire Academy Board of Visitors public teleconference [email protected] . SUPPLEMENTARY INFORMATION: The Federal Emergency Management Agency (FEMA) published a Notice...
... to academic affairs; research; future learning and technology; and institutional advancement during... DEPARTMENT OF DEFENSE Department of the Air Force Air University Board of Visitors Meeting ACTION: Notice of meeting of the Air University Board of Visitors. SUMMARY: Under the provisions of the Federal...
... relating to academic affairs; research; future learning and technology; and institutional advancement... DEPARTMENT OF DEFENSE Department of the Air Force Air University Board of Visitors Meeting ACTION: Notice of Meeting of the Air University Board of Visitors. SUMMARY: Under the provisions of the Federal...
...; research; future learning and technology; and institutional advancement. Pursuant to 5 U.S.C. 552b, as... DEPARTMENT OF DEFENSE Department of the Air Force Air University Board of Visitors Meeting ACTION: Notice of Meeting of the Air University Board of Visitors. SUMMARY: Under the provisions of the Federal...
Komatsu, Hiroko; Yagasaki, Kaori; Saito, Yoshinobu; Oguma, Yuko
While community-wide interventions to promote physical activity have been encouraged in older adults, evidence of their effectiveness remains limited. We conducted a qualitative study among older adults participating in regular group exercise to understand their perceptions of the physical, mental, and social changes they underwent as a result of the physical activity. We conducted a qualitative study with purposeful sampling to explore the experiences of older adults who participated in regular group exercise as part of a community-wide physical activity intervention. Four focus group interviews were conducted between April and June of 2016 at community halls in Fujisawa City. The participants in the focus group interviews were 26 older adults with a mean age of 74.69 years (range: 66-86). The interviews were analysed using the constant comparative method in the grounded theory approach. We used qualitative research software NVivo10® to track the coding and manage the data. The finding 'regular group exercise contributes to balanced health in older adults' emerged as an overarching theme with seven categories (regular group exercise, functional health, active mind, enjoyment, social connectedness, mutual support, and expanding communities). Although the participants perceived that they were aging physically and cognitively, the regular group exercise helped them to improve or maintain their functional health and enjoy their lives. They felt socially connected and experienced a sense of security in the community through caring for others and supporting each other. As the older adults began to seek value beyond individuals, they gradually expanded their communities beyond geographical and generational boundaries. The participants achieved balanced health in the physical, mental, and social domains through regular group exercise as part of a community-wide physical activity intervention and contributed to expanding communities through social connectedness and
Staff Members, Fellows and Pensioners are reminded that any change in their marital status, as well as any change in the spouse or registered partner's income or health insurance cover, shall be notified in writing to CERN, within 30 calendar days of the change, in accordance with Articles III 6.01 to 6.03 of the Rules of the CERN Health Insurance Scheme. Such changes may have consequences on the conditions of the spouse or registered partner's affiliation to the CERN Health Insurance Scheme (CHIS) or on the payment of the supplementary contribution to the CHIS for the coverage of the spouse or registered partner. From 1.1.2007, for the following monthly income brackets, the indexed amounts in Swiss francs of the monthly supplementary contribution are: more than 2'500 CHF and up to 4'250 CHF: 134.- more than 4'250 CHF and up to 7'500 CHF: 234.- more than 7'500 CHF and up to 10'000 CHF: 369.- more than 10'000 CHF: 461.- It is in the member of the personnel's interest to declare a change in the annual ...
Daley, Amanda J
Physical inactivity among children is a serious public health problem. It has been suggested that high levels of screen time are contributory factors that encourage sedentary lifestyles in young people. As physical inactivity and obesity levels continue to rise in young people, it has been proposed that new-generation active computer- and video-console games (otherwise known as "exergaming") may offer the opportunity to contribute to young people's energy expenditure during their free time. Although studies have produced some encouraging results regarding the energy costs involved in playing active video-console games, the energy costs of playing the authentic versions of activity-based video games are substantially larger, highlighting that active gaming is no substitute for real sports and activities. A small number of exergaming activities engage children in moderate-intensity activity, but most do not. Only 3 very small trials have considered the effects of exergaming on physical activity levels and/or other health outcomes in children. Evidence from these trials has been mixed; positive trends for improvements in some health outcomes in the intervention groups were noted in 2 trials. No adequately powered randomized, controlled trial has been published to date, and no trial has assessed the long-term impact of exergaming on children's health. We now need high-quality randomized, controlled trials to evaluate the effectiveness and sustainability of exergaming, as well as its clinical relevance; until such studies take place, we should remain cautious about its ability to positively affect children's health.
Chabrol, Henri; Beck, Charline; Laconi, Stéphanie
The Marijuana Motives Measure (MMM), which is derived from a scale measuring alcohol use motives, has been the main instrument used to explore the role of motives in cannabis use and related problems. Two studies attempted to developed specific cannabis use motives but none of them showed a unique association to cannabis use and problems when controlling for MMM motives. The aim of our study was to examine if additional motives contributed to problematic use beyond MMM motives and psychopathological symptoms. Participants were 249 high-school students who completed the Cannabis Use Disorder Identification Test-Revised (CUDIT-R) assessing cannabis use and problematic use, the MMM and a new scale measuring motives derived from clinical experience with adolescents using cannabis (CED motives), and scales measuring anxiety and depressive symptoms and borderline personality traits. Among the 107 participants using cannabis, 39 reached the cut-off score for problematic cannabis use. Hierarchical multiple regression analyses controlling for psychopathological variables showed that only one CED motives, Health (sleep, form, energy, appetite, health), was a significant predictor of both frequency of use and problematic use symptoms. The importance of Health motive may be linked to the role of depressive symptoms and may have implication for treatment. We suggest to add the Health subscale to the MMM and to further study the role of health motive in both use and dependence. Copyright © 2016. Published by Elsevier Ltd.
Skibins, Jeffrey C; Powell, Robert B
Zoos in the 21st century are striving to make effective contributions to conservation. Although zoos are extremely popular and host over 600 million visitors worldwide, one challenge zoos face is how to effectively engage visitors and raise awareness and action for conservation. To this end, zoos commonly rely on charismatic megafauna, which have been shown to elicit a connection with zoo visitors. However, little is known about how to measure a connection to a species or how this connection may influence conservation behaviors. This study had two sequential objectives. The first was to develop a scale to measure visitors' connection to a species (Conservation Caring). The second was to investigate the relationship of Conservation Caring to pro-conservation behaviors, following a zoo experience. Pre- (n = 411) and post-visit (n = 452) responses were collected from three sites in order to assess the reliability and validity of a scale to measure Conservation Caring. Structural equation modeling was used to explore the relationship between Conservation Caring and pro-conservation behaviors. Conservation Caring was deemed a valid and reliable scale and was a strong predictor of species oriented behaviors (β = 0.62), for example, "adopting" an animal, but a weak predictor for biodiversity oriented behaviors (β = 0.07), for example, supporting sustainability policies. Results support the role zoos can play in fostering a connection to wildlife and stimulating pro-conservation behaviors. Additionally, visitors connected to a wide array of animals. On the basis of these results, zoos may recruit a wider assemblage of species as potential flagships. © 2013 Wiley Periodicals, Inc.
Full Text Available Health infrastructure is one of the weaknesses of socio-economic development in Romania and in other European states. In order to get a better picture of the Romanian health system issues, this paper analyzes a number of statistical indicators considered representative for the national and European health infrastructure for a 20 years period, between 1990 and 2010. Our paper has three main objectives: (a to identify the main trends for health infrastructure in some of the European Union countries; (b to describe the evolution of the health system in Romania, the comparative situation at the European level as well as regional level indicators dynamics; (c to overview the Regional Operational Program in Romania, how much does it help the regional health infrastructure in our country. At the European level, there is a constant decrease in the number of hospital beds. For this indicator, Romania has slightly higher values than the European average. We must mention that the hospital beds indicator offers limited information on health infrastructure which also includes medical equipment and specific devices and practices. The number of hospitals in Romania increased with 18.9% during the last 20 years (1990-2010. During the observed timeline, the number of hospitals in Romania had a constant positive evolution at regional level. The number of doctors in hospitals has an increasing trend at the local as well as at the international level. Romania has a number of doctors twice lower than the European average (3.6 doctors for one thousand inhabitants. The Regional Operational Program (ROP has a limited influence in achieving the objectives stated in Applicants Guide for Priority Axis 3. Major Intervention Area 3.1. This happens because supporting infrastructure improvements will not create institutional modernization. The financial contribution through ROP will result in the modernization of 11% of the existing hospitals in Romania.
Jacqueline Silveira de Quadros
Full Text Available Objective: to understand the contributions of obstetrical nursing to health education activities aimed at the parturition process. Methods: qualitative research conducted with ten hospitalized puerperal women who had vaginal delivery in a maternity ward. Results: two categories emerged from the data of this research: Weaknesses of prenatal care for pregnant women and The obstetrical nurse as potentiator of humanized care. Conclusion: obstetrical nursing, through educational work, strives to promote a reframing of the process of parturition, rescuing parturition as a physiological process, and emphasizing the use of natural resources in the evolution of labor and delivery.
Rodríguez, Maribel Blázquez; Gallardo, Eva Bolaños
Medical or Health Anthropology focused on the study of women continues to be a main area of anthropological study in Spain. The contributions of two referential figures in feminist health anthropology, Marcia Inhorn and Mari Luz Esteban, are applied to review the findings of a qualitative research study on the menstrual cycle carried out through 20 interviews with women between the ages of 16 and 44 years, between 2013 and 2014, in the municipality of Madrid. The analysis shows that menstruation is a clear example of the reproductive essentialization of women, of biological reductionism, of the medicalization of women's bodies and, above all, of the standardization of bodies. The visibilization and questioning of these assumptions through the voices of the women interviewed highlight the importance of this field within medical anthropology.
Malmusi, Davide; Vives, Alejandra; Benach, Joan; Borrell, Carme
Women experience poorer health than men despite their longer life expectancy, due to a higher prevalence of non-fatal chronic illnesses. This paper aims to explore whether the unequal gender distribution of roles and resources can account for inequalities in general self-rated health (SRH) by gender, across social classes, in a Southern European population. Cross-sectional study of residents in Catalonia aged 25-64, using data from the 2006 population living conditions survey (n=5,817). Poisson regression models were used to calculate the fair/poor SRH prevalence ratio (PR) by gender and to estimate the contribution of variables assessing several dimensions of living conditions as the reduction in the PR after their inclusion in the model. Analyses were stratified by social class (non-manual and manual). SRH was poorer for women among both non-manual (PR 1.39, 95% CI 1.09-1.76) and manual social classes (PR 1.36, 95% CI 1.20-1.56). Adjustment for individual income alone eliminated the association between sex and SRH, especially among manual classes (PR 1.01, 95% CI 0.85-1.19; among non-manual 1.19, 0.92-1.54). The association was also reduced when adjusting by employment conditions among manual classes, and household material and economic situation, time in household chores and residential environment among non-manual classes. Gender inequalities in individual income appear to contribute largely to women's poorer health. Individual income may indicate the availability of economic resources, but also the history of access to the labour market and potentially the degree of independence and power within the household. Policies to facilitate women's labour market participation, to close the gender pay gap, or to raise non-contributory pensions may be helpful to improve women's health.
William C Cockerham
Full Text Available This paper examines recent trends in theory in health sociology in the United States and finds that the use of theory is flourishing. The central thesis is that the field has reached a mature state and is in the early stage of a paradigm shift away from a past focus on methodological individualism (in which the individual is the primary unit of analysis toward a growing utilization of theories with a structural orientation This outcome is materially aided by research methods (e.g. hierarchal linear modeling, biomarkers providing measures of structural effects on the health of the individual that were often absent or underdeveloped in the past. Structure needs to be accounted for in any social endeavor and contemporary medical sociology appears to be doing precisely that as part of the next stage of its evolution. The recent contributions to theory in the sociology of health discussed in this paper are fundamental cause, medicalization, social capital, neighborhood disadvantage, and health lifestyle theories.
influence their experience of the event. Escapists rated Venues and Shows and Stalls as the most important KSF in managing the festival, whereas Festival Junkies and Culture Seekers rated Safety and Personnel and Shows and Stalls as the most important. The value of the research: This research provides several insights. First, travel motives are a good base or foundation for segmenting visitors to arts festivals. Hence, it is important to have an in-depth understanding of why visitors attend the arts festival and what they expect to experience at the arts festival. Second, this research makes a contribution to the literature around travel motives, market segmentation, festival management and need satisfaction. Finally, the results show that festival organisers cannot base their planning on a general evaluation of visitors, but that different markets have different needs and also regard different factors are important to their overall experience. Conclusion: This research can help festival organisers understand what visitors want to experience at an arts festival and how they want to experience it.
Human Resources Department
Staff Members, Fellows and Pensioners are reminded that any change in the marital status of members of the personnel, as well as any change in the spouse's income or health insurance cover, shall be notified in writing to CERN, within 30 calendar days of the change, in accordance with Article R IV 1.17 of the Staff Regulations. Such changes may have consequences on the conditions of the spouse's affiliation to the CERN Health Insurance Scheme (CHIS) or on the payment of the supplementary contribution to the CHIS for the coverage of the spouse. Changes to the rules and simplification to the system are currently being prepared and should be operational by mid-2005. Meanwhile from 1.1.2005, for the following income brackets, the indexed amounts in Swiss francs of the monthly supplementary contribution are: more than 30'000 CHF and up to 50'000 CHF: 134.- more than 50'000 CHF and up to 90'000 CHF: 234.- more than 90'000 CHF and up to 130'000 CHF: 369.- more than 130'000 CHF: 459.- It is in the member o...
Lina M. Grisales
Full Text Available During the General Assembly of the United Nations, in September 2000,189 countries (including Colombia committed to eight objectives leading to a more human and fairer world. Such objectives are called the Millennium Development Goals (mdg and to achieve them it is crucial to incorporate them in the action agendas of each country. The purpose of this monograph is to recognize current public policies in Colombia and Antioquia leading the achievement of the Millennium Development Goals, specifically those related to the reduction of mortality among children less than 5 years of age, improvement of maternal health and fighting against hiv/aids, malaria and dengue.In Colombia, Conpes 91 of 2005 is the only guideline given by the Government establishing goals and strategies to achieve the Millennium Development Goals in 2015. Nevertheless, other policies, programs and projects before and even after the Millennium Statement (but without explicit purpose contribute to achieving such goals. Revision of those policies is an effort for the research project “Degree of contribution of public policies to the achievement of the Millennium Development Goals related to the health sector, Antioquia, 2006”, which will evaluate the impact these guidelines have had in the achievement of the development goals in that particular sector.
Staff members, fellows and pensioners are reminded that they must notify CERN of any change in their marital status and any change in the income or health insurance cover of their spouse or registered partner, in writing and within 30 calendar days of the change, in accordance with Articles III 6.01 to 6.03 of the Rules of the CERN Health Insurance Scheme (CHIS). Such changes may affect the conditions of the spouse or registered partner’s membership of the CHIS or the payment of the supplementary contribution to the CHIS. For more information see: http://cern.ch/chis/contribsupp.asp From 1.1.2009 onwards, the following indexed monthly supplementary contributions, expressed in Swiss francs, are payable for the various monthly income brackets: •\tmore than 2’500 CHF and up to 4’250 CHF: 134.- •\tmore than 4’250 CHF and up to 7’500 CHF: 234.- •\tmore than 7’500 CHF and up to 10’000 CHF: 369.- •\tmore than 10’000 CHF: 485.- It is in the member of...
Full Text Available Abstract Background Socio-economic status, smoking, and exposure to increased levels of environmental air pollution are associated with adverse effects on respiratory health. We assessed the contribution of occupational exposures, smoking and outdoor air pollution as competing factors for the association between socio-economic status and respiratory health indicators in a cohort of women from the Ruhr area aged 55 at the time of investigation between 1985 and 1990. Methods Data of 1251 women with spirometry and complete questionnaire information about respiratory diseases, smoking and potential confounders were used in the analyses. Exposure to large-scale air pollution was assessed with data from monitoring stations. Exposure to small-scale air pollution was assessed as traffic-related exposure by distance to the nearest major road. Socio-economic status was defined by educational level. Multiple regression models were used to estimate the contribution of occupational exposures, smoking and outdoor air pollution to social differences in respiratory health. Results Women with less than 10 years of school education in comparison to more than 10 years of school education were more often occupationally exposed (16.4% vs. 10.1%, smoked more often (20.3% vs. 13.9%, and lived more often close to major roads (26.0% vs. 22.9%. Long-term exposure to increased levels of PM10 was significantly associated with lower school education. Women with low school education were more likely to suffer from respiratory symptoms and had reduced lung function. In the multivariate analysis the associations between education and respiratory health attenuated after adjusting for occupational exposure, smoking and outdoor air pollution. The crude odds ratio for the association between the lung function indicator FEV1 less than 80% of predicted value and educational level (10 years of school education was 1.83 (95% CI: 1.22–2.74. This changed to 1.56 (95% CI: 1.03–2
Full Text Available Stress activates the hypothalamic-pituitary-adrenal (HPA axis, which then modulates the degree of adaptation and response to a later stressor. It is known that early life stress can impact on later health but less is known about how early life stress impairs HPA axis activity, contributing to maladaptation of the stress response system. Early life stress exposure (either prenatally or in the early postnatal period can impact developmental pathways resulting in lasting structural and regulatory changes that predispose to adulthood disease. Epidemiological, clinical and experimental studies have demonstrated that early life stress produces long-term hyper responsiveness to stress with exaggerated circulating glucocorticoids, and enhanced anxiety and depression-like behaviours. Recently, evidence has emerged on early life stress induced metabolic derangements, for example hyperinsulinemia and altered insulin sensitivity on exposure to a high energy diet later in life. This draws our attention to the contribution of later environment to disease vulnerability. Early life stress can alter the expression of genes in peripheral tissues, such as the glucocorticoid receptor and 11-beta hydroxysteroid dehydrogenase (11β-HSD1. We propose that interactions between altered HPA axis activity and liver 11β-HSD1 modulates both tissue and circulating glucocorticoid availability, with adverse metabolic consequences. This review discusses the potential mechanisms underlying early life stress induced maladaptation of the HPA axis, and its subsequent effects on energy utilisation and expenditure. The effects of positive later environments as a means of ameliorating early life stress induced health deficits, and proposed mechanisms underpinning the interaction between early life stress and subsequent detrimental environmental exposures on metabolic risk will be outlined. Limitations in current methodology linking early life stress and later health outcomes will also
Maniam, Jayanthi; Antoniadis, Christopher; Morris, Margaret J.
Stress activates the hypothalamic–pituitary–adrenal (HPA) axis, which then modulates the degree of adaptation and response to a later stressor. It is known that early-life stress can impact on later health but less is known about how early-life stress impairs HPA axis activity, contributing to maladaptation of the stress–response system. Early-life stress exposure (either prenatally or in the early postnatal period) can impact developmental pathways resulting in lasting structural and regulatory changes that predispose to adulthood disease. Epidemiological, clinical, and experimental studies have demonstrated that early-life stress produces long term hyper-responsiveness to stress with exaggerated circulating glucocorticoids, and enhanced anxiety and depression-like behaviors. Recently, evidence has emerged on early-life stress-induced metabolic derangements, for example hyperinsulinemia and altered insulin sensitivity on exposure to a high energy diet later in life. This draws our attention to the contribution of later environment to disease vulnerability. Early-life stress can alter the expression of genes in peripheral tissues, such as the glucocorticoid receptor and 11-beta hydroxysteroid dehydrogenase (11β-HSD1). We propose that interactions between altered HPA axis activity and liver 11β-HSD1 modulates both tissue and circulating glucocorticoid availability, with adverse metabolic consequences. This review discusses the potential mechanisms underlying early-life stress-induced maladaptation of the HPA axis, and its subsequent effects on energy utilization and expenditure. The effects of positive later environments as a means of ameliorating early-life stress-induced health deficits, and proposed mechanisms underpinning the interaction between early-life stress and subsequent detrimental environmental exposures on metabolic risk will be outlined. Limitations in current methodology linking early-life stress and later health outcomes will also be
Marra Carlo A
Full Text Available Abstract Background Cognition is a multidimensional construct and to our knowledge, no previous studies have examined the independent contribution of specific domains of cognition to health related quality of life. To determine whether executive functions are independently associated with health related quality of life assessed using Quality Adjusted Life Years (QALYs calculated from the EuroQol EQ-5D (EQ-5D in older women after adjusting for known covariates, including global cognition. Therefore, we conducted a secondary analysis of community-dwelling older women aged 65-75 years who participated in a 12-month randomized controlled trial of resistance training. We assessed global cognition using the Mini-Mental State Examination (MMSE and executive functions using the: 1 Stroop Test; 2 Trail Making Test (Part B and 3 Digits Verbal Span Backwards Test. We calculated QALYs from the EQ-5D administered at baseline, 6 months and 12 months. Results Our multivariate linear regression model demonstrated the specific executive processes of set shifting and working memory, as measured by Trail Making Test (Part B and Digits Verbal Span Backward Test (p Conclusions Our study highlights the specific executive processes of set shifting and working memory were independently associated with QALYs -- a measure of health related quality of life. Given that executive functions explain variability in QALYs, clinicians may need to consider assessing executive functions when measuring health related quality of life. Further, the EQ-5D may be used to track changes in health status over time and serve as a screening tool for clinicians. Trial Registration ClinicalTrials.gov Identifier: NCT00426881.
Hegger, Ingrid; Marks, Lisanne K; Janssen, Susan W J; Schuit, Albertine J; van Oers, Hans A M
The Dutch Health Care Performance Report, issued by the National Institute of Public Health and the Environment, aims to monitor health care performance in The Netherlands. Both the National Institute and the Ministry of Health wish to increase the contribution of the Report to health care policy-making. Our aim was to identify ways to achieve that. We used contribution mapping as a theoretical framework that recognizes alignment of research as crucial to managing contributions to policy-making. To investigate which areas need alignment efforts by researchers and/or policy-makers, we interviewed National Institute researchers and policy-makers from the Ministry of Health and assessed the process for developing the 2010 Report. We identified six areas where alignment is specifically relevant for enhancing the contributions of future versions of the Dutch Health Care Performance Report: well-balanced information for different ministerial directorates; backstage work; double role actors; reports of other knowledge institutes; data collection/generation and presentation forms. The contribution of health care performance reporting to policy-making is complex and requires continuous alignment efforts between researchers and policy-makers. These efforts should form an inseparable part of health care performance reporting and although this demands considerable resources, it is worth considering since it may pay back in better contributions to policy-making. © The Author(s) 2015.
Gurpreet Singh Chhabra
Full Text Available Objective: To study the prevalence of psychosocial problems in male adolescents and find out various factors contributing to psycho-social ill health. Methods: 500 adolescents were interviewed using a pre-tested structured questionnaire to elicit the information about the psychosocial problems including depression, suicidal thoughts and suicidal attempts. Association of academic performance, family problems, psychological problems and substance abuse was also included. Results: More than one third (39.6% adolescents were having psychological problems. These problems were significantly higher in middle adolescence (14-16 years, large extended families (> 8 members and lower socioeconomic status. Residence had no significant relation to psychological problems in the adolescents. On correlation, these adolescents with psychological problems were having significantly more academic problems, family disputes, domestic violence, lesser number of close friends and greater substance abuse. Conclusion: Considering that male adolescents from large families with lesser education and lower income had higher prevalence of psychosocial problems, it is essential for health care planners to design comprehensive family and health education programs for the adolescents. The family support, teacher student rapport and peer group communication should be strengthened to counteract unsafe behaviours in the adolescents.
Farmer, Julie; Phillips, Rebecca C; Singhal, Sonica; Quiñonez, Carlos
To quantify the extent to which income and education explain gradients in oral health outcomes. Using data from the Canadian Community Health Survey (CCHS 2003), binary logistic regression models were constructed to examine the relationship between income and education on self-reported oral health (SROH) and chewing difficulties (CD) while controlling for age, sex, ethnicity, employment status and dental insurance coverage. The relative index of inequality (RII) was utilized to quantify the extent to which income and education explain gradients in poor SROH and CD. Income and education gradients were present for SROH and CD. From fully adjusted models, income inequalities were greater for CD (RIIinc = 2.85) than for SROH (RIIinc = 2.75), with no substantial difference in education inequalities between the two. Income explained 37.4% and 42.4% of the education gradient in SROH and CD respectively, whereas education explained 45.2% and 6.1% of income gradients in SROH and CD respectively. Education appears to play a larger role than income when explaining inequalities in SROH; however, it is the opposite for CD. In this sample of the Canadian adult population, income explained over one third of the education gradient in SROH and CDs, whereas the contribution of education to income gradients varied by choice of self-reported outcome. Results call for stakeholders to improve affordability of dental care in order to reduce inequalities in the Canadian population.
The complexities inherent in understanding the social determinants of health are often not well-served by quantitative approaches. My aim is to show that well-designed and well-conducted ethnographic studies have an important contribution to make in this regard. Ethnographic research designs are a difficult but rigorous approach to research questions that require us to understand the complexity of people's social and cultural lives. I draw on an ethnographic study to describe the complexities of studying maternal health in a rural area in India. I then show how the lessons learnt in that setting and context can be applied to studies done in very different settings. I show how ethnographic research depends for rigour on a theoretical framework for sample selection; why immersion in the community under study, and rapport building with research participants, is important to ensure rich and meaningful data; and how flexible approaches to data collection lead to the gradual emergence of an analysis based on intense cross-referencing with community views and thus a conclusion that explains the similarities and differences observed. When using ethnographic research design it can be difficult to specify in advance the exact details of the study design. Researchers can encounter issues in the field that require them to change what they planned on doing. In rigorous ethnographic studies, the researcher in the field is the research instrument and needs to be well trained in the method. Ethnographic research is challenging, but nevertheless provides a rewarding way of researching complex health problems that require an understanding of the social and cultural determinants of health.
Full Text Available The Hackathon concept is attracting interest as a vehicle for participatory development in both Health and Information systems. Publically available datasets, cloud based data storage, and increasingly sophisticated analytical methods, combined with user friendly development tools for mobile devices are inspiring innovation in the participatory medicine space. This has the potential to disrupt traditional methods and deliver solutions more rapidly, and in a form more likely to meet requirements. In health applications this involves putting the patient and their supports at the centre of design. This work contributes to solving the challenges involved in bringing a diverse cohort of designers, developers, problem owners, healthcare providers, patients, and citizens together to solve user-driven self-care problems using technology. We use a descriptive case study approach focussing on two weekend-long hackathons dubbed “Health Hackathon: Solving Self-care”. We gather thick data from multiple sources according to the process defined by Geertz (1994 first, to provide a rich picture of the role of hackathons in participatory medicine and second, to contribute evidence to the practise of running a hackathon. Some key originalities of our work include seeking more candid responses via self-serve interviews. Through this, controversially, we noted a marked emphasis on the creative process over concerns for privacy and ethics around the personal data cloud created by hackathon products. We build on existing theories of participatory medicine and emerging methodologies for conducting hackathons to provide evidence of the efficacy of the hacking approach both in terms of outcome and team dynamics. Through interviews, observation, twitter feeds and a pre-survey, we identify a number of success factors including (1 group size, (2 maturity of the idea, (3 level of involvement of a mentor, and (4 involvement of students. In addition we identify five skills
Joumard-Cubizolles, Laurie; Lee, Jetty Chung-Yung; Vigor, Claire; Leung, Ho Hang; Bertrand-Michel, Justine; Galano, Jean-Marie; Mazur, André; Durand, Thierry; Gladine, Cecile
Omega 3 polyunsaturated fatty acids have been reported to confer beneficial health effects notably in the field of cardiovascular and inflammatory diseases. The current knowledge suggests a significant portion of the effects of omega 3 polyunsaturated fatty acids are mediated by their oxygenated metabolites. This review attempts to cover the current literature about the contribution of specific omega 3 oxygenated metabolites, namely omega 3 isoprostanoids, which are produced through free-radical mediated oxidation. A special emphasis has been given to the most biologically relevant omega 3 polyunsaturated fatty acids namely the α-linolenic, eicosapentaenoic and docosahexaenoic acids. The review includes a comprehensive description of the biosynthetic pathways, a summary of studies related to the biological significance of omega 3 isoprostanoids as well as a critical description of analytical development in the field of omega 3 isoprostanoids profiling in biological samples. Copyright © 2017 Elsevier Inc. All rights reserved.
Saray Sánchez Martínez
Full Text Available A descriptive longitudinal study was made with the aim of designing a system of actions to contribute to the promotion of sexual education in adolescents in Cabaiguan Municipality, period from 2009 until the first half of 2013. Population was constituted by 203 pregnant adolescents who entered into the palace of motherhood, coinciding with the sample. Data were collected in the book of hospital and impact surveys to diagnose the factors that influence in the appearances of teenage pregnancy. Interview was conducted to comprehensively Specialists General Medicine and Obstetrics and Gynecology Specialists know their views and proposals on the subject. As a result of the work it confirms that there are deficiencies in the information that have teenagers about this theme which leads the author to the design of actions for promoting health in the municipality, to improve this situation.
Birnbach, David J; Rosen, Lisa F; Fitzpatrick, Maureen; Arheart, Kristopher L; Munoz-Price, L Silvia
Patients in an intensive care unit (ICU) are frequently immunocompromised and might be highly susceptible to infection. Visitors to an ICU who do not adequately clean their hands could carry pathogenic organisms, resulting in risk to a vulnerable patient population. This observational study identifies pathogens carried on the hands of visitors into an ICU and investigates the effect of hand hygiene. Two observers, one stationed outside and one inside the ICU, evaluated whether visitors performed hand hygiene at any of the wall-mounted alcohol-based hand sanitizer dispensers prior to reaching a patient's room. Upon reaching a patient's room, the dominant hand of all of the participants was cultured. Of the 55 participating visitors, 35 did not disinfect their hands. Among the cultures of those who failed to perform hand hygiene, eight cultures grew Gram-negative rods and one grew methicillin-resistant Staphylococcus aureus. Of the cultures of the 20 individuals who performed hand hygiene, 14 (70%) had no growth on the cultures, and the remaining six (30%) showed only the usual skin flora. The visitors who do not perform hand hygiene might carry pathogens that pose a risk to ICU patients. Copyright © 2015 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.
Kothencz, Gyula; Kolcsár, Ronald; Cabrera-Barona, Pablo; Szilassi, Péter
Individual perceptions are essential when evaluating the well-being benefits from urban green spaces. This study predicted the influence of perceived green space characteristics in the city of Szeged, Hungary, on two well-being variables: the green space visitors' level of satisfaction and the self-reported quality of life. The applied logistic regression analysis used nine predictors: seven perceived green space characteristics from a questionnaire survey among visitors of five urban green spaces of Szeged; and the frequency of green space visitors' crowd-sourced recreational running paths and photographs picturing green space aesthetics. Results revealed that perceived green space characteristics with direct well-being benefits were strong predictors of both dependent variables. Perceived green space characteristics with indirect, yet fundamental, well-being benefits, namely, regulating ecosystem services had minor influence on the dependent variables. The crowd-sourced geo-tagged data predicted only the perceived quality of life contributions; but revealed spatial patterns of recreational green space use and aesthetics. This study recommends that regulating ecosystem services should be planned with a focus on residents' aesthetic and recreational needs. Further research on the combination of green space visitors´ perceptions and crowd-sourced geo-tagged data is suggested to promote planning for well-being and health benefits of urban green spaces.
Ponizovsky, Alexander M; Drannikov, Angela
To examine the individual contributions of insecure attachment styles and depression symptom severity to health-related quality of life (HRQoL) in patients diagnosed with adjustment disorder (AJD) with depressed mood. Participants were 67 patients diagnosed with International Classification of Diseases, Tenth edition AJD with depressed mood, who completed standardised self-report questionnaires measuring study variables. Mean scores and SDs were computed for the outcome and predictor measures. Pearson correlations among the measures were computed. The study hypotheses were tested using analysis of variance (ANOVA) and multiple regression analyses. All analyses were performed using the SPSS-17 software package (SPSS Inc., Chicago, IL, United States). ANOVA showed a significant main effect of the insecure attachment styles on depression symptom severity and life satisfaction scores. The results suggest that depressive symptoms were more severe (F = 4.13, df = 2.67, P insecure groups did not significantly differ by these variables. The anxious/ambivalent attachment style and depression symptom severity significantly contributed to HRQoL, accounting for 21.4% and 29.7% of the total variance, respectively [R(2) = 0.79; Adjusted R(2) = 0.77; F (5, 67) = 33.68, P < 0.0001], even after controlling for gender, marital and employment status confounders. The results show that the anxious/ambivalent attachment style together with depression symptom severity substantially and independently predict the HRQoL outcome in AJD with depressed mood.
... consumers How to be a good visitor during flu season 11/20/2017 Access a printer-friendly ... of infection prevention. This is especially true during flu season. According to the CDC, influenza (the flu) ...
The Mendenhall Glacier Visitor Center of Tongass National Forest in Juneau, Alaska is experiencing vehicular and pedestrian congestion. This study was initiated by the United States Forest Service, Alaska Region, in cooperation with Western Federal L...
Hede, Anne-Marie; Garma, Romana; Josiassen, Alexander
of perceived authenticity, resonating with Bal's (1996) research in this area. Findings also confirm that consumer scepticism and expectations are antecedents to perceived authenticity of the visitor experience in museums, and that perceived authenticity in turn affects visitor satisfaction and perceived...... corporate hypocrisy. Practical implications -This research provides a framework for museums to manage visitors' perceptions of authenticity, and to plan and design exhibits accordingly. Originality/value - Our research, set in the museum context, articulates the basis of perceived authenticity, its....... To investigate authenticity in a model with two antecedents and two outcomes, an additional data set was collected. Hypotheses were tested using structural equation modelling. Findings -The results show that perceived authenticity of the museum, the visitor and the materials in the museum are dimensions...
Full Text Available Museums all over the world appear to be targeting their visitors for resources, thanks to diminishing state support. The purpose of this study is to recognize the profiles and motivations of visitors to museums in Ankara, in order to provide for the development of strategies that will help translate these visits to regular active participation. The results of the study conducted at Ankara’s five principal museums show that these museums play a significant part in education for the visitors. Certain internal and external factors – such as advertising and promotion – are essential to boost museum visits. Study results call attention to external factors in particular, as driving forces for recurrent museum visitors.
We recommend expanding the Hooded Vulture nest monitoring programme to include more pairs. Keywords: Alopochen aegyptiaca, Chacma Baboon, Egyptian Goose, Hooded Vulture, Kruger-to-Canyons Biosphere Region, Martial Eagle, Necrosyrtes monachus, nest visitors, Papio ursinus, Polemaetus bellicosus ...
features, much of the visitors center's electricity comes from photovoltaic (PV) panels on the roof. These solar panels convert sunlight directly into electricity, some of which is stored in batteries. Any
Leung, Y.-F.; Marion, J.L.
Resource and social impacts caused by recreationists and tourists have become a management concern in national parks and equivalent protected areas. The need to contain visitor impacts within acceptable limits has prompted park and protected area managers to implement a wide variety of strategies and actions, many of which are spatial in nature. This paper classifies and illustrates the basic spatial strategies for managing visitor impacts in parks and protected areas. A typology of four spatial strategies was proposed based on the recreation and park management literature. Spatial segregation is a common strategy for shielding sensitive resources from visitor impacts or for separating potentially conflicting types of use. Two forms of spatial segregation are zoning and closure. A spatial containment strategy is intended to minimize the aggregate extent of visitor impacts by confining use to limited designated or established Iocations. In contrast, a spatial dispersal strategy seeks to spread visitor use, reducing the frequency of use to levels that avoid or minimize permanent resource impacts or visitor crowding and conflict. Finally, a spatial configuration strategy minimizes impacting visitor behavior though the judicious spatial arrangement of facilities. These four spatial strategics can be implemented separately or in combination at varying spatial scales within a single park. A survey of national park managers provides an empirical example of the diversity of implemented spatial strategies in managing visitor impacts. Spatial segregation is frequently applied in the form of camping restrictions or closures to protect sensitive natural or cultural resources and to separate incompatible visitor activities. Spatial containment is the most widely applied strategy for minimizing the areal extent of resource impacts. Spatial dispersal is commonly applied to reduce visitor crowding or conflicts in popular destination areas but is less frequently applied or
Liyanage, Sherry; Coca-Stefaniak, Andres; Powell, Raymond
Abstract\\ud \\ud Purpose – Dark tourism and, more specifically, visitor experiences at Nazi concentration camp memorials are emerging fields of research in tourism studies and destination management. This paper builds on this growing body of knowledge and focuses on the World War II Nazi concentration camp at Dachau in Germany to explore the psychological impact of the site on its visitors as well as critical self-reflection processes triggered by this experience.\\ud \\ud Design/methodology/app...
David R. Perkins
Full Text Available Weather events have the potential to greatly impact business operations and profitability, especially in outdoor-oriented economic sectors such as Tourism, Recreation, and Leisure (TRL. Although a substantive body of work focuses on the macroscale impacts of climate change, less is known about how daily weather events influence attendance decisions, particularly relating to the physiological thermal comfort levels of each visitor. To address this imbalance, this paper focuses on ambient thermal environments and visitor behavior at the Phoenix and Atlanta zoos. Daily visitor attendances at each zoo from September 2001 to June 2011, were paired with the Physiologically Equivalent Temperature (PET to help measure the thermal conditions most likely experienced by zoo visitors. PET was calculated using hourly atmospheric variables of temperature, humidity, wind speed, and cloud cover from 7 a.m. to 7 p.m. at each zoological park location and then classified based on thermal comfort categories established by the American Society of Heating and Air Conditioning Engineers (ASHRAE. The major findings suggested that in both Phoenix and Atlanta, optimal thermal regimes for peak attendance occurred within “slightly warm” and “warm” PET-based thermal categories. Additionally, visitors seemed to be averse to the most commonly occurring thermal extreme since visitors appeared to avoid the zoo on excessively hot days in Phoenix and excessively cold days in Atlanta. Finally, changes in the daily weather impacted visitor attendance as both zoos experienced peak attendance on days with dynamic changes in the thermal regimes and depressed attendances on days with stagnant thermal regimes. Building a better understanding of how weather events impact visitor demand can help improve our assessments of the potential impacts future climate change may have on tourism.
Mullens, J.A.; Valentine, T.E.; Mihalczo, J.T.
This report describes a set of NWIS measurements made during demonstrations to Russian visitors on August 28, 1997. These measurements will be given to the Russian visitors from Arzamus-16 as part of their NWIS training (part of a DOE laboratory-to-laboratory exchange program). These measurements are made on standard highly enriched Uranium annular castings (as used for storage). Associated NWIS calibration runs were made in air (no casting, just the NWIS Californium source and detectors)
Harnois, Catherine E; Bastos, João L
This study examines the extent to which discrimination and harassment contribute to gendered health disparities. Analyzing data from the 2006, 2010, and 2014 General Social Surveys ( N = 3,724), we ask the following: (1) To what extent are perceptions of workplace gender discrimination and sexual harassment associated with self-reported mental and physical health? (2) How do multiple forms of workplace mistreatment (e.g., racism, ageism, and sexism) combine to structure workers' self-assessed health? and (3) To what extent do perceptions of mistreatment contribute to the gender gap in self-assessed health? Multivariate analyses show that among women, but not men, perceptions of workplace gender discrimination are negatively associated with poor mental health, and perceptions of sexual harassment are associated with poor physical health. Among men and women, perceptions of multiple forms of mistreatment are associated with worse mental health. Gender discrimination partially explains the gender gap in self-reported mental health.
Versijpt, J.; Dierckx, R.A.; Bondt, P. de [Division of Nuclear Medicine, University Hospital Gent (Belgium); Dierckx, I. [Department of Radiology, St. Elisabeth Hospital Antwerpen (Belgium); Lambrecht, L. [Outpatient Internal Medicine Clinic, Gent (Belgium); Sadeleer, C. de [Division of Nuclear Medicine, University Hospital Gent (Belgium)]|[Department of Nuclear Medicine, O.L.V. Hospital Geraardsbergen (Belgium)
Patients with a suspicion of bone damage following an industrial or traffic accident are often referred for bone scintigraphy as part of an occupational health or medical insurance investigation. The aim of this study was to assess the contribution and the potential role of bone scintigraphy compared with X-ray investigations in the aforementioned situation. To this end we evaluated 70 consecutive patients referred for bone scintigraphy during 1996 and 1997 by occupational health or medical insurance physicians. The most common reasons for referral were the exclusion of occult fractures of hands and feet, whiplash injuries, reflex sympathetic dystrophy or avascular necrosis, or the differentiation between an old and a recent vertebral fracture. X-rays were only available for comparative review of 53 patients, so only those were analysed. The results of bone scintigraphy were compared with X-rays, and their contribution and potential role in occupational health or medical insurance investigations assessed. In 31 out of the 53 patients investigated, bone scintigraphy findings concurred with X-rays as to the number and location of abnormalities. For 19 of the 53 patients, bone scintigraphy showed clinically relevant additional foci when compared with X-rays, predominantly involving lesions to hands/wrists and feet/ankles. Among these 19 patients, scintigraphic diagnoses were subsequently confirmed in ten cases by means of X-ray or computed tomography. In four patients, supplementary radiological investigations revealed no abnormalities, and in five patients no further investigations were undertaken. Finally, in three of the 53 patients, X-rays revealed bone damage (burst fractures) whilst the corresponding bone scintigraphy was negative, thus excluding recent injury. In conclusion, in 22 patients, representing 42% of the cases analysed, bone scintigraphy was conclusive compared with X-ray imaging in the final diagnosis and in this way in detecting occult or excluding
Versijpt, J.; Dierckx, R.A.; Bondt, P. de; Dierckx, I.; Lambrecht, L.; Sadeleer, C. de
Patients with a suspicion of bone damage following an industrial or traffic accident are often referred for bone scintigraphy as part of an occupational health or medical insurance investigation. The aim of this study was to assess the contribution and the potential role of bone scintigraphy compared with X-ray investigations in the aforementioned situation. To this end we evaluated 70 consecutive patients referred for bone scintigraphy during 1996 and 1997 by occupational health or medical insurance physicians. The most common reasons for referral were the exclusion of occult fractures of hands and feet, whiplash injuries, reflex sympathetic dystrophy or avascular necrosis, or the differentiation between an old and a recent vertebral fracture. X-rays were only available for comparative review of 53 patients, so only those were analysed. The results of bone scintigraphy were compared with X-rays, and their contribution and potential role in occupational health or medical insurance investigations assessed. In 31 out of the 53 patients investigated, bone scintigraphy findings concurred with X-rays as to the number and location of abnormalities. For 19 of the 53 patients, bone scintigraphy showed clinically relevant additional foci when compared with X-rays, predominantly involving lesions to hands/wrists and feet/ankles. Among these 19 patients, scintigraphic diagnoses were subsequently confirmed in ten cases by means of X-ray or computed tomography. In four patients, supplementary radiological investigations revealed no abnormalities, and in five patients no further investigations were undertaken. Finally, in three of the 53 patients, X-rays revealed bone damage (burst fractures) whilst the corresponding bone scintigraphy was negative, thus excluding recent injury. In conclusion, in 22 patients, representing 42% of the cases analysed, bone scintigraphy was conclusive compared with X-ray imaging in the final diagnosis and in this way in detecting occult or excluding
Kurtze, Nanna; Eikemo, Terje A; Kamphuis, Carlijn B M
Behavioural, material and psychosocial risk factors may explain educational inequalities in general health. To what extent these risk factors have similar or different contributions to educational inequalities in mental health is unknown. Data were derived from the Norwegian Survey of Level of Living from 2005, comprising 5791 respondents aged ≥ 25 years. The study objectives were addressed by means of a series of logistic regression analyses in which we examined: (i) educational inequalities in self-reported general and mental health; (ii) the associations between behavioural, material and psychosocial risk factors and general and mental health, controlled for sex, age and education; and (iii) the contribution of risk factors to the observed health gradients. The lower educated were more likely to be in poor health [odds ratio (OR): 3.46 (95% confidence interval, CI: 2.84-4.21)] and to be in poor mental health [OR: 1.41 (95% CI: 1.12-1.78)] than the highest educated. The joint contribution of behavioural, material and psychosocial risk factors explained all the variations of mental health inequalities, whereas these were able to explain ~40% of the inequalities in general health. Both behavioural and material risk factors contributed substantially to the explanation of general and mental health inequalities, whereas the psychosocial risk factor (i.e. having close persons to communicate with) only seemed to make a larger difference for the explanation of mental health inequalities. Policies and interventions to reduce health inequalities should have a broad focus. Combined strategies should be applied to improve physical activity, decrease smoking and improve material and psychosocial conditions among lower educated groups, to achieve the true potential of reducing inequalities in both general and mental health.
Ryan, Máirín; Moran, Patrick S; Harrington, Patricia; Murphy, Linda; O'Neill, Michelle; Whelan, Marty; Teljeur, Conor
The aim of this study was to illustrate the contribution of stakeholder engagement to the impact of health technology assessment (HTA) using an Irish HTA of a national public access defibrillation (PAD) program. In response to draft legislation that proposed a PAD program, the Minister for Health requested that Health Information and Quality Authority undertake an HTA to inform the design and implementation of a national PAD program and the necessary underpinning legislation. The draft legislation outlined a program requiring widespread installation and maintenance of automatic external defibrillators in specified premises. Stakeholder engagement to optimize the impact of the HTA included one-to-one interviews with politicians, engagement with an Expert Advisory Group, public and targeted consultation, and positive media management. The HTA quantified the clinical benefits of the proposed PAD program as modest, identified that substantial costs would fall on small/medium businesses at a time of economic recession, and that none of the programs modeled were cost-effective. The Senator who proposed the Bill actively publicized the HTA process and its findings and encouraged participation in the public consultation. Participation of key stakeholders was important for the quality and acceptability of the HTA findings and advice. Media management promoted public engagement and understanding. The Bill did not progress. The HTA informed the decision not to progress with legislation for a national PAD program. Engagement was tailored to ensure that key stakeholders including politicians and the public were informed of the HTA process, the findings, and the advice, thereby maximizing acceptance. Appropriate stakeholder engagement optimizes the impact of HTA.
The capacity to research, develop and manufacture systems that employ components based on nano- and microstructures with biological functionality, and are capable to share, ubiquitously, information is at the forefront of worldwide competition. A new generation of advanced materials, processes and emerging technologies is building up enabling highly integrated, miniaturized and smart micro-nano-bio-systems to be engineered. These fast technology developments are also stimulating the explosive growth in life sciences, which is leading to an ever increasing understanding of life at the sub-cellular and molecular level. By bringing these parallel developments to biomedicine and health, ultrafast and sensitive systems can be developed to prevent illness, to support lifestyle, to make early diagnosis or treat diseases with high accuracy and less invasiveness, and to support body functions or to replace lost functionality. Such systems will enable the delivery of individualized health services with better access and outcomes at lower costs than previously deemed possible, making a substantial contribution to bringing healthcare expenditures under control and increase its productivity. The MNBS (Micro-Nano-Bio Systems) group of EU funded projects aims at speeding up the convergence of micro- and nanotechnology with the life sciences and accelerating the development of highly integrated diagnostic, monitoring and therapeutics devices. This paper presents R&D activities supported through the MNBS group that are relevant to pHealth and discusses directions to be taken in order to overcome the current problems. Finally, it addresses future challenges to build highly integrated and reliable systems including innovation and usability issues.
Davis, S Fowler; Enderby, P; Harrop, D; Hindle, L
The objective was to identify a selection of the best examples of the public health contributions by Allied Health Professionals (AHPs) in order to encourage a wider awareness and participation from that workforce to public health practice. A mapping exercise was used to identify evidence-based interventions that could lead to health improvements across a population. A rapid review was undertaken to identify evidence, followed by a survey of Allied Health Profession (AHP) practitioners and an expert panel consensus method to select the examples of AHP public health interventions. Nine evidence-based interventions are identified and selected as examples of current AHP good practice. These examples represent a contribution to public health and include screening interventions, secondary prevention and risk management. This study contributes to a strategy for AHPs in public health by appraising the effectiveness and impact of some exemplar AHP practices that contribute to health improvement. There is a need for AHPs to measure the impact of their interventions and to demonstrate evidence of outcomes at population level. © The Author 2016. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: email@example.com.
Alan E. Watson; John C. Hendee; Hans P. Zaglauer
A study of visitors to Oregon's Eagle Cap Wilderness in 1965 offered a baseline against which to evaluate how those who recreate in wilderness have changed their views of wilderness. A study of visitors to that same wilderness area in 1993 provided comparative data. Some characteristics of the visitors changed in ways that would suggest that the values visitors...
Junker, Robert R; Höcherl, Nicole; Blüthgen, Nico
1. Network analyses provide insights into the diversity and complexity of ecological interactions and have motivated conclusions about community stability and co-evolution. However, biological traits and mechanisms such as chemical signals regulating the interactions between individual species--the microstructure of a network--are poorly understood. 2. We linked the responses of receivers (flower visitors) towards signals (flower scent) to the structure of a highly diverse natural flower-insect network. For each interaction, we define link temperature--a newly developed metric--as the deviation of the observed interaction strength from neutrality, assuming that animals randomly interact with flowers. 3. Link temperature was positively correlated to the specific visitors' responses to floral scents, experimentally examined in a mobile olfactometer. Thus, communication between plants and consumers via phytochemical signals reflects a significant part of the microstructure in a complex network. Negative as well as positive responses towards floral scents contributed to these results, where individual experience was important apart from innate behaviour. 4. Our results indicate that: (1) biological mechanisms have a profound impact on the microstructure of complex networks that underlies the outcome of aggregate statistics, and (2) floral scents act as a filter, promoting the visitation of some flower visitors, but also inhibiting the visitation of others.
Full Text Available Meat and meat products constitute important source of protein, fat, and several functional compounds. Although beef consumption may implicate possible negative impacts on human health, its consumption can also contribute to human health. Quality traits of beef, as well as its nutritional properties, depend on animal genetics, feeding, livestock practices, and post mortem procedures. Available data show that emerging beef production systems are able to improve both, quality and nutritional traits of beef in a sustainable way. In this context, Argentina’s actions are aimed at maximising beef beneficial effects and minimising its negative impact on human health, in a way of contributing to global food security.
Rusnakova, V; Bacharova, L
Of the study was to contribute to quality improvement initiatives in Slovak health services through systematic approach to the education and training in quality management (QM). Consequently, the main objectives were to analyse the content of the education in QM abroad, to conduct an audit of perceived training needs in Slovakia, and to propose the design of QM training programme to be applied within CME scheme based on the study results. Triangular method in the design of the study was implemented. Review of relevant information, data from the questionnaire and semi-structured interview in the sample of 67 Slovak trainees from Health Management School and School of Public Health--were adopted in complementary fashion. Highlighted in the survey are positive attitudes to training in quality management documented by the median score higher than 6 in all tested areas, on scale 0-10. No significant differences in profession groups as physicians, nurses, HC managers or among training institutions involved were displayed. However, potential obstacles were identified in deeper study using interviews. The absence of knowledge and skills in management in general and in quality management approaches especially are observed. Typically, the role of strategic planning is undermined. The large scale of quality management approaches is converted to problems of accreditation. Barriers to participative culture, innovation, devolution of accountability, resistance to change and to team based management are authentic findings as well. Drawn from the study were related to: fostering managers--"transformational leaders" for locally driven decision making in health care policy and practice; need of training activities for the continuing education in quality with respect to specific target groups interests and their level of knowledge in management; content of training oriented towards combination of rational utilization of information, critical analytical skills and planning for quality
Smith, Lisa; Medves, Jennifer; Harrison, Margaret B; Tranmer, Joan; Waytuck, Brett
Policies concerning restricted or open visiting hours are being challenged in health care institutions internationally, with no apparent consensus on the appropriateness of the visiting hour policies for pediatric and adult patients. The rules that govern practice are often based on the institutional precedent and assumptions of staff, and may have little or no evidence to support them. Policy and practice related to visiting hours is of pressing concern in Canada, and in Ontario specifically, following the reaction to the Severe Acute Respiratory Syndrome (SARS) outbreak in 2003 and subsequent changes in visiting policies in most health care settings. A systematic investigation of the impact of hospital visiting hours on visitors (including patients, families, and significant others) would inform decision-makers who are responsible for hospital policies about the best available evidence. The objective of this review was to appraise and synthesize the best available evidence on the impact of hospital visiting hours on patients and their visitors. Types of participants This review considered studies that included both pediatric and adult hospital patients and their visitors. Participants were either patients, visitors, or health care providers in the following hospital settings: medical/surgical units, critical care (ICU, CCU, NICU), pediatrics, maternity, or general hospital wards.Articles were excluded if participants came from the following settings: post-operative and post-anaesthesia care units (PACU), dementia wards, long-term care settings or retirement homes, or delivery rooms. PACUs were excluded because there are aspects of the presence of visitors to these units that are very specific, and differ from the general visits to patients who are not in the immediate post-operative stage. Dementia wards, long-term care settings and retirement homes were excluded because these were considered to be their "home", so visiting would be quite different from that on
Full Text Available This study aimed to investigate the social representations of professionals included in the team of Family Health Strategy (physicians, nurses and dentists respecting the action possibilities and contributions of the pharmacist for the basic care, and based on social psychology and, particularly, on the theory of social representations. The epistemological basis of the research is qualitative, and the data were collected by means of individual semi-structured interviews, which were submitted to analysis of categorical thematic content. Apparently, the majority of professionals already inserted in the team know and recognize the importance of professional pharmacists in the basic care, as well as their potential contribution to this topic. The representations were constructed according to the following parameters: a the study object and the intervention area, b the individual practice of every professional and c his/her action in specific cases. The quality of the professional or personal experience concerning the action of these professionals has contributed for the knowledge about the possibilities of pharmacists' intervention in basic care.Este estudo teve por objetivo investigar as representações sociais dos profissionais incluídos na equipe de Estratégia em Saúde da Família (médico, enfermeiro e odontólogo, sobre as possibilidades de atuação e as contribuições do farmacêutico na atenção básica, tendo por fundamento a psicologia social e, particularmente, a teoria das representações sociais. A base epistemológica da pesquisa é qualitativa, sendo os dados coletados por meio de entrevistas individuais semi-estruturadas e analisados por meio de análise de conteúdo categorial temático. Constatou-se que a maioria dos profissionais já inseridos na equipe conhece e reconhece a importância do profissional farmacêutico na atenção básica e as suas possibilidades de contribuição. As representações foram construídas a
Silva, R.; West, J. J.; Lamarque, J.; Shindell, D.; Collins, W.; Dalsoren, S. B.; Faluvegi, G. S.; Folberth, G.; Horowitz, L. W.; Nagashima, T.; Naik, V.; Rumbold, S.; Skeie, R.; Sudo, K.; Takemura, T.; Bergmann, D. J.; Cameron-Smith, P. J.; Cionni, I.; Doherty, R. M.; Eyring, V.; Josse, B.; MacKenzie, I. A.; Plummer, D.; Righi, M.; Stevenson, D. S.; Strode, S. A.; Szopa, S.; Zeng, G.
At present, exposure to outdoor air pollution from ozone and fine particulate matter (PM2.5) causes over 2 million deaths per year, due to respiratory and cardiovascular diseases and lung cancer. Future ambient concentrations of ozone and PM2.5 will be affected by both air pollutant emissions and climate change. Here we estimate the potential impact of future outdoor air pollution on premature human mortality, and isolate the contribution of future climate change due to its effect on air quality. We use modeled present-day (2000) and future global ozone and PM2.5 concentrations from simulations with an ensemble of chemistry-climate models from the Atmospheric Chemistry and Climate Model Intercomparison Project (ACCMIP). Future air pollution was modeled for global greenhouse gas and air pollutant emissions in the four IPCC AR5 Representative Concentration Pathway (RCP) scenarios, for 2030, 2050 and 2100. All model outputs are regridded to a common 0.5°x0.5° horizontal resolution. Future premature mortality is estimated for each RCP scenario and year based on changes in concentrations of ozone and PM2.5 relative to 2000. Using a health impact function, changes in concentrations for each RCP scenario are combined with future population and cause-specific baseline mortality rates as projected by a single independent scenario in which the global incidence of cardiopulmonary diseases is expected to increase. The effect of climate change is isolated by considering the difference between air pollutant concentrations from simulations with 2000 emissions and a future year climate and simulations with 2000 emissions and climate. Uncertainties in the results reflect the uncertainty in the concentration-response function and that associated with variability among models. Few previous studies have quantified the effects of future climate change on global human health via changes in air quality, and this is the first such study to use an ensemble of global models.
Rodger, Sylvia; Stephens, Elizabeth; Clark, Michele; Ash, Susan; Graves, Nicholas
Currently in the Australian higher education sector, the productivity benefits of occupational therapy clinical education placements are a contested issue. This article will report results of a study that developed a methodology for documenting time use during placements and investigated the productivity changes associated with occupational therapy clinical education placements in Queensland, Australia. Supervisors' and students' time use during placements and how this changed for supervisors compared to pre- and post-placement is also presented. Using a cohort survey design, participants were students from two Queensland universities, and their supervisors employed by Queensland Health. Time use was recorded in 30 minute blocks according to particular categories. There was a significant increase in supervisors' time spent in patient care activities (F = 94.011(2,12.37 df) , P increasing between pre- and during placement (P = 0.028). There was a significant decrease in supervisors' time spent in placement activities (F = 5.133(2,19.18 df) , P = 0.016) from during to post-placement. Students spent more time than supervisors in patient care activities while on placement. A novel method for reporting productivity and time-use changes during clinical education programs for occupational therapy has been applied. Supervisors spent considerable time in assessing and managing students and their clinical education role should be seen as core business in standard occupational therapy practice. This paper will contribute to future assessments of the economic impact of student placements for allied health disciplines. © 2011 The Authors. Australian Occupational Therapy Journal © 2011 Occupational Therapy Australia.
Roe, Katie; McConney, Andrew; Mansfield, Caroline F.
Modern zoos utilise a variety of education tools for communicating with visitors. Previous research has discussed the benefits of providing multiple education communications, yet little research provides an indication of what communications are being employed within zoos today. This research is a two-phased, mixed-methods investigation into the…
Lindqvist, Olav; Tishelman, Carol
Just as pain medications aim to relieve physical suffering, supportive surrounding for death and dying may facilitate well-being and comfort. However, little has been written of the experience of or preferences for the surroundings in which death and dying take place. In this study, we aim to complement our research from perspectives of patients, family members and staff, with perspectives from an international sample of the general public. Data derives from a project teaming artists and craftspeople together to create prototypes of space for difficult conversations in end-of-life (EoL) settings. These prototypes were presented in a museum exhibition, "Room for Death", in Stockholm in 2012. As project consultants, palliative care researchers contributed a question to the public viewing the exhibition, to explore their reflections: "How would you like it to be around you when you are dying?" Five-hundred and twelve responses were obtained from visitors from 46 countries. While preliminary analysis pointed to many similarities in responses across countries, continued analysis with a phenomenographic approach allowed us to distinguish different foci related to how preferences for surroundings for EoL were conceptualized. Responses were categorized in the following inductively-derived categories: The familiar death, The 'larger-than life' death, The lone death, The mediated death, The calm and peaceful death, The sensuous death, The 'green' death, and The distanced death. The responses could relate to a single category or be composites uniting different categories in individual combinations, and provide insight into different facets of contemporary reflections about death and dying. Despite the selective sample, these data give reason to consider how underlying assumptions and care provision in established forms for end-of-life care may differ from people's preferences. This project can be seen as an example of innovative endeavors to promote public awareness of issues
Flowers, Stephanie A; Ellingrod, Vicki L
The gut microbiome is composed of ~10(13) -10(14) microbial cells and viruses that exist in a symbiotic bidirectional communicative relationship with the host. Bacterial functions in the gut have an important role in healthy host metabolic function, and dysbiosis can contribute to the pathology of many medical conditions. Alterations in the relationship between gut microbiota and host have gained some attention in mental health because new evidence supports the association of gut bacteria to cognitive and emotional processes. Of interest, illnesses such as major depressive disorder are disproportionately prevalent in patients with gastrointestinal illnesses such as inflammatory bowel disease, which pathologically has been strongly linked to microbiome function. Not only is the microbiome associated with the disease itself, but it may also influence the effectiveness or adverse effects associated with pharmacologic agents used to treat these disorders. This field of study may also provide new insights on how dietary agents may help manage mental illness both directly as well as though their influence on the therapeutic and adverse effects of psychotropic agents. © 2015 Pharmacotherapy Publications, Inc.
Forsman, Anna K; Fredén, Lars; Lindqvist, Rafael; Wahlbeck, Kristian
The field of public mental health has been defined by an expert group convened by the Nordic School of Public Health (NHV) as encompassing the experience, occurrence, distribution and trajectories of positive mental health and mental health problems and their determinants; mental health promotion and prevention of mental disorders; as well as mental health system policies, governance and organization. The mental health priorities of the Nordic Council of Ministers in 2010 signalled a mutual Nordic exchange of knowledge in the following thematic areas: child and adolescent mental health; working life and mental health; mental health in older people; strengthening the role of primary care in mental health service provision; stronger involvement of users and carers; and reduction of use of coercion in psychiatric care. Efforts to realize these priorities included commissioning the Nordic Research Academy for Mental Health, an NHV-based network of research institutions with a common interest in mental health research across the Nordic countries, to develop, organize and follow-up projects on public mental health. The research initiatives included mental health policy analysis, register-based research and research focused on the users' perspective in a Nordic context, as well as EU-level research policy analysis. The public mental health research conducted at the NHV highlighted the complexity of mental health and emphasized that the broad determinants of mental health need to be increasingly addressed in both public health research and practice. For example, health promotion actions, improved access to health care, a healthy alcohol policy and prevention of suicides and violence are all needed to reduce the life expectancy gap - a red flag indicator of public health inequalities. By exchanging knowledge and best practice, the collaboration between the Nordic countries contributes to the welfare of the region. The expertise and traditions developed at the NHV are of
Full Text Available In modern tourism, events are of great importance. The increase in the number of events on a global scale has influenced the growth of competitive pressure and the need for a marketing approach in managing event development. Consumer satisfaction (service user is one of the basic elements in managing tourism development generally seen, and thus it is also important to manage and measure the satisfaction of event visitors. The satisfaction of event visitors is important bearing in mind its influence onto passing over positive experience, re-visits and tourism affirmation in areas where the event takes place. The paper analyzes the visitor satisfaction of three most important cultural events in Belgrade-BITEF, Jazz Festival and Belgrade book fair. The focus of the analysis is on visitor satisfaction which is the result of event participation, the contents which the event offers, as well as the following tourism contents of Belgrade, as a tourism destination. The analysis has been conducted based on an empirical research in which 450 participants, event visitors, took part in.
Erickson, Lance K.
The continuing development of exhibits at the Kennedy Space Center's Visitor Complex is an excellent opportunity for NASA personnel to promote science and provide insight into NASA programs and projects for the approximately 3 million visitors that come to KSC annually. Stated goals for the Visitor Complex, in fact, emphasize science awareness and recommend broadening the appeal of the displays and exhibits for all age groups. To this end, this summer project seeks to evaluate the science content of planned exhibits/displays in relation to these developing opportunities and identify specific areas for enhancement of existing or planned exhibits and displays. To help expand the educational and science content within the developing exhibits at the Visitor Complex, this project was structured to implement the goals of the Visitor Center Director. To accomplish this, the exhibits and displays planned for completion within the year underwent review and evaluation for science content and educational direction. Planning emphasis for the individual displays was directed at combining the elements of effective education with fundamental scientific integrity, within an appealing format.
Skydsgaard, Morten Arnika; Andersen, Hanne Møller; King, Heather
This paper explores how four design principles (curiosity, challenge, narratives and participation) facilitate reflection and discussion among young visitors in the issues-based exhibition Dear, Difficult Body. The investigation is based on a mixed-method approach combining questionnaire and inte......This paper explores how four design principles (curiosity, challenge, narratives and participation) facilitate reflection and discussion among young visitors in the issues-based exhibition Dear, Difficult Body. The investigation is based on a mixed-method approach combining questionnaire...... and interview data. The implementation of design principles resulted in a variety of exhibits which variously prompted reflection and discussion on the part of visitors. Exhibits with narratives, for example, here defined as both personal and expert narratives, were found to be effective in facilitating...... personal reflection but also prompted discussion. Participation, defined as including both physical interaction with exhibits, and dialogic interaction between visitors, facilitated the sharing of ideas and feelings between visitors. Exhibits with elements of curiosity and challenge were found to attract...
collectors and liberal arts enthusiasts. Analysis showed that the two hobby classes have distinct profiles including differences in the nature of their knowledge acquisition. Results. Across the two hobby classes, participants can be characterised as special interest museum visitors pursuing a long......-standing interest or hobby. The identified information needs were surprisingly well-defined known item needs and only few exploratory information needs were identified. Participants stressed the importance of personal channels and the social context of the hobby. Conclusions. The present study contributes...
Mans, Linda; van de Pas, Remco; Marschang, Sascha
Background: Following the adoption of the World Health Organization’s Global Code of Practice on the International Recruitment of Health Personnel (WHO Code), eight civil society organizations implemented the European Union (EU) funded project “Health Workers for All and All for Health Workers”
Diamond, Lisa C; Jacobs, Elizabeth A
Clinicians should be educated about how language barriers contribute to disparities for patients with limited English proficiency (LEP). However, educators must avoid developing educational interventions that increase health disparities for LEP patients. For example, studies suggest that teaching "Medical Spanish" or related courses may actually contribute to health care disparities if clinicians begin using these non-English language skills inappropriately with patients. We discuss the risks and benefits of teaching specific cultural competence skills and make evidence-based recommendations for the teaching content and methods for educational interventions focused on overcoming language barriers in health care. At minimum, we suggest such interventions include: (1) the role of language barriers in health disparities, (2) means of overcoming language barriers, (3) how to work with interpreters, (4) identifying and fixing problems in interpreted encounters, and (5) appropriate and safe use of one's own limited non-English language skills.
Sato, T.; Mochizuki, H.
The Rokkasho Visitors Center was built as a base for furthering the understanding of a large number of people, mainly Aomori Prefecture residents, of the Nuclear Fuel Cycle Project. The Center plays a key role in transmitting various information concerning the nuclear fuel cycle. The Visitors Center introduces in a simple manner the role and system of the nuclear fuel cycle by featuring various exhibits using electronics, graphic presentations and actual-size models. It also serves as a forum for communication with local communities and corporations. The Center has already attracted roughly 140 000 visitors in the year since its opening. Thus, it is fulfilling the objectives set in the beginning and giving shape to one form of nuclear energy public relations. (author)
Mygind, Lærke; Bentsen, Peter
The method of timing and tracking has a long history within visitor studies and exhibition evaluation. With an increase in indoor tracking research, sensor-based positioning tool usage in museums has grown, as have expectations regarding the efficacy of technological sensing systems. This literat......The method of timing and tracking has a long history within visitor studies and exhibition evaluation. With an increase in indoor tracking research, sensor-based positioning tool usage in museums has grown, as have expectations regarding the efficacy of technological sensing systems...... methods in terms of obtained level of detail, accuracy, level of obtrusiveness, automation of data entry, ability to time concurrent behaviors, and amount of observer training needed. Although individual sensor-based and traditional, observational methods had both strengths and weaknesses, all sensor......-based timing and tracking methods provided automated data entry and the opportunity to track a number of visitors simultaneously regardless of the available personnel....
Full Text Available The paper presents empirical studies on the appreciation of nature and landscape in the Eastern Ore Mountains (Saxony, Germany by tourism service providers (TSP and visitors. Attractive landscape and experience of nature are the most important reasons to visit this region and to spend leisure time there. Particularly mountain meadows, raised bogs and mixed forests are highly appreciated. Deforestation, industrial development and the decline of biodiversity would reduce attractiveness for visitors. We also assessed whether the tourism sector is prepared to contribute to the funding of nature conservation and landscape management. Use of general tax revenues is favoured, but other modes would also be accepted, e.g. a nature tax. Willingness to pay (WTP is ranging between €0.75 and €1.36 per guest per night by TSP, or between €1.06 and €2.73 per day by visitors. With respect to landscape preference and WTP we found in some cases significant differences among visitors, depending on region of residence, age and education level. A major part of the annual costs for nature conservation and landscape could be covered by public funds (taxes, if the results of the WTP approach were understood as a sign of societal demand and a call to action.
Singham, Timothy; Viding, Essi; Schoeler, Tabea; Arseneault, Louise; Ronald, Angelica; Cecil, Charlotte M; McCrory, Eamon; Rijsdijk, Frülhing; Pingault, Jean-Baptiste
Exposure to bullying is associated with poor mental health. However, the degree to which observed associations reflect direct detrimental contributions of exposure to bullying to mental health remains uncertain, as noncausal relationships may arise from genetic and environmental confounding (eg, preexisting vulnerabilities). Determining to what extent exposure to bullying contributes to mental health is an important concern, with implications for primary and secondary interventions. To characterize the concurrent and longitudinal contribution of exposure to bullying to mental health in childhood and adolescence using a twin differences design to strengthen causal inference. Participants were drawn from the Twins Early Development Study, a population-based cohort recruited from population records of births in England and Wales between January 1, 1994, and December 31, 1996. Data collection took place when the participants were between 11 and 16 years of age from December 1, 2005, to January 31, 2013. Data analysis was conducted from January 1, 2016, to June 20, 2017. Participants completed the Multidimensional Peer-Victimization Scale at 11 and 14 years of age. Mental health assessments at 11 and 16 years of age included anxiety, depression, hyperactivity and impulsivity, inattention, conduct problems, and psychotic-like experiences (eg, paranoid thoughts or cognitive disorganization). The 11 108 twins included in the final sample (5894 girls and 5214 boys) were a mean age of 11.3 years at the first assessment and 16.3 years at the last assessment. The most stringent twin differences estimates (monozygotic) were consistent with causal contribution of exposure to bullying at 11 years to concurrent anxiety, depression, hyperactivity and impulsivity, inattention, and conduct problems. Effects decreased over time; that is, substantial concurrent contributions to anxiety (β = 0.27; 95% CI, 0.22-0.33) persisted for 2 years (β = 0.12; 95% CI, 0.04-0.20) but not
Over the last ten years the possibilities for engaging in dialogue and participation with museum visitors have been greatly improved by developments in digital technologies. Throughout the world museums are experimenting with inclusive and participatory digital projects that can enhance the museum...... visitor experience. Many of these projects are unique and creative in their use of cutting edge technology, and in their search for finding new ways to reach differentiated groups of users. However, building on insights from user studies at a Danish digital museum installation, this paper also suggests...
British Nuclear Fuels plc undertakes a full range of fuel cycle services and is committed to an open-door policy in explaining its operations of the public; for which its Visitor's Centre at Sellafield is the flagship. The existing Centre was opened in 1988 and replaced an earlier, smaller, facility. In total, more than 1 000 000 visitors have been welcomed to Sellafield and the Site is now recognized as the largest tourist attraction in the region. This creates a high level of responsibility to the local area, to which Sellafield responds through its many community and education based projects. (author)
Han, Kimyoung; Cho, Minho; Chun, Kihong
The purpose of this study was to classify determinants of cost increases into two categories, negotiable factors and non-negotiable factors, in order to identify the determinants of health care expenditure increases and to clarify the contribution of associated factors selected based on a literature review. The data in this analysis was from the statistical yearbooks of National Health Insurance Service, the Economic Index from Statistics Korea and regional statistical yearbooks. The unit of analysis was the annual growth rate of variables of 16 cities and provinces from 2003 to 2010. First, multiple regression was used to identify the determinants of health care expenditures. We then used hierarchical multiple regression to calculate the contribution of associated factors. The changes of coefficients (R(2)) of predictors, which were entered into this analysis step by step based on the empirical evidence of the investigator could explain the contribution of predictors to increased medical cost. Health spending was mainly associated with the proportion of the elderly population, but the Medicare Economic Index (MEI) showed an inverse association. The contribution of predictors was as follows: the proportion of elderly in the population (22.4%), gross domestic product (GDP) per capita (4.5%), MEI (-12%), and other predictors (less than 1%). As Baby Boomers enter retirement, an increasing proportion of the population aged 65 and over and the GDP will continue to increase, thus accelerating the inflation of health care expenditures and precipitating a crisis in the health insurance system. Policy makers should consider providing comprehensive health services by an accountable care organization to achieve cost savings while ensuring high-quality care.
This text looks at the difference between sociology in medicine (collaborator of health institutions) and the sociology of medicine (independent of health institutions). If consistent, sociology in medicine should become a sociology of medicine. As an example, it is shown how the study of the social determinants of health and illness begins by assuming non-problematically the ontological reality of health and illness, but ends up problematizing the very concept of health-disease, demonstrating that the study of health determinants also requires the study of the determinants of the social construction of disease. The urgent necessity of objectifying collective health itself is argued. By applying sociological tools we can examine the so-called objective factors in the determination of health and disease, the socially constructed nature of these categories of knowledge, and the struggles and power relations that determine whether or not such categories are viable.
Mikkelsen, Bent Egberg
This case study focuses on school meal provision and its potential contribution to reducing social inequalities in health and improving learning outcomes among children and adolescents, using national approaches to school food services in Denmark and Sweden as examples. It describes the overall s...
Schindler, Holly S.
This study explores the relationship between residential, biological fathers' parental engagement, financial contributions, and psychological well-being in 2-parent families. Specifically, this study focuses on how fathers' parental engagement and financial contributions are related to their self-esteem, self-efficacy, and psychological distress.…
Background The online health care community is not just a place for the public to share physician reviews or medical knowledge, but also a physician-patient communication platform. The medical resources of developing countries are relatively inadequate, and the online health care community is a potential solution to alleviate the phenomenon of long hospital queues and the lack of medical resources in rural areas. However, the success of the online health care community depends on online contributions by physicians. Objective The aim of this study is to examine the effect of incentive mechanisms on physician’s online contribution behavior in the online health community. We addressed the following questions: (1) from which specialty area are physicians more likely to participate in online health care community activities, (2) what are the factors affecting physician online contributions, and (3) do incentive mechanisms, including psychological and material rewards, result in differences of physician online contributions? Methods We designed a longitudinal study involving a data sample in three waves. All data were collected from the Good Doctor website, which is the largest online health care community in China. We first used descriptive statistics to investigate the physician online contribution behavior in its entirety. Then multiple linear and quadratic regression models were applied to verify the causal relationship between rewards and physician online contribution. Results Our sample included 40,300 physicians from 3607 different hospitals, 10 different major specialty areas, and 31 different provinces or municipalities. Based on the multiple quadratic regression model, we found that the coefficients of the control variables, past physician online contributions, doctor review rating, clinic title, hospital level, and city level, were .415, .189, –.099, –.106, and –.143, respectively. For the psychological (or material) rewards, the standardized
Wang, Jying-Nan; Chiu, Ya-Ling; Yu, Haiyan; Hsu, Yuan-Teng
The online health care community is not just a place for the public to share physician reviews or medical knowledge, but also a physician-patient communication platform. The medical resources of developing countries are relatively inadequate, and the online health care community is a potential solution to alleviate the phenomenon of long hospital queues and the lack of medical resources in rural areas. However, the success of the online health care community depends on online contributions by physicians. The aim of this study is to examine the effect of incentive mechanisms on physician's online contribution behavior in the online health community. We addressed the following questions: (1) from which specialty area are physicians more likely to participate in online health care community activities, (2) what are the factors affecting physician online contributions, and (3) do incentive mechanisms, including psychological and material rewards, result in differences of physician online contributions? We designed a longitudinal study involving a data sample in three waves. All data were collected from the Good Doctor website, which is the largest online health care community in China. We first used descriptive statistics to investigate the physician online contribution behavior in its entirety. Then multiple linear and quadratic regression models were applied to verify the causal relationship between rewards and physician online contribution. Our sample included 40,300 physicians from 3607 different hospitals, 10 different major specialty areas, and 31 different provinces or municipalities. Based on the multiple quadratic regression model, we found that the coefficients of the control variables, past physician online contributions, doctor review rating, clinic title, hospital level, and city level, were .415, .189, -.099, -.106, and -.143, respectively. For the psychological (or material) rewards, the standardized coefficient of the main effect was 0.261 (or 0
Shimizu, Helena Eri; Rosales, Carlos
This study aimed to identify and analyze the main primary health care practices developed in the Family Health Care Program. Qualitative case study was carried out in the region of São Sebastião, DF. Data were collected through semi-structured interviews with team workers and observation of the work process. The author concluded that diverse basic practices are developed in primary health care, but others practices focused in health care promotion are necessary in order to transform the health care model.
Do, D Phuong; Finch, Brian Karl; Basurto-Davila, Ricardo; Bird, Chloe; Escarce, Jose; Lurie, Nicole
The persistence of the black health disadvantage has been a puzzling component of health in the United States in spite of general declines in rates of morbidity and mortality over the past century. Studies that have focused on well-established individual-level determinants of health such as socio-economic status and health behaviors have been unable to fully explain these disparities. Recent research has begun to focus on other factors such as racism, discrimination, and segregation. Variation in neighborhood context-socio-demographic composition, social aspects, and built environment-has been postulated as an additional explanation for racial disparities, but few attempts have been made to quantify its overall contribution to the black/white health gap. This analysis is an attempt to generate an estimate of place effects on explaining health disparities by utilizing data from the U.S. National Health Interview Survey (NHIS) (1989-1994), combined with a methodology for identifying residents of the same blocks both within and across NHIS survey cross-sections. Our results indicate that controlling for a single point-in-time measure of residential context results in a roughly 15-76% reduction of the black/white disparities in self-rated health that were previously unaccounted for by individual-level controls. The contribution of residential context toward explaining the black/white self-rated health gap varies by both age and gender such that contextual explanations of disparities decline with age and appear to be smaller among females.
De Silva, M J
There have been repeated calls to include mental health in the sustainable development goals (SDGs), arguing that progress in development will not be made without improvements in mental health. Although these calls are starting to gain political traction, currently only a tiny fraction of international development work includes mental health. A social determinants framework may be useful in incorporating mental health into sustainable development because it promotes a multi-sectorial and multi-disciplinary approach which is the corner stone of good development practice. Two approaches are suggested to make mental health a part of sustainable development: (1) integrate mental health into existing development programmes to promote social and economic environments that prevent mental health problems developing; (2) ensure that mental health programmes are better at promoting sustainable development by preventing the negative social and economic consequences of mental illness. Real-world examples of these approaches are provided. To achieve this, the mental health impact of wider development programmes, and the social and economic consequences of mental health interventions, must be evaluated. Development agencies should ensure that they have equity for mental health in all their policies, and investment must be increased for those mental health prevention, promotion and treatment programmes which have the greatest impact on sustainable development. The SDGs bring the promise of a more holistic approach to development. It is now the task of global mental health to demonstrate not just that mental health is an integral part of sustainable development, but that affordable and effective solutions exist which can improve mental health and development more broadly.
Giri, Aditi; Khatiwada, Prashant; Shrestha, Bikram; Chettri, Radheshyam Khatri
Almost 50% of the Nepali health budget is made up of international aid. International Non-Governmental Organizations working in the field of health are able to channel their funds directly to grass root level. During a 2010 conference, the Secretary of Population stated that the government has full knowledge and control over all funds and projects coming to Nepal. However, there are no documents to support this. The study aims to assess government and partner perceptions on whether Government of Nepal currently has full knowledge of contributions of international aid organizations and International Non-Governmental Organizations to health in Nepal and to assess if the government is able to control all foreign contributions to fit the objectives of Second Long Term Health Plan (1997-2017). A qualitative study was performed along with available literature review. Judgmental and snowball sampling led to 26 in depth interviews with key informants from the government, External Development Partners and International Non-Governmental Organizations. Results were triangulated based on source of data. Representatives of the Department of Health Services declined to be interviewed. Data collection was done until researchers felt data saturation had been reached with each group of key informants. While Ministry of Health and Population leads the sector wide approach that aims to integrate all donor and International Non-Governmental Organization contributions to health and direct them to the government's priority areas, questions were raised around its capacity to do so. Similarly, informants questioned the extent to which Social Welfare Council was able to control all International Non-Governmental Organizations contributions. Political tumult, corruption in the government, lack of human resources in the government, lack of coordination between government bodies, convoluted bureaucracy, and unreliability of donor and International Non-Governmental Organization contributions
Temesgen, Tedla Mulatu; Umer, Jemal Yousuf; Buda, Dawit Seyoum; Haregu, Tilahun Nigatu
Traditional birth attendants (TBAs) have been a subject of discussion in the provision of maternal and newborn health care. The objective of this study was to assess the role of trained traditional birth attendants in maternal and newborn health care in Afar Regional State of Ethiopia. A qualitative study was used where 21 in-depth interviews and 6 focus group discussions were conducted with health service providers, trained traditional birth attendants, mothers, men, kebele leaders and district health personnel. The findings of this study indicate that trained traditional birth attendants are the backbone of the maternal and child health development in pastoralist communities. However, the current numbers are inadequate and cannot meet the needs of the pastoralist communities including antenatal care, delivery, postnatal care and family planning. In addition to service delivery, all respondents agreed on multiple contributions of trained TBAs, which include counselling, child care, immunisation, postnatal care, detection of complication and other social services. Without deployment of adequate numbers of trained health workers for delivery services, trained traditional birth attendants remain vital for the rural community in need of maternal and child health care services. With close supportive supervision and evaluation of the trainings, the TBAs can greatly contribute to decreasing maternal and newborn mortality rates.
Firgo, Matthias; Fritz, Oliver
This paper is the first to apply an econometric shift-share model to tourism. The approach allows us to isolate the growth contributions of changes in regional touristic attractiveness from those induced by the structure of visitors, but does not share the caveats of the conventional shift-share approach. Our application to regional tourism in Austria reveals important results: First, differences in long-run performance between regions are mostly related to idiosyncratic changes in the touris...
The introduction of technically-advanced imaging systems in medicine carries with it potential health hazards, particularly from ionizing and nonionizing radiation exposure of human populations. This paper will discuss what we know and what we do not know about the health effects of low-level radiation, how the risks of radiation-induced health effects may be estimated, the sources of the scientific data, the dose-response models used, the uncertainties which limit precision of estimation of excess health risks from low-level radiation, and what the implications might be for radiation protection in medicine and public health policy
Kristensen, Ingeborg Hedegaard; Simonsen, Marianne; Trillingsgaard, Tea
-infant relations, and there was no significant difference between the two groups according to intentions, self-efficacy, age, years educated and working part or full time. Certificated Marte Meo-therapists had significantly higher skills assessing mother- infant interactions and they scored significantly higher...... high intention and self-efficacy to work with parent-infant relation, professionals certified as Marte Meo-therapists are 8-12% superior in terms of observation skills and knowledge. Further research is needed to determinate whether the level of knowledge and observation skills is associated...
Gerstl, Sibylle; Sauter, Justin; Kasanda, Joseph; Kinzelbach, Alfred
The Democratic Republic of the Congo is today one of the poorest countries in the world; the health status of the population ranks among the worst in Sub-Saharan Africa. Public health services charge user fees and drug prices. Since 2008, north-eastern Congo is facing a guerrilla war. Malteser International is assisting with free health care for internally displaced persons as well as the general population. Before the incursion the health system was based on user fees. The aim of this study was to determine the socio-economic conditions of the population and to assess their ability to contribute to health care. Heads of 552 randomly selected households in 23 clusters in two health zones were interviewed using a standardised questionnaire. The demographic description and socio-economic conditions of the study population were homogenous. Major source of income was agriculture (57%); 47% of the households earned less than US$ 5.5/week. Ninety-two percent of the interviewed households estimated that they would be able to contribute to consultation fees (maximum amount of US$ 0.27) and 79% to the drug prices (maximum amount of US$ 1.10). Six percent opted for free consultations and 19% for free drugs. Living conditions were very basic; the estimated income of the study population was low. Almost half of the population perceived their current living situation as fairly good/good. More than 90% of the study population estimated to be able to contribute to consultation fees and 80% to drug prices. As a result Malteser International suggested introducing flat-rates for health care services. Once the project ends, the population will have to pay again for their health service. One solution would be the introduction of a health care financing system with the goal to reach universal coverage to health care.
Full Text Available INTRODUCTION: The Democratic Republic of the Congo is today one of the poorest countries in the world; the health status of the population ranks among the worst in Sub-Saharan Africa. Public health services charge user fees and drug prices. Since 2008, north-eastern Congo is facing a guerrilla war. Malteser International is assisting with free health care for internally displaced persons as well as the general population. Before the incursion the health system was based on user fees. The aim of this study was to determine the socio-economic conditions of the population and to assess their ability to contribute to health care. METHODOLOGY: Heads of 552 randomly selected households in 23 clusters in two health zones were interviewed using a standardised questionnaire. FINDINGS: The demographic description and socio-economic conditions of the study population were homogenous. Major source of income was agriculture (57%; 47% of the households earned less than US$ 5.5/week. Ninety-two percent of the interviewed households estimated that they would be able to contribute to consultation fees (maximum amount of US$ 0.27 and 79% to the drug prices (maximum amount of US$ 1.10. Six percent opted for free consultations and 19% for free drugs. CONCLUSIONS: Living conditions were very basic; the estimated income of the study population was low. Almost half of the population perceived their current living situation as fairly good/good. More than 90% of the study population estimated to be able to contribute to consultation fees and 80% to drug prices. As a result Malteser International suggested introducing flat-rates for health care services. Once the project ends, the population will have to pay again for their health service. One solution would be the introduction of a health care financing system with the goal to reach universal coverage to health care.
Кира Владимировна Богатырева
Full Text Available The article discusses the activities of one of the founders of the national healthcare in the field of children’s health in the 1910-1920s - Zinoviy Petrovich Solovyov. The beginning of his work in the field of child health care has been initiated in the 1900s by the analysis of the summer day nursery shelters organization for peasant children. After the October revolution Z.P. Soloviev, being a staunch Bolshevik, begins to work in the field of the health care system construction of the country. Such principles as public good nature of health care, participation of population in health care, unity of medical science and health care practice were introduced in the Soviet public health care by his direct participation. When getting real mechanisms for people health improving in the country, Soloviev has been working on implementation of the concept of prevention in the nascent Soviet medicine. The last major achievement and the most important thing in his life Z.P. Soloviev considered the most famous organization of health camp of the Soviet Union, “Artek”. Thus, Z.P. Soloviev, being a country doctor and a public health statistician in pre-revolutionary time, worked on the problem of child health as a Deputy in the people's Commissariat of Soviet Russia throughout of his professional career. Currently, in a period of rethinking of the historical process of the health care system creation in the Russian Federation, the analysis of its founders activities, in particular, Z.P. Soloviev is relevant. The consistent work in the field of chidhood diseases prevention and child health care improoving in general are shown on the materials of Zinoviy Petrovich Soloviev publications аnd archival data.
Skov, Mette; Ingwersen, Peter
content analysis. It was found that metadata elements on factual object related information, provenience, and historic context was indicated to be relevant by the majority of the respondents, characterising the group of special interest museum visitors as information hungry. Further, four main...
Basballe, Ditte Amund; Halskov, Kim
Using animation, text, and visual effects as elements of projections on the Danish rune stone, Mejlbystenen (the Mejlby stone), we have explored approaches to engaging museum visitors. The installation positions itself in the field of previous installations and experiments exploring projection on...
Mae A. Davenport; Wayne A. Freimund; William T. Borrie; Robert E. Manning; William A. Valliere; Benjamin Wang
This research was designed to assist the managers of Yellowstone National Park (YNP) in their decision making about winter visitation. The focus of this report is on winter use patterns and winter visitor preferences. It is the authorâs hope that this information will benefit both the quality of winter experiences and the stewardship of the park resources. This report...
Ryan N.K. Brown; Randall S. Rosenberger; Jeffrey D. Kline; Troy E. Hall; Mark D. Needham
The 2003 Bear Butte and Booth (B&B) Fires burned much of the Mount Jefferson Wilderness in the Deschutes and Willamette National Forests, Oregon. A question for managers is how best to manage recreation in fire-affected areas in ways that minimize adverse impacts on visitor experiences and the recovering landscape. To help address this question, we used onsite...
William Gravley; John Dengler; Roy Ramthun; Chad Pierskalla
This study was a preliminary examination of the activity and spending behavior of visitors to Pipestem State Park in West Virginia. This state park is being used as a case study area to determine whether a new fish stocking program accompanied by appropriate marketing activities can increase park visitation by anglers and other sports-oriented people. The research was...
Daniel R. Williams
A core task of recreation research is to understand the relation between settings, scenery, and visitor experiences. This paper uses environmental psychology to describe four conceptual models underlying these relations: inherent/aesthetic, opportunity/goal-directed, symbolic, and expressive. The paper then describes some challenges to applying results to recreation...
... Section 36.37 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE, DEPARTMENT OF THE INTERIOR... compensation to persons who visit a refuge, including such services as providing food, accommodations... equal and are not additive. (2) In selecting persons to provide any type of visitor service for refuges...
Full Text Available Ananas comosus var comosus (L. Merr. is the third most important tropical fruit in the world production and the leading foreign exchange earner among fresh fruits exported from Ghana. A survey was conducted in pineapple farms in the Central region of Ghana to identify floral visitors and their activities on the flowers. Nectar concentration and energetics and effect of floral visitors on fruit production were determined. Fourteen species of butterflies and one ant species were the main insect floral visitors as well as four species of sunbirds. The mean nectar concentration was 23.3% (± 0.39, SE and pollination limitation did not significantly affect fruit yield (weight: p = 0.285; length: p = 0.056; width: p= 0.268. The study showed that butterflies, ants and sunbirds are the main floral visitors on A. comosus. However their visits did not results in pollination and fruit production was not affected in any way by floral visitation. Still, it was found that A. comosus provides an important nectar resource for its foragers. Even if pollination is not crucial in pineapple cultivation, it is still essential in pineapple breeding programs to promote genetic diversity and conservation.
Robinson, Lily Beatrice
Guided tours, field trips, and other non-formal learning experiences occur in a variety of settings such as museums, parks, civic buildings, and architectural landmarks for the purpose of educating the public. This study yielded four main findings. (1) Program educational goals were visitor awareness, positive affective experience, and advocacy.…
Hawaii State Commission on Manpower and Full Employment, Honolulu.
This report was undertaken in response to a request by the Sixth Legislature, which expressed its concern with the lack of coordination and overall human resource planning in the visitor industry and that the findings of the January 6-7, 1970 Travel Industry Congress had not been fully implemented. The State Commission on Manpower and Full…
Kartina Diah Kesuma Wardhani
Full Text Available E-commerce click stream data can form a certain pattern that describe visitor behavior while surfing the e-commerce website. This pattern can be used to initiate a design to determine alternative access sequence on the website. This research use heuristic miner algorithm to determine the pattern. σ-Algorithm and Genetic Mining are methods used for pattern recognition with frequent sequence item set approach. Heuristic Miner is an evolved form of those methods. σ-Algorithm assume that an activity in a website, that has been recorded in the data log, is a complete sequence from start to finish, without any tolerance to incomplete data or data with noise. On the other hand, Genetic Mining is a method that tolerate incomplete data or data with noise, so it can generate a more detailed e-commerce visitor access pattern. In this study, the same sequence of events obtained from six-generated patterns. The resulting pattern of visitor access is that visitors are often access the home page and then the product category page or the home page and then the full text search page.
C. Li; H.C. Zinn; G.E. Chick; J.D. Absher; A.R. Graefe; Y. Hsu
The purpose of this study was to examine the potential utility of HOFSTEDEâs measure of cultural values (1980) for group segmentation in an ethnically diverse population in a forest recreation context, and to validate the values segmentation, if any, via socio-demographic and service quality related variables. In 2002, the visitors to the Angeles National Forest (ANF)...
Cammeral Geide; Laurie Harmon; Robert Baker
The wine industry is a rapidly growing sector of Virginia's economy, yet little research has been done on this topic. The purpose of this study was to obtain a better understanding of northern Virginia winery visitors' motivations to help winery operators better focus their marketing efforts. This exploratory research project collected basic information about...
Orellana, D.A.; Bregt, A.K.; Ligtenberg, A.; Wachowicz, M.
GPS technology is widely used to produce detailed data on the movement of people. Analysing massive amounts of GPS data, however, can be cumbersome. We present a novel approach to processing such data to aid interpretation and understanding of the aggregated movement of visitors in natural
Lyon, K.; Cottrell, S.P.; Siikamaki, P.; Marwijk, van R.B.M.
Oulanka National Park, Finland aims to ensure nature conservation while providing high quality visitor experiences. The growth of outdoor recreation and nature tourism, however, has fueled concern about consequent pressures on the natural resources of the park. This analysis assessed the spatial
Apr 20, 2018 ... zoos shows their willingness to pay for conservation services at the zoos. Income (r = 0.25, p ... Therefore, to address the gap, the objective of this study is to ..... and gender had significant relationship with visitors. WTP. This is ...
Donald B.K. English; Susan M. Kocis; Stanley J. Zarnoch; J. Ross Arnold
In response to the need for improved information on recreational use of National Forest System lands, the authors have developed a nationwide, systematic monitoring process. This report documents the methods they used in estimating recreational use on an annual basis. The basic unit of measure is exiting volume of visitors from a recreation site on a given day. Sites...
...] National Fire Academy Board of Visitors AGENCY: Federal Emergency Management Agency, DHS. ACTION: Committee Management; Notice of Federal Advisory Committee meeting. SUMMARY: On Tuesday, March 29, 2011, the Federal Emergency Management Agency (FEMA) announced in the Federal Register at 76 FR 17425 that the National Fire...
...] National Fire Academy Board of Visitors AGENCY: Federal Emergency Management Agency, DHS. ACTION: Committee Management; Notice of Open Federal Advisory Committee Meeting. SUMMARY: The National Fire Academy Board of... the docket to read background documents or comments received by the National Fire Academy Board of...
Oluoha, Chukwuemeka; Ahaneku, Hycienth
The vision of Nigeria’s immunization program is to reach and sustain routine immunization coverage of greater than 90% for all vaccines by 2020. In order to achieve this, Abia state embarked on a unique private-public partnership (PPP) between private health facilities and the Abia state ministry of health. The aim of this partnership was to collaborate with private health facilities to provide free childhood immunization services in the state - the first of its kind in Nigeria. This is a retrospective study of the 2011 Abia state, Nigeria monthly immunization data. In the 4 local governments operating the PPP, 45% (79/175) of the health facilities that offered immunization services in 2011 were private health facilities and 55% (96/175) were public health facilities. However, 21% of the immunization services took place in private health facilities while 79% took place in public health facilities. Private health facilities were shown to have a modest contribution to immunization in the 4 local governments involved in the PPP. Efforts should be made to expand PPP in immunization nationally to improve immunization services in Nigeria. PMID:28299112
Nguyen, Ha; Snider, Jeremy; Ravishankar, Nirmala; Magvanjav, Oyunbileg
The present study provides evidence to support enhanced attention to reproductive health and comprehensive measures to increase access to quality reproductive health services. We compare and contrast the financing and utilization of reproductive health services in six sub-Saharan African countries using data from National Health Accounts and Demographic and Health Surveys. Spending on reproductive health in 2006 ranged from US$4 per woman of reproductive age in Ethiopia to US$17 in Uganda. These are below the necessary level for assuring adequate services given that an internationally recommended spending level for family planning alone was US$16 for 2006. Moreover, reproductive health spending shows signs of decline in tandem with insufficient improvement in service utilization. Public providers played a predominant role in antenatal and delivery care for institutional births, but home deliveries with unqualified attendants dominated. The private sector was a major supplier of condoms, oral pills and IUDs. Private clinics, pharmacies and drug vendors were important sources of STI treatment. The findings highlight the need to commit greatly increased funding for reproductive health services as well as more policy attention to the contribution of public, private and informal providers and the role of collaboration among them to expand access to services for under-served populations. Copyright © 2011 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.
Davies, Sara E
This article presents two approaches that have dominated International Relations in their approach to the international politics of health. The statist approach, which is primarily security-focused, seeks to link health initiatives to a foreign or defence policy remit. The globalist approach, in contrast, seeks to advance health not because of its intrinsic security value but because it advances the well-being and rights of individuals. This article charts the evolution of these approaches and demonstrates why both have the potential to shape our understanding of the evolving global health agenda. It examines how the statist and globalist perspectives have helped shape contemporary initiatives in global health governance and suggests that there is evidence of an emerging convergence between the two perspectives. This convergence is particularly clear in the articulation of a number of UN initiatives in this area - especially the One World, One Health Strategic Framework and the Oslo Ministerial Declaration (2007) which inspired the first UN General Assembly resolution on global health and foreign policy in 2009 and the UN Secretary-General's note "Global health and foreign policy: strategic opportunities and challenges". What remains to be seen is whether this convergence will deliver on securing states' interest long enough to promote the interests of the individuals who require global efforts to deliver local health improvements.
Reis, Juliana Gonçalves; Kobayashi, Keilla Miki; Ueno, Helene Mariko; Ribeiro, Cristiane Martins; Cardoso, Telma Abdalla de Oliveira
To analyze the main characteristics of the scientific production of Oswaldo Paulo Forattini, researcher and, for 40 years, editor of Revista de Saúde Pública. Descriptive study with bibliometric approach conducted in three steps. (1) identification of bibliographic records using the following search strategy: "Oswaldo Paulo Forattini" OR "Forattini OP" OR "Forattini" up information sources Google Scholar, Web of Science, and PubMed, in July 2016, which retrieved 867 records. (2) composition of research corpus, in which we included 351 bibliographic records of articles, books, book chapters, editorials, book reviews, informative notes and annual reports of the RSP and excluded 516 duplicates and acknowledgement notes, obituary notes, and nonretrievable citations. (3) data organization and analysis, in which we built databases for descriptive analysis and development of the MeSH coauthors and terms networks in VOSviewer software. For analysis of editorials, three reviewers read the full text of each editorial and categorized them according to subject, historical context and perspectives, relating them with historical milestones. Forattini's scientific production occurred from 1946 to 2009, most consisting of articles (n = 218; 62.1%), editorials (n = 43; 12.3%), and books (n = 13; 3.7%). The main subjects were Culicidae (36.8%), Triatominae (12.5%), and Epidemiology (10.0%). The coauthors of articles were his professors, colleagues of his generation, and graduate students. His editorials addressed critical reflections on the production of knowledge, research priorities, and factors that contributed to or hindered progress. The scope of subjects is broad, referring to socioeconomic and scientific development, public health issues in developed countries, or global health. The analysis shows Forattini's commitment with public health, research with vectors, training of researchers, and scientific communication. Analisar as principais características da produ
Frost, David M; LeBlanc, Allen J
This study examined the role of nonevent stress--in the form of frustrated personal project pursuits in the arenas of relationships and work--as a contributing factor to mental health disparities between heterosexual and lesbian, gay, and bisexual (LGB) populations. A purposive sample of 431 LGB (55%) and heterosexually identified (45%) individuals living in the United States and Canada completed the Personal Project Inventory by describing and rating core personal projects they were pursuing. The intensity of perceived barriers to the achievement of relationship- and work-related personal projects served as indicators nonevent stress. Hierarchical linear regression models tested the hypothesis that nonevent stress contributes to the association between sexual orientation and two indicators of mental health: depressive symptoms and psychological well-being. LGB individuals had significantly more depressive symptoms and lower levels of psychological well-being than heterosexuals. Indicators of nonevent stress were significantly associated with mental health outcomes and their inclusion in models attenuated sexual orientation differences in mental health. The critical indirect pathway leading from sexual minority status to mental health occurred via barriers to relationship projects from interpersonal sources. This research suggests that nonevent stress because of structural and interpersonal stigma may contribute to mental health disparities between LGB and heterosexual individuals. The findings have important implications for policy reform around same-sex relationship recognition and workplace discrimination. Future research and clinical work will benefit by expanding existing foci on stress to include nonevent stressors to better understand and address mental health problems, particularly in LGB populations.
... DEPARTMENT OF DEFENSE Office of the Secretary Defense Intelligence Agency National Intelligence University Board of Visitors Closed Meeting AGENCY: National Intelligence University, Defense Intelligence... hereby given that a closed meeting of the National Intelligence University Board of Visitors has been...
Gabriela Guedes de Sá Leitão
Full Text Available ABSTRACT Objective: to characterize educational actions related to human communication health produced at the Tele-Health Center for health professionals in primary care. Methods: a cross-sectional study was conducted at the Tele-Health Center at the Federal University of Pernambuco Clinical Hospital. Educational actions produced by tele-consultants between 2008 and 2014 linked to the health of human communication were considered. Data collection was conducted in two phases. In the first phase, the data were explored and educational actions were selected based on the title and the relationship with human communication. In the second phase, each action was observed and evaluated for content. The data were analyzed using descriptive statistics. Results: a few educational actions related to human communication health were concentrated in 2014. Throughout the period analyzed, the actions were restricted to the field of language and concentrated on the education issue as well as the strategic area of child and adolescent health. The most frequent occupational category among the tele-consultants was nursing. Conclusion: a small number of educational actions addressing the health of human communication was produced and the participation of speech therapists remains incipient.
Byrne-Davis, Lucie M T; Bull, Eleanor R; Burton, Amy; Dharni, Nimarta; Gillison, Fiona; Maltinsky, Wendy; Mason, Corina; Sharma, Nisha; Armitage, Christopher J; Johnston, Marie; Byrne, Ged J; Hart, Jo K
Health partnerships often use health professional training to change practice with the aim of improving quality of care. Interventions to change practice can learn from behavioural science and focus not only on improving the competence and capability of health professionals but also their opportunity and motivation to make changes in practice. We describe a project that used behavioural scientist volunteers to enable health partnerships to understand and use the theories, techniques and assessments of behavioural science. This paper outlines how The Change Exchange, a collective of volunteer behavioural scientists, worked with health partnerships to strengthen their projects by translating behavioural science in situ. We describe three case studies in which behavioural scientists, embedded in health partnerships in Uganda, Sierra Leone and Mozambique, explored the behaviour change techniques used by educators, supported knowledge and skill development in behaviour change, monitored the impact of projects on psychological determinants of behaviour and made recommendations for future project developments. Challenges in the work included having time and space for behavioural science in already very busy health partnership schedules and the difficulties in using certain methods in other cultures. Future work could explore other modes of translation and further develop methods to make them more culturally applicable. Behavioural scientists could translate behavioural science which was understood and used by the health partnerships to strengthen their project work.
Muniz Pereira Urias, E.; Fu, Xiaolan; Ghauri, Pervez N; Väätänen, Juha
There is sufficient evidence to prove that the improved health status of a nation’s citizens results in economic growth and development via improved functionality and productivity of labor. It is also commonly accepted that healthcare expenditure significantly influences health status through, for
Osofsky, Howard J; Hansel, Tonya Cross; Osofsky, Joy D; Speier, Anthony
Environment as a contextual factor plays an important role in southeastern Louisiana, as this area represents a major economic hub for the United States port, petroleum, and fishing industries. The location also exposes the population to both natural and technological disasters, including Hurricane Katrina and the Gulf oil spill. This study explored associations among hurricane loss, oil spill disruption, and environmental quality of life on mental and physical health on over 1,000 residents (N = 1,225) using structural equation modeling techniques. Results showed that oil spill distress was associated with increased symptoms of mental and physical health; Hurricane Katrina loss; and decreased environmental quality of life. Findings also indicate that mental health symptoms explain the association among oil spill distress and physical health symptoms-specifically, those that overlap with somatic complaints. These findings provide important support of the need for mental health assessment and service availability for disaster recovery.
Lau, A Y S; Siek, K A; Fernandez-Luque, L; Tange, H; Chhanabhai, P; Li, S Y W; Elkin, P L; Arjabi, A; Walczowski, L; Ang, C S; Eysenbach, G
: To provide an overview on social media for consumers and patients in areas of health behaviours and outcomes. A directed review of recent literature. : We discuss the limitations and challenges of social media, ranging from social network sites (SNSs), computer games, mobile applications, to online videos. An overview of current users of social media (Generation Y), and potential users (such as low socioeconomic status and the chronically ill populations) is also presented. Future directions in social media research are also discussed. : We encourage the health informatics community to consider the socioeconomic class, age, culture, and literacy level of their populations, and select an appropriate medium and platform when designing social networked interventions for health. Little is known about the impact of second-hand experiences faciliated by social media, nor the quality and safety of social networks on health. Methodologies and theories from human computer interaction, human factors engineering and psychology may help guide the challenges in designing and evaluating social networked interventions for health. Further, by analysing how people search and navigate social media for health purposes, infodemiology and infoveillance are promising areas of research that should provide valuable insights on present and emergening health behaviours on a population scale.
This study examined visitor perceptions and attitudes towards their experience at a national wildlife refuge which limits access to its barrier beach during the nesting season of the threatened piping plover. It determined attitudes towards the closure, as well as what factors influenced these attitudes. It also examined how willingness to pay for refuge protection...
Full Text Available Despite the fact that health communication is a discipline developed only recently, its importance in human medicine is well recognized. However, it is less considered in veterinary medicine, even if it has the potential to improve public health because of the role of veterinary medicine in public health. For this reason, an One Health approach is useful for communication as well. This approach leads to a “One Communication” concept, which is the result of the synergy in communicative efforts both in human and in veterinary medicine. Our analysis explores the potential of communication in several veterinary fields: institutions, food safety, companion animal and food-producing animal practice, pharmacology and drugs, wildlife fauna and environment. In almost all the areas of veterinary activity communication can contribute to human health. It takes many forms and use several channels, and this variety of communicative opportunities represent a challenge for veterinarians. For this reason, the communication course should be included in the curricula of Veterinary Medicine Schools. As One Health, One Communication is a strategy for expanding collaborations in health communication and it will enhance public health.
Hirschberg, Stefan; Bauer, Christian; Burgherr, Peter; Cazzoli, Eric; Heck, Thomas; Spada, Matteo; Treyer, Karin
As a part of comprehensive analysis of current and future energy systems we carried out numerous analyses of health effects of a wide spectrum of electricity supply technologies including advanced ones, operating in various countries under different conditions. The scope of the analysis covers full energy chains, i.e. fossil, nuclear and renewable power plants and the various stages of fuel cycles. State-of-the-art methods are used for the estimation of health effects. This paper addresses health effects in terms of reduced life expectancy in the context of normal operation as well as fatalities resulting from severe accidents and potential terrorist attacks. Based on the numerical results and identified patterns a comparative perspective on health effects associated with various electricity generation technologies and fuel cycles is provided. In particular the estimates of health risks from normal operation can be compared with those resulting from severe accidents and hypothetical terrorist attacks. A novel approach to the analysis of terrorist threat against energy infrastructure was developed, implemented and applied to selected energy facilities in various locations. Finally, major limitations of the current approach are identified and recommendations for further work are given. - Highlights: • We provide state-of-the-art comparative assessment of energy health risks. • The scope of the analysis should to the extent possible cover full energy chains. • Health impacts from normal operation dominate the risks. • We present novel approach to analysis of terrorist threat. • Limitations include technology choices, geographical coverage and terrorist issues.
Booth, Brenda M; Davis, Teri D; Cheney, Ann M; Mengeling, Michelle A; Torner, James C; Sadler, Anne G
The aim of this study was to determine whether current physical health status in female veterans is associated with rape during military service and same-sex partnership. Retrospective computer-assisted telephone interviews of 1004 Midwestern US female veterans identified from Veterans Affairs electronic records were conducted. Data included rape history including rape in military, sex partnership history, demographics, and medical history including chronic pain, mental health (depression and posttraumatic stress disorder [PTSD]), and the physical health component of the Short-Form 12-item interview (PCS-12). Physical health in this sample was lower than norm values [PCS-12: mean (standard deviation) = 43 ; norm: mean (standard deviation) = 50 ). Fifty-one percent of the participants reported rape in their lifetime, 25% reported rape in military, 11% reported history of women as sex partners, and 71% reported history of chronic pain. Multiple regression analysis indicated that physical health (PCS-12) was associated with chronic pain history (β = -.40, p rape in military (β = -.09, p = .002), and current PTSD (β = .07, p = .03), adjusting for demographic data. Mediational analysis indicated that chronic pain history significantly mediated relationships of women who have sex with women, childhood rape, PTSD, depression, and current substance use disorder with PCS-12. Both rape and sex partnership are adversely associated with lower physical functioning in female veterans. Clinicians evaluating the physical health of this population should therefore consider obtaining detailed sexual histories, and a multidisciplinary team is needed to address mental health issues in female veterans.
Pollack, Craig Evan; Cubbin, Catherine; Sania, Ayesha; Hayward, Mark; Vallone, Donna; Flaherty, Brian; Braveman, Paula A
Though wide disparities in wealth have been documented across racial/ethnic groups, it is largely unknown whether differences in wealth are associated with health disparities within racial/ethnic groups. Data from the Survey of Consumer Finances (2004, ages 25-64) and the Health and Retirement Survey (2004, ages 50+), containing a wide range of assets and debts variables, were used to calculate net worth (a standard measure of wealth). Among non-Hispanic black, Hispanic and non-Hispanic white populations, we tested whether wealth was associated with self-reported poor/fair health status after accounting for income and education. Except among the younger Hispanic population, net worth was significantly associated with poor/fair health status within each racial/ethnic group in both data sets. Adding net worth attenuated the association between education and poor/fair health (in all racial/ethnic groups) and between income and poor/fair health (except among older Hispanics). The results add to the literature indicating the importance of including measures of wealth in health research for what they may reveal about disparities not only between but also within different racial/ethnic groups.
Rosenköttera, N.; Vondeling, Hindrik; Blancquaert, I.; Mekel, O.C.L.; Kristensen, F.B.; Brand, A.
The European Union has named genomics as one of the promising research fields for the development of new health technologies. Major concerns with regard to these fields are, on the one hand, the rather slow and limited translation of new knowledge and, on the other hand, missing insights into the
Full Text Available Abstract Background “Grand challenges” in global health have focused on discovery and development of technologies to save lives. The “grander challenge” involves building institutions, systems, capacity and demand to effectively deliver strategies to improve health. In 2008, Makerere University began a radical institutional change to bring together four schools under one College of Health Sciences. This paper’s objective is to demonstrate how its leadership in training, research, and services can improve health in Uganda and internationally, which lies at the core of the College’s vision. Methods A comprehensive needs assessment involved five task forces that identified MakCHS’s contribution to the Ugandan government health priorities. Data were collected through analysis of key documents; systematic review of MakCHS publications and grants; surveys of patients, students and faculty; and key informant interviews of the College’s major stakeholders. Four pilot projects were conducted to demonstrate how the College can translate research into policy and practice, extend integrated outreach community-based education and service, and work with communities and key stakeholders to address their priority health problems. Results MakCHS inputs to the health sector include more than 600 health professionals graduating per year through 23 degree programs, many of whom assume leadership positions. MakCHS contributions to processes include strengthened approaches to engaging communities, standardized clinical care procedures, and evidence-informed policy development. Outputs include the largest number of outpatients and inpatient admissions in Uganda. From 2005-2009, MakCHS also produced 837 peer-reviewed research publications (67% in priority areas. Outcomes include an expanded knowledge pool, and contributions to coverage of health services and healthy behaviors. Impacts include discovery and applications of global significance, such as
van der Rijt, Tess; Pang Pangestu, Tikki
There is a widespread perception that developed countries in the Western world dictate the shaping and governance of global health. While there are many bodies that engage in global health governance, the World Health Organisation (WHO) is the only entity whereby 194 countries are invited to congregate together and engage in global health governance on an equal playing field. This paper examines the diversity of governance within the World Health Assembly (WHA), the supreme decision-making body of the WHO. It explores the degree and balance of policy influence between high, middle and low-income countries and the relevance of the WHO as a platform to exercise global governance. It finds that governance within the WHA is indeed diverse: relative to the number of Member States within the regions, all regions are well represented. While developed countries still dominate WHA governance, Western world countries do not overshadow decision-making, but rather there is evidence of strong engagement from the emerging economies. It is apparent that the WHO is still a relevant platform whereby all Member States can and do participate in the shaping of global health governance. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Patrick C. Reed
Many believe that Alaska is unique and that its location, resources, and population influence the use patterns and attitudes of its National Forest recreation visitors so that they seem notably different from visitors to other National Forests outside Alaska. Data from a recreation visitor survey called CUSTOMER were analyzed for the years 1991 to 1993 to identify...
This method of segmentation has proved to be successful and is used .... aimed at potential tourists (visitors) to maximise their marketing return on investment ... satisfaction; (3) repeat visitors are the type of tourists most likely to revisit a festival, ...... visitor relationships', Journal of Travel and Tourism Marketing, 2(2/3): 3–20.
Marseille, M.M.; Elands, B.H.M.; Brink, van den M.L.
This article explores which feelings and cognitions are involved in visitor experiences of zoo polar bears and how this experience relates to a visitor's conservation attitude. Data were collected through qualitative interviews with 30 visitors in two Dutch zoos. Most respondents believed that a
Jerry J. Vaske; Rodney R. Zwick; Maureen P. Donnelly
The Visitor Impact Management (VIM) process is designed to identify unacceptable changes occurring as a result of visitor use and to develop management strategies to keep visitor impacts within acceptable levels. All previous attempts to apply the VIM planning framework have concentrated on specific resources. This paper expands this focus to an entire state. Based on...
Both first-time and repeat visitor groups play a fundamental role in the overall well-being and success of a festival, and festival organisers must strive to achieve a balance between first-time and repeat visitors. Festival managers should therefore be aware of the festival attributes that differentiate between the first-time visitor ...
Lucas, Robert C.; Shechter, Mordechai
The article describes the use of a simulation for outdoor recreation management which is applicable for any type of dispersed recreation area where visitor flows are of concern, where there are capacity constraints, where visitor encounters are significant, and where it is desired to allow visitors substantial freedom to move about flexibly. (MJB)
Nina S. Roberts; Deborah J. Chavez; Benjamin M. Lara; Emilyn A. Sheffield
The national forests of California are experiencing an increase in new visitors yet, in some areas, a continued lack of ethnic diversity persists. In addition, changing demographics has led to a need for keeping up with trends while also being aware of constraints to visitor use. Knowing how to serve culturally diverse visitors in ways that are innovative and inclusive...
Talib, Zohray; van Schalkwyk, Susan; Couper, Ian; Pattanaik, Swaha; Turay, Khadija; Sagay, Atiene S; Baingana, Rhona; Baird, Sarah; Gaede, Bernhard; Iputo, Jehu; Kibore, Minnie; Manongi, Rachel; Matsika, Antony; Mogodi, Mpho; Ramucesse, Jeremais; Ross, Heather; Simuyeba, Moses; Haile-Mariam, Damen
African medical schools are expanding, straining resources at tertiary health facilities. Decentralizing clinical training can alleviate this tension. This study assessed the impact of decentralized training and contribution of undergraduate medical students at health facilities. Participants were from 11 Medical Education Partnership Initiative-funded medical schools in 10 African countries. Each school identified two clinical training sites-one rural and the other either peri-urban or urban. Qualitative and quantitative data collection tools were used to gather information about the sites, student activities, and staff perspectives between March 2015 and February 2016. Interviews with site staff were analyzed using a collaborative directed approach to content analysis, and frequencies were generated to describe site characteristics and student experiences. The clinical sites varied in level of care but were similar in scope of clinical services and types of clinical and nonclinical student activities. Staff indicated that students have a positive effect on job satisfaction and workload. Respondents reported that students improved the work environment, institutional reputation, and introduced evidence-based approaches. Students also contributed to perceived improvements in quality of care, patient experience, and community outreach. Staff highlighted the need for resources to support students. Students were seen as valuable resources for health facilities. They strengthened health care quality by supporting overburdened staff and by bringing rigor and accountability into the work environment. As medical schools expand, especially in low-resource settings, mobilizing new and existing resources for decentralized clinical training could transform health facilities into vibrant service and learning environments.
Fleming, Lora E; Haines, Andy; Golding, Brian; Kessel, Anthony; Cichowska, Anna; Sabel, Clive E; Depledge, Michael H; Sarran, Christophe; Osborne, Nicholas J; Whitmore, Ceri; Cocksedge, Nicola; Bloomfield, Daniel
Linking environmental, socioeconomic and health datasets provides new insights into the potential associations between climate change and human health and wellbeing, and underpins the development of decision support tools that will promote resilience to climate change, and thus enable more effective adaptation. This paper outlines the challenges and opportunities presented by advances in data collection, storage, analysis, and access, particularly focusing on "data mashups". These data mashups are integrations of different types and sources of data, frequently using open application programming interfaces and data sources, to produce enriched results that were not necessarily the original reason for assembling the raw source data. As an illustration of this potential, this paper describes a recently funded initiative to create such a facility in the UK for use in decision support around climate change and health, and provides examples of suitable sources of data and the purposes to which they can be directed, particularly for policy makers and public health decision makers.
Gupta, Sunjai; Jenkins, Rachel; Spicer, John; Marks, Marina; Mathers, Nigel; Hertel, Lise; Calamos Nasir, Laura; Wright, Fiona; Ruprah-Shah, Baljeet; Fisher, Brian; Morris, David; Stange, Kurt C; White, Robert; Giotaki, Gina; Burch, Tony; Millington-Sanders, Catherine; Thomas, Steve; Banarsee, Ricky; Thomas, Paul
The need for support for good mental health is enormous. General support for good mental health is needed for 100% of the population, and at all stages of life, from early childhood to end of life. Focused support is needed for the 17.6% of adults who have a mental disorder at any time, including those who also have a mental health problem amongst the 30% who report having a long-term condition of some kind. All sectors of society and all parts of the NHS need to play their part. Primary care cannot do this on its own. This paper describes how primary care practitioners can help stimulate such a grand alliance for health, by operating at four different levels - as individual practitioners, as organisations, as geographic clusters of organisations and as policy-makers.
Social marketing is a highly systematic approach to health improvement that sets out unambiguous success criteria focused on behaviour change. This paper reviews the key concepts and principles of social marketing and its recent rapid development across government in England in the public health field. This paper outlines the role of the National Social Marketing Centre and concludes with a discussion of the probable future impact of social marketing on public health practice. The paper argues that there is a close ideological match between social marketing and liberal democratic imperatives. Social marketing's focus on outcome, return on investment and its emphasis on developing interventions that can respond to diverse needs, means it is probable that social marketing will increasingly be required by governments as a standard part of public health programmes.
Takahashi-Omoe, H; Omoe, K
Zoonoses have earned recognition as the source of serious problems for both public and animal health throughout the world. Emerging infectious diseases have been occurring at an unprecedented rate since the 1970s and a large proportion of these diseases are considered zoonotic. To aid in controlling zoonoses, countermeasures have been strengthened against these diseases and are maintained at both national and international levels. Atypical example of this international effort can be found in the revised International Health Regulations (2005), known as the IHR (2005), which were instituted by the World Health Organization and have been implemented since 2007. In Japan, the appropriate Ministries have established frameworks for controlling zoonoses that employ both administrative and scientific approaches to fulfill the demands of the IHR (2005). In this paper, the authors present the Japanese framework for controlling zoonoses, as a useful example for global public and animal health management in coming years.
... observation, wildlife photography, auto touring, birding, hiking, boating/canoeing, visitor center, special...: Visitors to national wildlife refuges. Respondent's Obligation: Required to obtain or retain a benefit...
Edmonstone, John; Robson, Jean
This account of practice describes the introduction of an accredited postgraduate management qualification which used action learning as a major contribution to a blended learning approach in a fragile cross-border setting on the edge of Europe. Conventional management education has frequently been challenged on the grounds of relevance, efficacy…
Lamarche, Benoît; Givens, D.I.; Soedamah-Muthu, Sabita; Krauss, Ronald M.; Jakobsen, Marianne Uhre; Bischoff-Ferrari, Heike A.; Pan, An; Després, Jean Pierre
Although milk consumption is recommended in most dietary guidelines around the world, its contribution to overall diet quality remains a matter of debate in the scientific community as well as in the public domain. This article summarizes the discussion among experts in the field on the place of
Lehoux, Pascale; Miller, Fiona A.; Daudelin, Geneviève; Denis, Jean-Louis
Background: New technologies constitute an important cost-driver in healthcare, but the dynamics that lead to their emergence remains poorly understood from a health policy standpoint. The goal of this paper is to clarify how entrepreneurs, investors, and regulatory agencies influence the value of emerging health technologies. Methods: Our 5-year qualitative research program examined the processes through which new health technologies were envisioned, financed, developed and commercialized by entrepreneurial clinical teams operating in Quebec’s (Canada) publicly funded healthcare system. Results: Entrepreneurs have a direct influence over a new technology’s value proposition, but investors actively transform this value. Investors support a technology that can find a market, no matter its intrinsic value for clinical practice or healthcare systems. Regulatory agencies reinforce the "double" value of a new technology—as a health intervention and as an economic commodity—and provide economic worth to the venture that is bringing the technology to market. Conclusion: Policy-oriented initiatives such as early health technology assessment (HTA) and coverage with evidence may provide technology developers with useful input regarding the decisions they make at an early stage. But to foster technologies that bring more value to healthcare systems, policy-makers must actively support the consideration of health policy issues in innovation policy. PMID:28949463
Chapman, Ralph; Preval, Nicholas; Howden-Chapman, Philippa
An economic analysis of housing's linkages to health can assist policy makers and researchers to make better decisions about which housing interventions and policies are the most cost-beneficial. The challenge is to include cobenefits. The adoption in 2015 of the UN Sustainable Development Goals underscores the importance of understanding how policies interact, and the merit of comprehensively evaluating cobenefits. We explain our approach to the empirical assessment of such cobenefits in the housing and health context, and consider lessons from empirical economic appraisals of the impact of housing on health outcomes. Critical assumptions relating to cobenefits are explicitly examined. A key finding is that when wider policy outcome measures are included, such as mental health impacts and carbon emission reductions, it is important that effects of assumptions on outcomes are considered. Another is that differing values underlie appraisal, for example, the weight given to future generations through the discount rate. Cost-benefit analyses (CBAs) can better facilitate meaningful debate when they are based on explicit assumptions about values. In short, the insights drawn from an economic framework for housing-and-health studies are valuable, but nonetheless contingent. Given that housing interventions typically have both health and other cobenefits, and incorporate social value judgements, it is important to take a broad view but be explicit about how such interventions are assessed.
Muir-Cochrane, Eimear; van der Merwe, Marie; Nijman, Henk; Haglund, Kristina; Simpson, Alan; Bowers, Len
There is disagreement among psychiatric professionals about whether the doors of acute psychiatric wards should be kept locked to prevent patients from leaving and harming themselves or others. This study explored patient, staff, and visitor perceptions about the acceptability of locking the ward door on acute psychiatric inpatient wards. Interviews were conducted with 14 registered nurses, 15 patients, and six visitors from three different acute wards. Findings revealed commonalities across all groups, with general agreement that locking the door reduced absconding. Staff expressed feelings of guilt, embarrassment, and fear of being blamed when a patient absconded. Staff also reported that open wards created anxious vigilance to prevent an abscond and increased workload in allocating staff to watch the door, whereas staff on partially-locked doors also perceived an increased workload in letting people in and out of the ward. Patients had mixed feelings about the status of the door, expressing depression, a sense of stigma, and low self-esteem when the door was locked. The issue of balancing safety and security on acute psychiatric wards against the autonomy of patients is not easily resolved, and requires focused research to develop innovative nursing practices. © 2011 The Authors. International Journal of Mental Health Nursing © 2011 Australian College of Mental Health Nurses Inc.
Barthow, Christine; Jones, Bernadette; Macdonald, Lindsay; Vernall, Sue; Gallagher, Peter; McKinlay, Eileen
To describe the role, contribution and value of research nurses in New Zealand community-based or primary health care research. Research nurses are increasingly recognised as having a key role in undertaking successful research in hospitals and clinical trial units however only limited work has been undertaken to examine their role in community-based research. Undertaking health research in the community has unique challenges particularly in relation to research design and recruitment and retention of participants. We describe four community-based research projects involving research nurses, each with particular recruitment, retention and logistical problems. Vignettes are used to illustrate the role, contribution and value of research nurses in a diverse range of community research projects. The knowledge and skills used by research nurses in these projects included familiarity with communities, cultural competence, health care systems and practice philosophies and in particular with vulnerable populations. Their research actions and activities include competence with a broad range of research methodologies, organisational efficiency, family-centred approach, along with advocacy and flexibility. These are underpinned by nursing knowledge and clinical expertise contributing to an ability to work autonomously. These four projects demonstrate that research nurses in community-based research possess specific attributes which facilitate successful study development, implementation and outcome.
Antonio Giulio de Belvis
Full Text Available Background: The Italian Observatory Healthcare Report (IOHR - 8th edition  aims to help policy makers in the process of decision making through a set of validated indicators resulting from the multidisciplinary activity of several public health experts. Its main task is to gather comparable data on the health status and the quality of health care services throughout the Italian regions. Methods: The report adopts a European approach in order to build a benchmarking activity and the selection criteria of indicators include: meaning, feasibility and quality, comparability and reliability. Each indicator is analyzed by experts in terms of meaning, pattern, validity and limits, graphic representation; recommendations are included for decision makers. A peer reviewing is performed for quality assessment. Results: The IOHR 2010 included 96 indicators, analysed by 203 authors. Through comparable regional data coming from different sources, an overview of the Italian Health System, and a gauging of the impact that different regional organizational and institutional arrangements have on the quality of health services, have been provided. Though data analysis showed a North-South gradient in the quality and the organization of health care services, nevertheless, the overall health status of Italian population is good. Risk factors, lifestyles and prevention together with geographical and social differences in health status and service access are the main priorities. Conclusions: The IOHR helps monitoring the health status in the Italian regions through specific indicators characterized by scientific strictness. It contributes to identifying the situations of excellence and disseminating public health care control tools in order to facilitate the decision making process.
Kamso, Jean; Mvika, Eddy S; Ota, M O C; Okeibunor, Joseph; Mkanda, Pascal; Mihigo, Richard
The Global Polio Eradication Initiative (GPEI) massively invested to overcome the crippling disease in countries of the WHO African Region. In the context of economic crisis, almost all countries in the Region lack an adequate health workforce. Large amounts were invested by GPEI in human resources. This paper shows how the human resources funded by polio contributed to narrowing the gaps in health workforce and helped strengthening and supporting other priority health programmes in Angola, Chad, DRC, Nigeria, Tanzania, and Togo. The health workforce strengthening methods used in the five different countries included the following: policy development and strategic planning, microplanning, capacity building of public health and community workers, implementation and services, monitoring and evaluation, advocacy and social mobilization, and programme review. Staff funded by polio helped with achieving good coverage in vitamin A and insecticide-treated mosquito nets (Angola, Chad); improvement of EPI and integrated disease surveillance indicators, improved quality of data (all five countries), administrative support, smooth introduction of new vaccines, increased case detection, and early isolation of patients suffering from the Guinea worm (Chad); reduction of cholera, extension of directly observed TB short course treatment (Democratic Republic of Congo); significant staff performance improvement (Nigeria). GPEI investment achieved far beyond its primary goal, and contributed to narrowing the gaps in the health workforce in countries of the African Region, as demonstrated by the best practice documentation exercise. We recommend that expertise and experience of polio funded staff should be leveraged to strengthen, expand and support other public health programmes. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.
Elias, Flávia Tavares Silva; Araújo, Denizar Vianna
The universal access to a health care system for the Brazilian population was established in 1990. Brazil is a country with no tradition in the production and use of health economic evaluation (HEE) to guide decision making in the public health system. It is only within the last two decades that HEEs using a microeconomic approach have appeared in the academic field. On a national level, HEE and Health Technology Assessment (HTA), in a wider sense, were first taken into account in 2003. Two policies deserve to be mentioned - (i) the regulation of medicines in the Brazilian market, and (ii) science, technology and innovation policy. The latter required the fostering of applied research to encourage the application of methods which employ systematic reviews and economic analyses of cost-effectiveness to guide the incorporation of technologies in the Brazilian health care system. The Ministry of Health has initiated the process of incorporating these new technologies on a federal level during the last ten years. In spite of the improvement of HEE methods at Brazilian universities and research institutes, these technologies have not yet reached the governmental bodies. In Brazil, the main challenge lies in the production, interpretation and application of HEE to all technologies within the access scheme(s), and there is limited capacity building. Setting priorities can be the solution for Brazil to be able to perform HEE for relevant technologies within the access scheme(s) while the universal coverage system struggles with a triple burden of disease. Copyright © 2014. Published by Elsevier GmbH.
Nave, R.; D'Addezio, G.; Carosi, A.
impact of our exhibition. This first effort of visitor study has the aim to have a framework for exhibition impact and its edutaiment appeal, and represent a starting point in a wider and specific study on visitor learning. These kind of survey contribute to set up a reliable feedback loops between scientists and end users of natural hazards information that can help to close the gap between science and society.
The purpose of this paper is to investigate the effect of social dynamics on the performance of mutual health organisations (MHOs) exploring the influence of community wealth and community leadership on policy implementation. Four operating district mutual health insurance schemes were selected using geographical locations, among other criteria, as case studies. Data were gathered through interviews and documentary review. The findings were analysed using community field and social capital theories. Traditional leaders like the Chiefs serve as the pivot around which social and human capital of the communities revolve in the developmental process of the country. Lack of exhaustive examination of the financial and institutional viability issues of the MHOs. Future studies could assess the interplay between financial, institutional and social viability models when measuring the financial and overall sustainability of MHOs. Health policy makers need to involve traditional leaders in the formulation and implementation of national policies since their acceptance or rejection of central government policy could have negative consequences. Ghana is a dynamic country and there is the need to utilise existing social networks: inter-family and inter-tribal relationships to ensure the viability of MHOs. There is and can be a successful interplay between public sector funding and community sector revenue mobilisation for financing the health sector in Ghana. This justifies the complementarity between government funding and community's resource mobilisation efforts in the health sector.
Loganathan, Tharani; Jit, Mark; Hutubessy, Raymond; Ng, Chiu-Wan; Lee, Way-Seah; Verguet, Stéphane
To evaluate rotavirus vaccination in Malaysia from the household's perspective. The extended cost-effectiveness analysis (ECEA) framework quantifies the broader value of universal vaccination starting with non-health benefits such as financial risk protection and equity. These dimensions better enable decision-makers to evaluate policy on the public finance of health programmes. The incidence, health service utilisation and household expenditure related to rotavirus gastroenteritis according to national income quintiles were obtained from local data sources. Multiple birth cohorts were distributed into income quintiles and followed from birth over the first five years of life in a multicohort, static model. We found that the rich pay more out of pocket (OOP) than the poor, as the rich use more expensive private care. OOP payments among the poorest although small are high as a proportion of household income. Rotavirus vaccination results in substantial reduction in rotavirus episodes and expenditure and provides financial risk protection to all income groups. Poverty reduction benefits are concentrated amongst the poorest two income quintiles. We propose that universal vaccination complements health financing reforms in strengthening Universal Health Coverage (UHC). ECEA provides an important tool to understand the implications of vaccination for UHC, beyond traditional considerations of economic efficiency. © 2016 John Wiley & Sons Ltd.
Marshal, Sarah L; Oades, Lindsay G; Growe, Trevor P
One key component of recovery-oriented mental health services, typically overlooked, involves genuine collaboration between researchers and consumers to evaluate and improve services delivered within a recovery framework. Eighteen mental health consumers working with staff who had received training in the Collaborative Recovery Model (CRM) took part in in-depth focus group meetings, of approximately 2.5 hours each, to generate feedback to guide improvement of the CRM and its use in mental health services. Consumers identified clear avenues for improvement for the CRM both specific to the model and broadly applicable to recovery-oriented service provision. Findings suggest consumers want to be more engaged and empowered in the use of the CRM from the outset. Improved sampling procedures may have led to the identification of additional dissatisfied consumers. Collaboration with mental health consumers in the evaluation and improvement of recovery-oriented practice is crucial with an emphasis on rebuilding mental health services that are genuinely oriented to support recovery.
Full Text Available Evidence regarding the extent of mental health problems and the associated characteristics within an employee population is necessary to inform appropriate and tailored workplace mental health programs. Mental health within male dominated industries (such as mining has received recent public attention, chiefly through observations regarding suicide in such populations in Australia and internationally. Currently there is limited empirical evidence regarding the mental health needs in the mining industry as an exemplar of a male dominated workforce, and the relative contribution to such problems of individual, socio-economic and workplace factors. This study aimed to investigate the mental health and associated characteristics among employees in the Australian coal mining industry with a specific focus on identifying modifiable work characteristics.A cross-sectional study was conducted among employees (n = 1457 across eight coal mines stratified by key mine characteristics (state, mine type and employee commute arrangements. Participants completed measures of psychological distress (K10+ and key variables across four categories (socio-demographic characteristics, health history, current health behaviours, work attitudes and characteristics.Psychological distress levels within this sample were significantly higher in comparison with a community sample of employed Australians. The following factors contributed significantly to levels of psychological distress using hierarchical linear regression analysis: lower social networks; a past history of depression, anxiety or drug/alcohol problems; high recent alcohol use; work role (managers and a set of work characteristics (level of satisfaction with work, financial factors and job insecurity; perception of lower workplace support for people with mental health problems.This is the first study to examine the characteristics associated with mental health problems in the Australian coal mining industry. The
Considine, Robyn; Tynan, Ross; James, Carole; Wiggers, John; Lewin, Terry; Inder, Kerry; Perkins, David; Handley, Tonelle; Kelly, Brian
Evidence regarding the extent of mental health problems and the associated characteristics within an employee population is necessary to inform appropriate and tailored workplace mental health programs. Mental health within male dominated industries (such as mining) has received recent public attention, chiefly through observations regarding suicide in such populations in Australia and internationally. Currently there is limited empirical evidence regarding the mental health needs in the mining industry as an exemplar of a male dominated workforce, and the relative contribution to such problems of individual, socio-economic and workplace factors. This study aimed to investigate the mental health and associated characteristics among employees in the Australian coal mining industry with a specific focus on identifying modifiable work characteristics. A cross-sectional study was conducted among employees (n = 1457) across eight coal mines stratified by key mine characteristics (state, mine type and employee commute arrangements). Participants completed measures of psychological distress (K10+) and key variables across four categories (socio-demographic characteristics, health history, current health behaviours, work attitudes and characteristics). Psychological distress levels within this sample were significantly higher in comparison with a community sample of employed Australians. The following factors contributed significantly to levels of psychological distress using hierarchical linear regression analysis: lower social networks; a past history of depression, anxiety or drug/alcohol problems; high recent alcohol use; work role (managers) and a set of work characteristics (level of satisfaction with work, financial factors and job insecurity; perception of lower workplace support for people with mental health problems. This is the first study to examine the characteristics associated with mental health problems in the Australian coal mining industry. The findings
Carbonated beverages including energy drinks make up an increasing percentage of energy intake amongst adults as well as children and adolescents. Due to high content of di- or monosaccharides and biologically active compounds (mainly caffeine), their regular intake may involve addictions and potential health risks, including diabetes. Although consumption of energy drinks is usually not recommended by the manufacturers to the children under the age of 16, due to its popularity and unrestricted availability on market energy drinks are easily accessible to younger children. Low awareness of the potential health risks involved with such beverages in society together with unrestricted distribution and advertising requires undertaking general information campaign concerning energy drinks. In this paper a critical review has been made to discuss potential somatic and psychological health risks issue. Moreover, conclusions were supported with the results of the survey conducted among college and high-school adolescents.
Craig, Peter; Katikireddi, Srinivasa Vittal; Leyland, Alastair; Popham, Frank
Population health interventions are essential to reduce health inequalities and tackle other public health priorities, but they are not always amenable to experimental manipulation. Natural experiment (NE) approaches are attracting growing interest as a way of providing evidence in such circumstances. One key challenge in evaluating NEs is selective exposure to the intervention. Studies should be based on a clear theoretical understanding of the processes that determine exposure. Even if the observed effects are large and rapidly follow implementation, confidence in attributing these effects to the intervention can be improved by carefully considering alternative explanations. Causal inference can be strengthened by including additional design features alongside the principal method of effect estimation. NE studies often rely on existing (including routinely collected) data. Investment in such data sources and the infrastructure for linking exposure and outcome data is essential if the potential for such studies to inform decision making is to be realized.
Gilberto Ferreira de Souza Aguiar
Full Text Available The search for equity in access to services is presently an important principle in public policies for health in Brazil. Social inequalities in the Amazonia occur at high levels comparatively to the other regions in the country; and, within Amazonia, they particularly affect rural communities. The present study aims to appreciate associations between food and nutritional profile, adaptive strategies, and epidemiology in these communities, specially in areas of artisanal fishery, and also to suggest general lines of appropriated health policies. The construction of a context of equitable assistance and of sustainable health, without significant damage to biodiversity, depends on the capacity of public power in exploring the relationships between use and management of natural resources and the quality of life of riverine man.
Alvarez, Maria do Carmo Avamilano; Cuenca, Angela Maria Belloni; Noronha, Daisy Pires; Schor, Néia
Virtual libraries have been implemented in an attempt to organize scientific information found in the Internet, including the Biblioteca Virtual de Saúde Reprodutiva (BVSR), or Virtual Library on Reproductive Health. The aim is to provide quality information to researchers in the reproductive health field. The current study evaluates the use of the BVSR, emphasizing the users' expectations, difficulties, and suggestions. The study adopted a qualitative methodology. The focus group technique was applied to Internet chat groups through which reproductive health researchers communicated. Users expressed their expectations regarding information, highlighting the lack of time and the need to quickly obtain precise data. Use of virtual libraries for research increases where there is more trust in the institutions responsible for maintaining them. Researchers suggested the following: greater dissemination of the BVSR, publication of an electronic newsletter, and creation of a communications channel between the BVSR and users in order to foster intelligent collective communication.
Fenny, Ama Pokuaa; Kusi, Anthony; Arhinful, Daniel K; Asante, Felix Ankoma
The effort to expand access to healthcare and reduce health inequalities in many low income countries have meant that many have adopted different levels of social health protection mechanisms. Ghana introduced a National Health Insurance Scheme (NHIS) in 2005 with the aim of removing previous barriers created by the user fees financing system. Although the NHIS has made health accessible to some category of people, the majority of Ghanaians (60 %) are not enroled on the scheme. Earlier studies have looked at various factors that account for this low uptake. However, we recognise that this qualitative study will nuance the depth of these barriers to enrolment. Minimally structured, qualitative interviews were conducted with key stakeholders at the district, regional and national levels. Focus group discussions were also undertaken at the community level. Using an inductive and content analytic approach, the transcripts were analyzed to identify and define categories that explain low uptake of health insurance. The results are presented under two broad themes: sociocultural and systemic factors. Sociocultural factors identified were 1) vulnerability within certain groups such as the aged and the disabled groups which impeded access to the NHIS 2) cultural and religious norms which discouraged enrolment into the scheme. System-wide factors were 1) inadequate distribution of social infrastructure such as healthcare facilities, 2) weak administrative processes within the NHIS, and 3) poor quality of care. Mapping the interplay of these dynamic relations between the NHIS, its clients and service providers, the study identifies critical factors at the policy-making level, service provider level, and client level (reflective in household and community level institutional arrangements) that affect enrolment in the scheme. Our findings inform a number of potential reforms in the area of distribution of health resources and cost containment to expand coverage, increase
Florence, Curtis S; Thorpe, Kenneth E
Market reform of health insurance is proposed to increase coverage and reduce growth in spending by providing an incentive to choose low-cost plans. However, having a choice of plans could result in risk segmentation. Risk-adjusted payments have been proposed to address risk segmentation but are criticized as ineffective. An alternative to risk adjustment is to subsidize premiums, as in the Federal Employees Health Benefits Program (FEHBP). Subsidizing premiums may also increase total premium spending. We find that there is little risk segmentation in the FEHBP and that reducing the premium subsidy would lower government premium spending and slightly increase risk segmentation.
Milovancevic, Milica Pejovic; Jovicic, Milica
It has been estimated that 9 to 13% of children and adolescents have a mental disorder that causes significant functioning impairment and that only one fifth of those who need mental health services actually receive them. The majority of children and adolescents are enrolled in schools, where they spend a considerable amount of time, and this is…
van Wijk, Evalina; Traut, Annalene; Julie, Hester
Aggressive and violent behaviour of inpatients in mental health facilities disrupts the therapeutic alliance and hampers treatment. The aim of the study was to describe patients' perceptions of the possible environmental and staff factors that might contribute to their aggressive and violent behaviour after admission to a mental health facility; and to propose strategies to prevent and manage such behaviour. A qualitative, phenomenological study was utilised, in which purposefully sampled inpatients were interviewed over a six-month period. Inpatients were invited to participate if they had been admitted for at least seven days and were in touch with reality. Forty inpatients in two mental health facilities in Cape Town participated in face-to-face, semi-structured interviews over a period of six months. Tesch's descriptive method of open coding formed the framework for the data analysis and presentation of the results. Trustworthiness was ensured in accordance with the principles of credibility, confirmability, transferability and dependability. Analysis of the data indicates two central categories in the factors contributing to patients' aggressive and violent behaviour, namely, environmental factors and the attitude and behaviour of staff. From the perspective of the inpatients included in this study, aggressive and violent episodes are common and require intervention. Specific strategies for preventing such behaviour are proposed and it is recommended that these strategies be incorporated into the in-service training programmes of the staff of mental health facilities. These strategies could prevent, or reduce, aggressive and violent behaviour in in-patient facilities.
Full Text Available Increased tourism in the Arctic calls for more knowledge to meet management challenges. This paper reviews existing knowledge of the effects of human use on vegetation, fauna and cultural heritage in Svalbard, and it addresses the need for site-specific knowledge for improved management. This paper draws upon scientific studies, knowledge held by management authorities and local people, the Governor's database on visitors and visited sites and our own data from landing sites we visited. There is a certain level of basic knowledge available, allowing us to roughly grade the vulnerability of sites. However, there is a thorough lack of site-specific data related to the management of single locations or groups of similar locations. Future research needs to address specific on-site challenges in the management of visitor sites. Relevant management models and measures are discussed. We contend that a shift away from a blanket application of the precautionary principle and towards a more integrated, site-specific and evidence-based management plan will contribute to more trusted and reliable, and thereby acceptable among stakeholders, decisions in the management of growing tourism activity in Svalbard.
Mariela Cristina Ayres de Oliveira
Full Text Available This research aimed to analyze the perceptions of residents of the Historic Centre in relation to the tourist attractions of Porto Nacional [TO], regarded as Brazil's cultural heritage. The survey was developed specifically in the streets of the Historic Center. At first, it was made a literature research in the library of the University of Tocantins and also digitally. The questionnaires were administered randomly with people who agreed to answer oral questions, the answers being transcribed by the researcher. Data were collected in December 2009 and were used as data collection technique, the semi-structured interview with open and closed questions, applied to residents of the Historic Center.Interviews with residents took an average of five days, lasting twenty minutes for each questionnaire.Concluding this collection, the data were analyzed in graphics and tables, in order to contribute to quantitative studies. The perception of the residents of the Historic Center offers an opportunity to know opinions on issues related to tourist attractions and their visitors. The research revealed the opinion of the people that were interviewed about the tourist attractions, visitors and potential economic growth of tourism in the city under study. To complete the survey highlights the final considerations, aimed to defend the heritage and the importance of disclosure and even tourism, and encourage the link between social problems and the role of the university.
Full Text Available Visitors’ perceptions of the quality of a tourism destination are fundamental for effective destination management and marketing. This paper deals with the topic of destination quality from the viewpoint of demand, i.e. from the viewpoint of a destination visitor. The results of perceiving the destination quality partial factors in the context of different behavioural characteristics of a visitor are presented, particularly, the way how spending and organizing a holiday influences the perception of destination quality factors (Kruskal-Wallis test. The research nineteen factors were designed on the basis of contemporary theories and on qualitative research. Some important quality aspects related to tourism were identified and assessed for the Czech population. The primary data were obtained through a questionnaire survey with quota sampling (n = 1097. The dependence of destination quality perception on the way of spending the holiday was revealed in the case of 8 factors (e.g., Availability of transportation to the destination, Availability and quality of information; Additional infrastructure, Sense of security, Destination cleanliness, Uniqueness of destination, Price level in the destination, Cultural monuments. The significant differences identified among various groups of respondents are described in detail in this study. The research findings contribute to better understanding of the behavioural mechanism and can be used by destination managers to design communication strategies for different segments of consumers for individual destinations to improve their competiveness.
Konan, Denise Eby; Chan, Hing Ling
This paper focuses on petroleum use and greenhouse gas emissions associated with economic activities in Hawaii. Data on economic activity, petroleum consumption by type (gasoline, diesel, aviation fuel, residual, propane), and emissions factors are compiled and analyzed. In the baseline year 1997, emissions are estimated to total approximately 23.2 million metric tons of carbon, 181 thousand metric tons of nitrous oxide, and 31 thousand metric tons of methane in terms of carbon-equivalent global warming potential over a 100-year horizon. Air transportation, electricity, and other transportation are the key economic activity responsible for GHG emissions associated with fossil fuel use. More than 22% of total emissions are attributed to visitor expenditures. On a per person per annum basis, emission rates generated by visitor demand are estimated to be higher than that of residents by a factor of 4.3 for carbon, 3.2 for methane, and 4.8 for nitrous oxide. (author)
C.Th.M. Schrijvers (Carola); H. van de Mheen (Dike); K. Stronks (Karien); J.P. Mackenbach (Johan)
textabstractBACKGROUND: The aim was to study the impact of different categories of working conditions on the association between occupational class and self-reported health in the working population. METHODS: Data were collected through a postal survey conducted in 1991
Lora E. Fleming
Full Text Available Linking environmental, socioeconomic and health datasets provides new insights into the potential associations between climate change and human health and wellbeing, and underpins the development of decision support tools that will promote resilience to climate change, and thus enable more effective adaptation. This paper outlines the challenges and opportunities presented by advances in data collection, storage, analysis, and access, particularly focusing on “data mashups”. These data mashups are integrations of different types and sources of data, frequently using open application programming interfaces and data sources, to produce enriched results that were not necessarily the original reason for assembling the raw source data. As an illustration of this potential, this paper describes a recently funded initiative to create such a facility in the UK for use in decision support around climate change and health, and provides examples of suitable sources of data and the purposes to which they can be directed, particularly for policy makers and public health decision makers.
This study identified factors that influence the health-related quality of life of people living with HIV (PLWH). A qualitative research approach was used for this study and focus group discussions (FGDs) were used for data collection, while grounded theory informed the data analysis. The key finding of this study is that ...
Porter, John D H
Academic disciplines like anthropology and epidemiology provide a niche for researchers to speak the same language, and to interrogate the assumptions that they use to investigate problems. How anthropological and epidemiological methods communicate and relate to each other affects the way public health policy is created but the philosophical underpinnings of each discipline makes this difficult. Anthropology is reflective, subjective and investigates complexity and the individual; epidemiology, in contrast, is objective and studies populations. Within epidemiological methods there is the utilitarian concept of potentially sacrificing the interests of the individual for the benefits of maximizing population welfare, whereas in anthropology the individual is always included. Other strengths of anthropology in the creation of public health policy include: its attention to complexity, questioning the familiar; helping with language and translation; reconfiguring boundaries to create novel frameworks; and being reflective. Public health requires research that is multi-, inter- and trans-disciplinary. To do this, there is a need for each discipline to respect the 'dignity of difference' between disciplines in order to help create appropriate and effective public health policy.
Corcoran, Tim; Rowling, Louise; Wise, Marilyn
Questions persist regarding implementation of mental health promotion, prevention, and early intervention initiatives in schools. To date, attention has targeted the "Whats" and "Hows" in design and implementation. Ongoing clarification of "Who" the key proponents are working in this space receives less consideration.…
Buchanan, Taylor L.; Lohse, Keith R.
We surveyed researchers in the health and exercise sciences to explore different areas and magnitudes of bias in researchers' decision making. Participants were presented with scenarios (testing a central hypothesis with p = 0.06 or p = 0.04) in a random order and surveyed about what they would do in each scenario. Participants showed significant…
Stavrianeas, Stasinos; Stewart, Mark
Students of exercise science are well positioned to facilitate a shift of the nation's attitude on health care from disease treatment to disease prevention. This report chronicles our efforts toward transforming the exercise physiology core course from a lecture-based, instructor-centered class to a student-centered environment in which…
Many people today are physically active as part of their recreation or leisure. Therefore, the purpose of this paper was to present an overview of literature that has explored the relationships that leisure and active recreation have to health and well-being. Research, both qualitative and quantitative, has been conducted in the ...
Souza, Luis Eugenio Portela Fernandes de
The relationships between health and socioeconomic development are diverse. These relationships find in the health economic complex a privileged ground for expression. The importance of health technologies increased exponentially since the middle of the 20th century, affecting health systems in terms of both, quality of care and economic aspects. In fact, the predominant model of care is based on fragmented, symptomatic therapy practices that encourages the use of products and services and promotes a passive participation of users rather than humanization of care. Overcoming this model requires changes in the health technology standards which, in turn, require changes in the technology standard of society. The critical theory of technology helps to understand the evolution of the industrial civilization. It enriches the discussion by suggesting the health economic complex be more sensibly adjusted to the requirements of comprehensive health care, and to inclusive and sustainable development. Resumo: As relações entre a saúde e o desenvolvimento socioeconômico são múltiplas. Essas relações têm o complexo econômico da saúde como o espaço privilegiado de sua expressão. A importância das tecnologias de saúde aumentou exponencialmente desde meados do século XX, com efeitos sobre os sistemas de saúde, tanto em qualidade da atenção, quanto em aspectos econômicos. Na realidade, predomina um modelo de atenção caracterizado por práticas fragmentadas, que enfatizam tratamentos sintomáticos, estimulam o consumismo de produtos e serviços e promovem, ao invés da humanização, uma participação passiva dos usuários. A superação desse modelo passa pela mudança do padrão tecnológico da saúde, que, por sua vez, exige a transformação do padrão tecnológico da sociedade. A teoria crítica da tecnologia ajuda a compreender a evolução da civilização industrial. Enriquece o debate, sugerindo uma conformação do complexo econômico da saúde mais
Full Text Available Background: Researchers, practitioners, and policymakers call for updated valid evidence to monitor, prevent, and control of alarming trends of health problems. To respond to these needs, health researches provide the vast multidisciplinary scientific fields. We quantify the national trends of health research outputs and its contribution in total science products. Methods: We systematically searched Scopus database with the most coverage in health and biomedicine discipline as the only sources for multidisciplinary citation reports, for all total and health-related publications, from 2000 to 2014. These scientometrics analyses covered the trends of main index of scientific products, citations, and collaborative papers. We also provided information on top institutions, journals, and collaborative research centers in the fields of health researches. Results: In Iran, over a 15-year period, 237,056 scientific papers have been published, of which 81,867 (34.53% were assigned to health-related fields. Pearson's Chi-square test showed significant time trends between published papers and their citations. Tehran University of Medical Sciences was responsible for 21.87% of knowledge productions share. The second and the third ranks with 11.15% and 7.28% belonged to Azad University and Shahid Beheshti University of Medical Sciences, respectively. In total fields, Iran had the most collaborative papers with the USA (4.17%, the UK (2.41%, and Canada (0.02%. In health-related papers, similar patterns of collaboration followed by 4.75%, 2.77%, and 1.93% of papers. Conclusions: Despite the ascending trends in health research outputs, more efforts required for the promotion of collaborative outputs that cause synergy of resources and the use of practical results. These analyses also could be useful for better planning and management of planning and conducting studies in these fields.
Evgeni L. Nikolaev
Full Text Available Background. A dentist’s professional activity requires a high level of personality traits that are usually regarded as a combination of both female and male traits. Androgynous gender identity corresponds to dentists’ professional requirements and allows the dentists to retain mental stability and psychological well-being. Objective. The goal of this study is to determine the specificity of the androgynous identity in dentists in the context of gender differences as indicators of mental health and subjective well-being. Design. The first stage of the research covered 129 dentists of both sexes to reveal their androgynous gender type using the Bem Sex Role Inventory. During the second stage, 117 androgynous dentists were studied using the SCL-90-R and Brief Subjective Well-being Questionnaire in an effort to reveal the specificity of the dentists’ mental health and self-esteem. Results. According to the results, individuals with an androgynous type of gender identity constitute the largest part of dentists (90.70 %, regardless of their biological sex. The expression of masculinity does not statistically differ from the expression of femininity within the androgynous sample. Regardless of their sex, these dentists are characterized by a higher level of mental health. No significant differences were revealed between androgynous men and androgynous women in their subjective well-being indicators — self-estimation of health, satisfaction with material status and success motivation. Conclusion. We concluded that androgyny is the most common type of gender identity in the men and women engaged in dentistry. The basic gender characteristic in the structure of androgynous identity in dentists is masculinity, which is closely interrelated with mental health and subjective well-being regardless of biological sex.
Gulnar Azevedo S Mendonça
Full Text Available OBJECTIVE: Selecting controls is one of the most difficult tasks in the design of case-control studies. Hospital controls may be inadequate and random controls drawn from the base population may be unavailable. The aim was to assess the use of hospital visitors as controls in a case-control study on the association of organochlorinated compounds and other risk factors for breast cancer conducted in the main hospital of the "Instituto Nacional de Câncer" -- INCA (National Cancer Institute in Rio de Janeiro (Brazil. METHODS: The study included 177 incident cases and 377 controls recruited among female visitors. Three different models of control group composition were compared: Model 1, with all selected visitors; Model 2, excluding women visiting relatives with breast cancer; and Model 3, excluding all women visiting relatives with any type of cancer. Odds ratios (OR and 95% confidence intervals were calculated to test the associations. RESULTS: Age-adjusted OR for breast cancer associated with risk factors other than family history of cancer, except smoking and breast size, were similar in the three models. Regarding family history of all cancers, except for breast cancer, there was a decreased risk in Models 1 and 2, while in Model 3 there was an increased risk, but not statistically significant. Family history of breast cancer was a risk factor in Models 2 and 3, but no association was found in Model 1. In multivariate analysis a significant risk of breast cancer was found when there was a family history of breast cancer in Models 2 and 3 but not in Model 1. CONCLUSIONS: These results indicate that while investigating risk factors unrelated to family history of cancer, the use of hospital visitors as controls may be a valid and feasible alternative.
The publication concerns visitors’ attractions as the primary aim of tourist trips and the primary component of the tourism system. The central issue addressed in the book can be formulated as the following question: what are the features of visitors’ attractions and the visitors features that determine visitors’ satisfaction. The paper consists of the theory part and the empirical study. As a result of theoretical investigation, a number of conclusions concerning the nature and concept of vi...
gathered at York Hospital resulted in the limitation of two visitors per patient at one time. This was not an arbitrary decision by management but...management is required to receive input from the consumer on many management decisions . Even discounting the above, the patient was felt to be a logical...proximity of the parking areas to the primary entrances, no additional staff entrances ,4 are needed, therefore no special locking devices for any auxillary
Powell, J.; Sizemore, M.; Cornils, K.
In September 2008, the Fernald Preserve Visitors Center was awarded the platinum certification level by the US Green Building Council (USGBC), the highest level achievable under the Leadership in Energy and Environmental Design New Construction and Major Renovations (LEED-NC) rating system. The Visitors Center, which is maintained and operated under the direction of the U.S. Department of Energy (DOE) Office of Legacy Management, is the first building in Ohio, the second DOE building and one of approximately 100 buildings worldwide to achieve platinum certification. As a sustainable building, the Visitors Center includes a ground source heat pump, a bio-treatment wetland system, recycled construction materials, native and no-irrigation plants and numerous other components to reduce energy, electricity, and water consumption and to lessen the building's impact on the environment. The building's conceptual design was originally developed by the University of Cincinnati's College of Design, Architecture, Art and Planning (DAAP), with input from the community, and the building was designed and built by the Megen Construction Company-glaserworks team, under the direction of S.M. Stoller, Corporation, the Legacy Management contractor for the Fernald Preserve and the DOE Office of Legacy Management. The project required a committed effort by all members of the project team. This is the first sustainable building constructed as part of the cleanup of the environmental legacy of the Cold War. The Visitors Center's exhibits, reading room, and programs will help to educate the community about the Fernald Preserve's environmental legacy and show how our decisions affect the environment. (authors)
NUCCI, MATEUS; ALVES-JUNIOR, ALTER VIEIRA
Abstract Considering the important roles of pollinators in ecosystem services, their identification and studies of their behavior would be extremely important to efforts directed towards their preservation and management. With the aim of examining the diversity and behavior of the floral visitors to Campomanesia adamantium (Cambessédes) O. Berg (“guavira”) and how they act in the pollination process, a total of 31 species belonging to the orders Hymenoptera (79.30 %), Coleoptera (11.34 %), Di...
He He; Jin Chen
Botanical gardens (BGs) have attracted millions of visitors worldwide; therefore, BGs have become important sites for displaying and education for biodiversity. Understanding garden visitors’ motivations and their traveling satisfactory degree is crucial for BG management and its role in public education. In this study, we conducted survey in five Chinese BGs, i.e., Xiamen BG, Wuhan BG of Chinese Academy of Sciences (CAS), Beijing BG, Kunming BG of CAS and Xishuangbanna Tropical Botanical Gar...
Kartina Diah Kesuma Wardhani; Wawan Yunanto
E-commerce click stream data can form a certain pattern that describe visitor behavior while surfing the e-commerce website. This pattern can be used to initiate a design to determine alternative access sequence on the website. This research use heuristic miner algorithm to determine the pattern. σ-Algorithm and Genetic Mining are methods used for pattern recognition with frequent sequence item set approach. Heuristic Miner is an evolved form of those methods. σ-Algorithm assume that an activ...
"This report has provided a brief outline of business immigration to Canada and to British Columbia from several source countries in the Asian Pacific Rim. The importance of business immigration to Canada in general, and British Columbia in particular, is [examined].... Even with the limited data currently available, this brief study indicates a very high statistical relationship between business immigration and other less formal and less permanent movements of people such as student flows and visitors." excerpt
Emily (Jintao Ma
Full Text Available China has become Australia’s most important source market and there are growing number of visitors participated in wine tourism. Using in-depth interviews, the study looked into Chinese tourists’ preferences, motivations and barriers to participate in wineries tours in Australia. The study enriched to literature on wine tourism. It offered practical implications for wineries and destinations to better understand and accommodate Chinese wine tourists’ needs and preferences.
Kathren, R.L.; Baalman, R.W.; Bair, W.J.
For more than a half century, Herbert M. Parker was a leading force in radiological physics. As a scientist, he was codeveloper of a systematic dosimetry scheme for implant therapy and the innovative proposer of radiological units with unambiguous physical and biological bases. He made seminal contributions to the development of scientifically based radiation protection standards and, as an administrator and manager as well as scientist, helped the Hanford Laboratories to achieve preeminance in several areas, including radiation biology, radioactive waste disposal, and environmental radioactivity. This volume brings together, sometimes from obscure sources, his works
Miranda, Helena; Gore, Rebecca J; Boyer, Jon; Nobrega, Suzanne; Punnett, Laura
Many worksite health promotion programs ignore the potential influence of working conditions on unhealthy behaviors. A study of nursing home employees (56% nursing aides) utilized a standardized questionnaire. We analyzed the cross-sectional associations between workplace stressors and obesity, cigarette smoking, and physical inactivity. Of 1506 respondents, 20% reported exposure to three or more workplace stressors (physical or organizational), such as lifting heavy loads, low decision latitude, low coworker support, regular night work, and physical assault. For each outcome, the prevalence ratio was between 1.5 and 2 for respondents with four or five job stressors. Individuals under age 40 had stronger associations between workplace stressors and smoking and obesity. Workplace stressors were strongly associated with smoking, obesity, and physical inactivity, even among the lowest-status workers. Current working conditions affected younger workers more than older workers. Although this study is cross-sectional, it has other strengths, including the broad range of work stressors studied. Strenuous physical work and psychosocial strain are common among low-wage workers such as nursing home aides. Workplace health promotion programs may be more effective if they include measures to reduce stressful work environment features, so that working conditions support rather than interfere with employee health.
Specter, Steven; Schuermann, Lily; Hakiruwizera, Celestin; Sow, Mah-Séré Keita
The revised International Health Regulations [IHR(2005)], which requires the Member States of the World Health Organization (WHO) to develop core capacities to detect, assess, report, and respond to public health threats, is bringing new challenges for national and international surveillance systems. As more countries move toward implementation and/or strengthening of their infectious disease surveillance programs, the strengthening of clinical microbiology laboratories becomes increasingly important because they serve as the first line responders to detect new and emerging microbial threats, re-emerging infectious diseases, the spread of antibiotic resistance, and the possibility of bioterrorism. In fact, IHR(2005) Core Capacity #8, "Laboratory", requires that laboratory services be a part of every phase of alert and response.Public health laboratories in many resource-constrained countries require financial and technical assistance to build their capacity. In recognition of this, in 2006, the American Society for Microbiology (ASM) established an International Laboratory Capacity Building Program, LabCap, housed under the ASM International Board. ASM LabCap utilizes ASM's vast resources and its membership's expertise-40,000 microbiologists worldwide-to strengthen clinical and public health laboratory systems in low and low-middle income countries. ASM LabCap's program activities align with HR(2005) by building the capability of resource-constrained countries to develop quality-assured, laboratory-based information which is critical to disease surveillance and the rapid detection of disease outbreaks, whether they stem from natural, deliberate or accidental causes.ASM LabCap helps build laboratory capacity under a cooperative agreement with the U.S. Centers for Disease Control and Prevention (CDC) and under a sub-contract with the Program for Appropriate Technology in Health (PATH) funded by the United States Agency for International Development (USAID
Chughtai, Saad; Blanchet, Karl
Research across the formal, natural and social sciences has greatly expanded our knowledge about complex systems in recent decades, informing a broadly inclusive, cross-disciplinary conceptual framework referred to as Systems Thinking (ST). Its use in public health is rapidly increasing, although there remains a poor understanding of how these ideas have been imported, adapted and elaborated by public health research networks worldwide. This review employed a mixed methods approach to narrate the development of ST in public health. Tabulated results from a literature search of the Web of Science Core Collection database were used to perform a bibliometric analysis and literature review. Annual publication counts and citation scores were used to analyse trends and identify popular and potential 'landmark' publications. Citation network and co-authorship network diagrams were analysed to identify groups of articles and researchers in various network roles. Our search string related to 763 publications. Filtering excluded 208 publications while citation tracing identified 2 texts. The final 557 publications were analysed, revealing a near-exponential growth in literature over recent years. Half of all articles were published after 2010 with almost a fifth (17.8%) published in 2014. Bibliographic analysis identified five distinct citation and co-authorship groups homophilous by common geography, research focus, inspiration or institutional affiliation. As a loosely related set of sciences, many public health researchers have developed different aspects of ST based on their underlying perspective. Early studies were inspired by Management-related literature, while later groups adopted a broadly inclusive understanding which incorporated related Systems sciences and approaches. ST is an increasingly popular subject of discussion within public health although its understanding and approaches remain unclear. Briefly tracing the introduction and development of these ideas
Kawasaki, Ryoko; Nakao, Rieko; Ohnishi, Mayumi
Objective: Participation in social activities is associated with physical and psychological health in the community-dwelling elderly population. We examined the two factors of social relations and community health resources, associated with higher self-rated health levels in the community-dwelling elderly. Methods: A total of 145 community-dwelling elderly people ≥ 65 years old from two neighborhood associations in Nagasaki City were recruited for this study, representing 85% of the officially registered ≥ 65-year-old population in the target area. Face-to-face interviews using a structured questionnaire were conducted by trained interviewers in August 2009, with questions related to sociodemographic characteristics, social relationships, and self-rated health (SRH). Community health resources (type and walking distance from home) were evaluated by one of the authors as a community assessment. Results: Seventy-eight community-dwelling elderly people (25 men and 53 women) participated in the study. Elderly people who reported going out every day were more likely to show higher SRH scores (excellent/good) than those going out less often (OR: 3.7; 95% confidence interval [CI]: 1.0, 14.2; P = 0.056). The numbers of interactions with friends in higher and lower SRH groups were 6.5 ± 8.4 (mean ± standard deviation) and 2.4 ± 1.1 ( P = 0.01, Mann-Whitney U test), respectively. The numbers of relatives talking on the phone in higher and lower SRH groups were 2.9 ± 1.3 and 2.2 ± 1.2 ( P = 0.031, Mann-Whitney U test), respectively. Meeting scores with friends in higher and lower SRH groups were 7.8 ± 5.8 and 4.5 ± 3.6 ( P = 0.068), respectively. The scores of community health resources among higher and lower SRH groups were 21.2 ± 1.5 and 20.9 ± 1.4 ( P = 0.547), respectively. The scores of community association/activities in higher and lower SRH groups were 3.9 ± 1.0 and 3.6 ± 0.9 ( P = 0.227), respectively. Conclusion: This study indicated the importance
Schweitzer, Robert D; Brough, Mark; Vromans, Lyn; Asic-Kobe, Mary
This study documents the mental health status of people from Burmese refugee backgrounds recently arrived in Australia, then examines the contributions of gender, pre-migration and post-migration factors in predicting mental health. Structured interviews, including a demographic questionnaire, the Harvard Trauma Questionnaire, the Post-migration Living Difficulties Checklist and Hopkins Symptom Checklist assessed pre-migration trauma, post-migration living difficulties, depression, anxiety, somatization and traumatization symptoms in a sample of 70 adults across five Burmese ethnic groups. Substantial proportions of participants reported psychological distress in symptomatic ranges including: post-traumatic stress disorder (9%), anxiety (20%) and depression (36%), as well as significant symptoms of somatization (37%). Participants reported multiple and severe pre-migration traumas. Post-migration living difficulties of greatest concern included communication problems and worry about family not in Australia. Gender did not predict mental health. Level of exposure to traumatic events and post-migration living difficulties each made unique and relatively equal contributions to traumatization symptoms. Post-migration living difficulties made unique contributions to depression, anxiety and somatization symptoms. While exposure to traumatic events impacted on participants' mental well-being, post-migration living difficulties had greater salience in predicting mental health outcomes of people from Burmese refugee backgrounds. Reported rates of post-traumatic stress disorder symptoms were consistent with a large review of adults across seven western countries. High levels of somatization point to a nuanced expression of distress. Findings have implications for service provision in terms of implementing appropriate interventions to effectively meet the needs of this newly arrived group in Australia.
Stack, David W; Peter, Newman; Manning, Robert E; Fristrup, Kurt M
Noise impacts resources and visitor experience in many protected natural areas, and visitors can be the dominant source of noise. This experimental study tested the efficacy and acceptability of signs asking visitors to be quiet at Muir Woods National Monument, California. Signs declaring a "quiet zone" (at the park's Cathedral Grove) or a "quiet day" (throughout the park) were posted on a randomized schedule that included control days (no signs). Visitor surveys were conducted to measure the cognitive and behavioral responses of visitors to the signs and test the acceptability of these management practices to visitors. Visitors were highly supportive of these management practices and reported that they consciously limited the amount of noise they produced. Sound level measurements showed substantial decreases on days when signs were posted. © 2011 Acoustical Society of America
Saito, Hajime; Minamiya, Yoshihiro
Due to the recent advances in radiological diagnostic technology, the role of video-assisted thoracoscopic surgery in thoracic disease has expanded, surgical indication extended to the elderly patients. Cancer patients receiving surgery, radiation therapy and/or chemotherapy may encounter complications in conjunction with the oral cavity such as aspiration pneumonia, surgical site infection and various type of infection. Recently, it is recognized that oral health care management is effective to prevent the postoperative infectious complications, especially pneumonia. Therefore, oral management should be scheduled before start of therapy to prevent these complications as supportive therapy of the cancer treatment. In this background, perioperative oral function management is highlighted in the remuneration for dental treatment revision of 2012,and the importance of oral care has been recognized in generally. In this manuscript, we introduce the several opinions and evidence based on the recent previous reports about the perioperative oral health care and management on thoracic surgery.
Kanagasabai, Thirumagal; Ardern, Chris I
To explore the interrelationship and mediating effect of factors that are beneficial (i.e., antioxidants) and harmful (i.e., inflammation and oxidative stress) to the relationship between sleep and cardiometabolic health. Cross-sectional data from the 2005-2006 National Health and Nutrition Examination Survey. Nationally representative population sample from the US. Age ≥ 20 y with sleep data; final analytical sample of n = 2,079. N/A. Metabolic syndrome was classified according to the Joint Interim Statement, and sleep duration was categorized as very short, short, adequate, and long sleepers (≤ 4, 5-6, 7-8, and ≥ 9 h per night, respectively). The indirect mediation effect was quantified as large (≥ 0.25), moderate (≥ 0.09), modest (≥ 0.01), and weak (sleep duration categories, whereas oxidative stress was elevated among short and very short sleepers. Select sleep duration- cardiometabolic health relationships were mediated by C-reactive protein (CRP), γ-glutamyl transferase (GGT), carotenoids, uric acid, and vitamins C and D, and were moderated by sex. Specifically, moderate-to-large indirect mediation by GGT, carotenoids, uric acid, and vitamin D were found for sleep duration-waist circumference and -systolic blood pressure relationships, whereas vitamin C was a moderate mediator of the sleep duration-diastolic blood pressure relationship. Several factors related to inflammation, oxidative stress, and antioxidant status were found to lie on the casual pathway of the sleep duration-cardiometabolic health relationship. Further longitudinal studies are needed to confirm our results. © 2015 Associated Professional Sleep Societies, LLC.
The purpose of this paper is to investigate how organisational frames of reference, which are neither not appropriately communicated nor supported, affect the wellbeing of workers. A review of the literature is used to develop a new model linking ambiguous frames of reference with reduced levels of workers' wellbeing. This is then tested using data collected in a study involving primary health care workers in Papua New Guinea (PNG). This paper finds that, for these particular workers, the model linking ambiguous frames of reference and reduced worker wellbeing is valid. The paper shows that there is a need for further research into a variety of areas including the importance of frames of reference to worker wellbeing, the significance of reference groups to organisational frames of reference and the consequences of reduced worker wellbeing in developing countries. In this paper, recommendations for changes to current PNG primary health care management practices, including ensuring the support for as well as communicating the organisational frame of reference, are discussed. The paper shows that the experiences of these particular primary health care workers not only demonstrates the validity of the new model but also brings a unique perspective to the field of worker wellbeing, which up until now has been dominated by research conducted in western countries.
R. B. Singh
Full Text Available In an urban area, the water is supplied through centralised municipal tap water system. For the present enquiry, the municipal supply of water for drinking and sanitation purposes has been assessed in terms of its availability and accessibility to the people, possible sources of water contamination and related health issues in Kolkata. The relevant data have been accessed from various secondary sources where the published data from West Bengal Pollution Control Board (WBPCB and Kolkata Municipal Corporation (KMC are noteworthy. The data thus obtained have been assessed qualitatively to depict the ground reality on sanitation and health related issues. The analyses of the data reveal that in Kolkata, the availability of good quality drinking water is not sufficient as the supply is low and inadequate. On the other hand, the underground water which is considered as the alternative source to the people is found to be contaminated with heavy metals like arsenic and lead. The non-availability of sufficientwater for drinking and sanitation purposes and consumption of contaminated water mayresult into poor health condition with various water borne diseases. The data on diseases from dispensaries (aided by KMC in Kolkata has revealed that people with water borne diseases are significant in number where they are found to be affected with diseases like Acute Diarrhoeal Infection and Dysenteries. Some suitable measures have been proposed whereby applying those, the availability and accessibility of water for drinking and proper sanitation could be enhanced and the occurrences of diseases might be avoided.
Ansari, Walid El; Oskrochi, Reza; Phillips, Ceri
A multi-site evaluation (survey) of five Kellogg-funded Community Partnerships (CPs) in South Africa was undertaken to explore the relationship between leadership skills and a range of 30 operational, functional and organisational factors deemed critical to successful CPs. The CPs were collaborative academic-health service-community efforts aimed at health professions education reforms. The level of agreement to eleven dichotomous (‘Yes/No’) leadership skills items was used to compute two measures of members’ appreciation of their CPs’ leadership. The associations between these measures and 30 CPs factors were explored, and the partnership factors that leadership skills explained were assessed after controlling. Respondents who perceived the leadership of their CPs favourably had more positive ratings across 30 other partnership factors than those who rated leadership skills less favourably, and were more likely to report a positive cost/ benefit ratio. In addition, respondents who viewed their CPs’ leadership positively also rated the operational understanding, the communication mechanisms, as well as the rules and procedures of the CPs more favourably. Leadership skills explained between 20% and 7% of the variance of 10 partnership factors. The influence of leaders’ skills in effective health-focussed partnerships is much broader than previously conceptualised. PMID:19440289
El Ansari, Walid; Oskrochi, Reza; Phillips, Ceri
A multi-site evaluation (survey) of five Kellogg-funded Community Partnerships (CPs) in South Africa was undertaken to explore the relationship between leadership skills and a range of 30 operational, functional and organisational factors deemed critical to successful CPs. The CPs were collaborative academic-health service-community efforts aimed at health professions education reforms. The level of agreement to eleven dichotomous ('Yes/No') leadership skills items was used to compute two measures of members' appreciation of their CPs' leadership. The associations between these measures and 30 CPs factors were explored, and the partnership factors that leadership skills explained were assessed after controlling. Respondents who perceived the leadership of their CPs favourably had more positive ratings across 30 other partnership factors than those who rated leadership skills less favourably, and were more likely to report a positive cost/ benefit ratio. In addition, respondents who viewed their CPs' leadership positively also rated the operational understanding, the communication mechanisms, as well as the rules and procedures of the CPs more favourably. Leadership skills explained between 20% and 7% of the variance of 10 partnership factors. The influence of leaders' skills in effective health-focussed partnerships is much broader than previously conceptualised.
Khamisa, Natasha; Peltzer, Karl; Oldenburg, Brian
Nurses have been found to experience higher levels of stress-related burnout compared to other health care professionals. Despite studies showing that both job satisfaction and burnout are effects of exposure to stressful working environments, leading to poor health among nurses, little is known about the causal nature and direction of these relationships. The aim of this systematic review is to identify published research that has formally investigated relationships between these variables. Six databases (including CINAHL, COCHRANE, EMBASE, MEDLINE, PROQUEST and PsyINFO) were searched for combinations of keywords, a manual search was conducted and an independent reviewer was asked to cross validate all the electronically identified articles. Of the eighty five articles that were identified from these databases, twenty one articles were excluded based on exclusion criteria; hence, a total of seventy articles were included in the study sample. The majority of identified studies exploring two and three way relationships (n = 63) were conducted in developed countries. Existing research includes predominantly cross-sectional studies (n = 68) with only a few longitudinal studies (n = 2); hence, the evidence base for causality is still very limited. Despite minimal availability of research concerning the small number of studies to investigate the relationships between work-related stress, burnout, job satisfaction and the general health of nurses, this review has identified some contradictory evidence for the role of job satisfaction. This emphasizes the need for further research towards understanding causality. PMID:23727902
Nwadiuko, Joseph; James, Keyonie; Switzer, Galen E; Stern, Jamie
There is increased interest in the capacity of US immigrants to contribute to their homelands via entrepreneurship and philanthropy. However, there has been little research examining how immigrant physicians may support health systems and what factors facilitate or raise barriers to increased support. This study used an observational design with paper questionnaire and interview components. Our sample was drawn from attendees of a 2011 conference for US Based Nigerian physicians; respondents who were not US residents, physicians, and of Nigerian birth or parentage were excluded from further analysis. Respondents were randomly selected to complete a follow-up interview with separate scripts for those having made past financial contributions or medical service trips to support Nigerian healthcare (Group A) and those who had done neither (Group B). Survey results were analyzed using Fischer exact tests and interviews were coded in pairs using thematic content analysis. Seventy-five of 156 (48 %) individuals who attended the conference met inclusion criteria and completed the survey, and 13 follow-up interviews were completed. In surveys, 65 % percent of respondents indicated a donation to an agency providing healthcare in Nigeria the previous year, 57 % indicated having gone on medical service trips in the prior 10 years and 45 % indicated it was "very likely" or "likely" that they would return to Nigeria to practice medicine. In interviews, respondents tended to favor gifts in kind and financial gifts as modes of contribution, with medical education facilities as the most popular target. Personal connections, often forged in medical school, tended to facilitate contributions. Individuals desiring to return permanently focused on their potential impact and worried about health system under-preparedness; those not desiring permanent return centered on how safety, financial security and health systems issues presented barriers. This study demonstrates several
Fazaeli, Amir Abbas; Seyedin, Hesam; Vosoogh Moghaddam, Abbas; Delavari, Alireza; Salimzadeh, H; Varmazyar, Hasan; Fazaeli, Ali Akbar
Social systems are dealing with the challenge of achieving fairness in the distribution of financial burden and protecting the risk of financial loss. The purpose of this paper is to present a trend analysis for the indicators related to fairness in healthcare's financial burden in rural and urban population of Iran during the eight years period of 2003 to 2010. We used the information gathered by statistical center of Iran through sampling processes for the household income and expenditures. The indicators of fairness in financial contribution of healthcare were calculated based on the WHO recommended methodology. The indices trend analysis of eight-year period for the rural, urban areas and the country level were computed. This study shows that in Iran the fairness of financial contribution index during the eight-year period has been decreased from 0.841 in 2003 to above 0.827 in 2010 and The percentage of people with catastrophic health expenditures has been increased from 2.3% to above 3.1%. The ratio of total treatment costs to the household overall capacity to pay has been increased from 0.055 to 0.068 and from 0.072 to 0.0818 in urban and rural areas respectively. There is a decline in fairness of financial contribution index during the study period. While, a trend stability of the proportion of households who suffered catastrophic health expenditures was found.
Fazaeli, Amir Abbas; Seyedin, Hesam; Moghaddam, Abbas Vosoogh; Delavari, Alireza; Salimzadeh, H.; Varmazyar, Hasan; Fazaeli, Ali Akbar
Background: Social systems are dealing with the challenge of achieving fairness in the distribution of financial burden and protecting the risk of financial loss. The purpose of this paper is to present a trend analysis for the indicators related to fairness in healthcare’s financial burden in rural and urban population of Iran during the eight years period of 2003 to 2010. Methods: We used the information gathered by statistical center of Iran through sampling processes for the household income and expenditures. The indicators of fairness in financial contribution of healthcare were calculated based on the WHO recommended methodology. The indices trend analysis of eight-year period for the rural, urban areas and the country level were computed. Results: This study shows that in Iran the fairness of financial contribution index during the eight-year period has been decreased from 0.841 in 2003 to above 0.827 in 2010 and The percentage of people with catastrophic health expenditures has been increased from 2.3% to above 3.1%. The ratio of total treatment costs to the household overall capacity to pay has been increased from 0.055 to 0.068 and from 0.072 to 0.0818 in urban and rural areas respectively. Conclusion: There is a decline in fairness of financial contribution index during the study period. While, a trend stability of the proportion of households who suffered catastrophic health expenditures was found. PMID:26156920
West, Allison L; Aparicio, Elizabeth M; Berlin, Lisa J; Jones Harden, Brenda
Implementation of evidence-based interventions in "real-world" settings is enhanced when front-line staff view the intervention as acceptable, appropriate, and feasible. This qualitative study addresses Early Head Start (EHS) home visitors' perceptions and experiences of an evidence-based parenting intervention, the Attachment and Biobehavioral Catch-up program (M. Dozier, O. Lindhiem, & J. Ackerman, 2005), when added to EHS services as usual within the context of a research-practice partnership. Thematic analysis of in-depth, qualitative interviews indicates that home visitors experienced the intervention as positive and helpful for EHS families. Some challenges included scheduling and uncertainty regarding the goals of the intervention. Concerns over participation in the research centered on information exchange, confidentiality, and time limitations. © 2017 Michigan Association for Infant Mental Health.
Cacaci, Margherita; Lelli, Rossella Colomba
The role of the veterinarian as a public health officer is intrinsic to the history and the culture of veterinary organization in Italy. The Veterinary service being part of the Health administration since the birth of the Italian State in the XIX Century. In the second half of the last century the birth of the Italian National Health Service confirmed that the function of the Italian veterinary service was to analyze and reduce the risks for the human population connected to the relationship man-animal-environment, animal health, food safety and security. The Italian Veterinary Medicine School curricula, reflected this "model" of veterinarian as well. In the majority of countries in the world, Veterinary Services are organized within the Agriculture Administration with the main function to assure animal health and wellbeing. After the so-called "Mad-cow crisis" the awareness of the direct and essential role of veterinary services in the prevention of human illness has been officially recognized and in the third millennium the old concept of "one health" and "human-animal interface" has gained popularity worldwide.The concept of Veterinary Public Health, has evolved at International level and has incorporated the more than a century old vision of the Italian Veterinary medicine and it is defined as "the sum of the contributions to the physical, mental and social development of people through the knowledge and application of veterinary science" (WHO, Future trends in veterinary public health. Gruppo di lavoro OMS: TE, Italy, 1999, Available from: http://www.who.int/zoonoses/vph/en/ . Last visited 16 Feb 2016, 1999).On the subject of Cooperation, Sustainability and Public Health, the EXPO 2015 event and the activities of international organizations WHO, FAO and World Organization for Animal Health are refocusing at present their worldwide mandate to protect human health and the economy of both the poorest Countries and the developed countries, according to the "new
Reiman, Arto; Pedersen, Louise Møller; Väyrynen, Seppo
. The concept of Safety Training Park (STP) has been developed to meet these challenges. Eighty stakeholders from the Finnish construction industry have been involved in the construction and financing of the STP in northern Finland (STPNF). This unique cooperation has contributed to the immediate success......, and evidence from the literature are presented with a focus on the pros and cons of the STPNF. The STP is a new and innovative method for safety training that stimulates different learning styles and inspires changes in individuals’ behavior and in the organizations’ safety climate. The stakeholders’ high...... commitment, a long-term perspective, and a strong safety climate are identified as preconditions for the STP concept to work....
Full Text Available Urban green spaces encourage outdoor activity and social communication that contribute to the health of local residents. Examining the relationship between the use of urban green spaces and factors influencing their utilization can provide essential references for green space site selection in urban planning. In contrast to previous studies that focused on internal factors, this study highlights the external factors (traffic convenience, population density and commercial facilities contributing to the use of urban green spaces. We conducted a spatiotemporal analysis of the distribution of visitors in 208 selected green spaces in central Beijing. We examined the relationship between the spatial pattern of visitor distribution within urban green spaces and external factors, using the Gini coefficient, kernel density estimation, and geographical detectors. The results of the study were as follows. The spatial distribution of visitors within central Beijing’s green spaces was concentrated, forming different agglomerations. The three examined external factors are all associated with the use of green spaces. Among them, commercial facilities are the important external factor associated with the use of green spaces. For the selection of sites for urban green spaces, we recommend consideration of external factors in order to balance urban green space utilization.
Evalina van Wijk
Objectives: The aim of the study was to describe patients’ perceptions of the possible environmental and staff factors that might contribute to their aggressive and violent behaviour after admission to a mental health facility; and to propose strategies to prevent and manage such behaviour. Research design: A qualitative, phenomenological study was utilised, in which purposefully sampled inpatients were interviewed over a six-month period. Inpatients were invited to participate if they had been admitted for at least seven days and were in touch with reality. Method: Forty inpatients in two mental health facilities in Cape Town participated in face-to-face, semi-structured interviews over a period of six months. Tesch’s descriptive method of open coding formed the framework for the data analysis and presentation of the results. Trustworthiness was ensured in accordance with the principles of credibility, confirmability, transferability and dependability. Results: Analysis of the data indicates two central categories in the factors contributing to patients’ aggressive and violent behaviour, namely, environmental factors and the attitude and behaviour of staff. Conclusion: From the perspective of the inpatients included in this study, aggressive and violent episodes are common and require intervention. Specific strategies for preventing such behaviour are proposed and it is recommended that these strategies be incorporated into the in-service training programmes of the staff of mental health facilities. These strategies could prevent, or reduce, aggressive and violent behaviour in in-patient facilities.
Pourat, Nadereh; Andersen, Ronald M; Marcus, Marvin
Existing studies of disparities in access to oral health care for underserved populations often focus on supply measures such as number of dentists. This approach overlooks the importance of other aspects of the dental care delivery system, such as personal and practice characteristics of dentists, that determine the capacity to provide care. This study aims to assess the role of such characteristics in access to care of underserved populations. We merged data from the 2003 California Health Interview Survey and a 2003 survey of California dentists in their Medical Study Service Areas (MSSAs). We examined the role of overall supply and other characteristics of dentists in income and racial/ethnic disparities in access, which was measured by annual dental visits and unmet need for dental care due to costs. We found that some characteristics of MSSAs, including higher proportions of dentists who were older, white, busy or overworked, and did not accept public insurance or discounted fees, inhibited access for low-income and minority populations. These findings highlight the importance of monitoring characteristics of dentists in addition to traditional measures of supply such as licensed-dentist-to-population ratios. The findings identify specific aspects of the delivery system such as dentists' participation in Medicaid, provision of discounted care, busyness, age, race/ethnicity, and gender that should be regularly monitored. These data will provide a better understanding of how the dental care delivery system is organized and how this knowledge can be used to develop more narrowly targeted policies to alleviate disparities. © 2014 American Association of Public Health Dentistry.
Macdiarmid, Jennie I
Eating more seasonal food is one proposal for moving towards more sustainable consumption patterns, based on the assumption that it could reduce the environmental impact of the diet. The aim of the present paper is to consider the implications of eating seasonal food on the different elements of sustainability (i.e. health, economics, society), not just the environment. Seasonality can be defined as either globally seasonal (i.e. produced in the natural production season but consumed anywhere in the world) or locally seasonal (i.e. produced in the natural production season and consumed within the same climatic zone). The environmental, health, economic and societal impact varies by the definition used. Global seasonality has the nutritional benefit of providing a more varied and consistent supply of fresh produce year round, but this increases demand for foods that in turn can have a high environmental cost in the country of production (e.g. water stress, land use change with loss of biodiversity). Greenhouse gas emissions of globally seasonal food are not necessarily higher than food produced locally as it depends more on the production system used than transportation. Eating more seasonal food, however, is only one element of a sustainable diet and should not overshadow some of the potentially more difficult dietary behaviours to change that could have greater environmental and health benefits (e.g. reducing overconsumption or meat consumption). For future guidelines for sustainable diets to be realistic they will need to take into account modern lifestyles, cultural and social expectations in the current food environment.
Bhalerao, V R; Galwankar, M; Kowli, S S; Kumar, R; Chaturvedi, R M
The role of involving prospective fathers in the care of pregnant women attending the Mother Craft Clinic of the Malavani Health Center in Bombay, India was evaluated. Beginning in October 1982, pregnant women attending the Clinic were requested to ask their husands to meet the resident medical officer of the center who was available on the premises of the Center on all days and evenings including the holidays. 1 of the medico-social workers explained to the women the reason and the need for their husbands coming and meeting the doctor at the Center. The outcome of the maternal health care program for the 270 women whose husbands were invited and came (Group 1) was compared with the outcome of the same program, under the same roof, for 405 women whose husbands could not be invited (Group 2). The husbands who attended the center were educated individually and in groups about their role in nutrition and health of their wives during pregnancy and their responsibility in subsequent child rearing. The physiology of pregnancy, complications of pregnancy, and the possible ways and means of preventing the complications were explained in detail. The husbands were also told to encourage their wives to attend the antenatal clinic of the center as often as possible. There was no difference in the socioeconomic, educational, cultural, and religious background of the 2 groups of women who were similar in parity distribution. The main difference between the 2 groups was a significantly lower perinatal mortality in Group 1. Only 60 of the 405 Group 2 women were considered eligible for postpartum sterilization (para 3 and higher). In contrast, 41 of the 270 Group 1 women were considered eligible for postpartum sterilization and 110 women accepted. The excess of those who accepted over those who were eligible came form the lower paras. This effort confirms that the involvement of prospective fathers is possible and pays good dividends even in an uneducated and low socioeconomic
Intersectoral action (ISA) has been at the forefront of public health policy discussions since the 1970s. ISA incorporates a broader perspective of public health issues and coordinates efforts to address the social, political, economic and environmental contexts from which health determinants operate and are created. Despite being forwarded as a useful way to address and treat complex or 'wicked' problems, such policy issues are still often addressed within, rather than across, disciplinary silos and ISA has been documented to fail more often than it succeeds. This paper contributes to an understanding of ISA by outlining and applying critical systems heuristics (CSH) theory and methods. CSH theory and methods are described and discussed before applying them to the example of addressing climate change and health equity through public health practice. CSH thinking provides useful tools to engage stakeholders, question relations of power that may exist between collaborating partners, and move beyond power inequalities that guide ISA initiatives. CSH is a compelling framing that can improve an understanding of the collaborative relationships that are a prerequisite for engaging in ISA to address complex or 'wicked' policy problems such as climate change. © 2013 John Wiley & Sons Ltd.
We know from rigorous evidence that nurses can exert an incredible impact on the everyday lives of people and their health. Nurses can also contribute in much wider spheres of influence by applying their knowledge and skills to address broader issues affecting population health across communities, nations and globally. Despite the prevalence of so many vexing health and social issues, nurses often fail to think globally, or even regionally, when they are lobbying for change. And while much political influence is local, some issues are simply too complex to rely on local influence alone. Importantly in all this, we must acknowledge the ways these complex health issues are shaped by economic and political agendas and not necessarily by healthcare agendas. As such, the nursing community has to act globally and locally, both within and outside of the nursing arena. This paper explores early thinking about an evolving model of spheres--or "bubbles"--of policy influence in which nurses can and must operate to more effectively impact key global health and healthcare challenges.
Bloom, David E.; Canning, David; Hu, Linlin; Liu, Yuanli; Mahal, Ajay; Yip, Winnie
We find that a cross-country model of economic growth successfully tracks the growth takeoffs in China and India. The major drivers of the predicted takeoffs are improved health, increased openness to trade, and a rising labor force-to-population ratio due to fertility decline. We also explore the effect of the reallocation of labor from low-productivity agriculture to the higher-productivity industry and service sectors. Including the money value of longevity improvements in a measure of full income reduces the gap between the magnitude of China's takeoff relative to India's due to the relative stagnation in life expectancy in China since 1980. PMID:20419074
Steelman, Susan C; Thomas, Sheila L
The study gathered data about librarians' membership in institutional animal care and use committees (IACUCs) and their professional activities supporting animal researchers. Libraries affiliated with medical schools that were members of the Association of American Medical Colleges were surveyed. A survey was distributed via library directors' email discussion lists and direct email messages. Sixty surveys were completed: 35 (58%) reported that librarians performed database searches for researchers, and 22 (37%) reported that a librarian currently serves on the IACUC. The survey suggests that academic health sciences librarians provide valuable, yet underutilized, services to support animal research investigators.
Bhalerao V; Galwankar M; Kowli S; Kumar R; Chaturvedi R
The role of involving prospective fathers in the care of pregnant women attending the Mother Craft Clinic of the Malavani Health Center in Bombay, India was evaluated. Beginning in October 1982, pregnant women attending the Clinic were requested to ask their husands to meet the resident medical officer of the center who was available on the premises of the Center on all days and evenings including the holidays. 1 of the medico-social workers explained to the women the reason and the need fo...
Karmaliani, Rozina; Pasha, Aneeta; Hirani, Saima; Somani, Rozina; Hirani, Shela; Asad, Nargis; Cassum, Laila; McFarlane, Judith
Pakistan ranks 125th out of 169 countries on the Gender Development Index and has high prevalence rates of Violence against Women (VAW). Contributing factors toward gender based violence at the micro, meso and macro levels include the acceptability of violence amongst both men and women, internalization of deservability, economic disempowerment, lack of formal education, joint family systems, entrenched patriarchal norms and values, and a lack of awareness of legal and other support systems. These factors have a long-lasting impact on the health of women and children. The gender disparities in the experience of women seeking health care in Pakistan are well-recognized and documented. In the past, common government policy responses to these disparities have included developing the role of community health workers (CHWs) and lady health visitors (LHVs). Despite being commendable initiatives, these too have been unsuccessful in addressing these multi-faceted disparities. Within this complex scenario, new interventions to address VAW and its impact on health in Pakistan include Group Counselling, Economic Skills Building, Health-Based Microfinance, and Family-Based models that increase male involvement, especially at the primary health care level. The purpose of this article is to outline key contributing factors to VAW, explore tested and new interventions, and highlight the opportunities that exist in implementing them.
Missmer, Stacey A; Seifer, David B; Jain, Tarun
To identify cultural differences in access to infertility care. Cross-sectional, self-administered survey. University hospital-based fertility center. Thirteen hundred fifty consecutive women who were seen for infertility care. None. Details about demographic characteristics, health care access, and treatment opinions based on patient race or ethnicity. The median age of participants was 35 years; 41% were white, 28% African American, 18% Hispanic, and 7% Asian. Compared with white women, African American and Hispanic women had been attempting to conceive for 1.5 years longer. They also found it more difficult to get an appointment, to take time off from work, and to pay for treatment. Forty-nine percent of respondents were concerned about the stigma of infertility, 46% about conceiving multiples, and 40% about financial costs. Disappointing one's spouse was of greater concern to African-American women, whereas avoiding the stigmatization of infertility was of greatest concern to Asian-American women. While the demand for infertility treatment increases in the United States, attention to cultural barriers to care and cultural meanings attributed to infertility should be addressed. Enhanced cultural competencies of the health care system need to be employed if equal access is to be realized as equal utilization for women of color seeking infertility care. Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
Brown, Stephanie L; Brown, R Michael
Although a growing body of evidence suggests that giving to (helping) others is linked reliably to better health and longevity for the helper, little is known about causal mechanisms. In the present paper we use a recently developed model of caregiving motivation to identify possible neurophysiological mechanisms. The model describes a mammalian neurohormonal system that evolved to regulate maternal care, but over time may have been recruited to support a wide variety of helping behaviors in humans and other social animals. According to the model, perception of need or distress in others activates caregiving motivation, which in turn, can facilitate helping behavior. Motivational regulation is governed by the medial preoptic area of the hypothalamus, interacting with certain other brain regions, hormones, and neuromodulators (especially oxytocin and progesterone). Consideration of neurohormonal circuitry and related evidence raises the possibility that it is these hormones, known to have stress-buffering and restorative properties, that are responsible, at least in part, for health and longevity benefits associated with helping others. Copyright © 2015 Elsevier Ltd. All rights reserved.
Full Text Available Abstract The use of natural honey (NH as a nutraceutical agent is associated with nutritional benefits and therapeutic promises. NH is widely accepted as food and medicine by all generations, traditions and civilizations, both ancient and modern. The nutritional profiles, including its use in infant and children feeding reported in different literatures as well as health indices and biomarkers observed by various researchers are illustrated in this manuscript. The review documents folk medicine, experimentation with animal models, and orthodox medical practices shown by clinical trials. This covers virtually all human organs and body systems extensively studied by different workers. The sources and adverse effects of NH contamination, as well as the preventive methods are identified. This could promote the availability of residue free honey and a wholesome natural product for domestic consumption and international market. This could also help to prevent health problems associated with NH poisoning. In addition, apicultural practices and the economic importance of honey are well documented. This report also includes information about a relatively unknown and uncommon South American stingless bee species. We concluded this review by identifying important roles for Ethno-entomologists, other Scientists and Apiculturists in the development of stingless bees to boost honey production, consumption and economic earnings.
França, Tânia; Medeiros, Katia Rejane de; Belisario, Soraia Almeida; Garcia, Ana Cláudia; Pinto, Isabela Cardoso de Matos; Castro, Janete Lima de; Pierantoni, Célia Regina
The article analyzes the role of Permanent Committees of Teaching-Service Integration (CIES) in the implementation of Permanent Education in Health Policy (EPS). It is a multicenter study with a qualitative-quantitative approach which used a self-applied online questionnaire and a semi-structured interview for data collection. The key respondants were the responsible for EPS Policy of the 27 State Health Secretariats (SES) and 7 coordinators of CIESs of the five regions of Brazil. The findings showed the existence of a specific EPS sector in most SES; high level of schooling, experience and stable employment status of the managers. Regarding CIESs, it was verified: existence in most of the states; creative process diversity; plural composition; regularity of meetings; good relationship with training institutions; difficulties in the use and management of resources destined for EPS. The study indicated progress, showing the importance of these instances as spaces of negotiation, agreement and development of EPS. However, challenges still need to be overcome in order to consolidate projects in the SES, strengthening the PNEPS.
Full Text Available The role of involving prospective fathers in the care of pregnant women attending the Mother Craft Clinic of the Malavani Health Center in Bombay, India was evaluated. Beginning in October 1982, pregnant women attending the Clinic were requested to ask their husands to meet the resident medical officer of the center who was available on the premises of the Center on all days and evenings including the holidays. 1 of the medico-social workers explained to the women the reason and the need for their husbands coming and meeting the doctor at the Center. The outcome of the maternal health care program for the 270 women whose husbands were invited and came (Group 1 was compared with the outcome of the same program, under the same roof, for 405 women whose husbands could not be invited (Group 2. The husbands who attended the center were educated individually and in groups about their role in nutrition and health of their wives during pregnancy and their responsibility in subsequent child rearing. The physiology of pregnancy, complications of pregnancy, and the possible ways and means of preventing the complications were explained in detail. The husbands were also told to encourage their wives to attend the antenatal clinic of the center as often as possible. There was no difference in the socioeconomic, educational, cultural, and religious background of the 2 groups of women who were similar in parity distribution. The main difference between the 2 groups was a significantly lower perinatal mortality in Group 1. Only 60 of the 405 Group 2 women were considered eligible for postpartum sterilization (para 3 and higher. In contrast, 41 of the 270 Group 1 women were considered eligible for postpartum sterilization and 110 women accepted. The excess of those who accepted over those who were eligible came form the lower paras. This effort confirms that the involvement of prospective fathers is possible and pays good dividends even in an uneducated and low
Rand, Debbie; Eng, Janice J; Tang, Pei-Fang; Hung, Chihya; Jeng, Jiann-Shing
Abstract Background Participation in daily physical activity (PA) post-stroke has not previously been investigated as a possible explanatory variable of health-related quality of life (HRQL). The aims were 1) to determine the contribution of daily PA to the HRQL of individuals with chronic stroke and 2) to assess the relationship between the functional ability of these individuals to the amount of daily PA. Methods The amount of daily PA of forty adults with chronic stroke (mean age 66.5 ± 9....
Full Text Available Lactic acid bacteria (LAB are extensively used in the manufacture of a wide variety of fermented dairy, meat, vegetable, bakery and wine products in the food and wine industry as well as in making silage for animal feed. Some LAB strains also have an increasingly important role as health-promoting probiotics. Molecular genetic research of LAB, focused mainly on the basic characterisation of traits essential for the industrial utilisation of these bacteria, forms a solid scientific basis for stabilisation, modification and improvement of these characteristics. The emphasis of this review is on the molecular genetic work done at the research laboratory of the author. Our research team is engaged on, two main projects: molecular genetic and biochemical characterisation of the proteolytic systems of industrial thermophilic lactobacilli and surface layer protein studies to develop protein production systems for food, feed, vaccine and diagnostic purposes.
Barbini, R.; Colao, F.; Fantoni, R.; Palucci, A.; Ribezzo, S.
The first European joint field campaign for the remote sensing of vegetation health was held in Viterbo (October 6 to 18, 1991) within the framework of the EUREKA/LASFLEUR project. Italian groups, from universities, ENEA (Italian Agency for Energy, New Technologies and the Environment) and CNR (Italian National Research Council), participated in this campaign together with several German groups from different institutes. The LIDAR (light detection and ranging) fluorosensor system built at the ENEA Frascati Research Center for the remote sensing of water and land was modified to detect fluorescence from trees in a field experiment. The new version of the set-up is presented in this paper together with the spectral and time resolved measurements that were performed. Results are discussed in view of correlating present data with the plant photosynthesis activity under different weather conditions and water stresses
G. L. Mikirtichan
Full Text Available Sophie Marie Dorothea Auguste Louise descended from German House of Württemberg and was the eldest daughter of the prince Friedrich II Eugen, Duke of Württemberg. She turned into Orthodoxy under the name of Maria Feodorovna. In September 1776 she married the future emperor — Paul I. One of the most significant pages in the history of Russia is associated with the name of Maria Feodorovna — formation of the charity as a system, including three main directions: public education, social support and health care. With her direct assistance 30 charity institutions (founding hospitals, a number of women institutes and other teaching and educational organizations, alms-houses, hospitals etc. were founded, most of them — for children.
Aebi, Marcel; Kuhn, Christine; Banaschewski, Tobias
were used to predict any problems/disorders, emotional problems/disorders and behavioural problems/disorders in a community sample (n = 252) and in a clinic sample (n = 95). RESULTS: The findings were strikingly similar in both samples. Parent and youth SDQ scales were related to any problem/disorder......BACKGROUND: Discrepancies between multiple informants often create considerable uncertainties in delivering services to youth. The present study assessed the ability of the parent and youth scales of the Strength and Difficulties Questionnaire (SDQ) to predict mental health problems/disorders....... Youth SDQ symptom and impact had the strongest association with emotional problems/disorder and parent SDQ symptom score were most strongly related to behavioural problems/disorders. Both the SDQ total and the impact scores significantly predicted emotional problems/disorders in males whereas...
Full Text Available AIM: To report the incidence of premenstrual syndrome in working women and the association of premenstrual syndrome with social and demographical factors, menstrual cycle, and nutritional status. The second aim of this study is to investigate the influence\tof premenstrual syndrome on working performance. Finally, to contribute to decrease the waste of labor time and unnecessary drugs usage caused by premenstrual syndrome.\tMATERIAL-METHODS: Totally 254 women aged between 19-49 years old who work in Dicle University Faculty of Medicine Hospital were enrolled for this prospective study. Data were obtained by face to face interview questionnaires.\tRESULTS: The incidence of premenstrual syndrome was 20.1%. The 91.7% of women had experienced mild or moderate symptoms in premenstrual period. The most common complains were pelvic pain, tension or restlessness, irritability or agitation, abdominal bloating and breast tenderness. Furthermore, in the presence of following factors; women with young ages ( CONCLUSION: The incidence of premenstrual syndrome is higher in working women and this condition may affect the whole population. In order to decrease the incidence of premenstrual syndrome and to increase the life quality of women; more attention\tshould be paid to this condition and proper precautions should be taken.
Cantone, M.C.; Birattari, C.; Merzagora, M.
It is widely accepted that Radiological Protection has a real social dimension and it is not restricted to the pure scientific and quantitative aspects. The quality in radiation protection is not reached by simply complying with current technical standards or by enforcing an improved or restricted regulation, but must also be pursued by promoting a culture of radiation protection. An effective dissemination of a radiation protection culture has to include education and training for those students who will become researchers in the involved fields, or who will be called in risk management and, as protection managers, will be asked to inform and train workers or to communicate with the public. Today, in most universities the education in ethics is a significant part of the training in medical, biological and biotechnological curricula but, it is still of poor consideration in those curricula which are traditionally related to Physical Science and even in those areas, like Health Physics, where implementation of interdisciplinary approaches and methodologies are important sources for progress. Moreover, recent advances in the research field of risk perception and communication are very rarely included in those courses. At the Health Physics post-graduate School of Milano State University, within the course of Radiation Protection, a new subject has been recently introduced facing the question of ethical problems and risk perception in radiation protection, and dealing with the activity of international organisations aimed to establish ethical principles for protection against ionising radiation. By referring to this context, students realize how the analysis of radiological risk includes both technological and ethical aspects. The hope is that a new generation of experts in heath physics will promote a dynamic development of knowledge and a higher degree of awareness even in ethical aspects within the academic, institutional or professional fields of radiation
Sherwen, Sally L; Hemsworth, Paul H; Butler, Kym L; Fanson, Kerry V; Magrath, Michael J L
Free range exhibits are becoming increasingly popular in zoos as a means to enhance interaction between visitors and animals. However very little research exists on the impacts of visitors on animal behaviour and stress in free range exhibits. We investigated the effects of visitor number on the behaviour and stress physiology of Kangaroo Island (KI) Kangaroos, Macropus fuliginosus fuliginosus, and Red Kangaroos, Macropus rufus, housed in two free range exhibits in Australian zoos. Behavioural observations were conducted on individual kangaroos at each site using instantaneous scan sampling to record activity (e.g., vigilance, foraging, resting) and distance from the visitor pathway. Individually identifiable faecal samples were collected at the end of each study day and analysed for faecal glucocorticoid metabolite (FGM) concentration. When visitor number increased, both KI Kangaroos and Red Kangaroos increased the time spent engaged in visitor-directed vigilance and KI Kangaroos also increased the time spent engaged in locomotion and decreased the time spent resting. There was no effect of visitor number on the distance kangaroos positioned themselves from the visitor pathway or FGM concentration in either species. While there are limitations in interpreting these results in terms of fear of visitors, there was no evidence of adverse effects animal welfare in these study groups based on avoidance behaviour or stress physiology under the range of visitor numbers that we studied. © 2015 Wiley Periodicals, Inc.
The solar energy system located at the Visitors' Center on the Stephens College Campus, Columbia, Missouri is discussed. The system is installed in a four-story, 15,000 square foot building. The solar energy system is an integral design of the building and utilizes 176 hydronic flat plate collectors which use a 50 percent water ethylene blycol solution and water-to-water heat exchanger. Solar heated water is stored in a 5,000 gallon water storage tank located in the basement equipment room. A natural gas fired hot water boiler supplies hot water when the solar energy heat supply fails to meet the demand. The designed solar contribution is 71 percent of the heating load.
Gutema Taressa Tura
Full Text Available Abstract Background Proper hand hygiene with soap and detergents prevents the transmission of many infectious diseases. However, commercial detergents are less likely to be accessible or affordable to poor people in remote rural areas. These people traditionally use some plant parts as a detergent even though their antibacterial activity has not been yet investigated. Therefore, this study aims to determine the antibacterial activities of some of the plants against bacteria isolated from humans. Methods Plants selected for this study are Phytolacca dodecandra fruits, Rumex nepalensis leaves, Grewia ferruginea bark and leaves. The samples of these plants were collected from rural areas of Jimma town based on their ethno-botanical survey and information on their local use. Acetone was used as a solvent to extract the bioactive constituents of the plants. The antibacterial activities of the plants were evaluated against reference strains and bacteria isolated from humans using disc diffusion and macro dilution methods. Results The plant extracts have shown varying antimicrobial activities against the bacterial species tested. Susceptibility testing shows zones of inhibition ranging from 8.0 ± 1.0 mm to 20.7 ± 5.5 mm. The MIC and MBC of the plants against the bacterial species tested were 3.13 and 12.5 mg/ml respectively. These variations are attributed to different concentrations of the bioactive constituents of the extracts like saponins, tannins, flavonoids and terpenoids. Conclusion The studied plants can contribute to achieve better personal hygiene since they are effective against different bacterial agents and are freely available in rural areas.
Kogan, Steven M; Lei, Man-Kit; Grange, Christina R; Simons, Ronald L; Brody, Gene H; Gibbons, Frederick X; Chen, Yi-Fu
Accumulating evidence suggests that African American men and women experience unique challenges in developing and maintaining stable, satisfying romantic relationships. Extant studies have linked relationship quality among African American couples to contemporaneous risk factors such as economic hardship and racial discrimination. Little research, however, has examined the contextual and intrapersonal processes in late childhood and adolescence that influence romantic relationship health among African American adults. We investigated competence-promoting parenting practices and exposure to community-related stressors in late childhood, and negative relational schemas in adolescence, as predictors of young adult romantic relationship health. Participants were 318 African American young adults (59.4% female) who had provided data at four time points from ages 10-22 years. Structural equation modeling indicated that exposure to community-related stressors and low levels of competence-promoting parenting contributed to negative relational schemas, which were proximal predictors of young adult relationship health. Relational schemas mediated the associations of competence-promoting parenting practices and exposure to community stressors in late childhood with romantic relationship health during young adulthood. Results suggest that enhancing caregiving practices, limiting youths' exposure to community stressors, and modifying relational schemas are important processes to be targeted for interventions designed to enhance African American adults' romantic relationships.
Kogan, Steven M.; Lei, Man-Kit; Grange, Christina R.; Simons, Ronald L.; Brody, Gene H.; Gibbons, Frederick X.; Chen, Yifu
Accumulating evidence suggests that African American men and women experience unique challenges in developing and maintaining stable, satisfying romantic relationships. Extant studies have linked relationship quality among African American couples to contemporaneous risk factors such as economic hardship and racial discrimination. Little research, however, has examined the contextual and intrapersonal processes in late childhood and adolescence that influence romantic relationship health among African American adults. We investigated competence-promoting parenting practices and exposure to community-related stressors in late childhood, and negative relational schemas in adolescence, as predictors of young adult romantic relationship health. Participants were 318 African American young adults (59.4% female) who had provided data at four time points from ages 10–22 years. Structural equation modeling indicated that exposure to community-related stressors and low levels of competence-promoting parenting contributed to negative relational schemas, which were proximal predictors of young adult relationship health. Relational schemas mediated the associations of competence-promoting parenting practices and exposure to community stressors in late childhood with romantic relationship health during young adulthood. Results suggest that enhancing caregiving practices, limiting youths’ exposure to community stressors, and modifying relational schemas are important processes to be targeted for interventions designed to enhance African American adults’ romantic relationships. PMID:23494451
Murakami, Haruka; Ryan, Katie Rose; Ohta, Yuji; Miyachi, Motohiko
Background Wii Fit was originally designed as a health and fitness interactive training experience for the general public. There are, however, many examples of Wii Fit being utilized in clinical settings. This article aims to identify the contribution of Wii Fit in the field of health promotion and rehabilitation by: (1) identifying the health-related domains for which the Wii Fit series has been tested, (2) clarifying the effect of Wii Fit in those identified health-related domains and (3) quantifying this effect. Method A systematic literature review was undertaken. The MEDLINE database and Games for Health Journal published content were explored using the search term “Wii-Fit.” Occurrences resulting from manual searches on Google and material suggested by experts in the field were also considered. Included articles were required to have measurements from Wii Fit activities for at least one relevant health indicator. The effect of Wii Fit interventions was assessed using meta-analyses for the following outcomes: activity-specific balance confidence score, Berg balance score (BBC) and time-up-and-go test (TUG). Findings A total of 115 articles highlighted that the Wii Fit has been tested in numerous healthy and pathological populations. Out of these, only a few intervention studies have focused on the prevention of chronic diseases. A large proportion of the studies focus on balance training (N = 55). This systematic review highlights several potential benefits of Wii Fit interventions and these positive observations are supported by meta-analyses data (N = 25). For example, the BBC and the TUG respond to a similar extend to Wii Fit interventions compared with traditional training. Conclusion Wii Fit has the potential to be used as a rehabilitation tool in different clinical situations. However, the current literature includes relatively few randomized controlled trials in each population. Further research is therefore required. PMID:28890847
Tripette, Julien; Murakami, Haruka; Ryan, Katie Rose; Ohta, Yuji; Miyachi, Motohiko
Wii Fit was originally designed as a health and fitness interactive training experience for the general public. There are, however, many examples of Wii Fit being utilized in clinical settings. This article aims to identify the contribution of Wii Fit in the field of health promotion and rehabilitation by: (1) identifying the health-related domains for which the Wii Fit series has been tested, (2) clarifying the effect of Wii Fit in those identified health-related domains and (3) quantifying this effect. A systematic literature review was undertaken. The MEDLINE database and Games for Health Journal published content were explored using the search term "Wii-Fit." Occurrences resulting from manual searches on Google and material suggested by experts in the field were also considered. Included articles were required to have measurements from Wii Fit activities for at least one relevant health indicator. The effect of Wii Fit interventions was assessed using meta-analyses for the following outcomes: activity-specific balance confidence score, Berg balance score (BBC) and time-up-and-go test (TUG). A total of 115 articles highlighted that the Wii Fit has been tested in numerous healthy and pathological populations. Out of these, only a few intervention studies have focused on the prevention of chronic diseases. A large proportion of the studies focus on balance training ( N = 55). This systematic review highlights several potential benefits of Wii Fit interventions and these positive observations are supported by meta-analyses data ( N = 25). For example, the BBC and the TUG respond to a similar extend to Wii Fit interventions compared with traditional training. Wii Fit has the potential to be used as a rehabilitation tool in different clinical situations. However, the current literature includes relatively few randomized controlled trials in each population. Further research is therefore required.
Whittle, Henry J; Palar, Kartika; Seligman, Hilary K; Napoles, Tessa; Frongillo, Edward A; Weiser, Sheri D
Food-insecure people living with HIV/AIDS (PLHIV) consistently exhibit worse clinical outcomes than their food-secure counterparts. This relationship is mediated in part through non-adherence to antiretroviral therapy (ART), sub-optimal engagement in HIV care, and poor mental health. An in-depth understanding of how these pathways operate in resource-rich settings, however, remains elusive. We aimed to understand the relationship between food insecurity and HIV health among low-income individuals in the San Francisco Bay Area using qualitative methods. Semi-structured in-depth interviews were conducted with 34 low-income PLHIV receiving food assistance from a non-profit organization. Interviews explored experiences with food insecurity and its perceived effects on HIV-related health, mental health, and health behaviors including taking ART and attending clinics. Thematic content analysis of transcripts followed an integrative inductive-deductive approach. Food insecurity was reported to contribute to poor ART adherence and missing scheduled clinic visits through various mechanisms, including exacerbated ART side effects in the absence of food, physical feelings of hunger and fatigue, and HIV stigma at public free-meal sites. Food insecurity led to depressive symptoms among participants by producing physical feelings of hunger, aggravating pre-existing struggles with depression, and nurturing a chronic self-perception of social failure. Participants further explained how food insecurity, depression, and ART non-adherence could reinforce each other in complex interactions. Our study demonstrates how food insecurity detrimentally shapes HIV health behavior and outcomes through complex and interacting mechanisms, acting via multiple socio-ecological levels of influence in this setting. The findings emphasize the need for broad, multisectoral approaches to tackling food insecurity among urban poor PLHIV in the United States. Copyright © 2016 Elsevier Ltd. All rights
Full Text Available Background Wii Fit was originally designed as a health and fitness interactive training experience for the general public. There are, however, many examples of Wii Fit being utilized in clinical settings. This article aims to identify the contribution of Wii Fit in the field of health promotion and rehabilitation by: (1 identifying the health-related domains for which the Wii Fit series has been tested, (2 clarifying the effect of Wii Fit in those identified health-related domains and (3 quantifying this effect. Method A systematic literature review was undertaken. The MEDLINE database and Games for Health Journal published content were explored using the search term “Wii-Fit.” Occurrences resulting from manual searches on Google and material suggested by experts in the field were also considered. Included articles were required to have measurements from Wii Fit activities for at least one relevant health indicator. The effect of Wii Fit interventions was assessed using meta-analyses for the following outcomes: activity-specific balance confidence score, Berg balance score (BBC and time-up-and-go test (TUG. Findings A total of 115 articles highlighted that the Wii Fit has been tested in numerous healthy and pathological populations. Out of these, only a few intervention studies have focused on the prevention of chronic diseases. A large proportion of the studies focus on balance training (N = 55. This systematic review highlights several potential benefits of Wii Fit interventions and these positive observations are supported by meta-analyses data (N = 25. For example, the BBC and the TUG respond to a similar extend to Wii Fit interventions compared with traditional training. Conclusion Wii Fit has the potential to be used as a rehabilitation tool in different clinical situations. However, the current literature includes relatively few randomized controlled trials in each population. Further research is therefore required.
Karopka, T; Schmuhl, H; Marcelo, A; Molin, J Dal; Wright, G
: To analyze the contribution of Free/Libre Open Source Software in health care (FLOSS-HC) and to give perspectives for future developments. The paper summarizes FLOSS-related trends in health care as anticipated by members of the IMIA Open Source Working Group. Data were obtained through literature review and personal experience and observations of the authors in the last two decades. A status quo is given by a frequency analysis of the database of Medfloss.org, one of the world's largest platforms dedicated to FLOSS-HC. The authors discuss current problems in the field of health care and finally give a prospective roadmap, a projection of the potential influences of FLOSS in health care. FLOSS-HC already exists for more than 2 decades. Several projects have shown that FLOSS may produce highly competitive alternatives to proprietary solutions that are at least equivalent in usability and have a better total cost of ownership ratio. The Medfloss.org database currently lists 221 projects of diverse application types. FLOSS principles hold a great potential for addressing several of the most critical problems in health care IT. The authors argue that an ecosystem perspective is relevant and that FLOSS principles are best suited to create health IT systems that are able to evolve over time as medical knowledge, technologies, insights, workflows etc. continuously change. All these factors that inherently influence the development of health IT systems are changing at an ever growing pace. Traditional models of software engineering are not able to follow these changes and provide up-to-date systems for an acceptable cost/value ratio. To allow FLOSS to positively influence Health IT in the future a "FLOSS-friendly" environment has to be provided. Policy makers should resolve uncertainties in the legal framework that disfavor FLOSS. Certification procedures should be specified in a way that they do not raise additional barriers for FLOSS.
Ilić Martinac, A
Full Text Available The regulatory system for medicinal products includes the existence of a legislative framework and a medicines agency as the regulatory body. The legislative framework for medicinal products has been amended several times so as to align it with the EU acquis communautaire, where medicinal products represent one of the best regulated and aligned areas. For the purpose of regulating the Croatian medicines market, the Agency for Medicinal Products and Medical Devices was established in 2003 to implement the procedure of granting marketing authorisation for medicinal products, to supervise the adverse reactions of medicinal products, to conduct laboratory tests of the quality of medicines and vaccines sampled from the market, to issue licences for the manufacture and distribution of medicinal products, to monitor medicine consumption, and to inform about medicines and promote their rational use. Medical devices are regulated under a special act, and the Agency conducts entries into the register in that field and carries out vigilance over medical devices. In this way, products intended for health care on the Croatian market are of the appropriate quality, safety and efficacy, and are under the constant supervision of the competent body that assesses their risk-to-benefit ratio. Upon accession of the Republic of Croatia to full membership in the European Union, the Agency will be included in the European authorisation procedures for medicines, such as the centralised procedure in the European Medicines Agency (EMA, and above all, the mutual recognition procedure and decentralised procedure in which the role of the agencies of EU Member States is greater. This article gives an overview of the most important regulatory activities in the field of medicinal products, and the readiness of the Agency to function in the future integrated European regulatory area.
Barbini, R; Colao, F; Fantoni, R; Palucci, A; Ribezzo, S [ENEA, Frascati (Italy). Dipt. Sviluppo Tecnologie di Punta
The second European joint field campaign for the remote sensing of vegetation health was held in Oberpfaffenhofen (D) (30 Jun-9 Jul 1992) within the framework of the EUREKA/LASFLEUR Project. Italian groups, from ENEA (Italian Agency for Energy, New Technologies and the Environment), CNR (Italian National Research Council) and Viterbo University participated in this campaign together with German, French and Swedish groups from different institutes. On the occasion of this campaign, the lidar (light detection and ranging) fluorosensor system built at ENEA Frascati for the remote sensing of water and territory was improved, on the basis of the former field experience on plant fluorescence remote detection gained during the first LASFLEUR campaign held in Viterbo, and carried out on-site by means of a movable container. The new version of the set-up is presented here, together with the measurements performed on the available targets (spruce, maple, elm and cornel trees, and mais plants). Data analysis is discussed in detail, attempting to correlate the present spectral domain measurements with the plant photosynthetic activity under different weather and (nutrition or water) stress conditions. Several correlations were found between different pigment concentrations in various vegetables and spectrally resolved remote sensed data on the same species. It was demonstrated that the measurements, when performed from an airborne platform, would allow for a remote vegetation recognition across large areas (monitoring cultivations or forests). Part of the campaign was dedicated to the inter-calibration of different lidar systems operating in the spectrally resolved mode: this point is discussed here as well. Some conclusions drawn at the end of the LASFLEUR project Phase 1 are presented at the end of this report, as discussed during the last Project Workshop held in Florence from October 22nd to 26th, 1992.
Rongen, Anne; Robroek, Suzan J W; Schaufeli, Wilmar; Burdorf, Alex
To investigate whether work engagement influences self-perceived health, work ability, and sickness absence beyond health behaviors and work-related characteristics. Employees of two organizations participated in a 6-month longitudinal study (n = 733). Using questionnaires, information was collected on health behaviors, work-related characteristics, and work engagement at baseline, and self-perceived health, work ability, and sickness absence at 6-month follow-up. Associations between baseline and follow-up variables were studied using multivariate and multinomial logistic regression analyses and changes in R2 were calculated. Low work engagement was related with low work ability (odds ratio: 3.68; 95% confidence interval: 2.15 to 6.30) and long-term sickness absence (odds ratio: 1.84; 95% confidence interval: 1.04 to 3.27). Work engagement increased the explained variance in work ability and sickness absence with 4.1% and 0.5%, respectively. Work engagement contributes to work ability beyond known health behaviors and work-related characteristics.
Full Text Available In this study, we propose two models for predicting people’s activity. The first model is the pedestrian distribution prediction (or postdiction model by multiple regression analysis using space syntax indices of urban fabric and people distribution data obtained from a field survey. The second model is a street choice model for visitors using multinomial logit model. We performed a questionnaire survey on the field to investigate the strolling routes of 46 visitors and obtained a total of 1211 street choices in their routes. We proposed a utility function, sum of weighted space syntax indices, and other indices, and estimated the parameters for weights on the basis of maximum likelihood. These models consider both street networks, distance from destination, direction of the street choice and other spatial compositions (numbers of pedestrians, cars, shops, and elevation. The first model explains the characteristics of the street where many people tend to walk or stay. The second model explains the mechanism underlying the street choice of visitors and clarifies the differences in the weights of street choice parameters among the various attributes, such as gender, existence of destinations, number of people, etc. For all the attributes considered, the influences of DISTANCE and DIRECTION are strong. On the other hand, the influences of Int.V, SHOPS, CARS, ELEVATION, and WIDTH are different for each attribute. People with defined destinations tend to choose streets that “have more shops, and are wider and lower”. In contrast, people with undefined destinations tend to choose streets of high Int.V. The choice of males is affected by Int.V, SHOPS, WIDTH (positive and CARS (negative. Females prefer streets that have many shops, and couples tend to choose downhill streets. The behavior of individual persons is affected by all variables. The behavior of people visiting in groups is affected by SHOP and WIDTH (positive.
Kawada, Ko; Yamada, Takashi; Kishimoto, Tatsuya
In this study, we propose two models for predicting people’s activity. The first model is the pedestrian distribution prediction (or postdiction) model by multiple regression analysis using space syntax indices of urban fabric and people distribution data obtained from a field survey. The second model is a street choice model for visitors using multinomial logit model. We performed a questionnaire survey on the field to investigate the strolling routes of 46 visitors and obtained a total of 1211 street choices in their routes. We proposed a utility function, sum of weighted space syntax indices, and other indices, and estimated the parameters for weights on the basis of maximum likelihood. These models consider both street networks, distance from destination, direction of the street choice and other spatial compositions (numbers of pedestrians, cars, shops, and elevation). The first model explains the characteristics of the street where many people tend to walk or stay. The second model explains the mechanism underlying the street choice of visitors and clarifies the differences in the weights of street choice parameters among the various attributes, such as gender, existence of destinations, number of people, etc. For all the attributes considered, the influences of DISTANCE and DIRECTION are strong. On the other hand, the influences of Int.V, SHOPS, CARS, ELEVATION, and WIDTH are different for each attribute. People with defined destinations tend to choose streets that “have more shops, and are wider and lower”. In contrast, people with undefined destinations tend to choose streets of high Int.V. The choice of males is affected by Int.V, SHOPS, WIDTH (positive) and CARS (negative). Females prefer streets that have many shops, and couples tend to choose downhill streets. The behavior of individual persons is affected by all variables. The behavior of people visiting in groups is affected by SHOP and WIDTH (positive). PMID:25379274
Basballe, Ditte Amund; Halskov, Kim
Using animation, text, and visual effects as elements of projections on the Danish rune stone, Mejlbystenen (the Mejlby stone), we have explored approaches to engaging museum visitors. The installation positions itself in the field of previous installations and experiments exploring projection...... on physical objects, but is unique in focusing on fusing the projection and the object in an engaging approach to communicating information at a cultural heritage museum. The Mejlby stone installation is now a permanent installation at a cultural and historical museum, and, based on observation as well...
Full Text Available One of the strategic development of the Serbian economy is tourism. Tourist destinations Tara has great tourism potential. The starting assumption for the development of tourism and creating a tourist destination brand of Tara is the analysis of image of tourism, and this is exactly the subject of the current paper. The image analysis includes the examination of preferences, attitudes and behavior of visitors to this tourist destination. This research is exploratory, but may be a useful starting point for further, more comprehensive research on which the results would be based upon serious analysis and making relevant decisions.
Erickson, Lance K.
As part of a two-year NASA-ASEE project, a preliminary evaluation and subsequent recommendations were developed to improve the education and science content of the Kennedy Space Center Visitor Complex exhibits. Recommendations for improvements in those exhibits were based on qualitative descriptions of the exhibits, on comparisons to similar exhibit collections, and on available evaluation processes. Because of the subjective nature of measuring content in a broad group of exhibits and displays, emphasis is placed on employing a survey format for a follow-on, more quantitative evaluation. The use of an external organization for this evaluation development is also recommended to reduce bias and increase validity.
The information activities at the permanent exhibitions at the four nuclear facility sites in Sweden have been enhanced during the last four years by travelling exhibitions touring the whole country. In this way it has been possible to communicate the most important facts about radioactive waste management to more than 100 000 Swedes annually, i.e. more people than visit all the permanent visitors'centres each year. Also these efforts have opened a dialogue between the general public and the very technicians and scientists who work daily with handling the radioactive waste and planning its future management
Viveki, R G; Halappanavar, A B; Patil, M S; Joshi, A V; Gunagi, Praveena; Halki, Sunanda B
The 2009 flu pandemic was a global outbreak of a new strain of H1N1 influenza virus often referred colloquially as "swine flu". The objectives of the study were: (1) To know the sociodemographic and awareness profile of visitors attending swine flu screening booths. (2) To reveal sources of information. The present cross-sectional study was undertaken among the visitors (18 years and above) attending swine flu screening booths organised within the Belgaum city during Ganesh festival from 28-08-2009 to 03-09-2009 by interviewing them using predesigned, pretested structured questionnaire on swine flu. The data was collected and analysed using SPSS software programme for windows (version 16). Chi-square test was applied. Out of 206 visitors, 132 (64.1%) were males and 107 (51.9%) were in the age group of 30-49 years; 183 (88.8%) had heard about swine flu. More than a third of the visitors (38.3%) disclosed that there was a vaccine to prevent swine flu. Majority responded that it could be transmitted by being in close proximity to pigs (49.0%) and by eating pork (51.5%). Newspaper/magazine (64.6%), television (61.7%), and public posters/pamphlets (44.2%) were common sources of information. The present study revealed that doctors/public health workers have played little role in creating awareness in the community. The improved communication between doctors and the community would help to spread correct information about the disease and the role that the community can play in controlling the spread of the disease.
Bustreo, F; Okwo-Bele, J-M; Kamara, L
Child mortality has decreased substantially globally-from 12.6 million in 1990 to 6.3 million in 2013-due, in large part to of governments' and organisations' work, to prevent pneumonia, diarrhoea and malaria, the main causes of death in the postneonatal period. In 2012, the World Health Assembly adopted the Decade of Vaccines Global Vaccine Action Plan 2011-2020 as the current framework aimed at preventing millions of deaths through more equitable access to existing vaccines for people in all communities. The Global Alliance for Vaccines and Immunization (GAVI) plays a critical role in this effort by financing and facilitating delivery platforms for vaccines, with focused support for the achievements of improved vaccination coverage and acceleration of the uptake of WHO-recommended lifesaving new vaccines in 73 low-income countries. The GAVI Alliance has contributed substantially towards the progress of Millennium Development Goal 4 and to improving women's lives. By 2013, the GAVI Alliance had immunised 440 million additional children and averted six million future deaths from vaccine-preventable diseases in the world's poorest countries. The GAVI Alliance is on track to reducing child mortality to 68 per 1000 live births by 2015 in supported countries. This paper discusses the GAVI Alliance achievements related to Millennium Development Goal 4 and its broader contribution to improving women's lives and health systems, as well as challenges and obstacles it has faced. Additionally, it looks at challenges for the future and how it will continue its work related to reducing child mortality and improving women's health. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Janzen, Bonnie; Hellsten, Laurie-Ann M
The contribution of unpaid family work quality to understanding social inequalities in women's mental health has been understudied and further limited by a scarcity of psychometrically sound instruments available to measure family work. Therefore, using a multi-item scale of family work quality with evidence of validity and reliability, the overall aim of the present study was to determine whether psychosocial qualities of unpaid family work contribute to educational inequities in women's mental health. Study participants in this cross-sectional study were 512 employed partnered mothers living in a Canadian province and recruited from an online research panel. The dependent variable was psychological distress. In addition to a 28-item measure assessing five dimensions of unpaid family work quality, independent variables included material deprivation, job decision latitude, job demands and several measures of the work-family interface. Multiple linear regression was the primary analysis. Compared to women with high school or less, university educated women reported lower psychological distress [b = - 2.23 (SE = 0.50) p = 0.001]. The introduction of material deprivation into the model resulted in the largest reduction to the education disparity (51%), followed by equity in responsibility for unpaid family work (25%), family-to-work facilitation (22%), and decision latitude in paid work (21%). When entered simultaneously into the final model, the association between education and psychological distress was reduced by 70% and became statistically non-significant [b = - 0.68 (SE = 0.47) p = 0.10]. In addition to the more established mechanisms of material conditions and decision latitude to explain mental health disparities, inequity in responsibility for unpaid family work may also play a role.
Van Oyen, Herman; Charafeddine, Rana; Deboosere, Patrick; Cox, Bianca; Lorant, Vincent; Nusselder, Wilma; Demarest, Stefaan
There is evidence that health inequalities by socio-economic status have persisted. We examined whether educational differences in Disability-Free Life Expectancy (DFLE) and Disability Life Expectancy (DLE) at age 25 has narrowed or widened between the 1990s and 2000s in Belgium. The contribution of mortality and disability prevalence to the secular trend is investigated. We used disability data from the 1997 and 2004 Belgian Health Interviews Surveys and mortality data from the 3-years follow-up of the 1991 and 2001 census population to assess education-related disparities in DFLE and DLE and to partition these differences into additive contributions of mortality and disability. Compared to the highest educated population, differences in the prevalence of disability accounted for at least 66% of the inequality in DFLE. In the latest period, the differences in DFLE compared to men with tertiary education was 4.8, 6.6, 9.7 and 18.6 years for men with, respectively higher secondary, lower secondary, primary and no education. Among females, inequalities in DFLE were, respectively 5.8, 5.1, 10.8 and 18.2 years. There was no evidence that the educational differences in DFLE narrowed since the 1990s. Compared to people with the highest educational attainment, the inequalities in DFLE increased over time for all educational groups except for men with primary education. The social divide in health increased over time: people with the highest education continued to live even longer, they continued to live even longer without disability and to live less years with disability.
Wissow, Lawrence S; Zafar, Waleed; Fothergill, Kate; Ruble, Anne; Slade, Eric
ratings than did those without co-located staff. Both diagnosis and cross-diagnosis complicating factors contribute to the work involved in providing mental health services in primary