WorldWideScience

Sample records for human health electronic

  1. Electronic cigarettes: human health effects

    OpenAIRE

    Callahan-Lyon, Priscilla

    2014-01-01

    Objective With the rapid increase in use of electronic nicotine delivery systems (ENDS), such as electronic cigarettes (e-cigarettes), users and non-users are exposed to the aerosol and product constituents. This is a review of published data on the human health effects of exposure to e-cigarettes and their components. Methods Literature searches were conducted through September 2013 using multiple electronic databases. Results Forty-four articles are included in this analysis. E-cigarette ae...

  2. Electronic cigarettes: human health effects.

    Science.gov (United States)

    Callahan-Lyon, Priscilla

    2014-05-01

    With the rapid increase in use of electronic nicotine delivery systems (ENDS), such as electronic cigarettes (e-cigarettes), users and non-users are exposed to the aerosol and product constituents. This is a review of published data on the human health effects of exposure to e-cigarettes and their components. Literature searches were conducted through September 2013 using multiple electronic databases. Forty-four articles are included in this analysis. E-cigarette aerosols may contain propylene glycol, glycerol, flavourings, other chemicals and, usually, nicotine. Aerosolised propylene glycol and glycerol produce mouth and throat irritation and dry cough. No data on the effects of flavouring inhalation were identified. Data on short-term health effects are limited and there are no adequate data on long-term effects. Aerosol exposure may be associated with respiratory function impairment, and serum cotinine levels are similar to those in traditional cigarette smokers. The high nicotine concentrations of some products increase exposure risks for non-users, particularly children. The dangers of secondhand and thirdhand aerosol exposure have not been thoroughly evaluated. Scientific evidence regarding the human health effects of e-cigarettes is limited. While e-cigarette aerosol may contain fewer toxicants than cigarette smoke, studies evaluating whether e-cigarettes are less harmful than cigarettes are inconclusive. Some evidence suggests that e-cigarette use may facilitate smoking cessation, but definitive data are lacking. No e-cigarette has been approved by FDA as a cessation aid. Environmental concerns and issues regarding non-user exposure exist. The health impact of e-cigarettes, for users and the public, cannot be determined with currently available data.

  3. Electronic cigarettes: human health effects

    Science.gov (United States)

    Callahan-Lyon, Priscilla

    2014-01-01

    Objective With the rapid increase in use of electronic nicotine delivery systems (ENDS), such as electronic cigarettes (e-cigarettes), users and non-users are exposed to the aerosol and product constituents. This is a review of published data on the human health effects of exposure to e-cigarettes and their components. Methods Literature searches were conducted through September 2013 using multiple electronic databases. Results Forty-four articles are included in this analysis. E-cigarette aerosols may contain propylene glycol, glycerol, flavourings, other chemicals and, usually, nicotine. Aerosolised propylene glycol and glycerol produce mouth and throat irritation and dry cough. No data on the effects of flavouring inhalation were identified. Data on short-term health effects are limited and there are no adequate data on long-term effects. Aerosol exposure may be associated with respiratory function impairment, and serum cotinine levels are similar to those in traditional cigarette smokers. The high nicotine concentrations of some products increase exposure risks for non-users, particularly children. The dangers of secondhand and thirdhand aerosol exposure have not been thoroughly evaluated. Conclusions Scientific evidence regarding the human health effects of e-cigarettes is limited. While e-cigarette aerosol may contain fewer toxicants than cigarette smoke, studies evaluating whether e-cigarettes are less harmful than cigarettes are inconclusive. Some evidence suggests that e-cigarette use may facilitate smoking cessation, but definitive data are lacking. No e-cigarette has been approved by FDA as a cessation aid. Environmental concerns and issues regarding non-user exposure exist. The health impact of e-cigarettes, for users and the public, cannot be determined with currently available data. PMID:24732161

  4. Effects of electronic cigarette smoking on human health.

    Science.gov (United States)

    Meo, S A; Al Asiri, S A

    2014-01-01

    Electronic cigarette smoking is gaining dramatic popularity and is steadily spreading among the adolescents, high income, urban population around the world. The aim of this study is to highlight the hazards of e-cigarette smoking on human health. In this study, we identified 38 published studies through a systematic database searches including ISI-web of science and pub-med. We searched the related literature by using the key words including Electronic cigarette, E-cigarette, E-vapers, incidence, hazards. Studies in which electronic cigarette smoking hazards was investigated were included in the study. No limitations on publication status, study design of publication were implemented. Finally we included 28 publications and remaining 10 were excluded. E-smoking can cause, nausea, vomiting, headache, dizziness, choking, burn injuries, upper respiratory tract irritation, dry cough, dryness of the eyes and mucous membrane, release of cytokines and pro-inflammatory mediators, allergic airway inflammation, decreased exhaled nitric oxide (FeNO) synthesis in the lungs, change in bronchial gene expression and risk of lung cancer. Electronic cigarettes are swiftly promoted as an alternative to conventional cigarette smoking, although its use is highly controversial. Electronic cigarettes are not a smoking cessation product. Non-scientific claims about e-cigarettes are creating confusion in public perception about e-cigarette and people believe that e-cigarettes are safe and less addictive, but its use is unsafe and hazardous to human health. E-cigarette smoking should be regulated in the same way as traditional cigarettes and must be prohibited to children and adolescents.

  5. Earthing: Health Implications of Reconnecting the Human Body to the Earth's Surface Electrons

    International Nuclear Information System (INIS)

    Chevalier, G.; Chevalier, G.; Sinatra, S.T.; Oschman, J.L.; Sokal, K.; Sokal, P.

    2012-01-01

    Environmental medicine generally addresses environmental factors with a negative impact on human health. However, emerging scientific research has revealed a surprisingly positive and overlooked environmental factor on health: direct physical contact with the vast supply of electrons on the surface of the Earth. Modern lifestyle separates humans from such contact. The research suggests that this disconnect may be a major contributor to physiological dysfunction and un wellness. Reconnection with the Earth's electrons has been found to promote intriguing physiological changes and subjective reports of well-being. Earthing (or grounding) refers to the discovery of benefits including better sleep and reduced pain from walking barefoot outside or sitting, working, or sleeping indoors connected to conductive systems that transfer the Earth's electrons from the ground into the body. This paper reviews the earthing research and the potential of earthing as a simple and easily accessed global modality of significant clinical importance

  6. Electronic cigarettes: health impact, nicotine replacement therapy, regulations

    Directory of Open Access Journals (Sweden)

    Zygmunt Zdrojewicz

    2017-03-01

    Full Text Available While the adverse effects of conventional cigarettes on human health have been thoroughly examined, in the last 15 years we have witnessed the birth of electronic cigarettes. There are many types of these devices available on the market. Studies are still underway to determine their negative impact on the human body. Electronic cigarettes comprise of power supply and a vaporising system. The user inhales the aerosol produced by heating up the liquid containing nicotine. In contrast with conventional cigarettes, the tobacco is not combusted, thus the compositions of the aerosol and cigarette smoke are considerably different. Out of 93 chemical substances present in the e-cigarette smoke, the aerosol contains only acetaldehyde, acetone, acrolein, formaldehyde and nicotine. More toxic substances, such as polycyclic aromatic hydrocarbons and heavy metals, are not present. The amount of evidence suggesting electronic cigarettes’ harmful effects on the human body is constantly increasing. Some reports imply that the electronic cigarettes negatively influence pregnancy, human psyche, respiratory and cardiovascular systems. They might also be involved in oncogenesis. With electronic cigarettes constantly gaining popularity, the question about the adverse effects of passive smoking becomes increasingly more relevant. Although various methods of helping people cease smoking or delivering nicotine to their bodies without burning toxic substances are being explored, electronic cigarettes are not recommended in nicotine substitution therapy. Legal regulations regarding electronic cigarettes are still being worked on. The purpose of this paper is to evaluate the effects electronic cigarettes have on the human’s health.

  7. Forecasting the Use of Electronic Health Records, An Exp...

    Data.gov (United States)

    U.S. Department of Health & Human Services — The authors of Forecasting the Use of Electronic Health Records, An Expert Opinion Approach, published in Volume 3, Issue 2 of the Medicare and Medicaid Research...

  8. Electronic Health Object

    Science.gov (United States)

    Almunawar, Mohammad Nabil; Anshari, Muhammad; Younis, Mustafa Z.; Kisa, Adnan

    2015-01-01

    Electronic health records (EHRs) store health-related patient information in an electronic format, improving the quality of health care management and increasing efficiency of health care processes. However, in existing information systems, health-related records are generated, managed, and controlled by health care organizations. Patients are perceived as recipients of care and normally cannot directly interact with the system that stores their health-related records; their participation in enriching this information is not possible. Many businesses now allow customers to participate in generating information for their systems, strengthening customer relationships. This trend is supported by Web 2.0, which enables interactivity through various means, including social networks. Health care systems should be able to take advantage of this development. This article proposes a novel framework in addressing the emerging need for interactivity while preserving and extending existing electronic medical data. The framework has 3 dimensions of patient health record: personal, social, and medical dimensions. The framework is designed to empower patients, changing their roles from static recipient of health care services to dynamic and active partners in health care processes. PMID:26660486

  9. Health-oriented electronic oral health record: development and evaluation.

    Science.gov (United States)

    Wongsapai, Mansuang; Suebnukarn, Siriwan; Rajchagool, Sunsanee; Beach, Daryl; Kawaguchi, Sachiko

    2014-06-01

    This study aims to develop and evaluate a new Health-oriented Electronic Oral Health Record that implements the health-oriented status and intervention index. The index takes the principles of holistic oral healthcare and applies them to the design and implementation of the Health-oriented Electronic Oral Health Record. We designed an experiment using focus groups and a consensus (Delphi process) method to develop a new health-oriented status and intervention index and graphical user interface. A comparative intervention study with qualitative and quantitative methods was used to compare an existing Electronic Oral Health Record to the Health-oriented Electronic Oral Health Record, focusing on dentist satisfaction, accuracy, and completeness of oral health status recording. The study was conducted by the dental staff of the Inter-country Center for Oral Health collaborative hospitals in Thailand. Overall, the user satisfaction questionnaire had a positive response to the Health-oriented Electronic Oral Health Record. The dentists found it easy to use and were generally satisfied with the impact on their work, oral health services, and surveillance. The dentists were significantly satisfied with the Health-oriented Electronic Oral Health Record compared to the existing Electronic Oral Health Record (p health information recorded using the Health-oriented Electronic Oral Health Record were 97.15 and 93.74 percent, respectively. This research concludes that the Health-oriented Electronic Oral Health Record satisfied many dentists, provided benefits to holistic oral healthcare, and facilitated the planning, managing, and evaluation of the healthcare delivery system.

  10. Electronic health records

    DEFF Research Database (Denmark)

    Kierkegaard, Patrick

    2011-01-01

    that a centralised European health record system will become a reality even before 2020. However, the concept of a centralised supranational central server raises concern about storing electronic medical records in a central location. The privacy threat posed by a supranational network is a key concern. Cross......-border and Interoperable electronic health record systems make confidential data more easily and rapidly accessible to a wider audience and increase the risk that personal data concerning health could be accidentally exposed or easily distributed to unauthorised parties by enabling greater access to a compilation...... of the personal data concerning health, from different sources, and throughout a lifetime....

  11. Department of Health and Human Services Semiannual Regulatory Agenda

    Science.gov (United States)

    2010-04-26

    ...-AB58 Specifications, and Certification Criteria for Electronic Health Record Technology (Rulemaking... Electronic Submission of Data From Studies Evaluating Human Drugs and Biologics....... 0910-AC52 137 Over-the... 147 Cigars Subject to the Family Smoking Prevention and Tobacco Control Act 0910-AG38 Food and Drug...

  12. An analysis of electronic health record-related patient safety incidents.

    Science.gov (United States)

    Palojoki, Sari; Mäkelä, Matti; Lehtonen, Lasse; Saranto, Kaija

    2017-06-01

    The aim of this study was to analyse electronic health record-related patient safety incidents in the patient safety incident reporting database in fully digital hospitals in Finland. We compare Finnish data to similar international data and discuss their content with regard to the literature. We analysed the types of electronic health record-related patient safety incidents that occurred at 23 hospitals during a 2-year period. A procedure of taxonomy mapping served to allow comparisons. This study represents a rare examination of patient safety risks in a fully digital environment. The proportion of electronic health record-related incidents was markedly higher in our study than in previous studies with similar data. Human-computer interaction problems were the most frequently reported. The results show the possibility of error arising from the complex interaction between clinicians and computers.

  13. Workshop--E-leaks: the privacy of health information in the age of electronic information.

    Science.gov (United States)

    Vonn, Michael; Lang, Renée; Perras, Maude

    2011-10-01

    This workshop examined some of the new challenges to health-related privacy emerging as a result of the proliferation of electronic communications and data storage, including through social media, electronic health records and ready access to personal information on the internet. The right to privacy is a human right. As such, protecting privacy and enforcing the duty of confidentiality regarding health information are fundamental to treating people with autonomy, dignity and respect. For people living with HIV, unauthorized disclosure of their status can lead to discrimination and breaches of other human rights. While this is not new, in this information age a new breed of privacy violation is emerging and our legal protections are not necessarily keeping pace.

  14. Electronic health records to facilitate clinical research.

    Science.gov (United States)

    Cowie, Martin R; Blomster, Juuso I; Curtis, Lesley H; Duclaux, Sylvie; Ford, Ian; Fritz, Fleur; Goldman, Samantha; Janmohamed, Salim; Kreuzer, Jörg; Leenay, Mark; Michel, Alexander; Ong, Seleen; Pell, Jill P; Southworth, Mary Ross; Stough, Wendy Gattis; Thoenes, Martin; Zannad, Faiez; Zalewski, Andrew

    2017-01-01

    Electronic health records (EHRs) provide opportunities to enhance patient care, embed performance measures in clinical practice, and facilitate clinical research. Concerns have been raised about the increasing recruitment challenges in trials, burdensome and obtrusive data collection, and uncertain generalizability of the results. Leveraging electronic health records to counterbalance these trends is an area of intense interest. The initial applications of electronic health records, as the primary data source is envisioned for observational studies, embedded pragmatic or post-marketing registry-based randomized studies, or comparative effectiveness studies. Advancing this approach to randomized clinical trials, electronic health records may potentially be used to assess study feasibility, to facilitate patient recruitment, and streamline data collection at baseline and follow-up. Ensuring data security and privacy, overcoming the challenges associated with linking diverse systems and maintaining infrastructure for repeat use of high quality data, are some of the challenges associated with using electronic health records in clinical research. Collaboration between academia, industry, regulatory bodies, policy makers, patients, and electronic health record vendors is critical for the greater use of electronic health records in clinical research. This manuscript identifies the key steps required to advance the role of electronic health records in cardiovascular clinical research.

  15. Electronic Health Record Meets Digital Library

    Science.gov (United States)

    Humphreys, Betsy L.

    2000-01-01

    Linking the electronic health record to the digital library is a Web-era reformulation of the long-standing informatics goal of seamless integration of automated clinical data and relevant knowledge-based information to support informed decisions. The spread of the Internet, the development of the World Wide Web, and converging format standards for electronic health data and digital publications make effective linking increasingly feasible. Some existing systems link electronic health data and knowledge-based information in limited settings or limited ways. Yet many challenging informatics research problems remain to be solved before flexible and seamless linking becomes a reality and before systems become capable of delivering the specific piece of information needed at the time and place a decision must be made. Connecting the electronic health record to the digital library also requires positive resolution of important policy issues, including health data privacy, government envouragement of high-speed communications, electronic intellectual property rights, and standards for health data and for digital libraries. Both the research problems and the policy issues should be important priorities for the field of medical informatics. PMID:10984463

  16. Health Care Personnel Perception of the Privacy of Electronic Health Records.

    Science.gov (United States)

    Saito, Kenji; Shofer, Frances S; Saberi, Poune; Green-McKenzie, Judith

    2017-06-01

    : Health care facilities are increasingly converting paper medical records to electronic health records. This study investigates the perception of privacy health care personnel have of electronic health records. A pilot tested, anonymous survey was administered to a convenience sample of health care personnel. Standard summary statistics and Chi-square analysis were used to assess differences in perception. Of the 93% (96/103) who responded, 65% were female and 43% white. The mean age was 44.3 years. Most (94%) felt that Medical Record privacy was important and one-third reported they would not seek care at their workplace if Electronic Health Records were used. Efforts to assure and communicate the integrity of electronic health records are essential toward reducing deterrents for health care personnel to access geographically convenient and timely health care.

  17. Potential Environmental and Human Health Impacts of Rechargeable Lithium Batteries in Electronic Waste

    Science.gov (United States)

    Kang, Daniel Hsing Po; Chen, Mengjun; Ogunseitan, Oladele A.

    2013-01-01

    Rechargeable lithium-ion (Li-ion) and lithium-polymer (Li-poly) batteries have recently become dominant in consumer electronic products because of advantages associated with energy density and product longevity. However, the small size of these batteries, the high rate of disposal of consumer products in which they are used, and the lack of uniform regulatory policy on their disposal means that lithium batteries may contribute substantially to environmental pollution and adverse human health impacts due to potentially toxic materials. In this research, we used standardized leaching tests, life-cycle impact assessment (LCIA), and hazard assessment models to evaluate hazardous waste classification, resource depletion potential, and toxicity potentials of lithium batteries used in cellphones. Our results demonstrate that according to U.S. federal regulations, defunct Li-ion batteries are classified hazardous due to their lead (Pb) content (average 6.29 mg/L; σ = 11.1; limit 5). However, according to California regulations, all lithium batteries tested are classified hazardous due to excessive levels of cobalt (average 163 544 mg/kg; σ = 62 897; limit 8000), copper (average 98 694 mg/kg; σ = 28 734; limit 2500), and nickel (average 9525 mg/kg; σ = 11 438; limit 2000). In some of the Li-ion batteries, the leached concentrations of chromium, lead, and thallium exceeded the California regulation limits. The environmental impact associated with resource depletion and human toxicity is mainly associated with cobalt, copper, nickel, thallium, and silver, whereas the ecotoxicity potential is primarily associated with cobalt, copper, nickel, thallium, and silver. However, the relative contribution of aluminum and lithium to human toxicity and ecotoxicity could not be estimated due to insufficient toxicity data in the models. These findings support the need for stronger government policy at the local, national, and international levels to encourage recovery, recycling, and

  18. Extended use of electronic health records by primary care physicians: Does the electronic health record artefact matter?

    Science.gov (United States)

    Raymond, Louis; Paré, Guy; Marchand, Marie

    2017-04-01

    The deployment of electronic health record systems is deemed to play a decisive role in the transformations currently being implemented in primary care medical practices. This study aims to characterize electronic health record systems from the perspective of family physicians. To achieve this goal, we conducted a survey of physicians practising in private clinics located in Quebec, Canada. We used valid responses from 331 respondents who were found to be representative of the larger population. Data provided by the physicians using the top three electronic health record software products were analysed in order to obtain statistically adequate sub-sample sizes. Significant differences were observed among the three products with regard to their functional capability. The extent to which each of the electronic health record functionalities are used by physicians also varied significantly. Our results confirm that the electronic health record artefact 'does matter', its clinical functionalities explaining why certain physicians make more extended use of their system than others.

  19. Stakeholder engagement: a key component of integrating genomic information into electronic health records.

    Science.gov (United States)

    Hartzler, Andrea; McCarty, Catherine A; Rasmussen, Luke V; Williams, Marc S; Brilliant, Murray; Bowton, Erica A; Clayton, Ellen Wright; Faucett, William A; Ferryman, Kadija; Field, Julie R; Fullerton, Stephanie M; Horowitz, Carol R; Koenig, Barbara A; McCormick, Jennifer B; Ralston, James D; Sanderson, Saskia C; Smith, Maureen E; Trinidad, Susan Brown

    2013-10-01

    Integrating genomic information into clinical care and the electronic health record can facilitate personalized medicine through genetically guided clinical decision support. Stakeholder involvement is critical to the success of these implementation efforts. Prior work on implementation of clinical information systems provides broad guidance to inform effective engagement strategies. We add to this evidence-based recommendations that are specific to issues at the intersection of genomics and the electronic health record. We describe stakeholder engagement strategies employed by the Electronic Medical Records and Genomics Network, a national consortium of US research institutions funded by the National Human Genome Research Institute to develop, disseminate, and apply approaches that combine genomic and electronic health record data. Through select examples drawn from sites of the Electronic Medical Records and Genomics Network, we illustrate a continuum of engagement strategies to inform genomic integration into commercial and homegrown electronic health records across a range of health-care settings. We frame engagement as activities to consult, involve, and partner with key stakeholder groups throughout specific phases of health information technology implementation. Our aim is to provide insights into engagement strategies to guide genomic integration based on our unique network experiences and lessons learned within the broader context of implementation research in biomedical informatics. On the basis of our collective experience, we describe key stakeholder practices, challenges, and considerations for successful genomic integration to support personalized medicine.

  20. Electronic health records: eliciting behavioral health providers' beliefs.

    Science.gov (United States)

    Shank, Nancy; Willborn, Elizabeth; Pytlikzillig, Lisa; Noel, Harmonijoie

    2012-04-01

    Interviews with 32 community behavioral health providers elicited perceived benefits and barriers of using electronic health records. Themes identified were (a) quality of care, (b) privacy and security, and (c) delivery of services. Benefits to quality of care were mentioned by 100% of the providers, and barriers by 59% of providers. Barriers involving privacy and security concerns were mentioned by 100% of providers, and benefits by 22%. Barriers to delivery of services were mentioned by 97% of providers, and benefits by 66%. Most providers (81%) expressed overall positive support for electronic behavioral health records.

  1. Development of clinical contents model markup language for electronic health records.

    Science.gov (United States)

    Yun, Ji-Hyun; Ahn, Sun-Ju; Kim, Yoon

    2012-09-01

    To develop dedicated markup language for clinical contents models (CCM) to facilitate the active use of CCM in electronic health record systems. Based on analysis of the structure and characteristics of CCM in the clinical domain, we designed extensible markup language (XML) based CCM markup language (CCML) schema manually. CCML faithfully reflects CCM in both the syntactic and semantic aspects. As this language is based on XML, it can be expressed and processed in computer systems and can be used in a technology-neutral way. CCML HAS THE FOLLOWING STRENGTHS: it is machine-readable and highly human-readable, it does not require a dedicated parser, and it can be applied for existing electronic health record systems.

  2. Merging Electronic Health Record Data and Genomics for Cardiovascular Research: A Science Advisory From the American Heart Association.

    Science.gov (United States)

    Hall, Jennifer L; Ryan, John J; Bray, Bruce E; Brown, Candice; Lanfear, David; Newby, L Kristin; Relling, Mary V; Risch, Neil J; Roden, Dan M; Shaw, Stanley Y; Tcheng, James E; Tenenbaum, Jessica; Wang, Thomas N; Weintraub, William S

    2016-04-01

    The process of scientific discovery is rapidly evolving. The funding climate has influenced a favorable shift in scientific discovery toward the use of existing resources such as the electronic health record. The electronic health record enables long-term outlooks on human health and disease, in conjunction with multidimensional phenotypes that include laboratory data, images, vital signs, and other clinical information. Initial work has confirmed the utility of the electronic health record for understanding mechanisms and patterns of variability in disease susceptibility, disease evolution, and drug responses. The addition of biobanks and genomic data to the information contained in the electronic health record has been demonstrated. The purpose of this statement is to discuss the current challenges in and the potential for merging electronic health record data and genomics for cardiovascular research. © 2016 American Heart Association, Inc.

  3. Electronic health records to facilitate clinical research

    OpenAIRE

    Cowie, Martin R.; Blomster, Juuso I.; Curtis, Lesley H.; Duclaux, Sylvie; Ford, Ian; Fritz, Fleur; Goldman, Samantha; Janmohamed, Salim; Kreuzer, J?rg; Leenay, Mark; Michel, Alexander; Ong, Seleen; Pell, Jill P.; Southworth, Mary Ross; Stough, Wendy Gattis

    2016-01-01

    Electronic health records (EHRs) provide opportunities to enhance patient care, embed performance measures in clinical practice, and facilitate clinical research. Concerns have been raised about the increasing recruitment challenges in trials, burdensome and obtrusive data collection, and uncertain generalizability of the results. Leveraging electronic health records to counterbalance these trends is an area of intense interest. The initial applications of electronic health records, as the pr...

  4. On human health.

    Science.gov (United States)

    van Spijk, Piet

    2015-05-01

    If it is true that health is a priority objective of medicine, then medical practice can only be successful if the meaning of the term "health" is known. Various attempts have been made over the years to define health. This paper proposes a new definition. In addition to current health concepts, it also takes into account the distinction between specifically human (great) health and health as the absence of disease and illness-i.e. small health. The feeling of leading a life that makes sense plays a key role in determining specifically human great health.

  5. 42 CFR 495.370 - Appeals process for a Medicaid provider receiving electronic health record incentive payments.

    Science.gov (United States)

    2010-10-01

    ... & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to the... provide that the provider (whether individual or entity) is also given any additional appeals rights that...

  6. Electronic health records for dummies

    CERN Document Server

    Williams, Trenor

    2010-01-01

    The straight scoop on choosing and implementing an electronic health records (EHR) system Doctors, nurses, and hospital and clinic administrators are interested in learning the best ways to implement and use an electronic health records system so that they can be shared across different health care settings via a network-connected information system. This helpful, plain-English guide provides need-to-know information on how to choose the right system, assure patients of the security of their records, and implement an EHR in such a way that it causes minimal disruption to the daily demands of a

  7. [The virtual library in equity, health, and human development].

    Science.gov (United States)

    Valdés, América

    2002-01-01

    This article attempts to describe the rationale that has led to the development of information sources dealing with equity, health, and human development in countries of Latin America and the Caribbean within the context of the Virtual Health Library (Biblioteca Virtual en Salud, BVS). Such information sources include the scientific literature, databases in printed and electronic format, institutional directories and lists of specialists, lists of events and courses, distance education programs, specialty journals and bulletins, as well as other means of disseminating health information. The pages that follow deal with the development of a Virtual Library in Equity, Health, and Human Development, an effort rooted in the conviction that decision-making and policy geared toward achieving greater equity in health must, of necessity, be based on coherent, well-organized, and readily accessible first-rate scientific information. Information is useless unless it is converted into knowledge that benefits society. The Virtual Library in Equity, Health, and Human Development is a coordinated effort to develop a decentralized regional network of scientific information sources, with strict quality control, from which public officials can draw data and practical examples that can help them set health and development policies geared toward achieving greater equity for all.

  8. Electronic Health Record Implementation: A SWOT Analysis.

    Science.gov (United States)

    Shahmoradi, Leila; Darrudi, Alireza; Arji, Goli; Farzaneh Nejad, Ahmadreza

    2017-10-01

    Electronic Health Record (EHR) is one of the most important achievements of information technology in healthcare domain, and if deployed effectively, it can yield predominant results. The aim of this study was a SWOT (strengths, weaknesses, opportunities, and threats) analysis in electronic health record implementation. This is a descriptive, analytical study conducted with the participation of a 90-member work force from Hospitals affiliated to Tehran University of Medical Sciences (TUMS). The data were collected by using a self-structured questionnaire and analyzed by SPSS software. Based on the results, the highest priority in strength analysis was related to timely and quick access to information. However, lack of hardware and infrastructures was the most important weakness. Having the potential to share information between different sectors and access to a variety of health statistics was the significant opportunity of EHR. Finally, the most substantial threats were the lack of strategic planning in the field of electronic health records together with physicians' and other clinical staff's resistance in the use of electronic health records. To facilitate successful adoption of electronic health record, some organizational, technical and resource elements contribute; moreover, the consideration of these factors is essential for HER implementation.

  9. Energy Harvesting from the Animal/Human Body for Self-Powered Electronics.

    Science.gov (United States)

    Dagdeviren, Canan; Li, Zhou; Wang, Zhong Lin

    2017-06-21

    Living subjects (i.e., humans and animals) have abundant sources of energy in chemical, thermal, and mechanical forms. The use of these energies presents a viable way to overcome the battery capacity limitation that constrains the long-term operation of wearable/implantable devices. The intersection of novel materials and fabrication techniques offers boundless possibilities for the benefit of human health and well-being via various types of energy harvesters. This review summarizes the existing approaches that have been demonstrated to harvest energy from the bodies of living subjects for self-powered electronics. We present material choices, device layouts, and operation principles of these energy harvesters with a focus on in vivo applications. We discuss a broad range of energy harvesters placed in or on various body parts of human and animal models. We conclude with an outlook of future research in which the integration of various energy harvesters with advanced electronics can provide a new platform for the development of novel technologies for disease diagnostics, treatment, and prevention.

  10. Electronic Health Record Implementation: A SWOT Analysis

    Directory of Open Access Journals (Sweden)

    Leila Shahmoradi

    2017-12-01

    Full Text Available Electronic Health Record (EHR is one of the most important achievements of information technology in healthcare domain, and if deployed effectively, it can yield predominant results. The aim of this study was a SWOT (strengths, weaknesses, opportunities, and threats analysis in electronic health record implementation. This is a descriptive, analytical study conducted with the participation of a 90-member work force from Hospitals affiliated to Tehran University of Medical Sciences (TUMS. The data were collected by using a self-structured questionnaire and analyzed by SPSS software. Based on the results, the highest priority in strength analysis was related to timely and quick access to information. However, lack of hardware and infrastructures was the most important weakness. Having the potential to share information between different sectors and access to a variety of health statistics was the significant opportunity of EHR. Finally, the most substantial threats were the lack of strategic planning in the field of electronic health records together with physicians’ and other clinical staff’s resistance in the use of electronic health records. To facilitate successful adoption of electronic health record, some organizational, technical and resource elements contribute; moreover, the consideration of these factors is essential for HER implementation.

  11. Security Techniques for the Electronic Health Records.

    Science.gov (United States)

    Kruse, Clemens Scott; Smith, Brenna; Vanderlinden, Hannah; Nealand, Alexandra

    2017-08-01

    The privacy of patients and the security of their information is the most imperative barrier to entry when considering the adoption of electronic health records in the healthcare industry. Considering current legal regulations, this review seeks to analyze and discuss prominent security techniques for healthcare organizations seeking to adopt a secure electronic health records system. Additionally, the researchers sought to establish a foundation for further research for security in the healthcare industry. The researchers utilized the Texas State University Library to gain access to three online databases: PubMed (MEDLINE), CINAHL, and ProQuest Nursing and Allied Health Source. These sources were used to conduct searches on literature concerning security of electronic health records containing several inclusion and exclusion criteria. Researchers collected and analyzed 25 journals and reviews discussing security of electronic health records, 20 of which mentioned specific security methods and techniques. The most frequently mentioned security measures and techniques are categorized into three themes: administrative, physical, and technical safeguards. The sensitive nature of the information contained within electronic health records has prompted the need for advanced security techniques that are able to put these worries at ease. It is imperative for security techniques to cover the vast threats that are present across the three pillars of healthcare.

  12. Evaluation of Electronic Health Record Implementation in Hospitals.

    Science.gov (United States)

    Tubaishat, Ahmad

    2017-07-01

    The effectiveness of electronic health records has not previously been widely evaluated. Thus, this national cross-sectional study was conducted to evaluate electronic health records, from the perspective of nurses, by examining how they use the records, their opinions on the quality of the systems, and their overall levels of satisfaction with electronic health records. The relationship between these constructs was measured, and its predictors were investigated. A random sample of Jordanian hospitals that used electronic health records was selected, and data were gathered using a self-administered questionnaire, based on the DeLone and McLean Information Systems Success model. In total, 1648 nurses from 17 different hospitals participated in the study. Results indicated that nurses were largely positive about the use and quality of the systems and were satisfied with electronic health records. Significant positive correlations were found between these constructs, and a number of demographical and situational factors were found to have an effect on nurses' perceptions. The study provides a systematic evaluation of different facets of electronic health records, which is fundamental for recognizing the motives and challenges for success and for further enhancing this success. The work proves that nurses favor the use of electronic health records and are satisfied with it and perceive its high quality, and the findings should therefore encourage their ongoing implementation.

  13. Advances in electronic-nose technologies for the detection of volatile biomarker metabolites in the human breath

    Science.gov (United States)

    Alphus D. Wilson

    2015-01-01

    Recent advancements in the use of electronic-nose (e-nose) devices to analyze human breath profiles for the presence of specific volatile metabolites, known as biomarkers or chemical bio-indicators of specific human diseases, metabolic disorders and the overall health status of individuals, are providing the potential for new noninvasive tools and techniques useful to...

  14. The Future Is Coming: Electronic Health Records

    Science.gov (United States)

    ... Current Issue Past Issues The Future Is Coming: Electronic Health Records Past Issues / Spring 2009 Table of Contents For ... special conference on the cutting-edge topic of electronic health records (EHR) on May 20-21, 2009, on the ...

  15. Use of Electronic Health Records and Administrative Data for Public Health Surveillance of Eye Health and Vision-Related Conditions

    Science.gov (United States)

    Elliott, Amanda; Davidson, Arthur; Lum, Flora; Chiang, Michael; Saaddine, Jinan B; Zhang, Xinzhi; Crews, John E.; Chou, Chiu-Fang

    2014-01-01

    Purpose To discuss the current trend toward greater use of electronic health records and how these records could enhance public health surveillance of eye health and vision-related conditions. Methods We describe three currently available sources of electronic health data (Kaiser Permanente, the Veterans Health Administration, and the Centers for Medicare & Medicaid Services) and how these sources can contribute to a comprehensive vision and eye health surveillance system. Results Each of the three sources of electronic health data can contribute meaningfully to a comprehensive vision and eye health surveillance system, but none currently provide all the information required. The use of electronic health records for vision and eye health surveillance has both advantages and disadvantages. Conclusions Electronic health records may provide additional information needed to create a comprehensive vision and eye health surveillance system. Recommendations for incorporating electronic health records into such a system are presented. PMID:23158225

  16. Towards lifetime electronic health record implementation.

    Science.gov (United States)

    Gand, Kai; Richter, Peggy; Esswein, Werner

    2015-01-01

    Integrated care concepts can help to diminish demographic challenges. Hereof, the use of eHealth, esp. overarching electronic health records, is recognized as an efficient approach. The article aims at rigorously defining the concept of lifetime electronic health records (LEHRs) and the identification of core factors that need to be fulfilled in order to implement such. A literature review was conducted. Existing definitions were identified and relevant factors were categorized. The derived assessment categories are demonstrated by a case study on Germany. Seven dimensions to differentiate types of electronic health records were found. The analysis revealed, that culture, regulation, informational self-determination, incentives, compliance, ICT infrastructure and standards are important preconditions to successfully implement LEHRs. The article paves the way for LEHR implementation and therewith for integrated care. Besides the expected benefits of LEHRs, there are a number of ethical, legal and social concerns, which need to be balanced.

  17. Implementation of Electronic Health Records in US Nursing Homes.

    Science.gov (United States)

    Bjarnadottir, Ragnhildur I; Herzig, Carolyn T A; Travers, Jasmine L; Castle, Nicholas G; Stone, Patricia W

    2017-08-01

    While electronic health records have emerged as promising tools to help improve quality of care, nursing homes have lagged behind in implementation. This study assessed electronic health records implementation, associated facility characteristics, and potential impact on quality indicators in nursing homes. Using national Centers for Medicare & Medicaid Services and survey data for nursing homes, a cross-sectional analysis was conducted to identify variations between nursing homes that had and had not implemented electronic health records. A difference-in-differences analysis was used to estimate the longitudinal effect of electronic health records on commonly used quality indicators. Data from 927 nursing homes were examined, 49.1% of which had implemented electronic health records. Nursing homes with electronic health records were more likely to be nonprofit/government owned (P = .04) and had a lower percentage of Medicaid residents (P = .02) and higher certified nursing assistant and registered nurse staffing levels (P = .002 and .02, respectively). Difference-in-differences analysis showed greater quality improvements after implementation for five long-stay and two short-stay quality measures (P = .001 and .01, respectively) compared with those who did not implement electronic health records. Implementation rates in nursing homes are low compared with other settings, and better-resourced facilities are more likely to have implemented electronic health records. Consistent with other settings, electronic health records implementation improves quality in nursing homes, but further research is needed to better understand the mechanism for improvement and how it can best be supported.

  18. Quality and Electronic Health Records in Community Health Centers

    Science.gov (United States)

    Lesh, Kathryn A.

    2014-01-01

    Adoption and use of health information technology, the electronic health record (EHR) in particular, has the potential to help improve the quality of care, increase patient safety, and reduce health care costs. Unfortunately, adoption and use of health information technology has been slow, especially when compared to the adoption and use of…

  19. Training trainers in health and human rights: implementing curriculum change in South African health sciences institutions.

    Science.gov (United States)

    Ewert, Elena G; Baldwin-Ragaven, Laurel; London, Leslie

    2011-07-25

    The complicity of the South African health sector in apartheid and the international relevance of human rights as a professional obligation prompted moves to include human rights competencies in the curricula of health professionals in South Africa. A Train-the-Trainers course in Health and Human Rights was established in 1998 to equip faculty members from health sciences institutions nationwide with the necessary skills, attitudes and knowledge to teach human rights to their students. This study followed up participants to determine the extent of curriculum implementation, support needed as well as barriers encountered in integrating human rights into health sciences teaching and learning. A survey including both quantitative and qualitative components was distributed in 2007 to past course participants from 1998-2006 via telephone, fax and electronic communication. Out of 162 past participants, 46 (28%) completed the survey, the majority of whom were still employed in academic settings (67%). Twenty-two respondents (48%) implemented a total of 33 formal human rights courses into the curricula at their institutions. Respondents were nine times more likely (relative risk 9.26; 95% CI 5.14-16.66) to implement human rights education after completing the training. Seventy-two extracurricular activities were offered by 21 respondents, many of whom had successfully implemented formal curricula. Enabling factors for implementation included: prior teaching experience in human rights, general institutional support and the presence of allies - most commonly coworkers as well as deans. Frequently cited barriers to implementation included: budget restrictions, time constraints and perceived apathy of colleagues or students. Overall, respondents noted personal enrichment and optimism in teaching human rights. This Train-the-Trainer course provides the historical context, educational tools, and collective motivation to incorporate human rights educational initiatives at health

  20. Training Trainers in health and human rights: Implementing curriculum change in South African health sciences institutions

    Directory of Open Access Journals (Sweden)

    Baldwin-Ragaven Laurel

    2011-07-01

    Full Text Available Abstract Background The complicity of the South African health sector in apartheid and the international relevance of human rights as a professional obligation prompted moves to include human rights competencies in the curricula of health professionals in South Africa. A Train-the-Trainers course in Health and Human Rights was established in 1998 to equip faculty members from health sciences institutions nationwide with the necessary skills, attitudes and knowledge to teach human rights to their students. This study followed up participants to determine the extent of curriculum implementation, support needed as well as barriers encountered in integrating human rights into health sciences teaching and learning. Methods A survey including both quantitative and qualitative components was distributed in 2007 to past course participants from 1998-2006 via telephone, fax and electronic communication. Results Out of 162 past participants, 46 (28% completed the survey, the majority of whom were still employed in academic settings (67%. Twenty-two respondents (48% implemented a total of 33 formal human rights courses into the curricula at their institutions. Respondents were nine times more likely (relative risk 9.26; 95% CI 5.14-16.66 to implement human rights education after completing the training. Seventy-two extracurricular activities were offered by 21 respondents, many of whom had successfully implemented formal curricula. Enabling factors for implementation included: prior teaching experience in human rights, general institutional support and the presence of allies - most commonly coworkers as well as deans. Frequently cited barriers to implementation included: budget restrictions, time constraints and perceived apathy of colleagues or students. Overall, respondents noted personal enrichment and optimism in teaching human rights. Conclusion This Train-the-Trainer course provides the historical context, educational tools, and collective motivation

  1. Human enamel structure studied by high resolution electron microscopy

    International Nuclear Information System (INIS)

    Wen, S.L.

    1989-01-01

    Human enamel structural features are characterized by high resolution electron microscopy. The human enamel consists of polycrystals with a structure similar to Ca10(PO4)6(OH)2. This article describes the structural features of human enamel crystal at atomic and nanometer level. Besides the structural description, a great number of high resolution images are included. Research into the carious process in human enamel is very important for human beings. This article firstly describes the initiation of caries in enamel crystal at atomic and unit-cell level and secondly describes the further steps of caries with structural and chemical demineralization. The demineralization in fact, is the origin of caries in human enamel. The remineralization of carious areas in human enamel has drawn more and more attention as its potential application is realized. This process has been revealed by high resolution electron microscopy in detail in this article. On the other hand, the radiation effects on the structure of human enamel are also characterized by high resolution electron microscopy. In order to reveal this phenomenon clearly, a great number of electron micrographs have been shown, and a physical mechanism is proposed. 26 references

  2. Opening plenary speaker: Human genomics, precision medicine, and advancing human health.

    Science.gov (United States)

    Green, Eric D

    2016-08-01

    Starting with the launch of the Human Genome Project in 1990, the past quarter-century has brought spectacular achievements in genomics that dramatically empower the study of human biology and disease. The human genomics enterprise is now in the midst of an important transition, as the growing foundation of genomic knowledge is being used by researchers and clinicians to tackle increasingly complex problems in biomedicine. Of particular prominence is the use of revolutionary new DNA sequencing technologies for generating prodigious amounts of DNA sequence data to elucidate the complexities of genome structure, function, and evolution, as well as to unravel the genomic bases of rare and common diseases. Together, these developments are ushering in the era of genomic medicine. Augmenting the advances in human genomics have been innovations in technologies for measuring environmental and lifestyle information, electronic health records, and data science; together, these provide opportunities of unprecedented scale and scope for investigating the underpinnings of health and disease. To capitalize on these opportunities, U.S. President Barack Obama recently announced a major new research endeavor - the U.S. Precision Medicine Initiative. This bold effort will be framed around several key aims, which include accelerating the use of genomically informed approaches to cancer care, making important policy and regulatory changes, and establishing a large research cohort of >1 million volunteers to facilitate precision medicine research. The latter will include making the partnership with all participants a centerpiece feature in the cohort's design and development. The Precision Medicine Initiative represents a broad-based research program that will allow new approaches for individualized medical care to be rigorously tested, so as to establish a new evidence base for advancing clinical practice and, eventually, human health.

  3. Clinical genomics in the world of the electronic health record.

    Science.gov (United States)

    Marsolo, Keith; Spooner, S Andrew

    2013-10-01

    The widespread adoption of electronic health records presents a number of benefits to the field of clinical genomics. They include the ability to return results to the practitioner, to use genetic findings in clinical decision support, and to have data collected in the electronic health record that serve as a source of phenotypic information for analysis purposes. Not all electronic health records are created equal, however. They differ in their features, capabilities, and ease of use. Therefore, to understand the potential of the electronic health record, it is first necessary to understand its capabilities and the impact that implementation strategy has on usability. Specifically, we focus on the following areas: (i) how the electronic health record is used to capture data in clinical practice settings; (ii) how the implementation and configuration of the electronic health record affect the quality and availability of data; (iii) the management of clinical genetic test results and the feasibility of electronic health record integration; and (iv) the challenges of implementing an electronic health record in a research-intensive environment. This is followed by a discussion of the minimum functional requirements that an electronic health record must meet to enable the satisfactory integration of genomic results as well as the open issues that remain.

  4. [Occupational health status of electronics manufacturing female employees in China].

    Science.gov (United States)

    Wei, T T; Mei, L Y

    2018-02-06

    Electronics industry is a typical labor-intensive industry in China. There are a lot of female workers and various occupational hazard factors in the workplace. This article reviewed the characteristics of employment of women in electronics industry, occupational hazards of exposure, protective measures, occupational disease situation, influence of reproductive health and mental health, and occupational health management. Electronics female emplyees have the priority in reproductive health and mental health. Besides, this group has poor protective measures, occupational health management and policy should be taken to enhance the level of women health in electronics industry.

  5. Advances in Electronic-Nose Technologies for the Detection of Volatile Biomarker Metabolites in the Human Breath

    Directory of Open Access Journals (Sweden)

    Alphus D. Wilson

    2015-03-01

    Full Text Available Recent advancements in the use of electronic-nose (e-nose devices to analyze human breath profiles for the presence of specific volatile metabolites, known as biomarkers or chemical bio-indicators of specific human diseases, metabolic disorders and the overall health status of individuals, are providing the potential for new noninvasive tools and techniques useful to point-of-care clinical disease diagnoses. This exciting new area of electronic disease detection and diagnosis promises to yield much faster and earlier detection of human diseases and disorders, allowing earlier, more effective treatments, resulting in more rapid patient recovery from various afflictions. E-nose devices are particularly suited for the field of disease diagnostics, because they are sensitive to a wide range of volatile organic compounds (VOCs and can effectively distinguish between different complex gaseous mixtures via analysis of electronic aroma sensor-array output profiles of volatile metabolites present in the human breath. This review provides a summary of some recent developments of electronic-nose technologies, particularly involving breath analysis, with the potential for providing many new diagnostic applications for the detection of specific human diseases associated with different organs in the body, detectable from e-nose analyses of aberrant disease-associated VOCs present in air expired from the lungs.

  6. Integration of clinical research documentation in electronic health records.

    Science.gov (United States)

    Broach, Debra

    2015-04-01

    Clinical trials of investigational drugs and devices are often conducted within healthcare facilities concurrently with clinical care. With implementation of electronic health records, new communication methods are required to notify nonresearch clinicians of research participation. This article reviews clinical research source documentation, the electronic health record and the medical record, areas in which the research record and electronic health record overlap, and implications for the research nurse coordinator in documentation of the care of the patient/subject. Incorporation of clinical research documentation in the electronic health record will lead to a more complete patient/subject medical record in compliance with both research and medical records regulations. A literature search provided little information about the inclusion of clinical research documentation within the electronic health record. Although regulations and guidelines define both source documentation and the medical record, integration of research documentation in the electronic health record is not clearly defined. At minimum, the signed informed consent(s), investigational drug or device usage, and research team contact information should be documented within the electronic health record. Institutional policies should define a standardized process for this integration in the absence federal guidance. Nurses coordinating clinical trials are in an ideal position to define this integration.

  7. Practical guide to electronic resources in the humanities

    CERN Document Server

    Dubnjakovic, Ana

    2010-01-01

    From full-text article databases to digitized collections of primary source materials, newly emerging electronic resources have radically impacted how research in the humanities is conducted and discovered. This book, covering high-quality, up-to-date electronic resources for the humanities, is an easy-to-use annotated guide for the librarian, student, and scholar alike. It covers online databases, indexes, archives, and many other critical tools in key humanities disciplines including philosophy, religion, languages and literature, and performing and visual arts. Succinct overviews of key eme

  8. Electronic Health Record in Continuous Shared Health Care

    Czech Academy of Sciences Publication Activity Database

    Hanzlíček, Petr; Zvárová, Jana; Zvára, K.; Bureš, V.; Špidlen, Josef

    2005-01-01

    Roč. 11, - (2005), s. 1-6 ISSN 1727-1983. [EMBEC'05. European Medical and Biomedical Conference /3./. Prague, 20.11.2005-25.11.2005] R&D Projects: GA AV ČR 1ET200300413 Institutional research plan: CEZ:AV0Z10300504 Keywords : electronic health record * shared health care * information technology Subject RIV: BD - Theory of Information

  9. Electronic Communication of Protected Health Information: Privacy, Security, and HIPAA Compliance.

    Science.gov (United States)

    Drolet, Brian C; Marwaha, Jayson S; Hyatt, Brad; Blazar, Phillip E; Lifchez, Scott D

    2017-06-01

    Technology has enhanced modern health care delivery, particularly through accessibility to health information and ease of communication with tools like mobile device messaging (texting). However, text messaging has created new risks for breach of protected health information (PHI). In the current study, we sought to evaluate hand surgeons' knowledge and compliance with privacy and security standards for electronic communication by text message. A cross-sectional survey of the American Society for Surgery of the Hand membership was conducted in March and April 2016. Descriptive and inferential statistical analyses were performed of composite results as well as relevant subgroup analyses. A total of 409 responses were obtained (11% response rate). Although 63% of surgeons reported that they believe that text messaging does not meet Health Insurance Portability and Accountability Act of 1996 security standards, only 37% reported they do not use text messages to communicate PHI. Younger surgeons and respondents who believed that their texting was compliant were statistically significantly more like to report messaging of PHI (odds ratio, 1.59 and 1.22, respectively). A majority of hand surgeons in this study reported the use of text messaging to communicate PHI. Of note, neither the Health Insurance Portability and Accountability Act of 1996 statute nor US Department of Health and Human Services specifically prohibits this form of electronic communication. To be compliant, surgeons, practices, and institutions need to take reasonable security precautions to prevent breach of privacy with electronic communication. Communication of clinical information by text message is not prohibited under Health Insurance Portability and Accountability Act of 1996, but surgeons should use appropriate safeguards to prevent breach when using this form of communication. Copyright © 2017 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  10. Adoption of Electronic Health Records: A Roadmap for India

    Science.gov (United States)

    2016-01-01

    Objectives The objective of the study was to create a roadmap for the adoption of Electronic Health Record (EHR) in India based an analysis of the strategies of other countries and national scenarios of ICT use in India. Methods The strategies for adoption of EHR in other countries were analyzed to find the crucial steps taken. Apart from reports collected from stakeholders in the country, the study relied on the experience of the author in handling several e-health projects. Results It was found that there are four major areas where the countries considered have made substantial efforts: ICT infrastructure, Policy & regulations, Standards & interoperability, and Research, development & education. A set of crucial activities were identified in each area. Based on the analysis, a roadmap is suggested. It includes the creation of a secure health network; health information exchange; and the use of open-source software, a national health policy, privacy laws, an agency for health IT standards, R&D, human resource development, etc. Conclusions Although some steps have been initiated, several new steps need to be taken up for the successful adoption of EHR. It requires a coordinated effort from all the stakeholders. PMID:27895957

  11. Adoption of Electronic Health Records: A Roadmap for India.

    Science.gov (United States)

    Srivastava, Sunil Kumar

    2016-10-01

    The objective of the study was to create a roadmap for the adoption of Electronic Health Record (EHR) in India based an analysis of the strategies of other countries and national scenarios of ICT use in India. The strategies for adoption of EHR in other countries were analyzed to find the crucial steps taken. Apart from reports collected from stakeholders in the country, the study relied on the experience of the author in handling several e-health projects. It was found that there are four major areas where the countries considered have made substantial efforts: ICT infrastructure, Policy & regulations, Standards & interoperability, and Research, development & education. A set of crucial activities were identified in each area. Based on the analysis, a roadmap is suggested. It includes the creation of a secure health network; health information exchange; and the use of open-source software, a national health policy, privacy laws, an agency for health IT standards, R&D, human resource development, etc. Although some steps have been initiated, several new steps need to be taken up for the successful adoption of EHR. It requires a coordinated effort from all the stakeholders.

  12. Quality of nursing documentation: Paper-based health records versus electronic-based health records.

    Science.gov (United States)

    Akhu-Zaheya, Laila; Al-Maaitah, Rowaida; Bany Hani, Salam

    2018-02-01

    To assess and compare the quality of paper-based and electronic-based health records. The comparison examined three criteria: content, documentation process and structure. Nursing documentation is a significant indicator of the quality of patient care delivery. It can be either paper-based or organised within the system known as the electronic health records. Nursing documentation must be completed at the highest standards, to ensure the safety and quality of healthcare services. However, the evidence is not clear on which one of the two forms of documentation (paper-based versus electronic health records is more qualified. A retrospective, descriptive, comparative design was used to address the study's purposes. A convenient number of patients' records, from two public hospitals, were audited using the Cat-ch-Ing audit instrument. The sample size consisted of 434 records for both paper-based health records and electronic health records from medical and surgical wards. Electronic health records were better than paper-based health records in terms of process and structure. In terms of quantity and quality content, paper-based records were better than electronic health records. The study affirmed the poor quality of nursing documentation and lack of nurses' knowledge and skills in the nursing process and its application in both paper-based and electronic-based systems. Both forms of documentation revealed drawbacks in terms of content, process and structure. This study provided important information, which can guide policymakers and administrators in identifying effective strategies aimed at enhancing the quality of nursing documentation. Policies and actions to ensure quality nursing documentation at the national level should focus on improving nursing knowledge, competencies, practice in nursing process, enhancing the work environment and nursing workload, as well as strengthening the capacity building of nursing practice to improve the quality of nursing care and

  13. Human Exposure and Health

    Science.gov (United States)

    The ROE is divided into 5 themes: Air, Water, Land, Human Exposure and Health and Ecological Condition. From these themes, the report indicators address fundamental questions that the ROE attempts to answer. For human health there are 3 questions.

  14. Are electronic health records ready for genomic medicine?

    Science.gov (United States)

    Scheuner, Maren T; de Vries, Han; Kim, Benjamin; Meili, Robin C; Olmstead, Sarah H; Teleki, Stephanie

    2009-07-01

    The goal of this project was to assess genetic/genomic content in electronic health records. Semistructured interviews were conducted with key informants. Questions addressed documentation, organization, display, decision support and security of family history and genetic test information, and challenges and opportunities relating to integrating genetic/genomics content in electronic health records. There were 56 participants: 10 electronic health record specialists, 18 primary care clinicians, 16 medical geneticists, and 12 genetic counselors. Few clinicians felt their electronic record met their current genetic/genomic medicine needs. Barriers to integration were mostly related to problems with family history data collection, documentation, and organization. Lack of demand for genetics content and privacy concerns were also mentioned as challenges. Data elements and functionality requirements that clinicians see include: pedigree drawing; clinical decision support for familial risk assessment and genetic testing indications; a patient portal for patient-entered data; and standards for data elements, terminology, structure, interoperability, and clinical decision support rules. Although most said that there is little impact of genetics/genomics on electronic records today, many stated genetics/genomics would be a driver of content in the next 5-10 years. Electronic health records have the potential to enable clinical integration of genetic/genomic medicine and improve delivery of personalized health care; however, structured and standardized data elements and functionality requirements are needed.

  15. Effects of Thermal Resistance on One-Dimensional Thermal Analysis of the Epidermal Flexible Electronic Devices Integrated with Human Skin

    Science.gov (United States)

    Li, He; Cui, Yun

    2017-12-01

    Nowadays, flexible electronic devices are increasingly used in direct contact with human skin to monitor the real-time health of human body. Based on the Fourier heat conduction equation and Pennes bio-heat transfer equation, this paper deduces the analytical solutions of one - dimensional heat transfer for flexible electronic devices integrated with human skin under the condition of a constant power. The influence of contact thermal resistance between devices and skin is considered as well. The corresponding finite element model is established to verify the correctness of analytical solutions. The results show that the finite element analysis agrees well with the analytical solution. With bigger thermal resistance, temperature increase of skin surface will decrease. This result can provide guidance for the design of flexible electronic devices to reduce the negative impact that exceeding temperature leave on human skin.

  16. Operating Room Delays: Meaningful Use in Electronic Health Record.

    Science.gov (United States)

    Van Winkle, Rachelle A; Champagne, Mary T; Gilman-Mays, Meri; Aucoin, Julia

    2016-06-01

    Perioperative areas are the most costly to operate and account for more than 40% of expenses. The high costs prompted one organization to analyze surgical delays through a retrospective review of their new electronic health record. Electronic health records have made it easier to access and aggregate clinical data; 2123 operating room cases were analyzed. Implementing a new electronic health record system is complex; inaccurate data and poor implementation can introduce new problems. Validating the electronic health record development processes determines the ease of use and the user interface, specifically related to user compliance with the intent of the electronic health record development. The revalidation process after implementation determines if the intent of the design was fulfilled and data can be meaningfully used. In this organization, the data fields completed through automation provided quantifiable, meaningful data. However, data fields completed by staff that required subjective decision making resulted in incomplete data nearly 24% of the time. The ease of use was further complicated by 490 permutations (combinations of delay types and reasons) that were built into the electronic health record. Operating room delay themes emerged notwithstanding the significant complexity of the electronic health record build; however, improved accuracy could improve meaningful data collection and a more accurate root cause analysis of operating room delays. Accurate and meaningful use of data affords a more reliable approach in quality, safety, and cost-effective initiatives.

  17. Technology as friend or foe? Do electronic health records increase burnout?

    Science.gov (United States)

    Ehrenfeld, Jesse M; Wanderer, Jonathan P

    2018-06-01

    To summarize recent relevant studies regarding the use of electronic health records and physician burnout. Recently acquired knowledge regarding the relationship between electronic health record use, professional satisfaction, burnout, and desire to leave clinical practice are discussed. Adoption of electronic health records has increased across the United States and worldwide. Although electronic health records have many benefits, there is growing concern about the adverse consequences of their use on physician satisfaction and burnout. Poor usability, incongruent workflows, and the addition of clerical tasks to physician documentation requirements have been previously highlighted as ongoing concerns with electronic health record adoption. In multiple recent studies, electronic health records have been shown to decrease professional satisfaction, increase burnout, and the likelihood that a physician will reduce or leave clinical practice. One interventional study demonstrated a positive effect of a dedicated electronic health record entry clerk on physicians working in an outpatient practice.

  18. Teaching Electronic Health Record Communication Skills.

    Science.gov (United States)

    Palumbo, Mary Val; Sandoval, Marie; Hart, Vicki; Drill, Clarissa

    2016-06-01

    This pilot study investigated nurse practitioner students' communication skills when utilizing the electronic health record during history taking. The nurse practitioner students (n = 16) were videotaped utilizing the electronic health record while taking health histories with standardized patients. The students were videotaped during two separate sessions during one semester. Two observers recorded the time spent (1) typing and talking, (2) typing only, and (3) looking at the computer without talking. Total history taking time, computer placement, and communication skills were also recorded. During the formative session, mean history taking time was 11.4 minutes, with 3.5 minutes engaged with the computer (30.6% of visit). During the evaluative session, mean history taking time was 12.4 minutes, with 2.95 minutes engaged with the computer (24% of visit). The percentage of time individuals spent changed over the two visits: typing and talking, -3.1% (P = .3); typing only, +12.8% (P = .038); and looking at the computer, -9.6% (P = .039). This study demonstrated that time spent engaged with the computer during a patient encounter does decrease with student practice and education. Therefore, students benefit from instruction on electronic health record-specific communication skills, and use of a simple mnemonic to reinforce this is suggested.

  19. How Health Humanities Will Save the Life of the Humanities.

    Science.gov (United States)

    Klugman, Craig M

    2017-12-01

    In the last decade, the humanities have been shrinking in number of students, percent of faculty, and in number of degrees awarded. Humanities students also earn lower salaries than their STEM-prepared peers. At the same time, the health humanities have been in ascendance over the last fifteen years. The number of majors, minors and certificates has increased 266% in that time frame, attracting large numbers of students and preparing future patients, lay caregivers, and health care providers to interact with a complicated and dehumanized medical system. In 1982, British philosopher and educator Stephen Toulmin declared that medicine saved philosophy from irrelevance and possibly extinction. I propose that the health humanities can serve a similar function to stave off the decline of the broader humanities. The health humanities can (1) model an applied approach for the broader humanities to attract student interest; (2) develop students' capacity for critical reading, writing and reflection about health and medicine in society, practice, and their own lives and (3) inoculate all students against the influence of medicine, whether through preparing pre-health students to navigate the hidden medical curriculum or preparing future patients to navigate the health care system.

  20. Electronic Health Record for Continuous Shared Health Care

    Czech Academy of Sciences Publication Activity Database

    Hanzlíček, Petr; Zvárová, Jana

    2005-01-01

    Roč. 9, - (2005), s. 275-280 ISSN 1335-2393. [YBERC 2005. Young Biomedical Engineers and Researchers Conference. Stará Lesná, 13.07.2005-15.07.2005] R&D Projects: GA AV ČR 1ET200300413 Institutional research plan: CEZ:AV0Z10300504 Keywords : information society * telemedicine * electronic health record * digital signature * personal data protection * biomedical informatics Subject RIV: FQ - Public Health Care, Social Medicine

  1. Electronic Textbook in Human Physiology.

    Science.gov (United States)

    Broering, Naomi C.; Lilienfield, Lawrence S.

    1994-01-01

    Describes the development of an electronic textbook in human physiology at the Georgetown University Medical Center Library that was designed to enhance learning and visualization through a prototype knowledge base of core instructional materials stored in digital format on Macintosh computers. The use of computers in the medical curriculum is…

  2. Electronic cigarette liquid increases inflammation and virus infection in primary human airway epithelial cells.

    Science.gov (United States)

    Wu, Qun; Jiang, Di; Minor, Maisha; Chu, Hong Wei

    2014-01-01

    The use of electronic cigarettes (e-cigarettes) is rapidly increasing in the United States, especially among young people since e-cigarettes have been perceived as a safer alternative to conventional tobacco cigarettes. However, the scientific evidence regarding the human health effects of e-cigarettes on the lung is extremely limited. The major goal of our current study is to determine if e-cigarette use alters human young subject airway epithelial functions such as inflammatory response and innate immune defense against respiratory viral (i.e., human rhinovirus, HRV) infection. We examined the effects of e-cigarette liquid (e-liquid) on pro-inflammatory cytokine (e.g., IL-6) production, HRV infection and host defense molecules (e.g., short palate, lung, and nasal epithelium clone 1, SPLUNC1) in primary human airway epithelial cells from young healthy non-smokers. Additionally, we examined the role of SPLUNC1 in lung defense against HRV infection using a SPLUNC1 knockout mouse model. We found that nicotine-free e-liquid promoted IL-6 production and HRV infection. Addition of nicotine into e-liquid further amplified the effects of nicotine-free e-liquid. Moreover, SPLUNC1 deficiency in mice significantly increased lung HRV loads. E-liquid inhibited SPLUNC1 expression in primary human airway epithelial cells. These findings strongly suggest the deleterious health effects of e-cigarettes in the airways of young people. Our data will guide future studies to evaluate the impact of e-cigarettes on lung health in human populations, and help inform the public about potential health risks of e-cigarettes.

  3. Electronic cigarette liquid increases inflammation and virus infection in primary human airway epithelial cells.

    Directory of Open Access Journals (Sweden)

    Qun Wu

    Full Text Available The use of electronic cigarettes (e-cigarettes is rapidly increasing in the United States, especially among young people since e-cigarettes have been perceived as a safer alternative to conventional tobacco cigarettes. However, the scientific evidence regarding the human health effects of e-cigarettes on the lung is extremely limited. The major goal of our current study is to determine if e-cigarette use alters human young subject airway epithelial functions such as inflammatory response and innate immune defense against respiratory viral (i.e., human rhinovirus, HRV infection.We examined the effects of e-cigarette liquid (e-liquid on pro-inflammatory cytokine (e.g., IL-6 production, HRV infection and host defense molecules (e.g., short palate, lung, and nasal epithelium clone 1, SPLUNC1 in primary human airway epithelial cells from young healthy non-smokers. Additionally, we examined the role of SPLUNC1 in lung defense against HRV infection using a SPLUNC1 knockout mouse model. We found that nicotine-free e-liquid promoted IL-6 production and HRV infection. Addition of nicotine into e-liquid further amplified the effects of nicotine-free e-liquid. Moreover, SPLUNC1 deficiency in mice significantly increased lung HRV loads. E-liquid inhibited SPLUNC1 expression in primary human airway epithelial cells. These findings strongly suggest the deleterious health effects of e-cigarettes in the airways of young people. Our data will guide future studies to evaluate the impact of e-cigarettes on lung health in human populations, and help inform the public about potential health risks of e-cigarettes.

  4. (Public) Health and Human Rights in Practice.

    Science.gov (United States)

    Annas, George J; Mariner, Wendy K

    2016-02-01

    Public health's reliance on law to define and carry out public activities makes it impossible to define a set of ethical principles unique to public health. Public health ethics must be encompassed within--and consistent with--a broader set of principles that define the power and limits of governmental institutions. These include human rights, health law, and even medical ethics. The human right to health requires governments not only to respect individual human rights and personal freedoms, but also, importantly, to protect people from harm from external sources and third parties, and to fulfill the health needs of the population. Even if human rights are the natural language for public health, not all public health professionals are comfortable with the language of human rights. Some argue that individual human rights--such as autonomy and privacy--unfairly limit the permissible means to achieve the goal of health protection. We argue that public health should welcome and promote the human rights framework. In almost every instance, this will make public health more effective in the long run, because the goals of public health and human rights are the same: to promote human flourishing. Copyright © 2016 by Duke University Press.

  5. Mandatory Use of Electronic Health Records: Overcoming Physician Resistance

    Science.gov (United States)

    Brown, Viseeta K.

    2012-01-01

    Literature supports the idea that electronic health records hold tremendous value for the healthcare system in that it increases patient safety, improves the quality of care and provides greater efficiency. The move toward mandatory implementation of electronic health records is a growing concern in the United States health care industry. The…

  6. The use of electronic health records in Spanish hospitals.

    Science.gov (United States)

    Marca, Guillem; Perez, Angel; Blanco-Garcia, Martin German; Miravalles, Elena; Soley, Pere; Ortiga, Berta

    The aims of this study were to describe the level of adoption of electronic health records in Spanish hospitals and to identify potential barriers and facilitators to this process. We used an observational cross-sectional design. The survey was conducted between September and December 2011, using an electronic questionnaire distributed through email. We obtained a 30% response rate from the 214 hospitals contacted, all belonging to the Spanish National Health Service. The level of adoption of electronic health records in Spanish hospitals was found to be high: 39.1% of hospitals surveyed had a comprehensive EHR system while a basic system was functioning in 32.8% of the cases. However, in 2011 one third of the hospitals did not have a basic electronic health record system, although some have since implemented electronic functionalities, particularly those related to clinical documentation and patient administration. Respondents cited the acquisition and implementation costs as the main barriers to implementation. Facilitators for EHR implementation were: the possibility to hire technical support, both during and post implementation; security certification warranty; and objective third-party evaluations of EHR products. In conclusion, the number of hospitals that have electronic health records is in general high, being relatively higher in medium-sized hospitals.

  7. Electronic Health Records Place 1st at Indy 500

    Science.gov (United States)

    ... Navigation Bar Home Current Issue Past Issues EHR Electronic Health Records Place 1st at Indy 500 Past ... last May's Indy 500 had thousands of personal Electronic Health Records on hand for those attending—and ...

  8. Electronic Personal Health Record Use Among Nurses in the Nursing Informatics Community.

    Science.gov (United States)

    Gartrell, Kyungsook; Trinkoff, Alison M; Storr, Carla L; Wilson, Marisa L

    2015-07-01

    An electronic personal health record is a patient-centric tool that enables patients to securely access, manage, and share their health information with healthcare providers. It is presumed the nursing informatics community would be early adopters of electronic personal health record, yet no studies have been identified that examine the personal adoption of electronic personal health record's for their own healthcare. For this study, we sampled nurse members of the American Medical Informatics Association and the Healthcare Information and Management Systems Society with 183 responding. Multiple logistic regression analysis was used to identify those factors associated with electronic personal health record use. Overall, 72% were electronic personal health record users. Users tended to be older (aged >50 years), be more highly educated (72% master's or doctoral degrees), and hold positions as clinical informatics specialists or chief nursing informatics officers. Those whose healthcare providers used electronic health records were significantly more likely to use electronic personal health records (odds ratio, 5.99; 95% confidence interval, 1.40-25.61). Electronic personal health record users were significantly less concerned about privacy of health information online than nonusers (odds ratio, 0.32; 95% confidence interval, 0.14-0.70) adjusted for ethnicity, race, and practice region. Informatics nurses, with their patient-centered view of technology, are in prime position to influence development of electronic personal health records. Our findings can inform policy efforts to encourage informatics and other professional nursing groups to become leaders and users of electronic personal health record; such use could help them endorse and engage patients to use electronic personal health records. Having champions with expertise in and enthusiasm for the new technology can promote the adoptionof electronic personal health records among healthcare providers as well as

  9. eRegistries: Electronic registries for maternal and child health.

    Science.gov (United States)

    Frøen, J Frederik; Myhre, Sonja L; Frost, Michael J; Chou, Doris; Mehl, Garrett; Say, Lale; Cheng, Socheat; Fjeldheim, Ingvild; Friberg, Ingrid K; French, Steve; Jani, Jagrati V; Kaye, Jane; Lewis, John; Lunde, Ane; Mørkrid, Kjersti; Nankabirwa, Victoria; Nyanchoka, Linda; Stone, Hollie; Venkateswaran, Mahima; Wojcieszek, Aleena M; Temmerman, Marleen; Flenady, Vicki J

    2016-01-19

    The Global Roadmap for Health Measurement and Accountability sees integrated systems for health information as key to obtaining seamless, sustainable, and secure information exchanges at all levels of health systems. The Global Strategy for Women's, Children's and Adolescent's Health aims to achieve a continuum of quality of care with effective coverage of interventions. The WHO and World Bank recommend that countries focus on intervention coverage to monitor programs and progress for universal health coverage. Electronic health registries - eRegistries - represent integrated systems that secure a triple return on investments: First, effective single data collection for health workers to seamlessly follow individuals along the continuum of care and across disconnected cadres of care providers. Second, real-time public health surveillance and monitoring of intervention coverage, and third, feedback of information to individuals, care providers and the public for transparent accountability. This series on eRegistries presents frameworks and tools to facilitate the development and secure operation of eRegistries for maternal and child health. In this first paper of the eRegistries Series we have used WHO frameworks and taxonomy to map how eRegistries can support commonly used electronic and mobile applications to alleviate health systems constraints in maternal and child health. A web-based survey of public health officials in 64 low- and middle-income countries, and a systematic search of literature from 2005-2015, aimed to assess country capacities by the current status, quality and use of data in reproductive health registries. eRegistries can offer support for the 12 most commonly used electronic and mobile applications for health. Countries are implementing health registries in various forms, the majority in transition from paper-based data collection to electronic systems, but very few have eRegistries that can act as an integrating backbone for health

  10. An examination of electronic health information privacy in older adults.

    Science.gov (United States)

    Le, Thai; Thompson, Hilaire; Demiris, George

    2013-01-01

    Older adults are the quickest growing demographic group and are key consumers of health services. As the United States health system transitions to electronic health records, it is important to understand older adult perceptions of privacy and security. We performed a secondary analysis of the Health Information National Trends Survey (2012, Cycle 1), to examine differences in perceptions of electronic health information privacy between older adults and the general population. We found differences in the level of importance placed on access to electronic health information (older adults placed greater emphasis on provider as opposed to personal access) and tendency to withhold information out of concerns for privacy and security (older adults were less likely to withhold information). We provide recommendations to alleviate some of these privacy concerns. This may facilitate greater use of electronic health communication between patient and provider, while promoting shared decision making.

  11. Use of electronic health records and administrative data for public health surveillance of eye health and vision-related conditions in the United States.

    Science.gov (United States)

    Elliott, Amanda F; Davidson, Arthur; Lum, Flora; Chiang, Michael F; Saaddine, Jinan B; Zhang, Xinzhi; Crews, John E; Chou, Chiu-Fang

    2012-12-01

    To discuss the current trend toward greater use of electronic health records and how these records could enhance public health surveillance of eye health and vision-related conditions. Perspective, comparing systems. We describe 3 currently available sources of electronic health data (Kaiser Permanente, the Veterans Health Administration, and the Centers for Medicare & Medicaid Services) and how these sources can contribute to a comprehensive vision and eye health surveillance system. Each of the 3 sources of electronic health data can contribute meaningfully to a comprehensive vision and eye health surveillance system, but none currently provide all the information required. The use of electronic health records for vision and eye health surveillance has both advantages and disadvantages. Electronic health records may provide additional information needed to create a comprehensive vision and eye health surveillance system. Recommendations for incorporating electronic health records into such a system are presented. Copyright © 2012 Elsevier Inc. All rights reserved.

  12. Nutrition, health and human rights.

    Science.gov (United States)

    Brundtland, G H

    1999-07-01

    This paper presents the speech delivered by Gro Harlem Brundtland, Director-General of WHO, on issues related to nutrition from a health and a human rights perspective. According to Brundtland, nutrition is a universal factor that both affects and defines the health of all people. It affects not only growth and physical development of a child, but also his cognitive and social development. However, inequity, poverty, underdevelopment, as well as inadequate access to food, health and care still exist which have resulted to the deaths of millions of children and left many more suffering from diseases. Poverty has also been identified as the main obstacle to the attainment of health. The existence of structural poverty and ill health eventually leads to poor development, which includes poor nutrition, poor health, and poor human rights. The impact of poverty on health is further worsened by discrimination on the basis of race, color, sex, language, or religion. To address this issue, the WHO will renew their focus on the political and legal links between health and human rights. A human rights perspective provides the international community with an opportunity to support the development of public health policies and practices that promote healthy nutrition as a center of all social and economic development.

  13. Human rights approach to health.

    Science.gov (United States)

    Haigh, Fiona

    2002-04-01

    Adopting human rights approach to health carries many benefits, because it emphasizes the equality of all persons and their inherent right to health as the foundation of the health care system. It also argues that promotion and protection of health are fundamentally important social goals, focuses particularly on the needs of the most disadvantaged and vulnerable communities, balances individual needs with the common good, and so forth. However, it also raises some practical issues, such as organization of interdisciplinary education and work, and different use of the language, which often goes unacknowledged. The relationship between human rights and health is a reciprocal one, and can be beneficial or harmful. For the relationship to be beneficial and successful, the differences between human rights and public health approach to health, centered around the perspective taking, attitudes, and abilities of health professionals, need to be acknowledged and reconciled, and the need for interdisciplinarity adequately fulfilled.

  14. One health: The interface between veterinary and human health

    Directory of Open Access Journals (Sweden)

    Kshitiz Shrestha

    2018-01-01

    Full Text Available One Health is an emerging global key concept integrating human and animal health through international research and policy. The complex relationships between the human and animal have resulted in a human-animal-environment interface since prehistorical times. The people, animals, plants, and the environment are so intrinsically linked that prevention of risks and the mitigation of effects of crises that originate at the interface between humans, animals, and their environments can only improve health and wellbeing. The “One Health” approach has been successfully implemented in numerous projects around the world. The containment of pandemic threats such as avian influenza and severe acute respiratory syndrome within months of outbreak are few examples of successful applications of the One Health paradigm. The paper begins with a brief overview of the human-animal interface and continues with the socio-economic and public health impact caused by various zoonotic diseases such as Middle East respiratory syndrome, Influenza, and Ebola virus. This is followed by the role of “One Health” to deal the global problem by the global solution. It emphasizes the interdisciplinary collaboration, training for health professionals and institutional support to minimize global health threats due to infectious diseases. The broad definition of the concept is supposed to lead multiple interpretations that impede the effective implementation of One Health approach within veterinary profession, within the medical profession, by wildlife specialists and by environmentalists, while on the other side, it gives a value of interdisciplinary collaboration for reducing threats in human-animal-environment interface.

  15. Influence resistance on human health

    Science.gov (United States)

    Abdul Harits, M.; Bahtiar, Yusuf; Achdan, M. Syahdani; Sunarno, .

    2010-05-01

    Health is an important part of human life. Every person in this world want healthy body, in other words free of any disease. When seeing the pattern of human life today is high activity, always eat instant foods and lack of exercise makes a very bad human health from year to year. Therefore, there is need for the health revolution that can keep human health in order to remain in the condition is always healthy. Eat healthy foods four plus five perfect diligent exercise is the real solution to maintain health. In addition also advisable to always check each month to the doctor so that our health can be controlled. Most people underestimate it, especially the routine checks once a month to the doctor, therefore I created a simple research that aims to get people to mengonytrol health at any time without having to check into the doctor. By utilizing the resistance in the human body's health so we can be controlled. By using a simple tool to measure human resistance by using the concept of the bridge. Bridge circuit used to convert impedance variations into voltage variations. One advantage of this circuit is the voltage produced can vary around 0. This means strengthening can be used to raise the voltage level so as sensitivity to variations in impedance also increases. Another application is the impedance measurement accuracy. The bridge is the simplest and most widely used is the Wheatstone bridge circuit. This circuit is used for signal conditioning applications where a sensor can change the resistance value when the process variable is changed.

  16. NASA Human Health and Performance Strategy

    Science.gov (United States)

    Davis, Jeffrey R.

    2012-01-01

    In May 2007, what was then the Space Life Sciences Directorate, issued the 2007 Space Life Sciences Strategy for Human Space Exploration. In January 2012, leadership and key directorate personnel were once again brought together to assess the current and expected future environment against its 2007 Strategy and the Agency and Johnson Space Center goals and strategies. The result was a refined vision and mission, and revised goals, objectives, and strategies. One of the first changes implemented was to rename the directorate from Space Life Sciences to Human Health and Performance to better reflect our vision and mission. The most significant change in the directorate from 2007 to the present is the integration of the Human Research Program and Crew Health and Safety activities. Subsequently, the Human Health and Performance Directorate underwent a reorganization to achieve enhanced integration of research and development with operations to better support human spaceflight and International Space Station utilization. These changes also enable a more effective and efficient approach to human system risk mitigation. Since 2007, we have also made significant advances in external collaboration and implementation of new business models within the directorate and the Agency, and through two newly established virtual centers, the NASA Human Health and Performance Center and the Center of Excellence for Collaborative Innovation. Our 2012 Strategy builds upon these successes to address the Agency's increased emphasis on societal relevance and being a leader in research and development and innovative business and communications practices. The 2012 Human Health and Performance Vision is to lead the world in human health and performance innovations for life in space and on Earth. Our mission is to enable optimization of human health and performance throughout all phases of spaceflight. All HH&P functions are ultimately aimed at achieving this mission. Our activities enable

  17. Human Health at the Beach

    Science.gov (United States)

    ... and Research Centers Beaches Contact Us Share LEARN: Human Health at the Beach Swimming at beaches with pollution ... water pollution, there are other potential threats to human health at the beach to be aware of. The ...

  18. Dental Electronic Health Record Evaluation

    Czech Academy of Sciences Publication Activity Database

    Chleborád, K.; Zvára Jr., Karel; Dostálová, T.; Zvára, Karel; Ivančáková, R.; Zvárová, Jana; Smidl, L.; Trmal, J.; Psutka, J.

    2013-01-01

    Roč. 1, č. 1 (2013), s. 50-50 ISSN 1805-8698. [EFMI 2013 Special Topic Conference. 17.04.2013-19.04.2013, Prague] Institutional support: RVO:67985807 Keywords : dentistry * medical documentation * electronic health record Subject RIV: IN - Informatics, Computer Science

  19. Nurses' Perceptions of the Electronic Health Record

    Science.gov (United States)

    Crawley, Rocquel Devonne

    2013-01-01

    The implementation of electronic health records (EHR) by health care organizations has been limited. Despite the broad consensus on the potential benefits of EHRs, health care organizations have been slow to adopt the technology. The purpose of this qualitative phenomenological study was to explore licensed practical and registered nurses'…

  20. Lab-on-Skin: A Review of Flexible and Stretchable Electronics for Wearable Health Monitoring.

    Science.gov (United States)

    Liu, Yuhao; Pharr, Matt; Salvatore, Giovanni Antonio

    2017-10-24

    Skin is the largest organ of the human body, and it offers a diagnostic interface rich with vital biological signals from the inner organs, blood vessels, muscles, and dermis/epidermis. Soft, flexible, and stretchable electronic devices provide a novel platform to interface with soft tissues for robotic feedback and control, regenerative medicine, and continuous health monitoring. Here, we introduce the term "lab-on-skin" to describe a set of electronic devices that have physical properties, such as thickness, thermal mass, elastic modulus, and water-vapor permeability, which resemble those of the skin. These devices can conformally laminate on the epidermis to mitigate motion artifacts and mismatches in mechanical properties created by conventional, rigid electronics while simultaneously providing accurate, non-invasive, long-term, and continuous health monitoring. Recent progress in the design and fabrication of soft sensors with more advanced capabilities and enhanced reliability suggest an impending translation of these devices from the research lab to clinical environments. Regarding these advances, the first part of this manuscript reviews materials, design strategies, and powering systems used in soft electronics. Next, the paper provides an overview of applications of these devices in cardiology, dermatology, electrophysiology, and sweat diagnostics, with an emphasis on how these systems may replace conventional clinical tools. The review concludes with an outlook on current challenges and opportunities for future research directions in wearable health monitoring.

  1. Developing Humanities Collections in the Digital Age: Exploring Humanities Faculty Engagement with Electronic and Print Resources

    Science.gov (United States)

    Kachaluba, Sarah Buck; Brady, Jessica Evans; Critten, Jessica

    2014-01-01

    This article is based on quantitative and qualitative research examining humanities scholars' understandings of the advantages and disadvantages of print versus electronic information resources. It explores how humanities' faculty members at Florida State University (FSU) use print and electronic resources, as well as how they perceive these…

  2. Electronic health record standards, coding systems, frameworks, and infrastructures

    CERN Document Server

    Sinha, Pradeep K; Bendale, Prashant; Mantri, Manisha; Dande, Atreya

    2013-01-01

    Discover How Electronic Health Records Are Built to Drive the Next Generation of Healthcare Delivery The increased role of IT in the healthcare sector has led to the coining of a new phrase ""health informatics,"" which deals with the use of IT for better healthcare services. Health informatics applications often involve maintaining the health records of individuals, in digital form, which is referred to as an Electronic Health Record (EHR). Building and implementing an EHR infrastructure requires an understanding of healthcare standards, coding systems, and frameworks. This book provides an

  3. Linking human health and livestock health: a "one-health" platform for integrated analysis of human health, livestock health, and economic welfare in livestock dependent communities.

    Directory of Open Access Journals (Sweden)

    S M Thumbi

    Full Text Available For most rural households in sub-Saharan Africa, healthy livestock play a key role in averting the burden associated with zoonotic diseases, and in meeting household nutritional and socio-economic needs. However, there is limited understanding of the complex nutritional, socio-economic, and zoonotic pathways that link livestock health to human health and welfare. Here we describe a platform for integrated human health, animal health and economic welfare analysis designed to address this challenge. We provide baseline epidemiological data on disease syndromes in humans and the animals they keep, and provide examples of relationships between human health, animal health and household socio-economic status.We designed a study to obtain syndromic disease data in animals along with economic and behavioral information for 1500 rural households in Western Kenya already participating in a human syndromic disease surveillance study. Data collection started in February 2013, and each household is visited bi-weekly and data on four human syndromes (fever, jaundice, diarrhea and respiratory illness and nine animal syndromes (death, respiratory, reproductive, musculoskeletal, nervous, urogenital, digestive, udder disorders, and skin disorders in cattle, sheep, goats and chickens are collected. Additionally, data from a comprehensive socio-economic survey is collected every 3 months in each of the study households.Data from the first year of study showed 93% of the households owned at least one form of livestock (55%, 19%, 41% and 88% own cattle, sheep, goats and chickens respectively. Digestive disorders, mainly diarrhea episodes, were the most common syndromes observed in cattle, goats and sheep, accounting for 56% of all livestock syndromes, followed by respiratory illnesses (18%. In humans, respiratory illnesses accounted for 54% of all illnesses reported, followed by acute febrile illnesses (40% and diarrhea illnesses (5%. While controlling for household

  4. Linking human health and livestock health: a "one-health" platform for integrated analysis of human health, livestock health, and economic welfare in livestock dependent communities.

    Science.gov (United States)

    Thumbi, S M; Njenga, M Kariuki; Marsh, Thomas L; Noh, Susan; Otiang, Elkanah; Munyua, Peninah; Ochieng, Linus; Ogola, Eric; Yoder, Jonathan; Audi, Allan; Montgomery, Joel M; Bigogo, Godfrey; Breiman, Robert F; Palmer, Guy H; McElwain, Terry F

    2015-01-01

    For most rural households in sub-Saharan Africa, healthy livestock play a key role in averting the burden associated with zoonotic diseases, and in meeting household nutritional and socio-economic needs. However, there is limited understanding of the complex nutritional, socio-economic, and zoonotic pathways that link livestock health to human health and welfare. Here we describe a platform for integrated human health, animal health and economic welfare analysis designed to address this challenge. We provide baseline epidemiological data on disease syndromes in humans and the animals they keep, and provide examples of relationships between human health, animal health and household socio-economic status. We designed a study to obtain syndromic disease data in animals along with economic and behavioral information for 1500 rural households in Western Kenya already participating in a human syndromic disease surveillance study. Data collection started in February 2013, and each household is visited bi-weekly and data on four human syndromes (fever, jaundice, diarrhea and respiratory illness) and nine animal syndromes (death, respiratory, reproductive, musculoskeletal, nervous, urogenital, digestive, udder disorders, and skin disorders in cattle, sheep, goats and chickens) are collected. Additionally, data from a comprehensive socio-economic survey is collected every 3 months in each of the study households. Data from the first year of study showed 93% of the households owned at least one form of livestock (55%, 19%, 41% and 88% own cattle, sheep, goats and chickens respectively). Digestive disorders, mainly diarrhea episodes, were the most common syndromes observed in cattle, goats and sheep, accounting for 56% of all livestock syndromes, followed by respiratory illnesses (18%). In humans, respiratory illnesses accounted for 54% of all illnesses reported, followed by acute febrile illnesses (40%) and diarrhea illnesses (5%). While controlling for household size, the

  5. Ecological determinants of health: food and environment on human health.

    Science.gov (United States)

    Li, Alice M L

    2017-04-01

    Human health and diseases are determined by many complex factors. Health threats from the human-animal-ecosystems interface (HAEI) and zoonotic diseases (zoonoses) impose an increasing risk continuously to public health, from those emerging pathogens transmitted through contact with animals, food, water and contaminated environments. Immense challenges forced on the ecological perspectives on food and the eco-environments, including aquaculture, agriculture and the entire food systems. Impacts of food and eco-environments on human health will be examined amongst the importance of human interventions for intended purposes in lowering the adverse effects on the biodiversity. The complexity of relevant conditions defined as factors contributing to the ecological determinants of health will be illuminated from different perspectives based on concepts, citations, examples and models, in conjunction with harmful consequential effects of human-induced disturbances to our environments and food systems, together with the burdens from ecosystem disruption, environmental hazards and loss of ecosystem functions. The eco-health literacy should be further promoting under the "One Health" vision, with "One World" concept under Ecological Public Health Model for sustaining our environments and the planet earth for all beings, which is coincidentally echoing Confucian's theory for the environmental ethics of ecological harmony.

  6. Analysis of Human Resources Management Strategy in China Electronic Commerce Enterprises

    Science.gov (United States)

    Shao, Fang

    The paper discussed electronic-commerce's influence on enterprise human resources management, proposed and proved the human resources management strategy which electronic commerce enterprise should adopt from recruitment strategy to training strategy, keeping talent strategy and other ways.

  7. Climate change and human health: a One Health approach.

    Science.gov (United States)

    Patz, Jonathan A; Hahn, Micah B

    2013-01-01

    Climate change adds complexity and uncertainty to human health issues such as emerging infectious diseases, food security, and national sustainability planning that intensify the importance of interdisciplinary and collaborative research. Collaboration between veterinary, medical, and public health professionals to understand the ecological interactions and reactions to flux in a system can facilitate clearer understanding of climate change impacts on environmental, animal, and human health. Here we present a brief introduction to climate science and projections for the next century and a review of current knowledge on the impacts of climate-driven environmental change on human health. We then turn to the links between ecological and evolutionary responses to climate change and health. The literature on climate impacts on biological systems is rich in both content and historical data, but the connections between these changes and human health is less understood. We discuss five mechanisms by which climate changes impacts on biological systems will be felt by the human population: Modifications in Vector, Reservoir, and Pathogen Lifecycles; Diseases of Domestic and Wild Animals and Plants; Disruption of Synchrony Between Interacting Species; Trophic Cascades; and Alteration or Destruction of Habitat. Each species responds to environmental changes differently, and in order to predict the movement of disease through ecosystems, we have to rely on expertise from the fields of veterinary, medical, and public health, and these health professionals must take into account the dynamic nature of ecosystems in a changing climate.

  8. Nurses' Experiences of an Initial and Reimplemented Electronic Health Record Use.

    Science.gov (United States)

    Chang, Chi-Ping; Lee, Ting-Ting; Liu, Chia-Hui; Mills, Mary Etta

    2016-04-01

    The electronic health record is a key component of healthcare information systems. Currently, numerous hospitals have adopted electronic health records to replace paper-based records to document care processes and improve care quality. Integrating healthcare information system into traditional nursing daily operations requires time and effort for nurses to become familiarized with this new technology. In the stages of electronic health record implementation, smooth adoption can streamline clinical nursing activities. In order to explore the adoption process, a descriptive qualitative study design and focus group interviews were conducted 3 months after and 2 years after electronic health record system implementation (system aborted 1 year in between) in one hospital located in southern Taiwan. Content analysis was performed to analyze the interview data, and six main themes were derived, in the first stage: (1) liability, work stress, and anticipation for electronic health record; (2) slow network speed, user-unfriendly design for learning process; (3) insufficient information technology/organization support; on the second stage: (4) getting used to electronic health record and further system requirements, (5) benefits of electronic health record in time saving and documentation, (6) unrealistic information technology competence expectation and future use. It concluded that user-friendly design and support by informatics technology and manpower backup would facilitate this adoption process as well.

  9. The need for academic electronic health record systems in nurse education.

    Science.gov (United States)

    Chung, Joohyun; Cho, Insook

    2017-07-01

    The nursing profession has been slow to incorporate information technology into formal nurse education and practice. The aim of this study was to identify the use of academic electronic health record systems in nurse education and to determine student and faculty perceptions of academic electronic health record systems in nurse education. A quantitative research design with supportive qualitative research was used to gather information on nursing students' perceptions and nursing faculty's perceptions of academic electronic health record systems in nurse education. Eighty-three participants (21 nursing faculty and 62 students), from 5 nursing schools, participated in the study. A purposive sample of 9 nursing faculty was recruited from one university in the Midwestern United States to provide qualitative data for the study. The researcher-designed surveys (completed by faculty and students) were used for quantitative data collection. Qualitative data was taken from interviews, which were transcribed verbatim for analysis. Students and faculty agreed that academic electronic health record systems could be useful for teaching students to think critically about nursing documentation. Quantitative and qualitative findings revealed that academic electronic health record systems regarding nursing documentation could help prepare students for the future of health information technology. Meaningful adoption of academic electronic health record systems will help in building the undergraduate nursing students' competence in nursing documentation with electronic health record systems. Copyright © 2017. Published by Elsevier Ltd.

  10. Electronic health records: what are the most important barriers?

    Science.gov (United States)

    Ayatollahi, Haleh; Mirani, Nader; Haghani, Hamid

    2014-01-01

    The process of design and adoption of electronic health records may face a number of barriers. This study aimed to compare the importance of the main barriers from the experts' point of views in Iran. This survey study was completed in 2011. The potential participants (62 experts) included faculty members who worked in departments of health information technology and individuals who worked in the Ministry of Health in Iran and were in charge of the development and adoption of electronic health records. No sampling method was used in this study. Data were collected using a Likert-scale questionnaire ranging from 1 to 5. The validity of the questionnaire was established using content and face validity methods, and the reliability was calculated using Cronbach's alpha coefficient. The response rate was 51.6 percent. The participants' perspectives showed that the most important barriers in the process of design and adoption of electronic health records were technical barriers (mean = 3.84). Financial and ethical-legal barriers, with the mean value of 3.80 were other important barriers, and individual and organizational barriers, with the mean values of 3.59 and 3.50 were found to be less important than other barriers from the experts' perspectives. Strategic planning for the creation and adoption of electronic health records in the country, creating a team of experts to assess the potential barriers and develop strategies to eliminate them, and allocating financial resources can help to overcome most important barriers to the adoption of electronic health records.

  11. Leading toward value: the role of strategic human resource management in health system adaptability.

    Science.gov (United States)

    Garman, Andrew N; Polavarapu, Nandakishor; Grady, Jane C; Canar, W Jeffrey

    2013-01-01

    Personnel costs typically account for 60% or more of total operating expenses in health systems, and as such become a necessary focus in most if not all substantive health reform adaptations. This study sought to assess whether strategic alignment of the human resource (HR) and learning functions was associated with greater adaptive capacity in U.S. health systems. Data were gathered using a survey that was distributed electronically to chief human resource officers from two U.S.-based associations. The survey included questions about organizational structure, strategic human resource management, strategic learning, and organizational response to health reform. Significant correlations were found between strategic alignment of HR and HR's involvement in responses related to cost control (r = 0.46, p strategic alignment of organizational learning and HR involvement with these responses. Results suggest that HR structure may affect an organization's capacity for adaptive response. Top-management teams in health systems should consider positioning HR as part of the core leadership team, with a reporting relationship that allows HR to maximally participate in formulating and implementing organizational adaptation.

  12. Moving electronic medical records upstream: incorporating social determinants of health.

    Science.gov (United States)

    Gottlieb, Laura M; Tirozzi, Karen J; Manchanda, Rishi; Burns, Abby R; Sandel, Megan T

    2015-02-01

    Knowledge of the biological pathways and mechanisms connecting social factors with health has increased exponentially over the past 25 years, yet in most clinical settings, screening and intervention around social determinants of health are not part of standard clinical care. Electronic medical records provide new opportunities for assessing and managing social needs in clinical settings, particularly those serving vulnerable populations. To illustrate the feasibility of capturing information and promoting interventions related to social determinants of health in electronic medical records. Three case studies were examined in which electronic medical records have been used to collect data and address social determinants of health in clinical settings. From these case studies, we identified multiple functions that electronic medical records can perform to facilitate the integration of social determinants of health into clinical systems, including screening, triaging, referring, tracking, and data sharing. If barriers related to incentives, training, and privacy can be overcome, electronic medical record systems can improve the integration of social determinants of health into healthcare delivery systems. More evidence is needed to evaluate the impact of such integration on health care outcomes before widespread adoption can be recommended. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  13. Integrating an Academic Electronic Health Record: Challenges and Success Strategies.

    Science.gov (United States)

    Herbert, Valerie M; Connors, Helen

    2016-08-01

    Technology is increasing the complexity in the role of today's nurse. Healthcare organizations are integrating more health information technologies and relying on the electronic health record for data collection, communication, and decision making. Nursing faculty need to prepare graduates for this environment and incorporate an academic electronic health record into a nursing curriculum to meet student-program outcomes. Although the need exists for student preparation, some nursing programs are struggling with implementation, whereas others have been successful. To better understand these complexities, this project was intended to identify current challenges and success strategies of effective academic electronic health record integration into nursing curricula. Using Rogers' 1962 Diffusion of Innovation theory as a framework for technology adoption, a descriptive survey design was used to gain insights from deans and program directors of nursing schools involved with the national Health Informatics & Technology Scholars faculty development program or Cerner's Academic Education Solution Consortium, working to integrate an academic electronic health record in their respective nursing schools. The participants' experiences highlighted approaches used by these schools to integrate these technologies. Data from this project provide nursing education with effective strategies and potential challenges that should be addressed for successful academic electronic health record integration.

  14. Electronic health record use, intensity of hospital care, and patient outcomes.

    Science.gov (United States)

    Blecker, Saul; Goldfeld, Keith; Park, Naeun; Shine, Daniel; Austrian, Jonathan S; Braithwaite, R Scott; Radford, Martha J; Gourevitch, Marc N

    2014-03-01

    Previous studies have suggested that weekend hospital care is inferior to weekday care and that this difference may be related to diminished care intensity. The purpose of this study was to determine whether a metric for measuring intensity of hospital care based on use of the electronic health record was associated with patient-level outcomes. We performed a cohort study of hospitalizations at an academic medical center. Intensity of care was defined as the hourly number of provider accessions of the electronic health record, termed "electronic health record interactions." Hospitalizations were categorized on the basis of the mean difference in electronic health record interactions between the first Friday and the first Saturday of hospitalization. We used regression models to determine the association of these categories with patient outcomes after adjusting for covariates. Electronic health record interactions decreased from Friday to Saturday in 77% of the 9051 hospitalizations included in the study. Compared with hospitalizations with no change in Friday to Saturday electronic health record interactions, the relative lengths of stay for hospitalizations with a small, moderate, and large decrease in electronic health record interactions were 1.05 (95% confidence interval [CI], 1.00-1.10), 1.11 (95% CI, 1.05-1.17), and 1.25 (95% CI, 1.15-1.35), respectively. Although a large decrease in electronic health record interactions was associated with in-hospital mortality, these findings were not significant after risk adjustment (odds ratio 1.74, 95% CI, 0.93-3.25). Intensity of inpatient care, measured by electronic health record interactions, significantly diminished from Friday to Saturday, and this decrease was associated with length of stay. Hospitals should consider monitoring and correcting temporal fluctuations in care intensity. Copyright © 2014 Elsevier Inc. All rights reserved.

  15. NMR studies of transmembrane electron transport in human erythrocytes

    International Nuclear Information System (INIS)

    Kennett, E.C.; Bubb, W.A.; Kuchel, P.W.

    2002-01-01

    Full text: Electron transport systems exist in the plasma membranes of all cells. These systems appear to play a role in cell growth and proliferation, intracellular signalling, hormone responses, apoptotic events, cell defence and perhaps most importantly they enable the cell to respond to changes in the redox state of both the intra- and extracellular environments. Previously, 13 C NMR has been used to study transmembrane electron transport in human erythrocytes, specifically the reduction of extracellular 13 C-ferricyanide. NMR is a particularly useful tool for studying such systems as changes in the metabolic state of the cell can be observed concomitantly with extracellular reductase activity. We investigated the oxidation of extracellular NADH by human erythrocytes using 1 H and 31 P NMR spectroscopy. Recent results for glucose-starved human erythrocytes indicate that, under these conditions, extracellular NADH can be oxidised at the plasma membrane with the electron transfer across the membrane resulting in reduction of intracellular NAD + . The activity is inhibited by known trans-plasma membrane electron transport inhibitors (capsaicin and atebrin) and is unaffected by inhibition of the erythrocyte Band 3 anion transporter. These results suggest that electron import from extracellular NADH allows the cell to re-establish a reducing environment after the normal redox balance is disturbed

  16. Oceans and Human Health: Linking Ocean, Organism, and Human Health for Sustainable Management of Coastal Ecosystems

    Science.gov (United States)

    Sandifer, P. A.; Trtanj, J.; Collier, T. K.

    2012-12-01

    Scientists and policy-makers are increasingly recognizing that sustainable coastal communities depend on healthy and resilient economies, ecosystems, and people, and that the condition or "health" of the coastal ocean and humans are intimately and inextricably connected. A wealth of ecosystem services provided by ocean and coastal environments are crucial for human survival and well being. Nonetheless, the health of coastal communities, their economies, connected ecosystems and ecosystem services, and people are under increasing threats from health risks associated with environmental degradation, climate change, and unwise land use practices, all of which contribute to growing burdens of naturally-occurring and introduced pathogens, noxious algae, and chemical contaminants. The occurrence, frequency, intensity, geographic range, and number and kinds of ocean health threats are increasing, with concomitant health and economic effects and eroding public confidence in the safety and wholesomeness of coastal environments and resources. Concerns in the research and public health communities, many summarized in the seminal 1999 NRC Report, From Monsoons to Microbes and the 2004 final report of the US Commission on Ocean Policy, resulted in establishment of a new "meta-discipline" known as Oceans and Human Health (OHH). OHH brings together practitioners in oceanography, marine biology, ecology, biomedical science, medicine, economics and other social sciences, epidemiology, environmental management, and public health to focus on water- and food-borne causes of human and animal illnesses associated with ocean and coastal systems and on health benefits of seafood and other marine products. It integrates information across multiple disciplines to increase knowledge of ocean health risks and benefits and communicate such information to enhance public safety. Recognizing the need for a comprehensive approach to ocean health threats and benefits, Congress passed the Oceans and

  17. Accuracy of Laboratory Data Communication on ICU Daily Rounds Using an Electronic Health Record.

    Science.gov (United States)

    Artis, Kathryn A; Dyer, Edward; Mohan, Vishnu; Gold, Jeffrey A

    2017-02-01

    Accurately communicating patient data during daily ICU rounds is critically important since data provide the basis for clinical decision making. Despite its importance, high fidelity data communication during interprofessional ICU rounds is assumed, yet unproven. We created a robust but simple methodology to measure the prevalence of inaccurately communicated (misrepresented) data and to characterize data communication failures by type. We also assessed how commonly the rounding team detected data misrepresentation and whether data communication was impacted by environmental, human, and workflow factors. Direct observation of verbalized laboratory data during daily ICU rounds compared with data within the electronic health record and on presenters' paper prerounding notes. Twenty-six-bed academic medical ICU with a well-established electronic health record. ICU rounds presenter (medical student or resident physician), interprofessional rounding team. None. During 301 observed patient presentations including 4,945 audited laboratory results, presenters used a paper prerounding tool for 94.3% of presentations but tools contained only 78% of available electronic health record laboratory data. Ninty-six percent of patient presentations included at least one laboratory misrepresentation (mean, 6.3 per patient) and 38.9% of all audited laboratory data were inaccurately communicated. Most misrepresentation events were omissions. Only 7.8% of all laboratory misrepresentations were detected. Despite a structured interprofessional rounding script and a well-established electronic health record, clinician laboratory data retrieval and communication during ICU rounds at our institution was poor, prone to omissions and inaccuracies, yet largely unrecognized by the rounding team. This highlights an important patient safety issue that is likely widely prevalent, yet underrecognized.

  18. Human resources for health policies: a critical component in health policies

    Directory of Open Access Journals (Sweden)

    Dussault Gilles

    2003-04-01

    Full Text Available Abstract In the last few years, increasing attention has been paid to the development of health policies. But side by side with the presumed benefits of policy, many analysts share the opinion that a major drawback of health policies is their failure to make room for issues of human resources. Current approaches in human resources suggest a number of weaknesses: a reactive, ad hoc attitude towards problems of human resources; dispersal of accountability within human resources management (HRM; a limited notion of personnel administration that fails to encompass all aspects of HRM; and finally the short-term perspective of HRM. There are three broad arguments for modernizing the ways in which human resources for health are managed: • the central role of the workforce in the health sector; • the various challenges thrown up by health system reforms; • the need to anticipate the effect on the health workforce (and consequently on service provision arising from various macroscopic social trends impinging on health systems. The absence of appropriate human resources policies is responsible, in many countries, for a chronic imbalance with multifaceted effects on the health workforce: quantitative mismatch, qualitative disparity, unequal distribution and a lack of coordination between HRM actions and health policy needs. Four proposals have been put forward to modernize how the policy process is conducted in the development of human resources for health (HRH: • to move beyond the traditional approach of personnel administration to a more global concept of HRM; • to give more weight to the integrated, interdependent and systemic nature of the different components of HRM when preparing and implementing policy; • to foster a more proactive attitude among human resources (HR policy-makers and managers; • to promote the full commitment of all professionals and sectors in all phases of the process. The development of explicit human resources

  19. A Culture Of Health And Human Rights.

    Science.gov (United States)

    Mariner, Wendy K; Annas, George J

    2016-11-01

    A culture of health can be seen as a social norm that values health as the nation's priority or as an appeal to improve the social determinants of health. Better population health will require changing social and economic policies. Effective changes are unlikely unless health advocates can leverage a framework broader than health to mobilize political action in collaboration with non-health sector advocates. We suggest that human rights-the dominant international source of norms for government responsibilities-provides this broader framework. Human rights, as expressed in the Universal Declaration of Human Rights and enforceable treaties, require governments to assure their populations nondiscriminatory access to food, water, education, work, social security, and a standard of living adequate for health and well-being. The policies needed to realize human rights also improve population health, well-being, and equity. Aspirations for human rights are strong enough to endure beyond inevitable setbacks to specific causes. Project HOPE—The People-to-People Health Foundation, Inc.

  20. Electronic health systems: challenges faced by hospital-based providers.

    Science.gov (United States)

    Agno, Christina Farala; Guo, Kristina L

    2013-01-01

    The purpose of this article is to discuss specific challenges faced by hospitals adopting the use of electronic medical records and implementing electronic health record (EHR) systems. Challenges include user and information technology support; ease of technical use and software interface capabilities; compliance; and financial, legal, workforce training, and development issues. Electronic health records are essential to preventing medical errors, increasing consumer trust and use of the health system, and improving quality and overall efficiency. Government efforts are focused on ways to accelerate the adoption and use of EHRs as a means of facilitating data sharing, protecting health information privacy and security, quickly identifying emerging public health threats, and reducing medical errors and health care costs and increasing quality of care. This article will discuss physician and nonphysician staff training before, during, and after implementation; the effective use of EHR systems' technical features; the selection of a capable and secure EHR system; and the development of collaborative system implementation. Strategies that are necessary to help health care providers achieve successful implementation of EHR systems will be addressed.

  1. Management of laboratory data and information exchange in the electronic health record.

    Science.gov (United States)

    Wilkerson, Myra L; Henricks, Walter H; Castellani, William J; Whitsitt, Mark S; Sinard, John H

    2015-03-01

    In the era of the electronic health record, the success of laboratories and pathologists will depend on effective presentation and management of laboratory information, including test orders and results, and effective exchange of data between the laboratory information system and the electronic health record. In this third paper of a series that explores empowerment of pathology in the era of the electronic health record, we review key elements of managing laboratory information within the electronic health record and examine functional issues pertinent to pathologists and laboratories in the exchange of laboratory information between electronic health records and both anatomic and clinical pathology laboratory information systems. Issues with electronic order-entry and results-reporting interfaces are described, and considerations for setting up these interfaces are detailed in tables. The role of the laboratory medical director as mandated by the Clinical Laboratory Improvement Amendments of 1988 and the impacts of discordance between laboratory results and their display in the electronic health record are also discussed.

  2. Seaweed and human health.

    Science.gov (United States)

    Brown, Emma S; Allsopp, Philip J; Magee, Pamela J; Gill, Chris I R; Nitecki, Sonja; Strain, Conall R; McSorley, Emeir M

    2014-03-01

    Seaweeds may have an important role in modulating chronic disease. Rich in unique bioactive compounds not present in terrestrial food sources, including different proteins (lectins, phycobiliproteins, peptides, and amino acids), polyphenols, and polysaccharides, seaweeds are a novel source of compounds with potential to be exploited in human health applications. Purported benefits include antiviral, anticancer, and anticoagulant properties as well as the ability to modulate gut health and risk factors for obesity and diabetes. Though the majority of studies have been performed in cell and animal models, there is evidence of the beneficial effect of seaweed and seaweed components on markers of human health and disease status. This review is the first to critically evaluate these human studies, aiming to draw attention to gaps in current knowledge, which will aid the planning and implementation of future studies.

  3. Understanding and valuing the broader health system benefits of Uganda's national Human Resources for Health Information System investment.

    Science.gov (United States)

    Driessen, Julia; Settle, Dykki; Potenziani, David; Tulenko, Kate; Kabocho, Twaha; Wadembere, Ismail

    2015-08-31

    To address the need for timely and comprehensive human resources for health (HRH) information, governments and organizations have been actively investing in electronic health information interventions, including in low-resource settings. The economics of human resources information systems (HRISs) in low-resource settings are not well understood, however, and warrant investigation and validation. This case study describes Uganda's Human Resources for Health Information System (HRHIS), implemented with support from the US Agency for International Development, and documents perceptions of its impact on the health labour market against the backdrop of the costs of implementation. Through interviews with end users and implementers in six different settings, we document pre-implementation data challenges and consider how the HRHIS has been perceived to affect human resources decision-making and the healthcare employment environment. This multisite case study documented a range of perceived benefits of Uganda's HRHIS through interviews with end users that sought to capture the baseline (or pre-implementation) state of affairs, the perceived impact of the HRHIS and the monetary value associated with each benefit. In general, the system appears to be strengthening both demand for health workers (through improved awareness of staffing patterns) and supply (by improving licensing, recruitment and competency of the health workforce). This heightened ability to identify high-value employees makes the health sector more competitive for high-quality workers, and this elevation of the health workforce also has broader implications for health system performance and population health. Overall, it is clear that HRHIS end users in Uganda perceived the system to have significantly improved day-to-day operations as well as longer term institutional mandates. A more efficient and responsive approach to HRH allows the health sector to recruit the best candidates, train employees in

  4. Sharing electronic health records: the patient view

    Directory of Open Access Journals (Sweden)

    John Powell

    2006-03-01

    Full Text Available The introduction of a national electronic health record system to the National Health Service (NHS has raised concerns about issues of data accuracy, security and confidentiality. The primary aim of this project was to identify the extent to which primary care patients will allow their local electronic record data to be shared on a national database. The secondary aim was to identify the extent of inaccuracies in the existing primary care records, which will be used to populate the new national Spine. Fifty consecutive attenders to one general practitioner were given a paper printout of their full primary care electronic health record. Participants were asked to highlight information which they would not want to be shared on the national electronic database of records, and information which they considered to be incorrect. There was a 62% response rate (31/50. Five of the 31 patients (16% identified information that they would not want to be shared on the national record system. The items they identified related almost entirely to matters of pregnancy, contraception, sexual health and mental health. Ten respondents (32% identified incorrect information in their records (some of these turned out to be correct on further investigation. The findings in relation to data sharing fit with the commonly held assumption that matters related to sensitive or embarrassing issues, which may affect how the patient will be treated by other individuals or institutions, are most likely to be censored by patients. Previous work on this has tended to ask hypothetical questions concerning data sharing rather than examine a real situation. A larger study of representative samples of patients in both primary and secondary care settings is needed to further investigate issues of data sharing and consent.

  5. Validating an electronic health literacy scale in an older hispanic population.

    Science.gov (United States)

    Aponte, Judith; Nokes, Kathleen M

    2017-09-01

    To examine the validity of the Spanish version of an instrument used to measure electronic health literacy (eHEALS) with an older Hispanic population from a number of Spanish-language countries living in New York City in the United States (US). Although the Internet is available globally, complex skills are needed to use this source of valuable health-related information effectively. Electronic health literacy is a multifactorial concept that includes health literacy but also requires technology skills. Cross-sectional. Recruitment occurred at a Senior Organization located in a largely Hispanic neighbourhood in New York City (N = 100). Participants completed eHEALS and selected items from the Health Information National Trends Survey (HINTS) which assesses how adults use different communication channels, including the Internet, to obtain vital health information. Data from the US HINTS sample (N = 162) were matched to the Senior Organization sample on age range and Hispanic ethnicity. The average Senior Organization participant was 68 years old, female, born in one of six different Spanish-language countries, and completed high school while the average HINTS participant was 67 years old, female and had high school or less education. Although there was no relationship with the two HINTS subscales and electronic health literacy, there were significant relationships between electronic health literacy and health status and confidence in self-care. Inadequate electronic health literacy is a barrier to positive health outcomes. The Spanish version of eHEALS could be used as a screening instrument to identify gaps and tailored interventions could be developed to increase consumer confidence in using the Internet for reliable health-related information. Knowledge in self-management is related to positive health outcomes; all persons irrespective of their electronic health literacy should be able to use all sources of health information to enhance their self-care.

  6. Aspects of privacy for electronic health records.

    Science.gov (United States)

    Haas, Sebastian; Wohlgemuth, Sven; Echizen, Isao; Sonehara, Noboru; Müller, Günter

    2011-02-01

    Patients' medical data have been originally generated and maintained by health professionals in several independent electronic health records (EHRs). Centralized electronic health records accumulate medical data of patients to improve their availability and completeness; EHRs are not tied to a single medical institution anymore. Nowadays enterprises with the capacity and knowledge to maintain this kind of databases offer the services of maintaining EHRs and adding personal health data by the patients. These enterprises get access on the patients' medical data and act as a main point for collecting and disclosing personal data to third parties, e.g. among others doctors, healthcare service providers and drug stores. Existing systems like Microsoft HealthVault and Google Health comply with data protection acts by letting the patients decide on the usage and disclosure of their data. But they fail in satisfying essential requirements to privacy. We propose a privacy-protecting information system for controlled disclosure of personal data to third parties. Firstly, patients should be able to express and enforce obligations regarding a disclosure of health data to third parties. Secondly, an organization providing EHRs should neither be able to gain access to these health data nor establish a profile about patients. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  7. 76 FR 48769 - Metadata Standards To Support Nationwide Electronic Health Information Exchange

    Science.gov (United States)

    2011-08-09

    ... Medicare & Medicaid Services EHR Electronic Health Record EPAL Enterprise Privacy Authorization Language EO... care provider's electronic health record technology or requests for it to be transmitted to their... Specifications, and Certification Criteria for Electronic Health Record Technology; Interim Final Rule and Final...

  8. Rapid progress or lengthy process? electronic personal health records in mental health

    Directory of Open Access Journals (Sweden)

    Denis Mike

    2011-07-01

    Full Text Available Abstract A major objective of many healthcare providers is to increase patients' participation in their own care. The introduction of electronic personal health records (ePHRs may help to achieve this. An ePHR is an electronic database of an individual's health information, accessible to and maintained by the patient. ePHRs are very much in vogue, with an increasing number of studies reporting their potential utility as well as cost. However, the vast majority of these studies focus on general healthcare. Little attempt has been made to document the specific problems which might occur throughout the implementation of ePHRs in mental health. This review identifies such concerns through an electronic search of the literature. Several potential difficulties are highlighted and addressed, including access to information technology, identifying relevant populations and the handling of sensitive information. Special attention is paid to the concept of 'empowerment' and what this means in relation to ePHRs.

  9. Planetary health: protecting human health on a rapidly changing planet.

    Science.gov (United States)

    Myers, Samuel S

    2018-12-23

    The impact of human activities on our planet's natural systems has been intensifying rapidly in the past several decades, leading to disruption and transformation of most natural systems. These disruptions in the atmosphere, oceans, and across the terrestrial land surface are not only driving species to extinction, they pose serious threats to human health and wellbeing. Characterising and addressing these threats requires a paradigm shift. In a lecture delivered to the Academy of Medical Sciences on Nov 13, 2017, I describe the scale of human impacts on natural systems and the extensive associated health effects across nearly every dimension of human health. I highlight several overarching themes that emerge from planetary health and suggest advances in the way we train, reward, promote, and fund the generation of health scientists who will be tasked with breaking out of their disciplinary silos to address this urgent constellation of health threats. I propose that protecting the health of future generations requires taking better care of Earth's natural systems. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. An Overview of Soils and Human Health

    Science.gov (United States)

    Brevik, Eric C.

    2013-04-01

    Few people recognize the connection between soils and human health, even though soils are actually very important to health. Soils influence health through the nutrients taken up by plants and the animals that eat those plants, nutrients that are needed for adequate nutrition for growth and development. Soils can also act to harm human health in three major ways: i) toxic levels of substances or disease-causing organisms may enter the human food chain from the soil ii) humans can encounter pathogenic organisms through direct contact with the soil or inhaling dust from the soil, and iii) degraded soils produce nutrient-deficient foods leading to malnutrition. Soils have also been a major source of medicines. Therefore, soils form an integral link in the holistic view of human health. In this presentation, soils and their influence on human health are discussed from a broad perspective, including both direct influences of soils on health and indirect influences through things such as climate change, occupational exposure to soil amendments, and the role of soils in providing food security.

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

    Science.gov (United States)

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

    2012-01-01

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

  12. On-the-job training of health professionals for electronic health record and electronic medical record use: A scoping review

    Directory of Open Access Journals (Sweden)

    Valentina L. Younge

    2015-09-01

    Full Text Available The implementation of electronic health records (EHRs or electronic medical records (EMRs is well documented in health informatics literature yet, very few studies focus primarily on how health professionals in direct clinical care are trained for EHR or EMR use. Purpose: To investigate how health professionals in direct clinical care are trained to prepare them for EHR or EMR use. Methods: Systematic searches were conducted in CINAHL, EMBASE, Ovid MEDLINE, PsycINFO, PubMed and ISI WoS and, the Arksey and O’Malley scoping methodological framework was used to collect the data and analyze the results. Results: Training was done at implementation, orientation and post-implementation. Implementation and orientation training had a broader scope while post-implementation training focused on proficiency, efficiency and improvement. The multiplicity of training methods, types and levels of training identified appear to suggest that training is more effective when a combination of training methods are used.

  13. CDRH FOIA Electronic Reading Room

    Data.gov (United States)

    U.S. Department of Health & Human Services — The CDRH FOIA electronic reading room contains frequently requested information via the Freedom of Information Act from the Center for Devices and Radiological Health.

  14. Public health nursing, ethics and human rights.

    Science.gov (United States)

    Ivanov, Luba L; Oden, Tami L

    2013-05-01

    Public health nursing has a code of ethics that guides practice. This includes the American Nurses Association Code of Ethics for Nurses, Principles of the Ethical Practice of Public Health, and the Scope and Standards of Public Health Nursing. Human rights and Rights-based care in public health nursing practice are relatively new. They reflect human rights principles as outlined in the Universal Declaration of Human Rights and applied to public health practice. As our health care system is restructured and there are new advances in technology and genetics, a focus on providing care that is ethical and respects human rights is needed. Public health nurses can be in the forefront of providing care that reflects an ethical base and a rights-based approach to practice with populations. © 2013 Wiley Periodicals, Inc.

  15. The Relationship Between Magnet Designation, Electronic Health Record Adoption, and Medicare Meaningful Use Payments.

    Science.gov (United States)

    Lippincott, Christine; Foronda, Cynthia; Zdanowicz, Martin; McCabe, Brian E; Ambrosia, Todd

    2017-08-01

    The objective of this study was to examine the relationship between nursing excellence and electronic health record adoption. Of 6582 US hospitals, 4939 were eligible for the Medicare Electronic Health Record Incentive Program, and 6419 were eligible for evaluation on the HIMSS Analytics Electronic Medical Record Adoption Model. Of 399 Magnet hospitals, 330 were eligible for the Medicare Electronic Health Record Incentive Program, and 393 were eligible for evaluation in the HIMSS Analytics Electronic Medical Record Adoption Model. Meaningful use attestation was defined as receipt of a Medicare Electronic Health Record Incentive Program payment. The adoption electronic health record was defined as Level 6 and/or 7 on the HIMSS Analytics Electronic Medical Record Adoption Model. Logistic regression showed that Magnet-designated hospitals were more likely attest to Meaningful Use than non-Magnet hospitals (odds ratio = 3.58, P electronic health records than non-Magnet hospitals (Level 6 only: odds ratio = 3.68, P electronic health record use, which involves earning financial incentives for successful adoption. Continued investigation is needed to examine the relationships between the quality of nursing care, electronic health record usage, financial implications, and patient outcomes.

  16. Evaluating the data completeness in the Electronic Health Record after the Implementation of an Outpatient Electronic Health Record.

    Science.gov (United States)

    Soto, Mauricio; Capurro, Daniel; Catalán, Silvia

    2015-01-01

    Electronic health records (EHRs) present an opportunity for quality improvement in health organitations, particularly at the primary health level. However, EHR implementation impacts clinical workflows, and physicians frequently prefer to document in a non-structured way, which ultimately hinders the ability to measure quality indicators. We present an assessment of data completeness-a key data quality indicator-during the first 12 months after the implementation of an EHR at a teaching outpatient center in Santiago, Chile.

  17. Quantification of Wine Mixtures with an Electronic Nose and a Human Panel

    Science.gov (United States)

    Aleixandre, Manuel; Cabellos, Juan M.; Arroyo, Teresa; Horrillo, M. C.

    2018-01-01

    In this work, an electronic nose and a human panel were used for the quantification of wines formed by binary mixtures of four white grape varieties and two varieties of red wines at different percentages (from 0 to 100% in 10% steps for the electronic nose and from 0 to 100% in 25% steps for the human panel). The wines were prepared using the traditional method with commercial yeasts. Both techniques were able to quantify the mixtures tested, but it is important to note that the technology of the electronic nose is faster, simpler, and more objective than the human panel. In addition, better results of quantification were also obtained using the electronic nose. PMID:29484296

  18. Human Health Countermeasures (HHC) Element Management Plan: Human Research Program. Revision B

    Science.gov (United States)

    Norsk, Peter; Baumann, David

    2012-01-01

    NASA s Human Research Program (HRP) is an applied research and technology program within the Human Exploration and Operations Mission Directorate (HEOMD) that addresses human health and performance risk mitigation strategies in support of exploration missions. The HRP research and technology development is focused on the highest priority risks to crew health and safety with the goal of ensuring mission success and maintaining long-term crew health. Crew health and performance standards, defined by the NASA Chief Health and Medical Officer (CHMO), set the acceptable risk level for exploration missions. The HRP conducts research to inform these standards as well as provide deliverables, such as countermeasures, that ensure standards can be met to maximize human performance and mission success. The Human Health Countermeasures (HHC) Element was formed as part of the HRP to develop a scientifically-based, integrated approach to understanding and mitigating the health risks associated with human spaceflight. These health risks have been organized into four research portfolios that group similar or related risks. A fifth portfolio exists for managing technology developments and infrastructure projects. The HHC Element portfolios consist of: a) Vision and Cardiovascular; b) Exercise and Performance; c) Multisystem; d) Bone; and e) Technology and Infrastructure. The HHC identifies gaps associated with the health risks and plans human physiology research that will result in knowledge required to more fully understand risks and will result in validated countermeasures to mitigate risks.

  19. Improving Patient Safety With the Military Electronic Health Record

    Science.gov (United States)

    2005-01-01

    Consolidated Health Informatics (CHI) project, one of the 24 electronic government ( eGov ) Internet- based technology initiatives supporting the president’s...United States Department of Defense (DoD) has transformed health care delivery in its use of information technology to automate patient data...use throughout the Federal Government . The importance of standards in EHR systems was further recognized in an IOM report, which stated, “Electronic

  20. Biodiversity, air quality and human health

    Science.gov (United States)

    David J. Nowak; Sarah Jovan; Christina Branquinho; Sofia Augusto; Manuel C. Ribeiro; Conor E. Kretsch

    2015-01-01

    Air pollution is a significant problem in cities across the world. It affects human health and well-being, ecosystem health, crops, climate, visibility and human-made materials. Health effects related to air pollution include its impact on the pulmonary, cardiac, vascular and neurological systems (Section 2). Trees affect air quality through a number of means (Section...

  1. Ethics and subsequent use of electronic health record data.

    Science.gov (United States)

    Lee, Lisa M

    2017-07-01

    The digital health landscape in the United States is evolving and electronic health record data hold great promise for improving health and health equity. Like many scientific and technological advances in health and medicine, there exists an exciting narrative about what we can do with the new technology, as well as reflection about what we should do with it based on what we value. Ethical reflections about the use of EHR data for research and quality improvement have considered the important issues of privacy and informed consent for subsequent use of data. Additional ethical aspects are important in the conversation, including data validity, patient obligation to participate in the learning health system, and ethics integration into training for all personnel who interact with personal health data. Attention to these ethical issues is paramount to our realizing the benefits of electronic health data. Published by Elsevier Inc.

  2. Public health ethics and more-than-human solidarity.

    Science.gov (United States)

    Rock, Melanie J; Degeling, Chris

    2015-03-01

    This article contributes to the literature on One Health and public health ethics by expanding the principle of solidarity. We conceptualise solidarity to encompass not only practices intended to assist other people, but also practices intended to assist non-human others, including animals, plants, or places. To illustrate how manifestations of humanist and more-than-human solidarity may selectively complement one another, or collide, recent responses to Hendra virus in Australia and Rabies virus in Canada serve as case examples. Given that caring relationships are foundational to health promotion, people's efforts to care for non-human others are highly relevant to public health, even when these efforts conflict with edicts issued in the name of public health. In its most optimistic explication, One Health aims to attain optimal health for humans, non-human animals and their shared environments. As a field, public health ethics needs to move beyond an exclusive preoccupation with humans, so as to account for moral complexity arising from people's diverse connections with places, plants, and non-human animals. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. special article ethics and electronic health information technology

    African Journals Online (AJOL)

    David Ofori-Adjei

    Electronic Health Information Technology, (EHIT) has become an integral part of the national health care delivery system. Reliance on EHIT seems poised to grow in the years to come due to the myriad of advantages derived from the capture, storage, retrieval and analysis of large volumes of protected health data, and from ...

  4. Home heating & human health

    NARCIS (Netherlands)

    Jongeneel, Sophie

    2008-01-01

    Human health is influenced by pollutants in the air. Since people spend over 80% of their time indoors, indoor air quality may be more related to health problems than outdoor air qual-ity. Indoor air quality is deteriorating because of energy conservation

  5. Implementation of the Agitated Behavior Scale in the Electronic Health Record.

    Science.gov (United States)

    Wilson, Helen John; Dasgupta, Kritis; Michael, Kathleen

    The purpose of the study was to implement an Agitated Behavior Scale through an electronic health record and to evaluate the usability of the scale in a brain injury unit at a rehabilitation hospital. A quality improvement project was conducted in the brain injury unit at a large rehabilitation hospital with registered nurses as participants using convenience sampling. The project consisted of three phases and included education, implementation of the scale in the electronic health record, and administration of the survey questionnaire, which utilized the system usability scale. The Agitated Behavior Scale was found to be usable, and there was 92.2% compliance with the use of the electronic Electronic Agitated Behavior Scale. The Agitated Behavior Scale was effectively implemented in the electronic health record and was found to be usable in the assessment of agitation. Utilization of the scale through the electronic health record on a daily basis will allow for an early identification of agitation in patients with traumatic brain injury and enable prompt interventions to manage agitation.

  6. Perceptions of electronic health record implementation: a statewide survey of physicians in Rhode Island.

    Science.gov (United States)

    Wylie, Matthew C; Baier, Rosa R; Gardner, Rebekah L

    2014-10-01

    Although electronic health record use improves healthcare delivery, adoption into clinical practice is incomplete. We sought to identify the extent of adoption in Rhode Island and the characteristics of physicians and electronic health records associated with positive experience. We performed a cross-sectional study of data collected by the Rhode Island Department of Health for the Health Information Technology Survey 2009 to 2013. Survey questions included provider and practice demographics, health record information, and Likert-type scaled questions regarding how electronic health record use affected clinical practice. The survey response rate ranged from 50% to 65%, with 62% in 2013. Increasing numbers of physicians in Rhode Island use an electronic health record. In 2013, 81% of physicians used one, and adoption varied by clinical subspecialty. Most providers think that electronic health record use improves billing and quality improvement but has not improved job satisfaction. Physicians with longer and more sophisticated electronic health record use report positive effects of introduction on all aspects of practice examined (P electronic health record introduction (P electronic health record vendors most frequently used in Rhode Island, 5 were associated with improved job satisfaction. We report the largest statewide study of electronic health record adoption to date. We found increasing physician use in Rhode Island, and the extent of adoption varies by subspecialty. Although older physicians are less likely to be positive about electronic health record adoption, longer and more sophisticated use are associated with more positive opinions, suggesting acceptance will grow over time. Copyright © 2014 Elsevier Inc. All rights reserved.

  7. Soil, Food Security and Human Health

    Science.gov (United States)

    Oliver, Margaret

    2017-04-01

    "Upon this handful of soil our survival depends. Husband it and it will grow food, our fuel, and our shelter and surround us with beauty. Abuse it and the soil will collapse and die, taking humanity with it" Vedas Sanskrit Scripture, 1500 BC. As the world's population increases issues of food security become more pressing as does the need to sustain soil fertility and to minimize soil degradation. Soil and land are finite resources, and agricultural land is under severe competition from many other uses. Lack of adequate food and food of poor nutritional quality lead to under-nutrition of different degrees, all of which can cause ill- or suboptimal-health. The soil can affect human health directly and indirectly. Direct effects of soil or its constituents result from its ingestion, inhalation or absorption. For example, hook worms enter the body through the skin and cause anaemia, and fungi and dust can be inhaled resulting in respiratory problems. The soil is the source of actinomycetes on which our earliest antibiotics are based (actinomycin, neomycin and streptomycin). Furthermore, it is a potential reservoir of new antibiotics with methods such as functional metagenomics to identify antibiotic resistant genes. Indirect effects of soil arise from the quantity and quality of food that humans consume. Trace elements can have both beneficial and toxic effects on humans, especially where the range for optimal intake is narrow as for selenium. Deficiencies of four trace elements, iodine, iron, selenium and zinc, will be considered because of their substantial effects on human health. Relations between soil and human health are often difficult to extricate because of the many confounding factors present such as the source of food, social factors and so on. Nevertheless, recent scientific understanding of soil processes and factors that affect human health are enabling greater insight into the effects of soil on our health. Multidisciplinary research that includes soil

  8. The evolution of human rights in World Health Organization policy and the future of human rights through global health governance.

    Science.gov (United States)

    Meier, B M; Onzivu, W

    2014-02-01

    The World Health Organization (WHO) was intended to serve at the forefront of efforts to realize human rights to advance global health, and yet this promise of a rights-based approach to health has long been threatened by political constraints in international relations, organizational resistance to legal discourses, and medical ambivalence toward human rights. Through legal research on international treaty obligations, historical research in the WHO organizational archives, and interview research with global health stakeholders, this research examines WHO's contributions to (and, in many cases, negligence of) the rights-based approach to health. Based upon such research, this article analyzes the evolving role of WHO in the development and implementation of human rights for global health, reviews the current state of human rights leadership in the WHO Secretariat, and looks to future institutions to reclaim the mantle of human rights as a normative framework for global health governance. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  9. Personal, Electronic, Secure National Library of Medicine Hosts Health Records Conference

    Science.gov (United States)

    ... Bar Home Current Issue Past Issues EHR Personal, Electronic, Secure: National Library of Medicine Hosts Health Records ... One suggestion for saving money is to implement electronic personal health records. With this in mind, the ...

  10. Balancing Good Intentions: Protecting the Privacy of Electronic Health Information

    Science.gov (United States)

    McClanahan, Kitty

    2008-01-01

    Electronic information is a vital but complex component in the modern health care system, fueling ongoing efforts to develop a universal electronic health record infrastructure. This innovation creates a substantial tension between two desirable values: the increased quality and utility of patient medical records and the protection of the privacy…

  11. Electronic Animal Drug Product Listing Directory

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Electronic Animal Drug Product Listing Directory is a directory of all animal drug products that have been listed electronically since June 1, 2009, to comply...

  12. Modelling and implementing electronic health records in Denmark

    DEFF Research Database (Denmark)

    Bernstein, Knut; Rasmussen, Morten Bruun; Vingtoft, Søren

    2003-01-01

    The Danish Health IT strategy points out that integration between electronic health records (EHR) systems has a high priority. This paper reporst reports new tendencies in modelling and integration platforms globally and how this is reflected in the natinal development....

  13. [Agrochemicals and human health: contributions of healthcare professionals].

    Science.gov (United States)

    de Siqueira, Soraia Lemos; Kruse, Maria Henriqueta Luce

    2008-09-01

    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.

  14. NASA Space Flight Human-System Standard Human Factors, Habitability, and Environmental Health

    Science.gov (United States)

    Holubec, Keith; Connolly, Janis

    2010-01-01

    This slide presentation reviews the history, and development of NASA-STD-3001, NASA Space Flight Human-System Standard Human Factors, Habitability, and Environmental Health, and the related Human Integration Design Handbook. Currently being developed from NASA-STD-3000, this project standard currently in review will be available in two volumes, (i.e., Volume 1 -- VCrew Health and Volume 2 -- Human Factors, Habitability, and Environmental Health) and the handbook will be both available as a pdf file and as a interactive website.

  15. Human rights, health and the state in Bangladesh

    Directory of Open Access Journals (Sweden)

    Rahman Redwanur M

    2006-04-01

    Full Text Available Abstract Background This paper broadly discusses the role of the State of Bangladesh in the context of the health system and human rights. The interrelation between human rights, health and development are well documented. The recognition of health as a fundamental right by WHO and subsequent approval of health as an instrument of welfare by the Universal Declaration of Human Rights (UDHR and the International Covenant on Social, Economic and Cultural Rights (ICSECR further enhances the idea. Moreover, human rights are also recognized as an expedient of human development. The state is entrusted to realize the rights enunciated in the ICSECR. Discussion In exploring the relationship of the human rights and health situation in Bangladesh, it is argued, in this paper, that the constitution and major policy documents of the Bangladesh government have recognized the health rights and development. Bangladesh has ratified most of the international treaties and covenants including ICCPR, ICESCR; and a signatory of international declarations including Alma-Ata, ICPD, Beijing declarations, and Millennium Development Goals. However the implementation of government policies and plans in the development of health institutions, human resources, accessibility and availability, resource distribution, rural-urban disparity, the male-female gap has put the health system in a dismal state. Neither the right to health nor the right to development has been established in the development of health system or in providing health care. Summary The development and service pattern of the health system have negative correlation with human rights and contributed to the underdevelopment of Bangladesh. The government should take comprehensive approach in prioritizing the health rights of the citizens and progressive realization of these rights.

  16. Human and animal sentinels for shared health risks

    Directory of Open Access Journals (Sweden)

    Peter Rabinowitz, MD, MPH

    2009-03-01

    Full Text Available The tracking of sentinel health events in humans in order to detect and manage disease risks facing a larger population is a well accepted technique applied to influenza, occupational conditions and emerging infectious diseases. Similarly, animal health professionals routinely track disease events in sentinel animal colonies and sentinel herds. The use of animals as sentinels for human health threats, or of humans as sentinels for animal disease risk, dates back at least to the era when coal miners brought caged canaries into mines to provide early warning of toxic gases. Yet the full potential of linking animal and human health information to provide warning of such ‘shared risks’ from environmental hazards has not been realised. Reasons appear to include the professional segregation of human and animal health communities, the separation of human and animal surveillance data and evidence gaps in the linkages between human and animal responses to environmental health hazards. The ‘One Health initiative’ and growing international collaboration in response to pandemic threats, coupled with development in the fields of informatics and genomics, hold promise for improved sentinel event coordination in order to detect and reduce environmental health threats shared between species.

  17. Electronic Nicotine Delivery Systems Key Facts Infographic

    Data.gov (United States)

    U.S. Department of Health & Human Services — Explore the Electronic Nicotine Delivery Systems Key Facts Infographic which outlines key facts related to electronic nicotine delivery systems (ENDS), including...

  18. Proposing a Health Humanities Minor: Some Lessons.

    Science.gov (United States)

    Engholm, Virginia Bucurel; Boria, Damon

    2017-12-01

    For those interested in developing baccalaureate programs in health humanities, this essay draws on our experience of developing a minor in health humanities to share insights on what to expect, strategies that work well, and how to deal with obstacles. These insights range from how to explain the concept of health humanities to stakeholders (faculty, administrators, and community partners) to how to decide where to house a health humanities program. We share our insights in a way that promises to translate well to different institutional contexts. That said, this paper is more relevant for institutional contexts where budgets are stressed and, consequently, proposals to invest in humanities programs are a difficult sell. This paper is divided into sections addressing how to (a) earn institutional support, (b) gain campus buy-in, (c) identify benefits of the proposed program, (d) decide where to house the program, (e) calculate program cost, and (f) secure external funding. We conclude with some final reflections on the current status of our program and why we are committed to health humanities education.

  19. Human Rights and Health Services

    DEFF Research Database (Denmark)

    Skitsou, Alexandra; Bekos, Christos; Charalambous, George

    2016-01-01

    Background: It has been observed that health services provided to certain patients in Cyprus do not fully meet their human rights. Objective: This study was conducted to identify the main shortcomings of the Health System in Cyprus. Methodology: The relevant administrative decisions of the Ombuds......Background: It has been observed that health services provided to certain patients in Cyprus do not fully meet their human rights. Objective: This study was conducted to identify the main shortcomings of the Health System in Cyprus. Methodology: The relevant administrative decisions...... and their families to be essential. Conclusions: The paper concludes that implementing guidelines in accordance with international best practices, the establishment of at-home treatment and nursing facilities, counseling the mentally ill in a way that promotes their social integration and occupational rehabilitation......, ongoing education of health professionals along with relevant education of the community and the broad application of triage in the emergency departments will all contribute to delivering health services more effectively. Keywords: Cyprus, health services, patient rights...

  20. Special Article Ethics and Electronic Health Information Technology ...

    African Journals Online (AJOL)

    Objectives: The National Health Insurance Scheme (NHIS), and the National Identification Authority (NIA), pose ethical challenges to the physician-patient relationship due to interoperability. This paper explores (1) the national legislation on Electronic Health Information Technology (EHIT), (2) the ethics of information ...

  1. Implementing an Open Source Electronic Health Record System in Kenyan Health Care Facilities: Case Study.

    Science.gov (United States)

    Muinga, Naomi; Magare, Steve; Monda, Jonathan; Kamau, Onesmus; Houston, Stuart; Fraser, Hamish; Powell, John; English, Mike; Paton, Chris

    2018-04-18

    The Kenyan government, working with international partners and local organizations, has developed an eHealth strategy, specified standards, and guidelines for electronic health record adoption in public hospitals and implemented two major health information technology projects: District Health Information Software Version 2, for collating national health care indicators and a rollout of the KenyaEMR and International Quality Care Health Management Information Systems, for managing 600 HIV clinics across the country. Following these projects, a modified version of the Open Medical Record System electronic health record was specified and developed to fulfill the clinical and administrative requirements of health care facilities operated by devolved counties in Kenya and to automate the process of collating health care indicators and entering them into the District Health Information Software Version 2 system. We aimed to present a descriptive case study of the implementation of an open source electronic health record system in public health care facilities in Kenya. We conducted a landscape review of existing literature concerning eHealth policies and electronic health record development in Kenya. Following initial discussions with the Ministry of Health, the World Health Organization, and implementing partners, we conducted a series of visits to implementing sites to conduct semistructured individual interviews and group discussions with stakeholders to produce a historical case study of the implementation. This case study describes how consultants based in Kenya, working with developers in India and project stakeholders, implemented the new system into several public hospitals in a county in rural Kenya. The implementation process included upgrading the hospital information technology infrastructure, training users, and attempting to garner administrative and clinical buy-in for adoption of the system. The initial deployment was ultimately scaled back due to a

  2. Linking Human Health and Livestock Health: A “One-Health” Platform for Integrated Analysis of Human Health, Livestock Health, and Economic Welfare in Livestock Dependent Communities

    Science.gov (United States)

    Thumbi, S. M.; Njenga, M. Kariuki; Marsh, Thomas L.; Noh, Susan; Otiang, Elkanah; Munyua, Peninah; Ochieng, Linus; Ogola, Eric; Yoder, Jonathan; Audi, Allan; Montgomery, Joel M.; Bigogo, Godfrey; Breiman, Robert F.; Palmer, Guy H.; McElwain, Terry F.

    2015-01-01

    Background For most rural households in sub-Saharan Africa, healthy livestock play a key role in averting the burden associated with zoonotic diseases, and in meeting household nutritional and socio-economic needs. However, there is limited understanding of the complex nutritional, socio-economic, and zoonotic pathways that link livestock health to human health and welfare. Here we describe a platform for integrated human health, animal health and economic welfare analysis designed to address this challenge. We provide baseline epidemiological data on disease syndromes in humans and the animals they keep, and provide examples of relationships between human health, animal health and household socio-economic status. Method We designed a study to obtain syndromic disease data in animals along with economic and behavioral information for 1500 rural households in Western Kenya already participating in a human syndromic disease surveillance study. Data collection started in February 2013, and each household is visited bi-weekly and data on four human syndromes (fever, jaundice, diarrhea and respiratory illness) and nine animal syndromes (death, respiratory, reproductive, musculoskeletal, nervous, urogenital, digestive, udder disorders, and skin disorders in cattle, sheep, goats and chickens) are collected. Additionally, data from a comprehensive socio-economic survey is collected every 3 months in each of the study households. Findings Data from the first year of study showed 93% of the households owned at least one form of livestock (55%, 19%, 41% and 88% own cattle, sheep, goats and chickens respectively). Digestive disorders, mainly diarrhea episodes, were the most common syndromes observed in cattle, goats and sheep, accounting for 56% of all livestock syndromes, followed by respiratory illnesses (18%). In humans, respiratory illnesses accounted for 54% of all illnesses reported, followed by acute febrile illnesses (40%) and diarrhea illnesses (5%). While controlling

  3. Ethical, legal, and social implications of incorporating genomic information into electronic health records.

    Science.gov (United States)

    Hazin, Ribhi; Brothers, Kyle B; Malin, Bradley A; Koenig, Barbara A; Sanderson, Saskia C; Rothstein, Mark A; Williams, Marc S; Clayton, Ellen W; Kullo, Iftikhar J

    2013-10-01

    The inclusion of genomic data in the electronic health record raises important ethical, legal, and social issues. In this article, we highlight these challenges and discuss potential solutions. We provide a brief background on the current state of electronic health records in the context of genomic medicine, discuss the importance of equitable access to genome-enabled electronic health records, and consider the potential use of electronic health records for improving genomic literacy in patients and providers. We highlight the importance of privacy, access, and security, and of determining which genomic information is included in the electronic health record. Finally, we discuss the challenges of reporting incidental findings, storing and reinterpreting genomic data, and nondocumentation and duty to warn family members at potential genetic risk.

  4. Integrated Nationwide Electronic Health Records system: Semi-distributed architecture approach.

    Science.gov (United States)

    Fragidis, Leonidas L; Chatzoglou, Prodromos D; Aggelidis, Vassilios P

    2016-11-14

    The integration of heterogeneous electronic health records systems by building an interoperable nationwide electronic health record system provides undisputable benefits in health care, like superior health information quality, medical errors prevention and cost saving. This paper proposes a semi-distributed system architecture approach for an integrated national electronic health record system incorporating the advantages of the two dominant approaches, the centralized architecture and the distributed architecture. The high level design of the main elements for the proposed architecture is provided along with diagrams of execution and operation and data synchronization architecture for the proposed solution. The proposed approach effectively handles issues related to redundancy, consistency, security, privacy, availability, load balancing, maintainability, complexity and interoperability of citizen's health data. The proposed semi-distributed architecture offers a robust interoperability framework without healthcare providers to change their local EHR systems. It is a pragmatic approach taking into account the characteristics of the Greek national healthcare system along with the national public administration data communication network infrastructure, for achieving EHR integration with acceptable implementation cost.

  5. Transformative combinations: women's health and human rights.

    Science.gov (United States)

    Yamin, A E

    1997-01-01

    From the human rights perspective proposed in this article, a woman's good or ill health reflects more than biology or individual behaviors; it reflects her enjoyment (or lack thereof) of fundamental human rights that enable her to exercise basic power over the course and quality of her life. The "structural" view of health that such a human rights perspective suggests is concerned first with identifying the effects of social, economic, and political relations on women's health and then with promoting "interventions" aimed at transforming the laws, institutions, and structures that deny women's rights and well-being. Yet, traditional human rights law and practice have been limited to narrowly defined abuses by public officials against individuals that fail to capture the most pervasive denials of women's rights, which, though rooted in systematic discrimination, are frequently played out in so-called "private" institutions, primarily within the family. The experiences of women's health advocates in addressing complex women's health issues makes it clear that women's lack of access to economic and political power in the public sphere creates the conditions under which they are discriminated against and physically and sexually abused in the private sphere. Combining the pragmatic understanding of women's health professionals with an expansive conception of human rights norms has the potential to transform the fields of women's health and human rights.

  6. A review of electronic journal acquisition, management, and use in health sciences libraries.

    Science.gov (United States)

    Burrows, Suzetta

    2006-01-01

    The paper describes patterns of electronic journal usage in health sciences libraries during the past decade. The paper presents a case study, documenting the pattern of acquisition, management, and usage at the Louis Calder Memorial Library of the University of Miami Miller School of Medicine. Health sciences journals were early to offer electronic alternatives to print. As a result, health sciences libraries, their patrons, and the public at large were early to embrace the new versions and continue to embrace the significant changes in scholarly communication they enable. Although the patterns of electronic journals among health sciences libraries and other special and academic libraries have similarities, they also have differences. Broad studies of electronic journals in non-health sciences libraries have been published, but a retrospective review of electronic journals in health sciences libraries has not.

  7. Ethical questions must be considered for electronic health records.

    Science.gov (United States)

    Spriggs, Merle; Arnold, Michael V; Pearce, Christopher M; Fry, Craig

    2012-09-01

    National electronic health record initiatives are in progress in many countries around the world but the debate about the ethical issues and how they are to be addressed remains overshadowed by other issues. The discourse to which all others are answerable is a technical discourse, even where matters of privacy and consent are concerned. Yet a focus on technical issues and a failure to think about ethics are cited as factors in the failure of the UK health record system. In this paper, while the prime concern is the Australian Personally Controlled Electronic Health Record (PCEHR), the discussion is relevant to and informed by the international context. The authors draw attention to ethical and conceptual issues that have implications for the success or failure of electronic health records systems. Important ethical issues to consider as Australia moves towards a PCEHR system include: issues of equity that arise in the context of personal control, who benefits and who should pay, what are the legitimate uses of PCEHRs, and how we should implement privacy. The authors identify specific questions that need addressing.

  8. Interpreting the International Right to Health in a Human Rights-Based Approach to Health

    OpenAIRE

    Hunt, Paul

    2016-01-01

    Abstract This article tracks the shifting place of the international right to health, and human rights-based approaches to health, in the scholarly literature and United Nations (UN). From 1993 to 1994, the focus began to move from the right to health toward human rights-based approaches to health, including human rights guidance adopted by UN agencies in relation to specific health issues. There is a compelling case for a human rights-based approach to health, but it runs the risk of playing...

  9. Patient Perceptions of Electronic Health Records

    Science.gov (United States)

    Lulejian, Armine

    2011-01-01

    Research objective. Electronic Health Records (EHR) are expected to transform the way medicine is delivered with patients/consumers being the intended beneficiaries. However, little is known regarding patient knowledge and attitudes about EHRs. This study examined patient perceptions about EHR. Study design. Surveys were administered following…

  10. The human microbiota associated with overall health.

    Science.gov (United States)

    Xu, Xiaofei; Wang, Zhujun; Zhang, Xuewu

    2015-03-01

    Human body harbors diverse microbes, the main components include bacteria, eukaryotes and viruses. Emerging evidences show that the human microbiota is intrinsically linked with overall health. The development of next-generation sequencing provides an unprecedented opportunity to investigate the complex microbial communities that are associated with the human body. Many factors like host genetics and environmental factors have a major impact on the composition and dynamic changes of human microbiota. The purpose of this paper is to present an overview of the relationship between human health and human microbiota (skin, nasal, throat, oral, vaginal and gut microbiota), then to focus on the factors modulating the composition of the microbiota and the future challenges to manipulate the microbiota for personalized health.

  11. Electronic Health Information Legal Epidemiology Protocol 2014

    Data.gov (United States)

    U.S. Department of Health & Human Services — Authors: Cason Schmit, JD, Gregory Sunshine, JD, Dawn Pepin, JD, MPH, Tara Ramanathan, JD, MPH, Akshara Menon, JD, MPH, Matthew Penn, JD, MLIS The Health Information...

  12. Nurse's use of power to standardise nursing terminology in electronic health records.

    Science.gov (United States)

    Ali, Samira; Sieloff, Christina L

    2017-07-01

    To describe nurses' use of power to influence the incorporation of standardised nursing terminology within electronic health records. Little is known about nurses' potential use of power to influence the incorporation of standardised nursing terminology within electronic health records. The theory of group power within organisations informed the design of the descriptive, cross-sectional study used a survey method to assess nurses' use of power to influence the incorporation of standardised nursing terminology within electronic health records. The Sieloff-King Assessment of Group Power within Organizations © and Nursing Power Scale was used. A total of 232 nurses responded to the survey. The mean power capability score was moderately high at 134.22 (SD 18.49), suggesting that nurses could use power to achieve the incorporation of standardised nursing terminology within electronic health records. The nurses' power capacity was significantly correlated with their power capability (r = 0.96, P power to achieve their goals, such as the incorporation of standardised nursing terminology within electronic health records. Nurse administrators may use their power to influence the incorporation of standardised nursing terminology within electronic health records. If nurses lack power, this could decrease nurses' ability to achieve their goals and contribute to the achievement of effective patient outcomes. © 2017 John Wiley & Sons Ltd.

  13. Developing electronic cooperation tools: a case from norwegian health care.

    Science.gov (United States)

    Larsen, Eli; Mydske, Per Kristen

    2013-06-19

    Many countries aim to create electronic cooperational tools in health care, but the progress is rather slow. The study aimed to uncover how the authoritys' financing policies influence the development of electronic cooperational tools within public health care. An interpretative approach was used in this study. We performed 30 semistructured interviews with vendors, policy makers, and public authorities. Additionally, we conducted an extensive documentation study and participated in 18 workshops concerning information and communication technology (ICT) in Norwegian health care. We found that the interorganizational communication in sectors like health care, that have undergone an independent development of their internal information infrastructure would find it difficult to create electronic services that interconnect the organizations because such connections would affect all interconnected organizations within the heterogenic structure. The organizations would, to a large extent, depend on new functionality in existing information systems. Electronic patient records play a central role in all parts of the health care sector and therefore dependence is established to the information systems and theirs vendors. The Norwegian government authorities, which run more than 80% of the Norwegian health care, have not taken extraordinary steps to compensate for this dependency-the government's political philosophy is that each health care institution should pay for further electronic patient record development. However, cooperational tools are complex due to the number of players involved and the way they are intertwined with the overall workflow. The customers are not able to buy new functionalities on the drawing table, while the electronic patient record vendors are not willing to take the economic risk in developing cooperational tools. Thus, the market mechanisms in the domain are challenged. We also found that public projects that were only financed for the first

  14. Exploring faculty perceptions towards electronic health records for nursing education.

    Science.gov (United States)

    Kowitlawakul, Y; Chan, S W C; Wang, L; Wang, W

    2014-12-01

    The use of electronic health records in nursing education is rapidly increasing worldwide. The successful implementation of electronic health records for nursing education software program relies on students as well as nursing faculty members. This study aimed to explore the experiences and perceptions of nursing faculty members using electronic health records for nursing education software program, and to identify the influential factors for successful implementation of this technology. This exploratory qualitative study was conducted using in-depth individual interviews at a university in Singapore. Seven faculty members participated in the study. The data were gathered and analysed at the end of the semester in the 2012/2013 academic year. The participants' perceptions of the software program were organized into three main categories: innovation, transition and integration. The participants perceived this technology as innovative, with both values and challenges for the users. In addition, using the new software program was perceived as transitional process. The integration of this technology required time from faculty members and students, as well as support from administrators. The software program had only been implemented for 2-3 months at the time of the interviews. Consequently, the participants might have lacked the necessary skill and competence and confidence to implement it successfully. In addition, the unequal exposure to the software program might have had an impact on participants' perceptions. The findings show that the integration of electronic health records into nursing education curricula is dependent on the faculty members' experiences with the new technology, as well as their perceptions of it. Hence, cultivating a positive attitude towards the use of new technologies is important. Electronic health records are significant applications of health information technology. Health informatics competency should be included as a required competency

  15. Electronic Health Records: PHR Opportunities for Public Health – Part 2

    Centers for Disease Control (CDC) Podcasts

    In this podcast, Dr. Ken Mandl discusses electronic health records and personally-controlled health records. Dr. Mandl leads the IndivoHealth personally-controlled health record project, the original reference model for the Microsoft, Google, and Dossia personal health records (PHRs or PCHRs). He has successfully used PHRs for immunization and influenza, leads efforts in real-time surveillance systems, and is currently adapting personal health records for longitudinal and genomic research. The lecture was given at CDC on June 19, 2009.

  16. Electronic Health Records: PHR Opportunities for Public Health – Part 1

    Centers for Disease Control (CDC) Podcasts

    In this podcast, Dr. Ken Mandl discusses electronic health records and personally-controlled health records. Dr. Mandl leads the IndivoHealth personally-controlled health record project, the original reference model for the Microsoft, Google, and Dossia personal health records (PHRs or PCHRs). He has successfully used PHRs for immunization and influenza, leads efforts in real-time surveillance systems, and is currently adapting personal health records for longitudinal and genomic research. The lecture was given at CDC on June 19, 2009.

  17. Environmental contaminants, ecosystems and human health

    Energy Technology Data Exchange (ETDEWEB)

    Majumdar, S.K.; Miller, E.W.; Brenner, F.J. [eds.] [Lafayette College, Easton, PA (United States). Dept. of Biology

    1995-12-31

    The authors cover a variety of concerns regarding the adverse impacts of contaminants on ecosystems and human health. The twelve chapters in the first section of the text address the impact of contaminants on ecosystem function, and ten of the remaining twenty-two chapters are devoted to the effects of contaminants on human health. Part three presents eight case studies in humans, while the final four chapters provide the reader with an assessment of environmental problems and analyses. Two chapters, on the health effects of power plant generated air pollution and on black lung disease, have been abstracted separately for the IEA Coal Research CD-ROM.

  18. The Arctic Human Health Initiative: a legacy of the International Polar Year 2007-2009.

    Science.gov (United States)

    Parkinson, Alan J

    2013-01-01

    The International Polar Year (IPY) 2007-2008 represented a unique opportunity to further stimulate cooperation and coordination on Arctic health research and increase the awareness and visibility of Arctic regions. The Arctic Human Health Initiative (AHHI) was a US-led Arctic Council IPY coordinating project that aimed to build and expand on existing International Union for Circumpolar Health (IUCH) and Arctic Council human health interests. The project aimed to link researchers with potential international collaborators and to serve as a focal point for human health research, education, outreach and communication activities during the IPY. The progress of projects conducted as part of this initiative up until the end of the Arctic Council Swedish chairmanship in May 2013 is summarized in this report. The overall goals of the AHHI was to increase awareness and visibility of human health concerns of Arctic peoples, foster human health research, and promote health strategies that will improve health and well-being of all Arctic residents. Proposed activities to be recognized through the initiative included: expanding research networks that will enhance surveillance and monitoring of health issues of concern to Arctic peoples, and increase collaboration and coordination of human health research; fostering research that will examine the health impact of anthropogenic pollution, rapid modernization and economic development, climate variability, infectious and chronic diseases, intentional and unintentional injuries, promoting education, outreach and communication that will focus public and political attention on Arctic health issues, using a variety of publications, printed and electronic reports from scientific conferences, symposia and workshops targeting researchers, students, communities and policy makers; promoting the translation of research into health policy and community action including implementation of prevention strategies and health promotion; and

  19. [Views of health system administrators, professionals, and users concerning the electronic health record and facilitators and obstacles to its implementation].

    Science.gov (United States)

    Costa, Jose Felipe Riani; Portela, Margareth Crisóstomo

    2018-02-05

    The design and deployment of complex technologies like the electronic health record (EHR) involve technical, personal, social, and organizational issues. The Brazilian public and private scenario includes different local and regional initiatives for implementation of the electronic health record. The Brazilian Ministry of Health also has a proposal to develop a national EHR. The current study aimed to provide a comprehensive view of perceptions by health system administrators, professionals, and users concerning their experiences with the electronic health record and their opinions of the possibility of developing a national EHR. This qualitative study involved 28 semi-structured interviews. The results revealed both the diversity of factors that can influence the implementation of an electronic health record and the existence of convergences and aspects that tend to be valued differently according to the different points of view. Key aspects include discussions on the electronic health record's attributes and it impact on healthcare, especially in the case of local electronic health records, concerns over costs and confidentiality and privacy pertaining to electronic health records in general, and the possible implications of centralized versus decentralized data storage in the case of a national EHR. The interviews clearly showed the need to establish more effective communication among the various stakeholders, and that the different perspectives should be considered when drafting and deploying an EHR at the local, regional, and national levels.

  20. Is patient confidentiality compromised with the electronic health record?: a position paper.

    Science.gov (United States)

    Wallace, Ilse M

    2015-02-01

    In order for electronic health records to fulfill their expected benefits, protection of privacy of patient information is key. Lack of trust in confidentiality can lead to reluctance in disclosing all relevant information, which could have grave consequences. This position paper contemplates whether patient confidentiality is compromised by electronic health records. The position that confidentiality is compromised was supported by the four bioethical principles and argued that despite laws and various safeguards to protect patients' confidentiality, numerous data breaches have occurred. The position that confidentiality is not compromised was supported by virtue ethics and a utilitarian viewpoint and argued that safeguards keep information confidential and the public feels relatively safe with the electronic health record. The article concludes with an ethically superior position that confidentiality is compromised with the electronic health record. Although organizational and governmental ways of enhancing the confidentiality of patient information within the electronic health record facilitate confidentiality, the ultimate responsibility of maintaining confidentiality rests with the individual end-users and their ethical code of conduct. The American Nurses Association Code of Ethics for nurses calls for nurses to be watchful with data security in electronic communications.

  1. Health, vital goals, and central human capabilities.

    Science.gov (United States)

    Venkatapuram, Sridhar

    2013-06-01

    I argue for a conception of health as a person's ability to achieve or exercise a cluster of basic human activities. These basic activities are in turn specified through free-standing ethical reasoning about what constitutes a minimal conception of a human life with equal human dignity in the modern world. I arrive at this conception of health by closely following and modifying Lennart Nordenfelt's theory of health which presents health as the ability to achieve vital goals. Despite its strengths I transform Nordenfelt's argument in order to overcome three significant drawbacks. Nordenfelt makes vital goals relative to each community or context and significantly reflective of personal preferences. By doing so, Nordenfelt's conception of health faces problems with both socially relative concepts of health and subjectively defined wellbeing. Moreover, Nordenfelt does not ever explicitly specify a set of vital goals. The theory of health advanced here replaces Nordenfelt's (seemingly) empty set of preferences and society-relative vital goals with a human species-wide conception of basic vital goals, or 'central human capabilities and functionings'. These central human capabilities come out of the capabilities approach (CA) now familiar in political philosophy and economics, and particularly reflect the work of Martha Nussbaum. As a result, the health of an individual should be understood as the ability to achieve a basic cluster of beings and doings-or having the overarching capability, a meta-capability, to achieve a set of central or vital inter-related capabilities and functionings. © 2012 John Wiley & Sons Ltd.

  2. A decision technology system for health care electronic commerce.

    Science.gov (United States)

    Forgionne, G A; Gangopadhyay, A; Klein, J A; Eckhardt, R

    1999-08-01

    Mounting costs have escalated the pressure on health care providers and payers to improve decision making and control expenses. Transactions to form the needed decision data will routinely flow, often electronically, between the affected parties. Conventional health care information systems facilitate flow, process transactions, and generate useful decision information. Typically, such support is offered through a series of stand-alone systems that lose much useful decision knowledge and wisdom during health care electronic commerce (e-commerce). Integrating the stand-alone functions can enhance the quality and efficiency of the segmented support, create synergistic effects, and augment decision-making performance and value for both providers and payers. This article presents an information system that can provide complete and integrated support for e-commerce-based health care decision making. The article describes health care e-commerce, presents the system, examines the system's potential use and benefits, and draws implications for health care management and practice.

  3. Neonatal Nurses Experience Unintended Consequences and Risks to Patient Safety With Electronic Health Records.

    Science.gov (United States)

    Dudding, Katherine M; Gephart, Sheila M; Carrington, Jane M

    2018-04-01

    In this article, we examine the unintended consequences of nurses' use of electronic health records. We define these as unforeseen events, change in workflow, or an unanticipated result of implementation and use of electronic health records. Unintended consequences experienced by nurses while using electronic health records have been well researched. However, few studies have focused on neonatal nurses, and it is unclear to what extent unintended consequences threaten patient safety. A new instrument called the Carrington-Gephart Unintended Consequences of Electronic Health Record Questionnaire has been validated, and secondary analysis using the tool explored the phenomena among neonatal nurses (N = 40). The purposes of this study were to describe unintended consequences of use of electronic health records for neonatal nurses and to explore relationships between the phenomena and characteristics of the nurse and the electronic health record. The most frequent unintended consequences of electronic health record use were due to interruptions, followed by a heavier workload due to the electronic health record, changes to the workflow, and altered communication patterns. Neonatal nurses used workarounds most often with motivation to better assist patients. Teamwork was moderately related to higher unintended consequences including patient safety risks (r = 0.427, P = .007), system design (r = 0.419, P = .009), and technology barriers (r = 0.431, P = .007). Communication about patients was reduced when patient safety risks were high (r = -0.437, P = .003). By determining the frequency with which neonatal nurses experience unintended consequences of electronic health record use, future research can be targeted to improve electronic health record design through customization, integration, and refinement to support patient safety and better outcomes.

  4. Classification of human pathogen bacteria for early screening using electronic nose

    Science.gov (United States)

    Zulkifli, Syahida Amani; Mohamad, Che Wan Syarifah Robiah; Abdullah, Abu Hassan

    2017-10-01

    This paper present human pathogen bacteria for early screening using electronic nose. Electronic nose (E-nose) known as gas sensor array is a device that analyze the odor measurement give the fast response and less time consuming for clinical diagnosis. Many bacterial pathogens could lead to life threatening infections. Accurate and rapid diagnosis is crucial for the successful management of these infections disease. The conventional method need more time to detect the growth of bacterial. Alternatively, the bacteria are Pseudomonas aeruginosa and Shigella cultured on different media agar can be detected and classifies according to the volatile compound in shorter time using electronic nose (E-nose). Then, the data from electronic nose (E-nose) is processed using statistical method which is principal component analysis (PCA). The study shows the capability of electronic nose (E-nose) for early screening for bacterial infection in human stomach.

  5. Electronic Health Record for Forensic Dentistry

    Czech Academy of Sciences Publication Activity Database

    Zvárová, Jana; Dostálová, T.; Hanzlíček, Petr; Teuberová, Z.; Nagy, Miroslav; Pieš, Martin; Seydlová, M.; Eliášová, H.; Šimková, H.

    2008-01-01

    Roč. 47, č. 1 (2008), s. 8-13 ISSN 0026-1270 R&D Projects: GA MŠk(CZ) 1M06014 Institutional research plan: CEZ:AV0Z10300504 Keywords : electronic health record * structured data entry * forensic dentistry Subject RIV: IN - Informatics, Computer Science Impact factor: 1.057, year: 2008

  6. Electronic communication and collaboration in a health care practice.

    Science.gov (United States)

    Safran, C; Jones, P C; Rind, D; Bush, B; Cytryn, K N; Patel, V L

    1998-02-01

    Using cognitive evaluation techniques, this study examines the effects of an electronic patient record and electronic mail on the interactions of health care providers. We find that the least structured communication methods are also the most heavily used: face-to-face, telephone, and electronic mail. Positive benefits of electronically-mediated interactions include improving communication, collaboration, and access to information to support decision-making. Negative factors include the potential for overloading clinicians with unwanted or unnecessary communications.

  7. Inter-professional electronic documents and child health: a study of persisting non-electronic communication in the use of electronic documents.

    Science.gov (United States)

    Saario, Sirpa; Hall, Christopher; Peckover, Sue

    2012-12-01

    Information and communication technologies are widely used in health and social care settings to replace previous means of record keeping, assessment and communication. Commentary on the strengths and weaknesses of such systems abound, thus it is useful to examine how they are used in practice. This article draws on findings from two separate studies, conducted between 2005 and 2007, which examined how child health and welfare professionals use electronic documents in Finland and England. Known respectively as Miranda and CAF, these systems are different in terms of structure and function but in their everyday use common features are identified, notably the continued use of and reliance on non-electronic means of communication. Based on interviews with professionals, three forms of non-electronic communication are described: alternative records, phone calls and letters, which facilitate the sharing of the electronic record. Finally, the electronic documents are further analysed as potential boundary objects which aim to create common understanding between sites and professionals. Copyright © 2012 Elsevier Ltd. All rights reserved.

  8. Shared Electronic Health Record Systems: Key Legal and Security Challenges.

    Science.gov (United States)

    Christiansen, Ellen K; Skipenes, Eva; Hausken, Marie F; Skeie, Svein; Østbye, Truls; Iversen, Marjolein M

    2017-11-01

    Use of shared electronic health records opens a whole range of new possibilities for flexible and fruitful cooperation among health personnel in different health institutions, to the benefit of the patients. There are, however, unsolved legal and security challenges. The overall aim of this article is to highlight legal and security challenges that should be considered before using shared electronic cooperation platforms and health record systems to avoid legal and security "surprises" subsequent to the implementation. Practical lessons learned from the use of a web-based ulcer record system involving patients, community nurses, GPs, and hospital nurses and doctors in specialist health care are used to illustrate challenges we faced. Discussion of possible legal and security challenges is critical for successful implementation of shared electronic collaboration systems. Key challenges include (1) allocation of responsibility, (2) documentation routines, (3) and integrated or federated access control. We discuss and suggest how challenges of legal and security aspects can be handled. This discussion may be useful for both current and future users, as well as policy makers.

  9. Selenium and Human Health

    Directory of Open Access Journals (Sweden)

    M Abedi

    2013-04-01

    Full Text Available Introduction: Selenium is an essential element for human health and it is toxic at high concentrations. Selenium is a constituent component of selenoproteins that have enzymatic and structural roles in human biochemistry. Selenium is a best antioxidant and catalyst for production of thyroid hormone. This element has the key role in the immune function; prevention of AIDS progression and the deactivity of toxins. Furthermore, selenium is essential for sperm motility and can reduce abortions. Selenium deficiency was also associated with adverse mood states. The findings regarding cardiovascular disease risk related to selenium deficiency is unclear, though other conditions such as vascular inflammation, oxidative stress and selenium deficiency can cause this disease too. Moreover, consuming of 60 mg of selenium per day may be associated with reduction of cancer risk. In this study, a review of studies has been performed on the biochemical function of selenium toxicity, and its effects on human health. Furthermore, certain identified cancers associated with selenium have been discussed to absorb more attention to the status of this element and also as a guide for further studies. Selenium plays the dual character (useful and harmful in human health, and then it is necessary to determine the concentration of this element in body fluids and tissues. An appropriate method for routine measurement of selenium in clinical laboratories is electro thermal atomic absorption spectrometry (ETAAS with very low detection limit and good precision.

  10. Regular-fat dairy and human health

    DEFF Research Database (Denmark)

    Astrup, Arne; Bradley, Beth H Rice; Brenna, J Thomas

    2016-01-01

    In recent history, some dietary recommendations have treated dairy fat as an unnecessary source of calories and saturated fat in the human diet. These assumptions, however, have recently been brought into question by current research on regular fat dairy products and human health. In an effort to......, cheese and yogurt, can be important components of an overall healthy dietary pattern. Systematic examination of the effects of dietary patterns that include regular-fat milk, cheese and yogurt on human health is warranted....

  11. Health implications of human trafficking.

    Science.gov (United States)

    Richards, Tiffany A

    2014-01-01

    Freedom is arguably the most cherished right in the United States. But each year, approximately 14,500 to 17,500 women, men and children are trafficked into the United States for the purposes of forced labor or sexual exploitation. Human trafficking has significant effects on both physical and mental health. This article describes the features of human trafficking, its physical and mental health effects and the vital role nurses can play in providing care to this vulnerable population. © 2014 AWHONN.

  12. Will electronic personal health records benefit providers and patients in rural America?

    Science.gov (United States)

    Hargreaves, John S

    2010-03-01

    The objective of this study was to educate stakeholders (e.g., providers, patients, insurers, government) in the healthcare industry about electronic personal health records (PHRs) and their potential application in rural America. Extensive research was performed on PHRs through standard literature search, product demonstrations, educational webinars, and fact finding via news releases. Various stakeholders are eager to transform the healthcare industry into the digital age like other industries (i.e., banking, retail). Despite low adoption of PHRs in 2008 (2.7% of U.S. adults), patients are interested in secure messaging and eVisits with their physicians, online appointment scheduling and reminders, and online access to their laboratory and radiology results. Federal agencies (e.g., Health and Human Services, Department of Defense, Veterans Affairs [VA]), popular information technology (IT) vendors (e.g., Google, Microsoft), and large insurers (e.g., Aetna) have energized the industry through pilot programs and new product announcements. It remains to be seen if barriers to adoption, including privacy concerns, lack of interoperability standards and funding, and provider resistance, can be overcome to enable PHRs to become a critical tool in the creation of a more efficient and less costly U.S. healthcare industry. Electronic PHRs hold great promise to enhance access and improve the quality of care provided to patients in rural America. Government, vendors, and insurers should create incentives for providers and patients to implement PHRs. Likewise, patients need to become more aware of PHRs and their ability to improve health outcomes.

  13. Public Trust in Health Information Sharing: Implications for Biobanking and Electronic Health Record Systems

    Directory of Open Access Journals (Sweden)

    Jodyn Platt

    2015-02-01

    Full Text Available Biobanks are made all the more valuable when the biological samples they hold can be linked to health information collected in research, electronic health records, or public health practice. Public trust in such systems that share health information for research and health care practice is understudied. Our research examines characteristics of the general public that predict trust in a health system that includes researchers, health care providers, insurance companies and public health departments. We created a 119-item survey of predictors and attributes of system trust and fielded it using Amazon’s MTurk system (n = 447. We found that seeing one’s primary care provider, having a favorable view of data sharing and believing that data sharing will improve the quality of health care, as well as psychosocial factors (altruism and generalized trust were positively and significantly associated with system trust. As expected, privacy concern, but counterintuitively, knowledge about health information sharing were negatively associated with system trust. We conclude that, in order to assure the public’s trust, policy makers charged with setting best practices for governance of biobanks and access to electronic health records should leverage critical access points to engage a diverse public in joint decision making.

  14. Where Public Health Meets Human Rights

    Science.gov (United States)

    Kiragu, Karusa; Sawicki, Olga; Smith, Sally; Brion, Sophie; Sharma, Aditi; Mworeko, Lilian; Iovita, Alexandrina

    2017-01-01

    Abstract In 2014, the World Health Organization (WHO) initiated a process for validation of the elimination of mother-to-child transmission (EMTCT) of HIV and syphilis by countries. For the first time in such a process for the validation of disease elimination, WHO introduced norms and approaches that are grounded in human rights, gender equality, and community engagement. This human rights-based validation process can serve as a key opportunity to enhance accountability for human rights protection by evaluating EMTCT programs against human rights norms and standards, including in relation to gender equality and by ensuring the provision of discrimination-free quality services. The rights-based validation process also involves the assessment of participation of affected communities in EMTCT program development, implementation, and monitoring and evaluation. It brings awareness to the types of human rights abuses and inequalities faced by women living with, at risk of, or affected by HIV and syphilis, and commits governments to eliminate those barriers. This process demonstrates the importance and feasibility of integrating human rights, gender, and community into key public health interventions in a manner that improves health outcomes, legitimizes the participation of affected communities, and advances the human rights of women living with HIV. PMID:29302179

  15. Human resources for health in Europe

    National Research Council Canada - National Science Library

    McKee, Martin; Dubois, Carl-Ardy; Nolte, Ellen

    2006-01-01

    ... systems in the field of personnel. The authors also identify which strategies are most likely to lead to the optimal management of health professionals in the future. Human Resources for Health in Europe is key reading for health policymakers and postgraduates taking courses in health services management, health policy and health economics. It is also ...

  16. Security Attacks and Solutions in Electronic Health (E-health) Systems.

    Science.gov (United States)

    Zeadally, Sherali; Isaac, Jesús Téllez; Baig, Zubair

    2016-12-01

    For centuries, healthcare has been a basic service provided by many governments to their citizens. Over the past few decades, we have witnessed a significant transformation in the quality of healthcare services provided by healthcare organizations and professionals. Recent advances have led to the emergence of Electronic Health (E-health), largely made possible by the massive deployment and adoption of information and communication technologies (ICTs). However, cybercriminals and attackers are exploiting vulnerabilities associated primarily with ICTs, causing data breaches of patients' confidential digital health information records. Here, we review recent security attacks reported for E-healthcare and discuss the solutions proposed to mitigate them. We also identify security challenges that must be addressed by E-health system designers and implementers in the future, to respond to threats that could arise as E-health systems become integrated with technologies such as cloud computing, the Internet of Things, and smart cities.

  17. Electronic health record case studies to advance environmental public health tracking.

    Science.gov (United States)

    Namulanda, Gonza; Qualters, Judith; Vaidyanathan, Ambarish; Roberts, Eric; Richardson, Max; Fraser, Alicia; McVeigh, Katharine H; Patterson, Scott

    2018-03-01

    Data from traditional public health surveillance systems can have some limitations, e.g., timeliness, geographic level, and amount of data accessible. Electronic health records (EHRs) could present an opportunity to supplement current sources of routinely collected surveillance data. The National Environmental Public Health Tracking Program (Tracking Program) sought to explore the use of EHRs for advancing environmental public health surveillance practices. The Tracking Program funded four state/local health departments to obtain and pilot the use of EHR data to address several issues including the challenges and technical requirements for accessing EHR data, and the core data elements required to integrate EHR data within their departments' Tracking Programs. The results of these pilot projects highlighted the potential of EHR data for public health surveillance of rare diseases that may lack comprehensive registries, and surveillance of prevalent health conditions or risk factors for health outcomes at a finer geographic level. EHRs therefore, may have potential to supplement traditional sources of public health surveillance data. Published by Elsevier Inc.

  18. Smart Card Based Integrated Electronic Health Record System For Clinical Practice

    OpenAIRE

    N. Anju Latha; B. Rama Murthy; U. Sunitha

    2012-01-01

    Smart cards are used in information technologies as portable integrated devices with data storage and data processing capabilities. As in other fields, smart card use in health systems became popular due to their increased capacity and performance. Smart cards are used as a Electronic Health Record (EHR) Their efficient use with easy and fast data access facilities leads to implementation particularly widespread in hospitals. In this paper, a smart card based Integrated Electronic health Reco...

  19. Behavioral Health Providers and Electronic Health Records: An Exploratory Beliefs Elicitation and Segmentation Study

    Science.gov (United States)

    Shank, Nancy

    2011-01-01

    The widespread adoption of electronic health records (EHRs) is a public policy strategy to improve healthcare quality and reduce accelerating health care costs. Much research has focused on medical providers' perceptions of EHRs, but little is known about those of behavioral health providers. This research was informed by the theory of reasoned…

  20. Electronic Health Records: Overcoming Obstacles to Improve Acceptance and Utilization for Mental Health Clinicians

    Science.gov (United States)

    Odom, Stephen A.

    2017-01-01

    The dynamics and progress of the integration of the electronic health record (EHR) into health-care disciplines have been described and examined using theories related to technology adoption. Previous studies have examined health-care clinician resistance to the EHR in primary care, hospital, and urgent care medical settings, but few studies have…

  1. Wilderness, biodiversity, and human health

    Science.gov (United States)

    Daniel L. Dustin; Keri A. Schwab; Kelly S. Bricker

    2015-01-01

    This paper illustrates how wilderness, biodiversity, and human health are intertwined. Proceeding from the assumption that humankind is part of, rather than apart from, nature, health is re-imagined as a dynamic relationship that can best be conceived in broad ecological terms. Health, from an ecological perspective, is a measure of the wellness of the individual and...

  2. 'Only connect': the case for public health humanities.

    Science.gov (United States)

    Saffran, Lise

    2014-12-01

    Humanities in health has until now been primarily understood to mean humanities in medicine and has generally failed to include public health. I will argue in this paper that the common justifications for the former--including increased empathy among practitioners--are at least as applicable, if not more, to the latter. Growing emphasis on the social determinants of health and cultural competency in public health require public health students and professionals to develop a nuanced understanding of the influence of social context on health behaviour and to empathise with people in difficult circumstances. Literary fiction has been demonstrated to have an impact on skills related to empathy and social intelligence. Further, translating epidemiological evidence into public policy is a core task of public health and there is a growing body of research to indicate that statistical evidence is more persuasive when combined with narrative evidence. In this article I explore similarities and differences between proposed humanities in public health and programmes in humanities in medicine and highlight research gaps and possible implications of a more expansive view of humanities in 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.

  3. Flexible Sensing Electronics for Wearable/Attachable Health Monitoring.

    Science.gov (United States)

    Wang, Xuewen; Liu, Zheng; Zhang, Ting

    2017-07-01

    Wearable or attachable health monitoring smart systems are considered to be the next generation of personal portable devices for remote medicine practices. Smart flexible sensing electronics are components crucial in endowing health monitoring systems with the capability of real-time tracking of physiological signals. These signals are closely associated with body conditions, such as heart rate, wrist pulse, body temperature, blood/intraocular pressure and blood/sweat bio-information. Monitoring such physiological signals provides a convenient and non-invasive way for disease diagnoses and health assessments. This Review summarizes the recent progress of flexible sensing electronics for their use in wearable/attachable health monitoring systems. Meanwhile, we present an overview of different materials and configurations for flexible sensors, including piezo-resistive, piezo-electrical, capacitive, and field effect transistor based devices, and analyze the working principles in monitoring physiological signals. In addition, the future perspectives of wearable healthcare systems and the technical demands on their commercialization are briefly discussed. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  4. The Internet in Connecting Electronics Health Record Mobile Clients

    Czech Academy of Sciences Publication Activity Database

    Hanzlíček, Petr; Špidlen, Josef; Zvárová, Jana

    2002-01-01

    Roč. 10, č. 6 (2002), s. 502-503 ISSN 0928-7329. [Mednet 2002. Qualit-e-Health. World Conference on the Internet in Medicine /7./. 04.12.2002-07.12.2002, Amsterdam] Institutional research plan: AV0Z1030915 Keywords : distributed electronic health record * mobile health data access Subject RIV: BD - Theory of Information

  5. Optimization of human, animal, and environmental health by using the One Health approach.

    Science.gov (United States)

    Sleeman, Jonathan M; DeLiberto, Thomas; Nguyen, Natalie

    2017-08-31

    Emerging diseases are increasing burdens on public health, negatively affecting the world economy, causing extinction of species, and disrupting ecological integrity. One Health recognizes that human, domestic animal, and wildlife health are interconnected within ecosystem health and provides a framework for the development of multidisciplinary solutions to global health challenges. To date, most health-promoting interventions have focused largely on single-sector outcomes. For example, risk for transmission of zoonotic pathogens from bush-meat hunting is primarily focused on human hygiene and personal protection. However, bush-meat hunting is a complex issue promoting the need for holistic strategies to reduce transmission of zoonotic disease while addressing food security and wildlife conservation issues. Temporal and spatial separation of humans and wildlife, risk communication, and other preventative strategies should allow wildlife and humans to co-exist. Upstream surveillance, vaccination, and other tools to prevent pathogen spillover are also needed. Clear multi-sector outcomes should be defined, and a systems-based approach is needed to develop interventions that reduce risks and balance the needs of humans, wildlife, and the environment. The ultimate goal is long-term action to reduce forces driving emerging diseases and provide interdisciplinary scientific approaches to management of risks, thereby achieving optimal outcomes for human, animal, and environmental health.

  6. Optimization of human, animal, and environmental health by using the One Health approach

    Science.gov (United States)

    Sleeman, Jonathan M.; DeLiberto, Thomas; Nguyen, Natalie T.

    2017-01-01

    Emerging diseases are increasing burdens on public health, negatively affecting the world economy, causing extinction of species, and disrupting ecological integrity. One Health recognizes that human, domestic animal, and wildlife health are interconnected within ecosystem health and provides a framework for the development of multidisciplinary solutions to global health challenges. To date, most health-promoting interventions have focused largely on single-sector outcomes. For example, risk for transmission of zoonotic pathogens from bush-meat hunting is primarily focused on human hygiene and personal protection. However, bush-meat hunting is a complex issue promoting the need for holistic strategies to reduce transmission of zoonotic disease while addressing food security and wildlife conservation issues. Temporal and spatial separation of humans and wildlife, risk communication, and other preventative strategies should allow wildlife and humans to co-exist. Upstream surveillance, vaccination, and other tools to prevent pathogen spillover are also needed. Clear multi-sector outcomes should be defined, and a systems-based approach is needed to develop interventions that reduce risks and balance the needs of humans, wildlife, and the environment. The ultimate goal is long-term action to reduce forces driving emerging diseases and provide interdisciplinary scientific approaches to management of risks, thereby achieving optimal outcomes for human, animal, and environmental health.

  7. Implementing electronic health care predictive analytics: considerations and challenges.

    Science.gov (United States)

    Amarasingham, Ruben; Patzer, Rachel E; Huesch, Marco; Nguyen, Nam Q; Xie, Bin

    2014-07-01

    The use of predictive modeling for real-time clinical decision making is increasingly recognized as a way to achieve the Triple Aim of improving outcomes, enhancing patients' experiences, and reducing health care costs. The development and validation of predictive models for clinical practice is only the initial step in the journey toward mainstream implementation of real-time point-of-care predictions. Integrating electronic health care predictive analytics (e-HPA) into the clinical work flow, testing e-HPA in a patient population, and subsequently disseminating e-HPA across US health care systems on a broad scale require thoughtful planning. Input is needed from policy makers, health care executives, researchers, and practitioners as the field evolves. This article describes some of the considerations and challenges of implementing e-HPA, including the need to ensure patients' privacy, establish a health system monitoring team to oversee implementation, incorporate predictive analytics into medical education, and make sure that electronic systems do not replace or crowd out decision making by physicians and patients. Project HOPE—The People-to-People Health Foundation, Inc.

  8. The New HIT: Human Health Information Technology.

    Science.gov (United States)

    Leung, Tiffany I; Goldstein, Mary K; Musen, Mark A; Cronkite, Ruth; Chen, Jonathan H; Gottlieb, Assaf; Leitersdorf, Eran

    2017-01-01

    Humanism in medicine is defined as health care providers' attitudes and actions that demonstrate respect for patients' values and concerns in relation to their social, psychological and spiritual life domains. Specifically, humanistic clinical medicine involves showing respect for the patient, building a personal connection, and eliciting and addressing a patient's emotional response to illness. Health information technology (IT) often interferes with humanistic clinical practice, potentially disabling these core aspects of the therapeutic patient-physician relationship. Health IT has evolved rapidly in recent years - and the imperative to maintain humanism in practice has never been greater. In this vision paper, we aim to discuss why preserving humanism is imperative in the design and implementation of health IT systems.

  9. EVA Health and Human Performance Benchmarking Study

    Science.gov (United States)

    Abercromby, A. F.; Norcross, J.; Jarvis, S. L.

    2016-01-01

    Multiple HRP Risks and Gaps require detailed characterization of human health and performance during exploration extravehicular activity (EVA) tasks; however, a rigorous and comprehensive methodology for characterizing and comparing the health and human performance implications of current and future EVA spacesuit designs does not exist. This study will identify and implement functional tasks and metrics, both objective and subjective, that are relevant to health and human performance, such as metabolic expenditure, suit fit, discomfort, suited postural stability, cognitive performance, and potentially biochemical responses for humans working inside different EVA suits doing functional tasks under the appropriate simulated reduced gravity environments. This study will provide health and human performance benchmark data for humans working in current EVA suits (EMU, Mark III, and Z2) as well as shirtsleeves using a standard set of tasks and metrics with quantified reliability. Results and methodologies developed during this test will provide benchmark data against which future EVA suits, and different suit configurations (eg, varied pressure, mass, CG) may be reliably compared in subsequent tests. Results will also inform fitness for duty standards as well as design requirements and operations concepts for future EVA suits and other exploration systems.

  10. A Brief History of Soils and Human Health Studies

    Science.gov (United States)

    Brevik, Eric C.; Sauer, Thomas J.

    2013-04-01

    The idea that there are links between soils and human health is an ancient one. The Bible depicts Moses as understanding that fertile soil was essential to the well-being of his people in approximately 1400 B.C. as they entered Canaan, and in 400 B.C. Hippocrates provided a list of things that should be considered in a proper medical evaluation, including the ground. Moving into the 18th and 19th Centuries, some North American farmers have been documented as recognizing a link between soils and human vitality. However, the recognition of links between soils and human health by these early people was based on casual observations leading to logical conclusions rather than scientific investigation. In the 1900s the idea that soils influence human health gained considerable traction. At least three chapters in the 1938 USDA Yearbook of Agriculture included recognition of the importance of soil as the origin of many of the mineral elements necessary for human health and in the 1957 USDA Yearbook of Agriculture scientists realized that soils were not only important in the supply of essential nutrients, but that they could also supply toxic levels of elements to the human diet. The U.S. Department of Agriculture established the Plant, Soil and Nutrition Research Unit (PSNRU) on the Cornell University campus in 1940 with a mission to conduct research at the interface of human nutrition and agriculture to improve the nutritional quality and health-promoting properties of food crops. A major human health breakthrough in 1940 was the isolation of antibiotic compounds from soil organisms by the research group at Rutgers University lead by Selman Waksman. Soil microorganisms create antibiotic compounds in an effort to gain a competitive advantage in the soil ecosystem. Humans have been able to isolate those compounds and use them advantageously in the fight against bacterial infections. Waksman was awarded the Nobel Prize in Physiology or Medicine in 1952, the only soil

  11. Terroir as a Concept to Improve Human Health

    Science.gov (United States)

    Brevik, Eric C.; Steffan, Joshua J.; Burgess, Lynn C.; Cerdà, Artemi; Pereg, Lily

    2017-04-01

    Soil is important to human health because of the ability of healthy soils to supply nutrients through food products, medications derived from soil, its ability to clean water, and for many other positive reasons. On the other hand, degraded soils can have negative impacts on human health through processes such as dust generation and by acting as a point of human contact with heavy metals, organic chemicals, and pathogens. Despite the definite links between soil and human health, it is likely that most people don't think about soil when considering human health issues. In fact, there appears to be a disconnect between most people in our modern society and soil, and when people do notice soil it often seems to be in a negative context, leading to terms such as "soiled", "dirty", "dirt poor", etc. People pay attention to and care for things that matter to them, and creating a more positive public image of soil has the possibility of improving human health by leading to careful and caring treatment of the soil resource. The concept of terroir is a good example of a setting within which soils have a more positive image. While terroir originally established a connection between those who love wine and the soils that produce those wines, the concept has been expanded to many additional products such as cacao, cheese, coffee, fruits, olive oil, and vegetables. If the terroir concept could be expanded to include additional products that are important to people and expanded into parts of the world where it is not currently well known, that may provide an increased positive perception of soil, and thereby indirectly improve human health. It may even be possible to provide a terroir link to direct health benefits, such as medications derived from a given soil environment, and therefore provide a very focused emphasis on soil and human health issues. Therefore, we advocate a concerted effort to expand the terroir concept as a means to improve overall human health.

  12. Role of Plastics on Human Health.

    Science.gov (United States)

    Kumar, Pramod

    2018-05-01

    Plastics, currently the universal workhorse materials of modern economy, because of their low cost and varied functional properties are posing serious threat to environment and consumer's health in many direct and indirect ways. Rising concern about the impact of plastics on environment and human health, has forced the industry to look for alternatives. This review studies current understanding of benefits and concerns surrounding use of plastics, reviews literature about health effects in humans and discusses the current state of evidence, as well as future research trends. There is increasing concern regarding additives in plastics to which most people are exposed, such as phthalates, bisphenol A or polybrominated diphenyl ethers (PBDE), and their detection in humans, leading to harmful impact on health. The studies are divided, among many other issues on the fact of considering these additives as carcinogens or toxicants, but there is a consensus that these chemicals have the ability to alter the endocrine system. Human data are limited compared to large body of experimental evidence documenting reproductive or developmental toxicity in relation to these compounds in animals. The concentrations of these additives in young children, a segment particularly sensitive to exogenous insults, are typically higher, indicating the need to decrease exposure to these compounds. The rapid increase in usage of plastics and increased awareness about its health hazard has lent urgency to the whole issue.

  13. A systematic review of health effects of electronic cigarettes

    DEFF Research Database (Denmark)

    Pisinger, Charlotta; Døssing, Martin

    2014-01-01

    OBJECTIVE: To provide a systematic review of the existing literature on health consequences of vaporing of electronic cigarettes (ECs). METHODS: Search in: PubMed, EMBASE and CINAHL. INCLUSION CRITERIA: Original publications describing a health-related topic, published before 14 August 2014. PRISMA...

  14. Electronic Health Records: PHR Opportunities for Public Health – Part 2

    Centers for Disease Control (CDC) Podcasts

    2009-09-10

    In this podcast, Dr. Ken Mandl discusses electronic health records and personally-controlled health records. Dr. Mandl leads the IndivoHealth personally-controlled health record project, the original reference model for the Microsoft, Google, and Dossia personal health records (PHRs or PCHRs). He has successfully used PHRs for immunization and influenza, leads efforts in real-time surveillance systems, and is currently adapting personal health records for longitudinal and genomic research. The lecture was given at CDC on June 19, 2009.  Created: 9/10/2009 by Coordinating Center for Health Information Service (CCHIS), Healthy Healthcare Settings Goal Team, Office of Strategy and Innovation.   Date Released: 6/3/2010.

  15. Electronic Health Records: PHR Opportunities for Public Health – Part 1

    Centers for Disease Control (CDC) Podcasts

    2009-09-10

    In this podcast, Dr. Ken Mandl discusses electronic health records and personally-controlled health records. Dr. Mandl leads the IndivoHealth personally-controlled health record project, the original reference model for the Microsoft, Google, and Dossia personal health records (PHRs or PCHRs). He has successfully used PHRs for immunization and influenza, leads efforts in real-time surveillance systems, and is currently adapting personal health records for longitudinal and genomic research. The lecture was given at CDC on June 19, 2009.  Created: 9/10/2009 by Coordinating Center for Health Information Service (CCHIS), Healthy Healthcare Settings Goal Team, Office of Strategy and Innovation.   Date Released: 6/3/2010.

  16. Semantic Interoperability in the Structured Electronic Health Record

    Czech Academy of Sciences Publication Activity Database

    Hanzlíček, Petr; Přečková, Petra; Zvárová, Jana

    -, č. 69 (2007), s. 52-53 ISSN 0926-4981 Institutional research plan: CEZ:AV0Z10300504 Keywords : electronic health record * terminology * classification Subject RIV: IN - Informatics, Computer Science

  17. Plastic and Human Health: A Micro Issue?

    Science.gov (United States)

    Wright, Stephanie L; Kelly, Frank J

    2017-06-20

    Microplastics are a pollutant of environmental concern. Their presence in food destined for human consumption and in air samples has been reported. Thus, microplastic exposure via diet or inhalation could occur, the human health effects of which are unknown. The current review article draws upon cross-disciplinary scientific literature to discuss and evaluate the potential human health impacts of microplastics and outlines urgent areas for future research. Key literature up to September 2016 relating to accumulation, particle toxicity, and chemical and microbial contaminants was critically examined. Although microplastics and human health is an emerging field, complementary existing fields indicate potential particle, chemical and microbial hazards. If inhaled or ingested, microplastics may accumulate and exert localized particle toxicity by inducing or enhancing an immune response. Chemical toxicity could occur due to the localized leaching of component monomers, endogenous additives, and adsorbed environmental pollutants. Chronic exposure is anticipated to be of greater concern due to the accumulative effect that could occur. This is expected to be dose-dependent, and a robust evidence-base of exposure levels is currently lacking. Although there is potential for microplastics to impact human health, assessing current exposure levels and burdens is key. This information will guide future research into the potential mechanisms of toxicity and hence therein possible health effects.

  18. The Pan American Health Organization and the mainstreaming of human rights in regional health governance.

    Science.gov (United States)

    Meier, Benjamin Mason; Ayala, Ana S

    2014-01-01

    In the absence of centralized human rights leadership in an increasingly fragmented global health policy landscape, regional health offices have stepped forward to advance the rights-based approach to health. Reviewing the efforts of the Pan American Health Organization (PAHO), this article explores the evolution of human rights in PAHO policy, assesses efforts to mainstream human rights in the Pan American Sanitary Bureau (PASB), and analyzes the future of the rights-based approach through regional health governance, providing lessons for other regional health offices and global health institutions. This article explores PAHO's 15-year effort to mainstream human rights through PASB technical units, national capacity-building, the Inter-American human rights system, and the PAHO Directing Council. Through documentary analysis of PAHO policies and semi-structured interviews with key PASB stakeholders, the authors analyze the understandings and actions of policymakers and technical officers in implementing human rights through PAHO governance. Analyzing the themes arising from this narrative, the authors examine the structural role of secretariat leadership, state support, legal expertise, and technical unit commitment in facilitating a rights-based approach to the health in the Americas. Human rights are increasingly framing PAHO efforts, and this analysis of the structures underlying PAHO's approach provides an understanding of the institutional determinants of the rights-based approach to health, highlighting generalizable themes for the mainstreaming of human rights through regional health governance. With this regional-level understanding of health governance, future national-level research can begin to understand the causal forces linking regional human rights work with national policy reforms and public health outcomes. © 2014 American Society of Law, Medicine & Ethics, Inc.

  19. Electronic Health Records and US Public Health: Current Realities and Future Promise

    Science.gov (United States)

    Parrish, R. Gibson; Ross, David A.

    2013-01-01

    Electronic health records (EHRs) could contribute to improving population health in the United States. Realizing this potential will require understanding what EHRs can realistically offer to efforts to improve population health, the requirements for obtaining useful information from EHRs, and a plan for addressing these requirements. Potential contributions of EHRs to improving population health include better understanding of the level and distribution of disease, function, and well-being within populations. Requirements are improved population coverage of EHRs, standardized EHR content and reporting methods, and adequate legal authority for using EHRs, particularly for population health. A collaborative national effort to address the most pressing prerequisites for and barriers to the use of EHRs for improving population health is needed to realize the EHR’s potential. PMID:23865646

  20. Factors affecting willingness to share electronic health data among California consumers.

    Science.gov (United States)

    Kim, Katherine K; Sankar, Pamela; Wilson, Machelle D; Haynes, Sarah C

    2017-04-04

    Robust technology infrastructure is needed to enable learning health care systems to improve quality, access, and cost. Such infrastructure relies on the trust and confidence of individuals to share their health data for healthcare and research. Few studies have addressed consumers' views on electronic data sharing and fewer still have explored the dual purposes of healthcare and research together. The objective of the study is to explore factors that affect consumers' willingness to share electronic health information for healthcare and research. This study involved a random-digit dial telephone survey of 800 adult Californians conducted in English and Spanish. Logistic regression was performed using backward selection to test for significant (p-value ≤ 0.05) associations of each explanatory variable with the outcome variable. The odds of consent for electronic data sharing for healthcare decreased as Likert scale ratings for EHR impact on privacy worsened, odds ratio (OR) = 0.74, 95% CI [0.60, 0.90]; security, OR = 0.80, 95% CI [0.66, 0.98]; and quality, OR = 0.59, 95% CI [0.46-0.75]. The odds of consent for sharing for research was greater for those who think EHR will improve research quality, OR = 11.26, 95% CI [4.13, 30.73]; those who value research benefit over privacy OR = 2.72, 95% CI [1.55, 4.78]; and those who value control over research benefit OR = 0.49, 95% CI [0.26, 0.94]. Consumers' choices about electronically sharing health information are affected by their attitudes toward EHRs as well as beliefs about research benefit and individual control. Design of person-centered interventions utilizing electronically collected health information, and policies regarding data sharing should address these values of importance to people. Understanding of these perspectives is critical for leveraging health data to support learning health care systems.

  1. Leveraging electronic health records for predictive modeling of post-surgical complications.

    Science.gov (United States)

    Weller, Grant B; Lovely, Jenna; Larson, David W; Earnshaw, Berton A; Huebner, Marianne

    2017-01-01

    Hospital-specific electronic health record systems are used to inform clinical practice about best practices and quality improvements. Many surgical centers have developed deterministic clinical decision rules to discover adverse events (e.g. postoperative complications) using electronic health record data. However, these data provide opportunities to use probabilistic methods for early prediction of adverse health events, which may be more informative than deterministic algorithms. Electronic health record data from a set of 9598 colorectal surgery cases from 2010 to 2014 were used to predict the occurrence of selected complications including surgical site infection, ileus, and bleeding. Consistent with previous studies, we find a high rate of missing values for both covariates and complication information (4-90%). Several machine learning classification methods are trained on an 80% random sample of cases and tested on a remaining holdout set. Predictive performance varies by complication, although an area under the receiver operating characteristic curve as high as 0.86 on testing data was achieved for bleeding complications, and accuracy for all complications compares favorably to existing clinical decision rules. Our results confirm that electronic health records provide opportunities for improved risk prediction of surgical complications; however, consideration of data quality and consistency standards is an important step in predictive modeling with such data.

  2. Electronic health records: what does your signature signify?

    Directory of Open Access Journals (Sweden)

    Victoroff MD Michael S

    2012-08-01

    Full Text Available Abstract Electronic health records serve multiple purposes, including clinical communication, legal documentation, financial transaction capture, research and analytics. Electronic signatures attached to entries in EHRs have different logical and legal meanings for different users. Some of these are vestiges from historic paper formats that require reconsideration. Traditionally accepted functions of signatures, such as identity verification, attestation, consent, authorization and non-repudiation can become ambiguous in the context of computer-assisted workflow processes that incorporate functions like logins, auto-fill and audit trails. This article exposes the incompatibility of expectations among typical users of electronically signed information.

  3. Interdependence, Human Rights and Global Health Law.

    Science.gov (United States)

    Viens, A M

    2015-12-01

    The connection between health and human rights continues to play a prominent role within global health law. In particular, a number of theorists rely on the claim that there is a relation of interdependence between health and human rights. The nature and extent of this relation, however, is rarely defined, developed or defended in a conceptually robust way. This paper seeks to explore the source, scope and strength of this putative relation and what role it might play in developing a global health law framework.

  4. Factors Influencing Acceptance of Electronic Health Records in Hospitals

    OpenAIRE

    Wilkins, Melinda A

    2009-01-01

    The study's aim was to examine factors that may influence health information managers in the adoption of electronic health records. The Technology Acceptance Model (TAM) served as theoretical foundation for this quantitative study. Hospital health information managers in Arkansas were queried as to the constructs of perceived usefulness, perceived ease of use, and behavior intention. The study population comprised 94 health information managers with a return rate of 74.5 percent. One manager ...

  5. Innovative uses of electronic health records and social media for public health surveillance.

    Science.gov (United States)

    Eggleston, Emma M; Weitzman, Elissa R

    2014-03-01

    Electronic health records (EHRs) and social media have the potential to enrich public health surveillance of diabetes. Clinical and patient-facing data sources for diabetes surveillance are needed given its profound public health impact, opportunity for primary and secondary prevention, persistent disparities, and requirement for self-management. Initiatives to employ data from EHRs and social media for diabetes surveillance are in their infancy. With their transformative potential come practical limitations and ethical considerations. We explore applications of EHR and social media for diabetes surveillance, limitations to approaches, and steps for moving forward in this partnership between patients, health systems, and public health.

  6. Proteomic approach in human health and disease: Preventive and cure studies

    Directory of Open Access Journals (Sweden)

    Khaled MM Koriem

    2018-01-01

    Full Text Available Proteomic is a branch of science that deals with various numbers of proteins where proteins are essential human constituents. Proteomic has a lot of functions inside the human and animal living organisms. This review helps to make a thought on the importance of proteomic application in human health and disease with special reference to preventive and cure studies. The human health can be divided into physical and mental health. The physical health relates to keeping human body state in a good health and to nutritional type and environmental factors. The mental health correlates to human psychological state. The main factors that affect the status of human health are human diet, exercise and sleep. The healthy diet is very important and needs to maintain the human health. The training program exercise improves human fitness and overall health and wellness. The sleep is a vital factor to sustain the human health. The human disease indicates abnormal human condition which influences the specific human part or the whole human body. There are external and internal factors which induce human disease. The external factors include pathogens while internal factors include allergies and autoimmunity. There are 4 principle types of human diseases: (1 infectious disease, (2 deficiency disease, (3 genetic disease and (4 physiological disease. There are many and various external microbes' factors that induce human infectious disease and these agents include viruses, bacteria, fungi and protozoa. The lack of necessary and vital dietary rudiments such as vitamins and minerals is the main cause of human deficiency disease. The genetic disease is initiated by hereditary disturbances that occur in the human genetic map. The physiological disease occurs when the normal human function body is affected due to human organs become malfunction. In conclusion, proteomic plays a vital and significant role in human health and disease.

  7. Human health effects of air pollution

    International Nuclear Information System (INIS)

    Kampa, Marilena; Castanas, Elias

    2008-01-01

    Hazardous chemicals escape to the environment by a number of natural and/or anthropogenic activities and may cause adverse effects on human health and the environment. Increased combustion of fossil fuels in the last century is responsible for the progressive change in the atmospheric composition. Air pollutants, such as carbon monoxide (CO), sulfur dioxide (SO 2 ), nitrogen oxides (NOx), volatile organic compounds (VOCs), ozone (O 3 ), heavy metals, and respirable particulate matter (PM2.5 and PM10), differ in their chemical composition, reaction properties, emission, time of disintegration and ability to diffuse in long or short distances. Air pollution has both acute and chronic effects on human health, affecting a number of different systems and organs. It ranges from minor upper respiratory irritation to chronic respiratory and heart disease, lung cancer, acute respiratory infections in children and chronic bronchitis in adults, aggravating pre-existing heart and lung disease, or asthmatic attacks. In addition, short- and long-term exposures have also been linked with premature mortality and reduced life expectancy. These effects of air pollutants on human health and their mechanism of action are briefly discussed. - The effect of air pollutants on human health and underlying mechanisms of cellular action are discussed

  8. Determinants of primary care nurses' intention to adopt an electronic health record in their clinical practice.

    Science.gov (United States)

    Leblanc, Genevieve; Gagnon, Marie-Pierre; Sanderson, Duncan

    2012-09-01

    A provincial electronic health record is being developed in the Province of Quebec (and in all other provinces in Canada), and authorities hope that it will enable a safer and more efficient healthcare system for citizens. However, the expected benefits can occur only if healthcare professionals, including nurses, adopt this technology. Although attention to the use of the electronic health record by nurses is growing, better understanding of nurses' intention to use an electronic health record is needed and could help managers to better plan its implementation. This study examined the factors that influence primary care nurses' intention to adopt the provincial electronic health record, since intention influences electronic health record use and implementation success. Using a modified version of Ajzen's Theory of Planned Theory of Planned Behavior, a questionnaire was developed and pretested. Questionnaires were distributed to 199 primary care nurses. Multiple hierarchical regression indicated that the Theory of Planned Behavior variables explained 58% of the variance in nurses' intention to adopt an electronic health record. The strong intention to adopt the electronic health record is mainly determined by perceived behavioral control, normative beliefs, and attitudes. The implications of the study are that healthcare managers could facilitate adoption of an electronic health record by strengthening nurses' intention to adopt the electronic health record, which in turn can be influenced through interventions oriented toward the belief that using an electronic health record will improve the quality of patient care.

  9. Perioperative nurses' attitudes toward the electronic health record.

    Science.gov (United States)

    Yontz, Laura S; Zinn, Jennifer L; Schumacher, Edward J

    2015-02-01

    The adoption of an electronic health record (EHR) is mandated under current health care legislation reform. The EHR provides data that are patient centered and improves patient safety. There are limited data; however, regarding the attitudes of perioperative nurses toward the use of the EHR. The purpose of this project was to identify perioperative nurses' attitudes toward the use of the EHR. Quantitative descriptive survey was used to determine attitudes toward the electronic health record. Perioperative nurses in a southeastern health system completed an online survey to determine their attitudes toward the EHR in providing patient care. Overall, respondents felt the EHR was beneficial, did not add to the workload, improved documentation, and would not eliminate any nursing jobs. Nursing acceptance and the utilization of the EHR are necessary for the successful integration of an EHR and to support the goal of patient-centered care. Identification of attitudes and potential barriers of perioperative nurses in using the EHR will improve patient safety, communication, reduce costs, and empower those who implement an EHR. Copyright © 2015 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.

  10. Electronic Prognostics for Vehicle Health Management, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — All electronic systems are prone to wear-out and eventual failure and this has direct implications for Vehicle Health Management for NASA with its long space...

  11. 77 FR 23193 - Medicare and Medicaid Programs; Electronic Health Record Incentive Program-Stage 2; Corrections

    Science.gov (United States)

    2012-04-18

    ..., 413, and 495 [CMS-0044-CN] RIN 0938-AQ84 Medicare and Medicaid Programs; Electronic Health Record... proposed rule entitled ``Medicare and Medicaid Programs; Electronic Health Record Incentive Program--Stage... (77 FR 13698), the proposed rule entitled ``Medicare and Medicaid Programs; Electronic Health Record...

  12. Exposure to UV radiation and human health

    Science.gov (United States)

    Kimlin, Michael G.

    2005-08-01

    This paper will overview the significant issues facing researchers in relating the impact of exposure to sunlight and human health. Exposure to solar ultraviolet radiation is the major causative factor in most sun-related skin and eye disorders, however, very little is known quantitatively about human UV exposures. Interestingly, human exposure to sunlight also has a nutritional impact, namely the development of pre-Vitamin D, which is an important nutrient in bone health. New research suggest that low vitamin D status may be a causative factor in the development of selective types of cancer and autoimminue diseases, as well as a contributing factor in bone health. The 'health duality' aspect of sunlight exposure is an interesting and controversial topic that is a research focus of Kimlin's research group.

  13. Nanotechnology and health safety--toxicity and risk assessments of nanostructured materials on human health.

    Science.gov (United States)

    Singh, Surya; Nalwa, Hari Singh

    2007-09-01

    The field of nanotechnology has recently emerged as the most commercially viable technology of this century because of its wide-ranging applications in our daily lives. Man-made nanostructured materials such as fullerenes, nanoparticles, nanopowders, nanotubes, nanowires, nanorods, nanofibers, quantum dots, dendrimers, nanoclusters, nanocrystals, and nanocomposites are globally produced in large quantities due to their wide potential applications, e.g., in skincare and consumer products, healthcare, electronics, photonics, biotechnology, engineering products, pharmaceuticals, drug delivery, and agriculture. Human exposure to these nanostructured materials is inevitable, as they can enter the body through the lungs or other organs via food, drink, and medicine and affect different organs and tissues such as the brain, liver, kidney, heart, colon, spleen, bone, blood, etc., and may cause cytotoxic effects, e.g., deformation and inhibition of cell growth leading to various diseases in humans and animals. Since a very wide variety of nanostructured materials exits, their interactions with biological systems and toxicity largely depend upon their properties, such as size, concentration, solubility, chemical and biological properties, and stability. The toxicity of nanostructured materials could be reduced by chemical approaches such by surface treatment, functionalization, and composite formation. This review summarizes the sources of various nanostructured materials and their human exposure, biocompatibility in relation to potential toxicological effects, risk assessment, and safety evaluation on human and animal health as well as on the environment.

  14. Oceans and human health: Emerging public health risks n the marine environment

    Science.gov (United States)

    Fleming, L.E.; Broad, K.; Clement, A.; Dewailly, E.; Elmir, S.; Knap, A.; Pomponi, S.A.; Smith, S.; Gabriele, H. Solo; Walsh, P.

    2008-01-01

    There has been an increasing recognition of the inter-relationship between human health and the oceans. Traditionally, the focus of research and concern has been on the impact of human activities on the oceans, particularly through anthropogenic pollution and the exploitation of marine resources. More recently, there has been recognition of the potential direct impact of the oceans on human health, both detrimental and beneficial. Areas identified include: global change, harmful algal blooms (HABs), microbial and chemical contamination of marine waters and seafood, and marine models and natural products from the seas. It is hoped that through the recognition of the inter-dependence of the health of both humans and the oceans, efforts will be made to restore and preserve the oceans. PMID:16996542

  15. The Human Right to Equal Access to Health Care

    NARCIS (Netherlands)

    M. San Giorgi (Maite)

    2012-01-01

    textabstractThe right to equal access to health care is a fundamental principle that is part of the human right to health care. For victims of a violation of the human right to equal access to health care it is important that a judicial or quasi-judicial human rights body can adjudicate their

  16. Biometrics for electronic health records.

    Science.gov (United States)

    Flores Zuniga, Alejandro Enrique; Win, Khin Than; Susilo, Willy

    2010-10-01

    Securing electronic health records, in scenarios in which the provision of care services is share among multiple actors, could become a complex and costly activity. Correct identification of patients and physician, protection of privacy and confidentiality, assignment of access permissions for healthcare providers and resolutions of conflicts rise as main points of concern in the development of interconnected health information networks. Biometric technologies have been proposed as a possible technological solution for these issues due to its ability to provide a mechanism for unique verification of an individual identity. This paper presents an analysis of the benefit as well as disadvantages offered by biometric technology. A comparison between this technology and more traditional identification methods is used to determine the key benefits and flaws of the use biometric in health information systems. The comparison as been made considering the viability of the technologies for medical environments, global security needs, the contemplation of a share care environment and the costs involved in the implementation and maintenance of such technologies. This paper also discusses alternative uses for biometrics technologies in health care environments. The outcome of this analysis lays in the fact that even when biometric technologies offer several advantages over traditional method of identification, they are still in the early stages of providing a suitable solution for a health care environment.

  17. 76 FR 40454 - Proposed Information Collection (VSO Access to VHA Electronic Health Records) Activity; Comment...

    Science.gov (United States)

    2011-07-08

    ... Access to VHA Electronic Health Records) Activity; Comment Request AGENCY: Veterans Health Administration... Access to VHA Electronic Health Records, VA Form 10- 0400. OMB Control Number: 2900-0710. Type of Review... were granted power of attorney by veterans who have medical information recorded in VHA electronic...

  18. The Arctic Human Health Initiative: a legacy of the International Polar Year 2007–2009

    Directory of Open Access Journals (Sweden)

    Alan J. Parkinson

    2013-08-01

    Full Text Available Background . The International Polar Year (IPY 2007–2008 represented a unique opportunity to further stimulate cooperation and coordination on Arctic health research and increase the awareness and visibility of Arctic regions. The Arctic Human Health Initiative (AHHI was a US-led Arctic Council IPY coordinating project that aimed to build and expand on existing International Union for Circumpolar Health (IUCH and Arctic Council human health interests. The project aimed to link researchers with potential international collaborators and to serve as a focal point for human health research, education, outreach and communication activities during the IPY. The progress of projects conducted as part of this initiative up until the end of the Arctic Council Swedish chairmanship in May 2013 is summarized in this report. Design . The overall goals of the AHHI was to increase awareness and visibility of human health concerns of Arctic peoples, foster human health research, and promote health strategies that will improve health and well-being of all Arctic residents. Proposed activities to be recognized through the initiative included: expanding research networks that will enhance surveillance and monitoring of health issues of concern to Arctic peoples, and increase collaboration and coordination of human health research; fostering research that will examine the health impact of anthropogenic pollution, rapid modernization and economic development, climate variability, infectious and chronic diseases, intentional and unintentional injuries, promoting education, outreach and communication that will focus public and political attention on Arctic health issues, using a variety of publications, printed and electronic reports from scientific conferences, symposia and workshops targeting researchers, students, communities and policy makers; promoting the translation of research into health policy and community action including implementation of prevention

  19. Changes to Workflow and Process Measures in the PICU During Transition From Semi to Full Electronic Health Record.

    Science.gov (United States)

    Salib, Mina; Hoffmann, Raymond G; Dasgupta, Mahua; Zimmerman, Haydee; Hanson, Sheila

    2015-10-01

    Studies showing the changes in workflow during transition from semi to full electronic medical records are lacking. This objective study is to identify the changes in workflow in the PICU during transition from semi to full electronic health record. Prospective observational study. Children's Hospital of Wisconsin Institutional Review Board waived the need for approval so this study was institutional review board exempt. This study measured clinical workflow variables at a 72-bed PICU during different phases of transition to a full electronic health record, which occurred on November 4, 2012. Phases of electronic health record transition were defined as follows: pre-electronic health record (baseline data prior to transition to full electronic health record), transition phase (3 wk after electronic health record), and stabilization (6 mo after electronic health record). Data were analyzed for the three phases using Mann-Whitney U test with a two-sided p value of less than 0.05 considered significant. Seventy-two bed PICU. All patients in the PICU were included during the study periods. Five hundred and sixty-four patients with 2,355 patient days were evaluated in the three phases. Duration of rounds decreased from a median of 9 minutes per patient pre--electronic health record to 7 minutes per patient post electronic health record. Time to final note decreased from 2.06 days pre--electronic health record to 0.5 days post electronic health record. Time to first medication administration after admission also decreased from 33 minutes pre--electronic health record and 7 minutes post electronic health record. Time to Time to medication reconciliation was significantly higher pre-electronic health record than post electronic health record and percent of medication reconciliation completion was significantly lower pre--electronic health record than post electronic health record and percent of medication reconciliation completion was significantly higher pre--electronic

  20. 45 CFR 170.210 - Standards for health information technology to protect electronic health information created...

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Standards for health information technology to... Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH INFORMATION TECHNOLOGY HEALTH INFORMATION... FOR HEALTH INFORMATION TECHNOLOGY Standards and Implementation Specifications for Health Information...

  1. Electronic cigarettes: incorporating human factors engineering into risk assessments

    OpenAIRE

    Yang, Ling; Rudy, Susan F; Cheng, James M; Durmowicz, Elizabeth L

    2014-01-01

    Objective A systematic review was conducted to evaluate the impact of human factors (HF) on the risks associated with electronic cigarettes (e-cigarettes) and to identify research gaps. HF is the evaluation of human interactions with products and includes the analysis of user, environment and product complexity. Consideration of HF may mitigate known and potential hazards from the use and misuse of a consumer product, including e-cigarettes. Methods Five databases were searched through Januar...

  2. Impacts of “metals” on human health

    DEFF Research Database (Denmark)

    Pizzol, Massimo; Christensen, Per; Schmidt, Jannick Højrup

    2011-01-01

    This paper looks into the differences and uncertainties in determining the impact of “metals” emissions on human health, in Life Cycle Impact Assessment (LCIA). Metals are diverse substances, with different properties and characteristics, considered important in LCIA because of their toxicity...... to humans and ecosystems. First, we defined a list of the most significant metals in terms of impacts on human health. This was done according to precise criteria accounting for both physical and toxic properties of the metals. Second, we performed a LCIA on different key processes using various existing...... to the total impact on human health changes greatly according to the LCIA method used. These differences are due mainly to the number of metals included in each method and to the technique used to calculate the characterization factors. Results obtained with USEtox show no apparent correlation with results...

  3. XML and its impact on content and structure in electronic health care documents.

    Science.gov (United States)

    Sokolowski, R.; Dudeck, J.

    1999-01-01

    Worldwide information networks have the requirement that electronic documents must be easily accessible, portable, flexible and system-independent. With the development of XML (eXtensible Markup Language), the future of electronic documents, health care informatics and the Web itself are about to change. The intent of the recently formed ASTM E31.25 subcommittee, "XML DTDs for Health Care", is to develop standard electronic document representations of paper-based health care documents and forms. A goal of the subcommittee is to work together to enhance existing levels of interoperability among the various XML/SGML standardization efforts, products and systems in health care. The ASTM E31.25 subcommittee uses common practices and software standards to develop the implementation recommendations for XML documents in health care. The implementation recommendations are being developed to standardize the many different structures of documents. These recommendations are in the form of a set of standard DTDs, or document type definitions that match the electronic document requirements in the health care industry. This paper discusses recent efforts of the ASTM E31.25 subcommittee. PMID:10566338

  4. 76 FR 56503 - Agency Information Collection Activity (VSO Access to VHA Electronic Health Records) Under OMB...

    Science.gov (United States)

    2011-09-13

    ... (VSO Access to VHA Electronic Health Records) Under OMB Review AGENCY: Veterans Health Administration... Electronic Health Records, VA Form 10- 0400. OMB Control Number: 2900-0710. Type of Review: Extension of a... power of attorney by veterans who have medical information recorded in VHA electronic health records...

  5. Ecosystem change and human health: implementation economics and policy.

    Science.gov (United States)

    Pattanayak, S K; Kramer, R A; Vincent, J R

    2017-06-05

    Several recent initiatives such as Planetary Health , EcoHealth and One Health claim that human health depends on flourishing natural ecosystems. However, little has been said about the operational and implementation challenges of health-oriented conservation actions on the ground. We contend that ecological-epidemiological research must be complemented by a form of implementation science that examines: (i) the links between specific conservation actions and the resulting ecological changes, and (ii) how this ecological change impacts human health and well-being, when human behaviours are considered. Drawing on the policy evaluation tradition in public economics, first, we present three examples of recent social science research on conservation interventions that affect human health. These examples are from low- and middle-income countries in the tropics and subtropics. Second, drawing on these examples, we present three propositions related to impact evaluation and non-market valuation that can help guide future multidisciplinary research on conservation and human health. Research guided by these propositions will allow stakeholders to determine how ecosystem-mediated strategies for health promotion compare with more conventional biomedical prevention and treatment strategies for safeguarding health.This article is part of the themed issue 'Conservation, biodiversity and infectious disease: scientific evidence and policy implications'. © 2017 The Authors.

  6. School Health Connection Goes Electronic: Developing a Health Information Management System for New Orleans' School-Based Health Centers. Program Results Report

    Science.gov (United States)

    Rastorfer, Darl

    2011-01-01

    From February 2008 through April 2011, School Health Connection, a program of the Louisiana Public Health Institute, developed an electronic health information management system for newly established school-based health centers in Greater New Orleans. School Health Connection was established as part of a broader effort to restore community health…

  7. The use of quality benchmarking in assessing web resources for the dermatology virtual branch library of the National electronic Library for Health (NeLH).

    Science.gov (United States)

    Kamel Boulos, M N; Roudsari, A V; Gordon, C; Muir Gray, J A

    2001-01-01

    In 1998, the U.K. National Health Service Information for Health Strategy proposed the implementation of a National electronic Library for Health to provide clinicians, healthcare managers and planners, patients and the public with easy, round the clock access to high quality, up-to-date electronic information on health and healthcare. The Virtual Branch Libraries are among the most important components of the National electronic Library for Health. They aim at creating online knowledge based communities, each concerned with some specific clinical and other health-related topics. This study is about the envisaged Dermatology Virtual Branch Libraries of the National electronic Library for Health. It aims at selecting suitable dermatology Web resources for inclusion in the forthcoming Virtual Branch Libraries after establishing preliminary quality benchmarking rules for this task. Psoriasis, being a common dermatological condition, has been chosen as a starting point. Because quality is a principal concern of the National electronic Library for Health, the study includes a review of the major quality benchmarking systems available today for assessing health-related Web sites. The methodology of developing a quality benchmarking system has been also reviewed. Aided by metasearch Web tools, candidate resources were hand-selected in light of the reviewed benchmarking systems and specific criteria set by the authors. Over 90 professional and patient-oriented Web resources on psoriasis and dermatology in general are suggested for inclusion in the forthcoming Dermatology Virtual Branch Libraries. The idea of an all-in knowledge-hallmarking instrument for the National electronic Library for Health is also proposed based on the reviewed quality benchmarking systems. Skilled, methodical, organized human reviewing, selection and filtering based on well-defined quality appraisal criteria seems likely to be the key ingredient in the envisaged National electronic Library for

  8. Human rights, public health and medicinal cannabis use.

    Science.gov (United States)

    Bone, Melissa; Seddon, Toby

    2016-01-01

    This paper explores the interplay between the human rights and drug control frameworks and critiques case law on medicinal cannabis use to demonstrate that a bona fide human rights perspective allows for a broader conception of 'health'. This broad conception, encompassing both medicalised and social constructionist definitions, can inform public health policies relating to medicinal cannabis use. The paper also demonstrates how a human rights lens can alleviate a core tension between the State and the individual within the drug policy field. The leading medicinal cannabis case in the UK highlights the judiciary's failure to engage with an individual's human right to health as they adopt an arbitrary, externalist view, focussing on the legality of cannabis to the exclusion of other concerns. Drawing on some international comparisons, the paper considers how a human rights perspective can lead to an approach to medicinal cannabis use which facilitates a holistic understanding of public health.

  9. Oceans and human health: Emerging public health risks n the marine environment

    OpenAIRE

    Fleming, L.E.; Broad, K.; Clement, A.; Dewailly, E.; Elmir, S.; Knap, A.; Pomponi, S.A.; Smith, S.; Gabriele, H. Solo; Walsh, P.

    2006-01-01

    There has been an increasing recognition of the inter-relationship between human health and the oceans. Traditionally, the focus of research and concern has been on the impact of human activities on the oceans, particularly through anthropogenic pollution and the exploitation of marine resources. More recently, there has been recognition of the potential direct impact of the oceans on human health, both detrimental and beneficial. Areas identified include: global change, harmful algal blooms ...

  10. Electronic health records to support obesity-related patient care: Results from a survey of United States physicians.

    Science.gov (United States)

    Bronder, Kayla L; Dooyema, Carrie A; Onufrak, Stephen J; Foltz, Jennifer L

    2015-08-01

    Obesity-related electronic health record functions increase the rates of measuring Body Mass Index, diagnosing obesity, and providing obesity services. This study describes the prevalence of obesity-related electronic health record functions in clinical practice and analyzes characteristics associated with increased obesity-related electronic health record sophistication. Data were analyzed from DocStyles, a web-based panel survey administered to 1507 primary care providers practicing in the United States in June, 2013. Physicians were asked if their electronic health record has specific obesity-related functions. Logistical regression analyses identified characteristics associated with improved obesity-related electronic health record sophistication. Of the 88% of providers with an electronic health record, 83% of electronic health records calculate Body Mass Index, 52% calculate pediatric Body Mass Index percentile, and 32% flag patients with abnormal Body Mass Index values. Only 36% provide obesity-related decision support and 17% suggest additional resources for obesity-related care. Characteristics associated with having a more sophisticated electronic health record include age ≤45years old, being a pediatrician or family practitioner, and practicing in a larger, outpatient practice. Few electronic health records optimally supported physician's obesity-related clinical care. The low rates of obesity-related electronic health record functions currently in practice highlight areas to improve the clinical health information technology in primary care practice. More work can be done to develop, implement, and promote the effective utilization of obesity-related electronic health record functions to improve obesity treatment and prevention efforts. Published by Elsevier Inc.

  11. Exploiting Multimodal Biometrics in E-Privacy Scheme for Electronic Health Records

    OpenAIRE

    Omotosho, Adebayo; Adegbola, Omotanwa; Adelakin, Barakat; Adelakun, Adeyemi; Emuoyibofarhe, Justice

    2015-01-01

    Existing approaches to protect the privacy of Electronic Health Records are either insufficient for existing medical laws or they are too restrictive in their usage. For example, smart card-based encryption systems require the patient to be always present to authorize access to medical records. Questionnaires were administered by 50 medical practitioners to identify and categorize different Electronic Health Records attributes. The system was implemented using multi biometrics of patients to ...

  12. User Interface of MUDR Electronic Health Record

    Czech Academy of Sciences Publication Activity Database

    Hanzlíček, Petr; Špidlen, Josef; Heroutová, Helena; Nagy, Miroslav

    2005-01-01

    Roč. 74, - (2005), s. 221-227 ISSN 1386-5056 R&D Projects: GA MŠk LN00B107 Institutional research plan: CEZ:AV0Z10300504 Keywords : electronic health record * user interface * data entry * knowledge base Subject RIV: BB - Applied Statistics, Operational Research Impact factor: 1.374, year: 2005

  13. NASA Human Health and Performance Information Architecture Panel

    Science.gov (United States)

    Johnson-Throop, Kathy; Kadwa, Binafer; VanBaalen, Mary

    2014-01-01

    The Human Health and Performance (HH&P) Directorate at NASA's Johnson Space Center has a mission to enable optimization of human health and performance throughout all phases of spaceflight. All HH&P functions are ultimately aimed at achieving this mission. Our activities enable mission success, optimizing human health and productivity in space before, during, and after the actual spaceflight experience of our crews, and include support for ground-based functions. Many of our spaceflight innovations also provide solutions for terrestrial challenges, thereby enhancing life on Earth.

  14. La Biblioteca Virtual en Equidad, Salud y Desarrollo Humano The Virtual Library in Equity, Health, and Human Development

    Directory of Open Access Journals (Sweden)

    América Valdés

    2002-06-01

    Full Text Available This article attempts to describe the rationale that has led to the development of information sources dealing with equity, health, and human development in countries of Latin America and the Caribbean within the context of the Virtual Health Library (Biblioteca Virtual en Salud, BVS. Such information sources include the scientific literature, databases in printed and electronic format, institutional directories and lists of specialists, lists of events and courses, distance education programs, specialty journals and bulletins, as well as other means of disseminating health information. The pages that follow deal with the development of a Virtual Library in Equity, Health, and Human Development, an effort rooted in the conviction that decision-making and policy geared toward achieving greater equity in health must, of necessity, be based on coherent, well-organized, and readily accessible first-rate scientific information. Information is useless unless it is converted into knowledge that benefits society. The Virtual Library in Equity, Health, and Human Development is a coordinated effort to develop a decentralized regional network of scientific information sources, with strict quality control, from which public officials can draw data and practical examples that can help them set health and development policies geared toward achieving greater equity for all.

  15. Human exposure, health hazards, and environmental regulations

    International Nuclear Information System (INIS)

    Steinemann, Anne

    2004-01-01

    United States environmental regulations, intended to protect human health, generally fail to address major sources of pollutants that endanger human health. These sources are surprisingly close to us and within our control, such as consumer products and building materials that we use within our homes, workplaces, schools, and other indoor environments. Even though these indoor sources account for nearly 90% of our pollutant exposure, they are virtually unregulated by existing laws. Even pollutant levels found in typical homes, if found outdoors, would often violate federal environmental standards. This article examines the importance of human exposure as a way to understand and reduce effects of pollutants on human health. Results from exposure studies challenge traditional thinking about pollutant hazards, and reveal deficiencies in our patchwork of laws. And results from epidemiological studies, showing increases in exposure-related diseases, underscore the need for new protections. Because we cannot rely solely on regulations to protect us, and because health effects from exposures can develop insidiously, greater efforts are needed to reduce and prevent significant exposures before they occur. Recommendations include the development and use of safer alternatives to common products, public education on ways to reduce exposure, systematic monitoring of human exposure to pollutants, and a precautionary approach in decision-making

  16. 42 CFR 423.159 - Electronic prescription drug program.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Electronic prescription drug program. 423.159 Section 423.159 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Cost Control and Quality...

  17. 42 CFR 423.160 - Standards for electronic prescribing.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Standards for electronic prescribing. 423.160 Section 423.160 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Cost Control and Quality...

  18. The Public Health Community Platform, Electronic Case Reporting, and the Digital Bridge.

    Science.gov (United States)

    Cooney, Mary Ann; Iademarco, Michael F; Huang, Monica; MacKenzie, William R; Davidson, Arthur J

    At the intersection of new technology advancements, ever-changing health policy, and fiscal constraints, public health agencies seek to leverage modern technical innovations and benefit from a more comprehensive and cooperative approach to transforming public health, health care, and other data into action. State health agencies recognized a way to advance population health was to integrate public health with clinical health data through electronic infectious disease case reporting. The Public Health Community Platform (PHCP) concept of bidirectional data flow and knowledge management became the foundation to build a cloud-based system connecting electronic health records to public health data for a select initial set of notifiable conditions. With challenges faced and lessons learned, significant progress was made and the PHCP grew into the Digital Bridge, a national governance model for systems change, bringing together software vendors, public health, and health care. As the model and technology advance together, opportunities to advance future connectivity solutions for both health care and public health will emerge.

  19. Coupled motions direct electrons along human microsomal P450 Chains.

    Directory of Open Access Journals (Sweden)

    Christopher R Pudney

    2011-12-01

    Full Text Available Protein domain motion is often implicated in biological electron transfer, but the general significance of motion is not clear. Motion has been implicated in the transfer of electrons from human cytochrome P450 reductase (CPR to all microsomal cytochrome P450s (CYPs. Our hypothesis is that tight coupling of motion with enzyme chemistry can signal "ready and waiting" states for electron transfer from CPR to downstream CYPs and support vectorial electron transfer across complex redox chains. We developed a novel approach to study the time-dependence of dynamical change during catalysis that reports on the changing conformational states of CPR. FRET was linked to stopped-flow studies of electron transfer in CPR that contains donor-acceptor fluorophores on the enzyme surface. Open and closed states of CPR were correlated with key steps in the catalytic cycle which demonstrated how redox chemistry and NADPH binding drive successive opening and closing of the enzyme. Specifically, we provide evidence that reduction of the flavin moieties in CPR induces CPR opening, whereas ligand binding induces CPR closing. A dynamic reaction cycle was created in which CPR optimizes internal electron transfer between flavin cofactors by adopting closed states and signals "ready and waiting" conformations to partner CYP enzymes by adopting more open states. This complex, temporal control of enzyme motion is used to catalyze directional electron transfer from NADPH→FAD→FMN→heme, thereby facilitating all microsomal P450-catalysed reactions. Motions critical to the broader biological functions of CPR are tightly coupled to enzyme chemistry in the human NADPH-CPR-CYP redox chain. That redox chemistry alone is sufficient to drive functionally necessary, large-scale conformational change is remarkable. Rather than relying on stochastic conformational sampling, our study highlights a need for tight coupling of motion to enzyme chemistry to give vectorial electron

  20. Globalization, human rights, and the social determinants of health.

    Science.gov (United States)

    Chapman, Audrey R

    2009-02-01

    Globalization, a process characterized by the growing interdependence of the world's people, impacts health systems and the social determinants of health in ways that are detrimental to health equity. In a world in which there are few countervailing normative and policy approaches to the dominant neoliberal regime underpinning globalization, the human rights paradigm constitutes a widely shared foundation for challenging globalization's effects. The substantive rights enumerated in human rights instruments include the right to the highest attainable level of physical and mental health and others that are relevant to the determinants of health. The rights stipulated in these documents impose extensive legal obligations on states that have ratified these documents and confer health entitlements on their residents. Human rights norms have also inspired civil society efforts to improve access to essential medicines and medical services, particularly for HIV/AIDS. Nevertheless, many factors reduce the potential counterweight human rights might exert, including and specifically the nature of the human rights approach, weak political commitments to promoting and protecting health rights on the part of some states and their lack of institutional and economic resources to do so. Global economic markets and the relative power of global economic institutions are also shrinking national policy space. This article reviews the potential contributions and limitations of human rights to achieving greater equity in shaping the social determinants of health.

  1. Electronic health records and cardiac implantable electronic devices: new paradigms and efficiencies.

    Science.gov (United States)

    Slotwiner, David J

    2016-10-01

    The anticipated advantages of electronic health records (EHRs)-improved efficiency and the ability to share information across the healthcare enterprise-have so far failed to materialize. There is growing recognition that interoperability holds the key to unlocking the greatest value of EHRs. Health information technology (HIT) systems including EHRs must be able to share data and be able to interpret the shared data. This requires a controlled vocabulary with explicit definitions (data elements) as well as protocols to communicate the context in which each data element is being used (syntactic structure). Cardiac implantable electronic devices (CIEDs) provide a clear example of the challenges faced by clinicians when data is not interoperable. The proprietary data formats created by each CIED manufacturer, as well as the multiple sources of data generated by CIEDs (hospital, office, remote monitoring, acute care setting), make it challenging to aggregate even a single patient's data into an EHR. The Heart Rhythm Society and CIED manufacturers have collaborated to develop and implement international standard-based specifications for interoperability that provide an end-to-end solution, enabling structured data to be communicated from CIED to a report generation system, EHR, research database, referring physician, registry, patient portal, and beyond. EHR and other health information technology vendors have been slow to implement these tools, in large part, because there have been no financial incentives for them to do so. It is incumbent upon us, as clinicians, to insist that the tools of interoperability be a prerequisite for the purchase of any and all health information technology systems.

  2. Human health and stoic moral norms.

    Science.gov (United States)

    Becker, Lawrence C

    2003-04-01

    For the philosophy of medicine, there are two things of interest about the stoic account of moral norms, quite apart from whether the rest of stoic ethical theory is compelling. One is the stoic version of naturalism: its account of practical reasoning, its solution to the is/ought problem, and its contention that norms for creating, sustaining, or restoring human health are tantamount to moral norms. The other is the stoic account of human agency: its description of the intimate connections between human health, rational agency, and moral norms. There is practical guidance to be gained from exploring those connections, whether or not one is ready to follow stoic moral theory all the way to its austere end.

  3. Client perceptions of the mental health engagement network: a qualitative analysis of an electronic personal health record

    OpenAIRE

    Forchuk, Cheryl; Reiss, Jeffrey P.; O’Regan, Tony; Ethridge, Paige; Donelle, Lorie; Rudnick, Abraham

    2015-01-01

    Background Information technologies such as websites, mobile phone applications, and virtual reality programs have been shown to deliver innovative and effective treatments for mental illness. Much of the research studying electronic mental health interventions focuses on symptom reduction; however, to facilitate the implementation of electronic interventions in usual mental health care, it is also important to investigate the perceptions of clients who will be using the technologies. To this...

  4. Mining Electronic Health Records Data: Domestic Violence and Adverse Health Effects.

    Science.gov (United States)

    Karakurt, Gunnur; Patel, Vishal; Whiting, Kathleen; Koyutürk, Mehmet

    2017-01-01

    Intimate partner violence (IPV) often culminates in acute physical injury, sexual assault, and mental health issues. It is crucial to understand the healthcare habits of victims to develop interventions that can drastically improve a victim's quality of life and prevent future abuse. The objective of this study is to mine de-identified and aggregated Electronic Health Record data to identify women's health issues that are potentially associated with IPV. In this study we compared health issues of female domestic abuse victims to female non-domestic abuse victims. The Domestic abuse population contained 5870 patients, while the Non-Domestic Abuse population contained 14,315,140 patients. Explorys provides National Big Data from the entire USA. Statistical analysis identified 2429 terms as significantly more prevalent among victims of domestic abuse, compared to the general population. These terms were classified into broad categories, including acute injury, chronic conditions, substance abuse, mental health, disorders, gynecological and pregnancy related problems.

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

    Science.gov (United States)

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

    2016-01-01

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

  6. Gut microbiomes and their metabolites shape human and animal health.

    Science.gov (United States)

    Park, Woojun

    2018-03-01

    The host genetic background, complex surrounding environments, and gut microbiome are very closely linked to human and animal health and disease. Although significant correlations between gut microbiota and human and animal health have been revealed, the specific roles of each gut bacterium in shaping human and animal health and disease remain unclear. However, recent omics-based studies using experimental animals and surveys of gut microbiota from unhealthy humans have provided insights into the relationships among microbial community, their metabolites, and human and animal health. This editorial introduces six review papers that provide new discoveries of disease-associated microbiomes and suggest possible microbiome-based therapeutic approaches to human disease.

  7. Mapping the institutional consolidation of EU human health expertise

    NARCIS (Netherlands)

    de Ruijter, A.

    The EU’s role in the field of human health is solidifying in terms of law and policy, but also with respect to the institutional organisation of human health expertise. In light of the emerging health-care union and questions regarding the nature and scope of a European health law, the institutional

  8. Mapping the institutional consolidation of EU human health expertise

    NARCIS (Netherlands)

    de Ruijter, Anniek

    2016-01-01

    The EU’s role in the field of human health is solidifying in terms of law and policy, but also with respect to the institutional organisation of human health expertise. In light of the emerging health-care union and questions regarding the nature and scope of a European health law, the institutional

  9. Platform links clinical data with electronic health records

    Science.gov (United States)

    To make data gathered from patients in clinical trials available for use in standard care, NCI has created a new computer tool to support interoperability between clinical research and electronic health record systems. This new software represents an inno

  10. PERFORMANCE PREMISES FOR HUMAN RESOURCES FROM PUBLIC HEALTH ORGANIZATIONS IN ROMANIA

    Directory of Open Access Journals (Sweden)

    Amalia-Luisa PUPĂZĂ

    2011-03-01

    Full Text Available Improving the performance of health sector human resources is a goal pursued by all developed or developing countries. However, the lack of human resources planning and lack of clear and transparent human resources policies may lead to a crisis in this area. Human resource planning should be a priority in terms of health policies. In Romania, the lack of a planning concept and the lack of a policy on human resources has led to the actual context, with a human resources crisis of public health organizations. The role that human resources play in the health care system is indisputable. Essential to achieve quality performance in health care is human resources management. To overcome the human resources crisis that public health organizations in Romania is facing , specialists in the field have made several key recommendations: development of a coherent policy formation, development and allocation of human resources in health, increasing the number of medical staff and opportunities of professional career development in the medical field. Health system reform involves changing some aspects of employment, working conditions, degree of decentralization of management, skills, salary system and staff motivation.

  11. Defining and incorporating basic nursing care actions into the electronic health record.

    Science.gov (United States)

    Englebright, Jane; Aldrich, Kelly; Taylor, Cathy R

    2014-01-01

    To develop a definition of basic nursing care for the hospitalized adult patient and drive uptake of that definition through the implementation of an electronic health record. A team of direct care nurses, assisted by subject matter experts, analyzed nursing theory and regulatory requirements related to basic nursing care. The resulting list of activities was coded using the Clinical Care Classification (CCC) system and incorporated into the electronic health record system of a 170-bed community hospital. Nine basic nursing care activities were identified as a result of analyzing nursing theory and regulatory requirements in the framework of a hypothetical "well" patient. One additional basic nursing care activity was identified following the pilot implementation in the electronic health record. The pilot hospital has successfully passed a post-implementation regulatory review with no recommendations related to the documentation of basic patient care. This project demonstrated that it is possible to define the concept of basic nursing care and to distinguish it from the interdisciplinary, problem-focused plan of care. The use of the electronic health record can help clarify, document, and communicate basic care elements and improve uptake among nurses. This project to define basic nursing care activities and incorporate into the electronic health record represents a first step in capturing meaningful data elements. When fully implemented, these data could be translated into knowledge for improving care outcomes and collaborative processes. © 2013 Sigma Theta Tau International.

  12. Scanning electron microscopy and electron probe microanalyses of the crystalline components of human and animal dental calculi

    International Nuclear Information System (INIS)

    LeGeros, R.Z.; Orly, I.; LeGeros, J.P.; Gomez, C.; Kazimiroff, J.; Tarpley, T.; Kerebel, B.

    1988-01-01

    A review of the use of scanning electron microscopy (SEM) and electron probe microanalyses in the study of dental calculus showed that such studies provided confirmatory and supplementary data on the morphological features of human dental calculi but gave only limited information on the identity of the crystalline or inorganic components. This study aimed to explore the potential of combined SEM and microanalyses in the identification of the crystalline components of the human and animal dental calculi. Human and animal calculi were analyzed. Identification of the crystalline components were made based on the combined information of the morphology (SEM) and Ca/P molar ratios of the crystals with the morphology and Ca/P molar ratio of synthetic calcium phosphates (brushite or DCPD; octacalcium phosphate, OCP; Mg-substituted whitlockite, beta-TCMP; CO 3 -substituted apatite, (CHA); and calcite. SEM showed similarities in morphological features of human and animal dental calculi but differences in the forms of crystals present. Microanalyses and crystal morphology data suggested the presence of CaCO 3 (calcite) and CHA in the animal (cat, dog, tiger) and of OCP, beta-TCMP and CHA in human dental calculi. X-ray diffraction and infrared (IR) absorption analyses confirmed these results. This exploratory study demonstrated that by taking into consideration what is known about the crystalline components of human and animal dental calculi, combined SEM and microanalyses can provide qualitative identification

  13. The Challenges of Electronic Health Records and Diabetes Electronic Prescribing: Implications for Safety Net Care for Diverse Populations

    Directory of Open Access Journals (Sweden)

    Neda Ratanawongsa

    2017-01-01

    Full Text Available Widespread electronic health record (EHR implementation creates new challenges in the diabetes care of complex and diverse populations, including safe medication prescribing for patients with limited health literacy and limited English proficiency. This review highlights how the EHR electronic prescribing transformation has affected diabetes care for vulnerable patients and offers recommendations for improving patient safety through EHR electronic prescribing design, implementation, policy, and research. Specifically, we present evidence for (1 the adoption of RxNorm; (2 standardized naming and picklist options for high alert medications such as insulin; (3 the widespread implementation of universal medication schedule and language-concordant labels, with the expansion of electronic prescription 140-character limit; (4 enhanced bidirectional communication with pharmacy partners; and (5 informatics and implementation research in safety net healthcare systems to examine how EHR tools and practices affect diverse vulnerable populations.

  14. An Electronic Patch for wearable health monitoring by reflectance pulse oximetry.

    Science.gov (United States)

    Haahr, Rasmus G; Duun, Sune B; Toft, Mette H; Belhage, Bo; Larsen, Jan; Birkelund, Karen; Thomsen, Erik V

    2012-02-01

    We report the development of an Electronic Patch for wearable health monitoring. The Electronic Patch is a new health monitoring system incorporating biomedical sensors, microelectronics, radio frequency (RF) communication, and a battery embedded in a 3-dimensional hydrocolloid polymer. In this paper the Electronic Patch is demonstrated with a new optical biomedical sensor for reflectance pulse oximetry so that the Electronic Patch in this case can measure the pulse and the oxygen saturation. The reflectance pulse oximetry solution is based on a recently developed annular backside silicon photodiode to enable low power consumption by the light emitting components. The Electronic Patch has a disposable part of soft adhesive hydrocolloid polymer and a reusable part of hard polylaurinlactam. The disposable part contains the battery. The reusable part contains the reflectance pulse oximetry sensor and microelectronics. The reusable part is 'clicked' into the disposable part when the patch is prepared for use. The patch has a size of 88 mm by 60 mm and a thickness of 5 mm.

  15. Public humanization policies: integrative literature review.

    Science.gov (United States)

    Moreira, Márcia Adriana Dias Meirelles; Lustosa, Abdon Moreira; Dutra, Fernando; Barros, Eveline de Oliveira; Batista, Jaqueline Brito Vidal; Duarte, Marcella Costa Souto

    2015-10-01

    The study aimed to investigate the scientific literature on Public Humanization Policies, available in online periodicals, from 2009 to 2012, in the health field. This is an integrative literature review conducted in the Virtual Health Library databases: Latin-America and Caribbean Health Sciences (Lilacs) and the Scientific Electronic Library Online (SciELO) and Portal Capes. Data were collected in July 2013. To this end, the following Health Sciences Descriptors (DeCS) were used: "Humanization of Care," "Public Policies," "National Humanization Policy". The sample consisted of 27 articles about the investigated theme. From the publications selected for the research, three categories emerged according to their respective approaches: National Human-ization Policy: history and processes involved in its implementation; National Humanization Policy: health professionals contribution; Humanization and in the care process. The study showed that the National Humanization Policy is an important benchmark in the development of health practices. For this reason, there is a pressing multiplication of related reflections on ways to promote human-ization in health services.

  16. Extrapolation in human health hazard characterization: a probabilistic approach

    NARCIS (Netherlands)

    Bokkers, B.G.H.

    2009-01-01

    A classical deterministic risk assessment often uses conservative, worst-case assumptions to estimate the possible health risk in humans. When such an assessment shows an unacceptable human health risk, a more realistic risk assessment may be needed to estimate the actual health impact in the

  17. Current patient and healthcare worker attitudes to eHealth and the personally controlled electronic health record in major hospitals.

    Science.gov (United States)

    Armani, R; Mitchell, L E; Allen-Graham, J; Heriot, N R; Kotsimbos, T; Wilson, J W

    2016-06-01

    The current health system in Australia is comprised of both electronic- and paper-based medical records. The Federal Government has approved funding for the development of an individual health identifier and a universally adopted online health repository. To determine attitudes and beliefs of patients and healthcare workers regarding the use of stored medical information and the personally controlled electronic health record (PCEHR) in selected major hospitals in Victoria. Qualitative survey of patients and healthcare workers (n = 600 each group) conducted during 2014 across five major hospitals in Melbourne to measure the awareness, attitudes and barriers to electronic health and the PCEHR. Of the patients, 93.3% support the concept of a shared electronic healthcare record, 33.7% were aware of the PCEHR and only 11% had registered. The majority of healthcare workers believed that the presence of a shared health record would result in an increased appropriateness of care and patient safety by reducing adverse drug events and improving the timeliness of care provided. However, only 46% of healthcare workers were aware of the PCEHR. This study provides a baseline evaluation of perceptions surrounding eHealth and PCHER in acute health services in five metropolitan centres. While there appears to be a readiness for adoption of these strategies for healthcare documentation, patients require motivation to register for the PCEHR, and healthcare workers require more information on the potential benefits to them to achieve more timely and efficient care. © 2016 Royal Australasian College of Physicians.

  18. Text mining electronic health records to identify hospital adverse events

    DEFF Research Database (Denmark)

    Gerdes, Lars Ulrik; Hardahl, Christian

    2013-01-01

    Manual reviews of health records to identify possible adverse events are time consuming. We are developing a method based on natural language processing to quickly search electronic health records for common triggers and adverse events. Our results agree fairly well with those obtained using manu...

  19. Electronic health records access during a disaster.

    Science.gov (United States)

    Morchel, Herman; Raheem, Murad; Stevens, Lee

    2014-01-01

    As has been demonstrated previously, medical care providers that employ an electronic health records (EHR) system provide more appropriate, cost effective care. Those providers are also better positioned than those who rely on paper records to recover if their facility is damaged as a result of severe storms, fires, or other events. The events surrounding Superstorm Sandy in 2012 made it apparent that, with relatively little additional effort and investment, health care providers with EHR systems may be able to use those systems for patient care purposes even during disasters that result in damage to buildings and facilities, widespread power outages, or both.

  20. Electronic health records challenges in design and implementation

    CERN Document Server

    Sittig, Dean F

    2013-01-01

    This book provides an overview of the challenges in electronic health records (EHR) design and implementation along with an introduction to the best practices that have been identified over the past several years. The book examines concerns surrounding EHR use and proposes eight examples of proper EHR use. It discusses the complex strategic planning that accompanies the systemic organizational changes associated with EHR programs and highlights key lessons learned regarding health information-including technology errors and risk management concerns.

  1. 2015 Edition Health Information Technology (Health IT) Certification Criteria, 2015 Edition Base Electronic Health Record (EHR) Definition, and ONC Health IT Certification Program Modifications. Final rule.

    Science.gov (United States)

    2015-10-16

    This final rule finalizes a new edition of certification criteria (the 2015 Edition health IT certification criteria or "2015 Edition'') and a new 2015 Edition Base Electronic Health Record (EHR) definition, while also modifying the ONC Health IT Certification Program to make it open and accessible to more types of health IT and health IT that supports various care and practice settings. The 2015 Edition establishes the capabilities and specifies the related standards and implementation specifications that Certified Electronic Health Record Technology (CEHRT) would need to include to, at a minimum, support the achievement of meaningful use by eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) under the Medicare and Medicaid EHR Incentive Programs (EHR Incentive Programs) when such edition is required for use under these programs.

  2. Improving immunization delivery using an electronic health record: the ImmProve project.

    Science.gov (United States)

    Bundy, David G; Persing, Nichole M; Solomon, Barry S; King, Tracy M; Murakami, Peter N; Thompson, Richard E; Engineer, Lilly D; Lehmann, Christoph U; Miller, Marlene R

    2013-01-01

    Though an essential pediatric preventive service, immunizations are challenging to deliver reliably. Our objective was to measure the impact on pediatric immunization rates of providing clinicians with electronic health record-derived immunization prompting. Operating in a large, urban, hospital-based pediatric primary care clinic, we evaluated 2 interventions to improve immunization delivery to children ages 2, 6, and 13 years: point-of-care, patient-specific electronic clinical decision support (CDS) when children overdue for immunizations presented for care, and provider-specific bulletins listing children overdue for immunizations. Overall, the proportion of children up to date for a composite of recommended immunizations at ages 2, 6, and 13 years was not different in the intervention (CDS active) and historical control (CDS not active) periods; historical immunization rates were high. The proportion of children receiving 2 doses of hepatitis A immunization before their second birthday was significantly improved during the intervention period. Human papillomavirus (HPV) immunization delivery was low during both control and intervention periods and was unchanged for 13-year-olds. For 14-year-olds, however, 4 of the 5 highest quarterly rates of complete HPV immunization occurred in the final year of the intervention. Provider-specific bulletins listing children overdue for immunizations increased the likelihood of identified children receiving catch-up hepatitis A immunizations (hazard ratio 1.32; 95% confidence interval 1.12-1.56); results for HPV and the composite of recommended immunizations were of a similar magnitude but not statistically significant. In our patient population, with high baseline uptake of recommended immunizations, electronic health record-derived immunization prompting had a limited effect on immunization delivery. Benefit was more clearly demonstrated for newer immunizations with lower baseline uptake. Copyright © 2013 Academic

  3. Development of archetypes of radiology for electronic health record

    International Nuclear Information System (INIS)

    Araujo, Tiago V.; Pires, Silvio R.; Paiva, Paulo B.

    2013-01-01

    This paper presents a proposal to develop archetypes for electronic patient records system based the openEHR Foundation model. Archetypes were developed specifically for the areas of radiology and diagnostic imaging, as for the early implementation of an electronic health records system. The archetypes developed are related to the examinations request, their execution and report, corresponding to both the administrative as diagnostic workflow inside a diagnostic imaging sector. (author)

  4. Leveraging the Value of Human Relationships to Improve Health Outcomes. Lessons learned from the OpenMRS Electronic Health Record System.

    Science.gov (United States)

    Kasthurirathne, Suranga N; Mamlin, Burke W; Cullen, Theresa

    2017-02-01

    Despite significant awareness on the value of leveraging patient relationships across the healthcare continuum, there is no research on the potential of using Electronic Health Record (EHR) systems to store structured patient relationship data, or its impact on enabling better healthcare. We sought to identify which EHR systems supported effective patient relationship data collection, and for systems that do, what types of relationship data is collected, how this data is used, and the perceived value of doing so. We performed a literature search to identify EHR systems that supported patient relationship data collection. Based on our results, we defined attributes of an effective patient relationship model. The Open Medical Record System (OpenMRS), an open source medical record platform for underserved settings met our eligibility criteria for effective patient relationship collection. We performed a survey to understand how the OpenMRS patient relationship model was used, and how it brought value to implementers. The OpenMRS patient relationship model has won widespread adoption across many implementations and is perceived to be valuable in enabling better health care delivery. Patient relationship information is widely used for community health programs and enabling chronic care. Additionally, many OpenMRS implementers were using this feature to collect custom relationship types for implementation specific needs. We believe that flexible patient relationship data collection is critical for better healthcare, and can inform community care and chronic care initiatives across the world. Additionally, patient relationship data could also be leveraged for many other initiatives such as patient centric care and in the field of precision medicine.

  5. Implementing Electronic Health Record Default Settings to Reduce Opioid Overprescribing: A Pilot Study.

    Science.gov (United States)

    Zivin, Kara; White, Jessica O; Chao, Sandra; Christensen, Anna L; Horner, Luke; Petersen, Dana M; Hobbs, Morgan R; Capreol, Grace; Halbritter, Kevin A; Jones, Christopher M

    2018-01-09

    To pilot test the effectiveness, feasibility, and acceptability of instituting a 15-pill quantity default in the electronic health record for new Schedule II opioid prescriptions. A mixed-methods pilot study in two health systems, including pre-post analysis of prescribed opioid quantity and focus groups or interviews with prescribers and health system administrators. We implemented a 15-pill electronic health record default for new Schedule II opioids and assessed opioid quantity before and after implementation using electronic health record data on 6,390 opioid prescriptions from 448 prescribers. We then analyzed themes from focus groups and interviews with four staff members and six prescribers. The proportion of opioid prescriptions for 15 pills increased at both sites after adding an electronic health record default, with one reaching statistical significance (from 4.1% to 7.2% at CHC, P = 0.280, and 15.9% to 37.2% at WVU, P default, although ease of implementation varied by electronic health record vendor. Most prescribers were not aware of the default change and stated that they made prescribing decisions based on patient clinical characteristics rather than defaults. This pilot provides initial evidence that changing default settings can increase the number of prescriptions at the default level. This low-cost and relatively simple intervention could have an impact on opioid overprescribing. However, default settings should be selected carefully to avoid unintended consequences. © 2018 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  6. Comparison of human and electronic observation for the measurement of compliance with hand hygiene.

    Science.gov (United States)

    Filho, Miguel Almeida O; Marra, Alexandre R; Magnus, Thyago Pereira; Rodrigues, Rodrigo Dias; Prado, Marcelo; de Souza Santini, Tales Roberto; da Silva Victor, Elivane; Ishibe, Eder Issao; Pavão Dos Santos, Oscar Fernando; Edmond, Michael B

    2014-11-01

    Monitoring of hand hygiene is an important part of the improvement of hospital quality indicators. This study was prospectively performed over a 14-week (electronic observer) period from December 3, 2013-March 9, 2014, to evaluate hand hygiene compliance in an adult step-down unit. We compared electronic handwash counters with the application of radiofrequency identification (RFID - ZigBee; i-Healthsys, São Carlos, Brazil) (electronic observer), which counts each activation of the alcohol gel dispenser to direct observation (human observer) using the iScrub application. For the overall time period of simultaneous electronic and human observation, we found that the electronic observer identified 414 hand hygiene episodes, whereas the human observers identified 448 episodes. Therefore, we found 92% (95% confidence interval [CI], 90%-95%) overall concordance (414/448), with an intraclass correlation coefficient of .87 (95% CI, 0.77-0.92). Our RFID (ZigBee) system showed good accuracy (92%) and is a useful method to monitor hand hygiene compliance. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  7. Measuring the Impact of the Human Rights on Health in Global Health Financing.

    Science.gov (United States)

    Davis, Sara L M

    2015-12-10

    In response to new scientific developments, UNAIDS, WHO, and global health financing institutions have joined together to promote a "fast-track" global scale-up of testing and treatment programs. They have set ambitious targets toward the goal of ending the three diseases by 2030. These numerical indicators, based on infectious disease modeling, can assist in measuring countries' progressive realization of the right to health. However, they only nominally reference the catastrophic impact that human rights abuses have on access to health services; they also do not measure the positive impact provided by law reform, legal aid, and other health-related human rights programs. Drawing on experience at the Global Fund to Fight AIDS, Tuberculosis and Malaria, which has incorporated expanded stakeholder consultation and human rights programming into its grants, the article argues that addressing human rights barriers to access is often an ad hoc activity occurring on the sidelines of a health grantmaking process that has focused on the scale-up of biomedical programs to meet global health indicators. To ensure that these biomedical programs have impact, UN agencies and health financing mechanisms must begin to more systematically and proactively integrate human rights policy and practice into their modeling and measurement tools. Copyright © 2015 Davis. This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original author and source are credited.

  8. 77 FR 48007 - Administrative Simplification: Adoption of Operating Rules for Health Care Electronic Funds...

    Science.gov (United States)

    2012-08-10

    ... electronic data interchange (EDI). Through the use of electronic funds transfers (EFT) for health care claim... care transactions results in higher use of EDI by health care providers.\\8\\ We expect usage of EFT and...

  9. Health and Human Rights in Karen State, Eastern Myanmar.

    Science.gov (United States)

    Davis, William W; Mullany, Luke C; Shwe Oo, Eh Kalu; Richards, Adam K; Iacopino, Vincent; Beyrer, Chris

    2015-01-01

    Decades of conflict in eastern Myanmar have resulted in high prevalence of human rights violations and poor health outcomes. While recent ceasefire agreements have reduced conflict in this area, it is unknown whether this has resulted in concomitant reductions in human rights violations. We conducted a two-stage cluster survey of 686 households in eastern Myanmar to assess health status, access to healthcare, food security, exposure to human rights violations and identification of alleged perpetrators over the 12 months prior to January 2012, a period of near-absence of conflict in this region. Household hunger (FANTA-2 scale) was moderate/high in 91 (13.2%) households, while the proportion of households reporting food shortages in each month of 2011 ranged from 19.9% in December to 47.0% in September, with food insecurity peaking just prior to the harvest. Diarrhea prevalence in children was 14.2% and in everyone it was 5.8%. Forced labor was the most common human rights violation (185 households, 24.9%), and 210 households (30.6%) reported experiencing one or more human rights violations in 2011. Multiple logistic regression analysis identified associations between human rights violations and poor health outcomes. Human rights violations and their health consequences persist despite reduced intensity of conflict in eastern Myanmar. Ceasefire agreements should include language that protects human rights, and reconciliation efforts should address the health consequences of decades of human rights violations.

  10. [Human resources for health in Ecuador's new model of care].

    Science.gov (United States)

    Espinosa, Verónica; de la Torre, Daniel; Acuña, Cecilia; Cadena, Cristina

    2017-06-08

    Describe strategies implemented by Ecuador's Ministry of Public Health (MPH) to strengthen human resources for health leadership and respond to the new model of care, as a part of the reform process in the period 2012-2015. A documentary review was carried out of primary and secondary sources on development of human resources for health before and after the reform. In the study period, Ecuador developed a new institutional and regulatory framework for developing human resources for health to respond to the requirements of a model of care based on primary health care. The MPH consolidated its steering role by forging strategic partnerships, implementing human resources planning methods, and making an unprecedented investment in health worker training, hiring, and wage increases. These elements constitute the initial core for development of human resources for health policy and a health-services study program consistent with the reform's objectives. Within the framework of the reform carried out from 2012 to 2015, intersectoral work by the MPH has led to considerable achievements in development of human resources for health. Notable achievements include strengthening of the steering role, development and implementation of standards and regulatory instruments, creation of new professional profiles, and hiring of professionals to implement the comprehensive health care model, which helped to solve problems carried over from the years prior to the reform.

  11. The Impact of Electronic Health Records on Ambulatory Costs

    Data.gov (United States)

    U.S. Department of Health & Human Services — Our nation is in the midst of an unprecedented investment in IT to support healthcare delivery. The centerpiece of the 2009 Health Information Technology for...

  12. Validation of asthma recording in electronic health records: a systematic review

    Directory of Open Access Journals (Sweden)

    Nissen F

    2017-12-01

    Full Text Available Francis Nissen,1 Jennifer K Quint,2 Samantha Wilkinson,1 Hana Mullerova,3 Liam Smeeth,1 Ian J Douglas1 1Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK; 2National Heart and Lung Institute, Imperial College, London, UK; 3RWD & Epidemiology, GSK R&D, Uxbridge, UK Objective: To describe the methods used to validate asthma diagnoses in electronic health records and summarize the results of the validation studies. Background: Electronic health records are increasingly being used for research on asthma to inform health services and health policy. Validation of the recording of asthma diagnoses in electronic health records is essential to use these databases for credible epidemiological asthma research.Methods: We searched EMBASE and MEDLINE databases for studies that validated asthma diagnoses detected in electronic health records up to October 2016. Two reviewers independently assessed the full text against the predetermined inclusion criteria. Key data including author, year, data source, case definitions, reference standard, and validation statistics (including sensitivity, specificity, positive predictive value [PPV], and negative predictive value [NPV] were summarized in two tables.Results: Thirteen studies met the inclusion criteria. Most studies demonstrated a high validity using at least one case definition (PPV >80%. Ten studies used a manual validation as the reference standard; each had at least one case definition with a PPV of at least 63%, up to 100%. We also found two studies using a second independent database to validate asthma diagnoses. The PPVs of the best performing case definitions ranged from 46% to 58%. We found one study which used a questionnaire as the reference standard to validate a database case definition; the PPV of the case definition algorithm in this study was 89%. Conclusion: Attaining high PPVs (>80% is possible using each of the discussed validation

  13. Humanized care in the family health strategy

    Directory of Open Access Journals (Sweden)

    Alana Tamar Oliveira de Sousa

    2010-01-01

    Full Text Available The Health Community Agent (HCA has contributed in a meaningful way to enhance the bond professional-user/family, providing, thus, the humanized care for the users who receive attention from the Family Health Strategy (FHS. This research had the aim to investigate the strategies adopted by the health community agents in order to supply the humanized care for the FHS user. It is an exploratory research of qualitative nature which was accomplished in the Basic Health Units – BHU, placed in the Distrito Sanitário III, in João Pessoa – PB. Thirtyhealth community agents, from the Family Health Strategy, took part in the research. The data were collected by means of a questionnaire related to the objective proposed by the investigation and, afterwards, they were analyzed qualitatively through the Collective Subject Discourse (CSD technique. In this way, it was possible to foresee three main ideas: promoting care based on respect for the user’s singularity as well as the valuing of empathic relationship; home visit, guidance, surveillance, pointing out solutions for the user’sneeds; enhancement of the bond between community and the team responsible for action planning. The Collective Subject Discourse of the participants involved in the research, as regards the humanized care practice, had as core the respect for the patient’s dignity, prioritizing his or her real needs and emphasizing the multidisciplinary task. This investigation enables the reflection about the valuable contribution of the health community agents concerning the promotion of the humanized care having as reference the mentioned strategies.

  14. Working together for health and human rights.

    Science.gov (United States)

    Sidel, V W

    2000-01-01

    The right to a standard of living adequate for health and well-being is being denied to vast numbers of people all over the world through increasing disparities in income and in wealth. In the name of economic development, a number of international and national policies have increased the grossly uneven distribution of income, with ever-growing numbers of people living in poverty as well as in increasing depths of poverty. Globalization, crippling levels of external debt, and the 'structural adjustment' policies of international agencies have expanded the numbers and the suffering of people living in poverty and have resulted in the neglect of government-funded social programs, of regulations protecting the environment, and of human development. Access to medical care, an essential element in the protection of health, is difficult for many, including the 44 million people in the United States who lack insurance coverage for the cost of medical care services. Working together for health and human rights also requires promotion of the right to peace. The right to life and health is threatened not only by the existence and active deployment of weapons of mass destruction, including nuclear, chemical and biological weapons and anti-personnel landmines, but also other weapons. The twentieth century has been the bloodiest in human history, with an estimated 250 wars, more than 110 million people killed, countless people wounded and at the least 50 million refugees. Health workers must work together with people in our communities for the promotion of health and human rights, which, in Sandwell and elsewhere, are inextricably intertwined.

  15. Electronic health indicators in the selected countries: Are these indicators the best?

    Science.gov (United States)

    Afshari, Somaye; Khorasani, Elahe; Yarmohammadian, Mohammad Hossein; Atighechian, Golrokh; Darab, Mohsen Ghaffari

    2013-01-01

    Many changes have been made in different sciences by developing and advancing information and communication technology in last two decades. E-health is a very broad term that includes many different activities related to the use of electronic devices, software as well as hardware in health organizations. The aim of this study is comparing electronic health indicators in the selected countries and discussion on the best indicators. This study has chosen 12 countries randomly based on the regional division of the WHO. The relevant numbers of health indicators and general indicators and information technology indicators are extracted of these countries. We use data from the Bitarf's comparative study, which is conducted by the Iranian Supreme Council of Information Technology in 2007. By using Pearson correlation test, the relations between health general indicators and IT indicators are studied. Data was analyzed based on the research objectives using SPSS software and in accordance with research questions Pearson correlation test were used. The findings show that there is a positive relation between indicators related to IT and "Total per capita health, healthy life expectancy, percent literacy". Furthermore, there is a mutual relation between IT indicators and "mortality indicator". This study showed differences between selective indicators among different countries. The modern world, with its technological advances, is not powerless in the face of these geographic and health disparity challenges. Researchers must not rely on the available indicators. They must consider indicators like e-business companies, electronic data internet, medical supplies, health electronic record, health information system, etc., In future, continuous studies in this field, to provide the exact and regular reports of amount of using of these indicators through different countries must be necessary.

  16. Client perceptions of the mental health engagement network: a qualitative analysis of an electronic personal health record.

    Science.gov (United States)

    Forchuk, Cheryl; Reiss, Jeffrey P; O'Regan, Tony; Ethridge, Paige; Donelle, Lorie; Rudnick, Abraham

    2015-10-14

    Information technologies such as websites, mobile phone applications, and virtual reality programs have been shown to deliver innovative and effective treatments for mental illness. Much of the research studying electronic mental health interventions focuses on symptom reduction; however, to facilitate the implementation of electronic interventions in usual mental health care, it is also important to investigate the perceptions of clients who will be using the technologies. To this end, a qualitative analysis of focus group discussions regarding the Mental Health Engagement Network, a web-based personal health record and smartphone intervention, is presented here. Individuals living in the community with a mood or psychotic disorder (n = 394) were provided with a smartphone and access to an electronic personal health record, the Lawson SMART Record, for 12 to 18 months to manage their mental health. This study employed a delayed-implementation design and obtained both quantitative and qualitative data through individual interviews and focus group sessions. Participants had the opportunity to participate in voluntary focus group sessions at three points throughout the study to discuss their perceptions of the technologies. Qualitative data from 95 focus group participants were analysed using a thematic analysis. Four overarching themes emerged from focus group discussions: 1) Versatile functionality of the Lawson SMART Record and smartphone facilitated use; 2) Aspects of the technologies as barriers to use; 3) Use of the Mental health Engagement Network technologies resulted in perceived positive outcomes; 4) Future enhancement of the Lawson SMART Record and intervention is recommended. These qualitative data provide a valuable contribution to the understanding of how smarttechnologies can be integrated into usual mental health care. Smartphones are extremely portable andcommonplace in society. Therefore, clients can use these devices to manage and track mental

  17. Flexible polymer transistors with high pressure sensitivity for application in electronic skin and health monitoring.

    Science.gov (United States)

    Schwartz, Gregor; Tee, Benjamin C-K; Mei, Jianguo; Appleton, Anthony L; Kim, Do Hwan; Wang, Huiliang; Bao, Zhenan

    2013-01-01

    Flexible pressure sensors are essential parts of an electronic skin to allow future biomedical prostheses and robots to naturally interact with humans and the environment. Mobile biomonitoring in long-term medical diagnostics is another attractive application for these sensors. Here we report the fabrication of flexible pressure-sensitive organic thin film transistors with a maximum sensitivity of 8.4 kPa(-1), a fast response time of 15,000 cycles and a low power consumption of monitoring, which may lead to the use of flexible pressure sensors in mobile health monitoring and remote diagnostics in cardiovascular medicine.

  18. Finding electronic information for health policy advocacy: a guide to improving search results.

    Science.gov (United States)

    Olsan, Tobie H; Bianchi, Carolanne; White, Pamela; Glessner, Theresa; Mapstone, Pamela L

    2011-12-01

    The success of advanced practice registered nurses' (APRNs') health policy advocacy depends on staying well informed about key issues. Searching for high-quality health policy information, however, can be frustrating and time consuming. Busy clinicians need strategies and tips to reduce information overload and to access synthesized research for evidence-based health policy. This article therefore offers APRNs practical guidelines and resources for searching electronic health policy information. Scholarly databases and Internet sites. Electronic health policy information is generated by a wide variety of public and private organizations and disseminated in hundreds of journals and Web pages. Specialty search tools are needed to retrieve the unindexed gray literature, which includes government documents, agency reports, fact sheets, standards, and statistics not produced by commercial publishers. Further, Internet users need to examine search results with a critical eye for information quality. Expertise in searching electronic health policy information is a prerequisite for developing APRNs' leadership in political arenas to influence health policy and the delivery of healthcare services. ©2011 The Author(s) Journal compilation ©2011 American Academy of Nurse Practitioners.

  19. Assessing electronic health record systems in emergency departments: Using a decision analytic Bayesian model.

    Science.gov (United States)

    Ben-Assuli, Ofir; Leshno, Moshe

    2016-09-01

    In the last decade, health providers have implemented information systems to improve accuracy in medical diagnosis and decision-making. This article evaluates the impact of an electronic health record on emergency department physicians' diagnosis and admission decisions. A decision analytic approach using a decision tree was constructed to model the admission decision process to assess the added value of medical information retrieved from the electronic health record. Using a Bayesian statistical model, this method was evaluated on two coronary artery disease scenarios. The results show that the cases of coronary artery disease were better diagnosed when the electronic health record was consulted and led to more informed admission decisions. Furthermore, the value of medical information required for a specific admission decision in emergency departments could be quantified. The findings support the notion that physicians and patient healthcare can benefit from implementing electronic health record systems in emergency departments. © The Author(s) 2015.

  20. Space Radiation and Risks to Human Health

    Science.gov (United States)

    Huff, Janice L.; Patel, Zarana S.; Simonsen, Lisa C.

    2014-01-01

    The radiation environment in space poses significant challenges to human health and is a major concern for long duration manned space missions. Outside the Earth's protective magnetosphere, astronauts are exposed to higher levels of galactic cosmic rays, whose physical characteristics are distinct from terrestrial sources of radiation such as x-rays and gamma-rays. Galactic cosmic rays consist of high energy and high mass nuclei as well as high energy protons; they impart unique biological damage as they traverse through tissue with impacts on human health that are largely unknown. The major health issues of concern are the risks of radiation carcinogenesis, acute and late decrements to the central nervous system, degenerative tissue effects such as cardiovascular disease, as well as possible acute radiation syndromes due to an unshielded exposure to a large solar particle event. The NASA Human Research Program's Space Radiation Program Element is focused on characterization and mitigation of these space radiation health risks along with understanding these risks in context of the other biological stressors found in the space environment. In this overview, we will provide a description of these health risks and the Element's research strategies to understand and mitigate these risks.

  1. Human radiation experimentation: a health physics perspective

    International Nuclear Information System (INIS)

    Kathren, R.L.

    1996-01-01

    This paper observes ethical human experimentation can be considered in terms of two basic principles or tests: informed, willing and knowledgeable subjects; and expectation of benefits. A number of human experiments are evaluated in terms of these principles, including a sixteenth century toxicology experiment, the deliberate exposure by an x-ray pioneer, and the plutonium injection cases of the 1940's. The following rational ethic is proposed for the practice of health physics with respect to human radiation experimentation: At all levels, the health physicist has a professional as well as personal obligation to ensure that proper human requirements, including proper informed consent and willing subjects, arc carried out with respect to human radiation experimentation, and must be convinced that the real or potential benefits to be derived from the experiment clearly exceed the potential detriment and risk. (author)

  2. Abstracting ICU Nursing Care Quality Data From the Electronic Health Record.

    Science.gov (United States)

    Seaman, Jennifer B; Evans, Anna C; Sciulli, Andrea M; Barnato, Amber E; Sereika, Susan M; Happ, Mary Beth

    2017-09-01

    The electronic health record is a potentially rich source of data for clinical research in the intensive care unit setting. We describe the iterative, multi-step process used to develop and test a data abstraction tool, used for collection of nursing care quality indicators from the electronic health record, for a pragmatic trial. We computed Cohen's kappa coefficient (κ) to assess interrater agreement or reliability of data abstracted using preliminary and finalized tools. In assessing the reliability of study data ( n = 1,440 cases) using the finalized tool, 108 randomly selected cases (10% of first half sample; 5% of last half sample) were independently abstracted by a second rater. We demonstrated mean κ values ranging from 0.61 to 0.99 for all indicators. Nursing care quality data can be accurately and reliably abstracted from the electronic health records of intensive care unit patients using a well-developed data collection tool and detailed training.

  3. The Almost Right Word: The Move From Medical to Health Humanities.

    Science.gov (United States)

    Jones, Therese; Blackie, Michael; Garden, Rebecca; Wear, Delese

    2017-07-01

    Since the emergence of the field in the 1970s, several trends have begun to challenge the original assumptions, claims, and practices of what became known as the medical humanities. In this article, the authors make the case for the health humanities as a more encompassing label because it captures recent theoretical and pedagogical developments in higher education such as the shift from rigid disciplinary boundaries to multi- and interdisciplinary inquiry, which has transformed humanities curricula in health professions. Calling the area of study health humanities also underscores the crucial distinction between medicine and health. Following a brief history of the field and the rationales that brought humanities disciplines to medical education in the first place-the "why" of the medical humanities-the authors turn to the "why" of the health humanities, using disability studies to illuminate those methodologies and materials that represent the distinction between the two. In addition, the authors make note of how humanities inquiry has now expanded across the landscape of other health professions curricula; how there is both awareness and evidence that medicine is only a minor determinant of health in human populations alongside social and cultural factors; and finally, how the current movement in health professions education is towards interdisciplinary and interprofessional learning experiences for students.

  4. Wind turbines and human health

    Directory of Open Access Journals (Sweden)

    Loren eKnopper

    2014-06-01

    Full Text Available The association between wind turbines and health effects is highly debated. Some argue that reported health effects are related to wind turbine operation (electromagnetic fields (EMF, shadow flicker, audible noise, low frequency noise, infrasound. Others suggest that when turbines are sited correctly, effects are more likely attributable to a number of subjective variables that result in an annoyed/stressed state. In this review we provide a bibliographic-like summary and analysis of the science around this issue specifically in terms of noise (including audible, low frequency noise and infrasound, EMF and shadow flicker. Now there are roughly 60 scientific peer-reviewed articles on this issue. The available scientific evidence suggests that EMF, shadow flicker, low frequency noise and infrasound from wind turbines are not likely to affect human health; some studies have found that audible noise from wind turbines can be annoying to some. Annoyance may be associated with some self-reported health effects (e.g., sleep disturbance especially at sound pressure levels >40 dB(A. Because environmental noise above certain levels is a recognized factor in a number of health issues, siting restrictions have been implemented in many jurisdictions to limit noise exposure. These setbacks should help alleviate annoyance from noise. Subjective variables (attitudes and expectations are also linked to annoyance and have the potential to facilitate other health complaints via the nocebo effect. Therefore, it is possible that a segment of the population may remain annoyed (or report other health impacts even when noise limits are enforced. Based on the findings and scientific merit of the available studies, the weight of evidence suggests that when sited properly, wind turbines are not related to adverse health. Stemming from this review, we provide a number of recommended best practices for wind turbine development in the context of human health.

  5. Wind turbines and human health.

    Science.gov (United States)

    Knopper, Loren D; Ollson, Christopher A; McCallum, Lindsay C; Whitfield Aslund, Melissa L; Berger, Robert G; Souweine, Kathleen; McDaniel, Mary

    2014-01-01

    The association between wind turbines and health effects is highly debated. Some argue that reported health effects are related to wind turbine operation [electromagnetic fields (EMF), shadow flicker, audible noise, low-frequency noise, infrasound]. Others suggest that when turbines are sited correctly, effects are more likely attributable to a number of subjective variables that result in an annoyed/stressed state. In this review, we provide a bibliographic-like summary and analysis of the science around this issue specifically in terms of noise (including audible, low-frequency noise, and infrasound), EMF, and shadow flicker. Now there are roughly 60 scientific peer-reviewed articles on this issue. The available scientific evidence suggests that EMF, shadow flicker, low-frequency noise, and infrasound from wind turbines are not likely to affect human health; some studies have found that audible noise from wind turbines can be annoying to some. Annoyance may be associated with some self-reported health effects (e.g., sleep disturbance) especially at sound pressure levels >40 dB(A). Because environmental noise above certain levels is a recognized factor in a number of health issues, siting restrictions have been implemented in many jurisdictions to limit noise exposure. These setbacks should help alleviate annoyance from noise. Subjective variables (attitudes and expectations) are also linked to annoyance and have the potential to facilitate other health complaints via the nocebo effect. Therefore, it is possible that a segment of the population may remain annoyed (or report other health impacts) even when noise limits are enforced. Based on the findings and scientific merit of the available studies, the weight of evidence suggests that when sited properly, wind turbines are not related to adverse health. Stemming from this review, we provide a number of recommended best practices for wind turbine development in the context of human health.

  6. Wind Turbines and Human Health

    Science.gov (United States)

    Knopper, Loren D.; Ollson, Christopher A.; McCallum, Lindsay C.; Whitfield Aslund, Melissa L.; Berger, Robert G.; Souweine, Kathleen; McDaniel, Mary

    2014-01-01

    The association between wind turbines and health effects is highly debated. Some argue that reported health effects are related to wind turbine operation [electromagnetic fields (EMF), shadow flicker, audible noise, low-frequency noise, infrasound]. Others suggest that when turbines are sited correctly, effects are more likely attributable to a number of subjective variables that result in an annoyed/stressed state. In this review, we provide a bibliographic-like summary and analysis of the science around this issue specifically in terms of noise (including audible, low-frequency noise, and infrasound), EMF, and shadow flicker. Now there are roughly 60 scientific peer-reviewed articles on this issue. The available scientific evidence suggests that EMF, shadow flicker, low-frequency noise, and infrasound from wind turbines are not likely to affect human health; some studies have found that audible noise from wind turbines can be annoying to some. Annoyance may be associated with some self-reported health effects (e.g., sleep disturbance) especially at sound pressure levels >40 dB(A). Because environmental noise above certain levels is a recognized factor in a number of health issues, siting restrictions have been implemented in many jurisdictions to limit noise exposure. These setbacks should help alleviate annoyance from noise. Subjective variables (attitudes and expectations) are also linked to annoyance and have the potential to facilitate other health complaints via the nocebo effect. Therefore, it is possible that a segment of the population may remain annoyed (or report other health impacts) even when noise limits are enforced. Based on the findings and scientific merit of the available studies, the weight of evidence suggests that when sited properly, wind turbines are not related to adverse health. Stemming from this review, we provide a number of recommended best practices for wind turbine development in the context of human health. PMID:24995266

  7. Electronic health record tools' support of nurses' clinical judgment and team communication.

    Science.gov (United States)

    Kossman, Susan P; Bonney, Leigh Ann; Kim, Myoung Jin

    2013-11-01

    Nurses need to quickly process information to form clinical judgments, communicate with the healthcare team, and guide optimal patient care. Electronic health records not only offer potential for enhanced care but also introduce unintended consequences through changes in workflow, clinical judgment, and communication. We investigated nurses' use of improvised (self-made) and electronic health record-generated cognitive artifacts on clinical judgment and team communication. Tanner's Clinical Judgment Model provided a framework and basis for questions in an online survey and focus group interviews. Findings indicated that (1) nurses rated self-made work lists and medication administration records highest for both clinical judgment and communication, (2) tools aided different dimensions of clinical judgment, and (3) interdisciplinary tools enhance team communication. Implications are that electronic health record tool redesign could better support nursing work.

  8. Developing Hydrogeological Site Characterization Strategies based on Human Health Risk

    Science.gov (United States)

    de Barros, F.; Rubin, Y.; Maxwell, R. M.

    2013-12-01

    In order to provide better sustainable groundwater quality management and minimize the impact of contamination in humans, improved understanding and quantification of the interaction between hydrogeological models, geological site information and human health are needed. Considering the joint influence of these components in the overall human health risk assessment and the corresponding sources of uncertainty aid decision makers to better allocate resources in data acquisition campaigns. This is important to (1) achieve remediation goals in a cost-effective manner, (2) protect human health and (3) keep water supplies clean in order to keep with quality standards. Such task is challenging since a full characterization of the subsurface is unfeasible due to financial and technological constraints. In addition, human exposure and physiological response to contamination are subject to uncertainty and variability. Normally, sampling strategies are developed with the goal of reducing uncertainty, but less often they are developed in the context of their impacts on the overall system uncertainty. Therefore, quantifying the impact from each of these components (hydrogeological, behavioral and physiological) in final human health risk prediction can provide guidance for decision makers to best allocate resources towards minimal prediction uncertainty. In this presentation, a multi-component human health risk-based framework is presented which allows decision makers to set priorities through an information entropy-based visualization tool. Results highlight the role of characteristic length-scales characterizing flow and transport in determining data needs within an integrated hydrogeological-health framework. Conditions where uncertainty reduction in human health risk predictions may benefit from better understanding of the health component, as opposed to a more detailed hydrogeological characterization, are also discussed. Finally, results illustrate how different dose

  9. Using Simulations to Improve Electronic Health Record Use, Clinician Training and Patient Safety: Recommendations From A Consensus Conference

    OpenAIRE

    Mohan, Vishnu; Woodcock, Deborah; McGrath, Karess; Scholl, Gretchen; Pranaat, Robert; Doberne, Julie W.; Chase, Dian A.; Gold, Jeffrey A.; Ash, Joan S.

    2017-01-01

    A group of informatics experts in simulation, biomedical informatics, patient safety, medical education, and human factors gathered at Corbett, Oregon on April 30 and May 1, 2015. Their objective: to create a consensus statement on best practices for the use of electronic health record (EHR) simulations in education and training, to improve patient safety, and to outline a strategy for future EHR simulation work. A qualitative approach was utilized to analyze data from the conference and gene...

  10. One health and cyanobacteria in freshwater systems: animal illnesses and deaths are sentinel events for human health risks.

    Science.gov (United States)

    Hilborn, Elizabeth D; Beasley, Val R

    2015-04-20

    Harmful cyanobacterial blooms have adversely impacted human and animal health for thousands of years. Recently, the health impacts of harmful cyanobacteria blooms are becoming more frequently detected and reported. However, reports of human and animal illnesses or deaths associated with harmful cyanobacteria blooms tend to be investigated and reported separately. Consequently, professionals working in human or in animal health do not always communicate findings related to these events with one another. Using the One Health concept of integration and collaboration among health disciplines, we systematically review the existing literature to discover where harmful cyanobacteria-associated animal illnesses and deaths have served as sentinel events to warn of potential human health risks. We find that illnesses or deaths among livestock, dogs and fish are all potentially useful as sentinel events for the presence of harmful cyanobacteria that may impact human health. We also describe ways to enhance the value of reports of cyanobacteria-associated illnesses and deaths in animals to protect human health. Efficient monitoring of environmental and animal health in a One Health collaborative framework can provide vital warnings of cyanobacteria-associated human health risks.

  11. Electronic Health Record Systems and Intent to Apply for Meaningful Use Incentives among Office-based Physician ...

    Science.gov (United States)

    ... Order from the National Technical Information Service NCHS Electronic Health Record Systems and Intent to Apply for ... In 2011, 57% of office-based physicians used electronic medical record/electronic health record (EMR/EHR) systems, ...

  12. [Human milk, immune responses and health effects].

    Science.gov (United States)

    Løland, Beate Fossum; Baerug, Anne B; Nylander, Gro

    2007-09-20

    Besides providing optimal nutrition to infants, human milk contains a multitude of immunological components. These components are important for protection against infections and also support the development and maturation of the infant's own immune system. This review focuses on the function of some classical immunocomponents of human milk. Relevant studies are presented that describe health benefits of human milk for the child and of lactation for the mother. Relevant articles were found mainly by searching PubMed. Humoral and cellular components of human milk confer protection against infections in the respiratory--, gastrointestinal--and urinary tract. Human milk also protects premature children from neonatal sepsis and necrotizing enterocolitis. There is evidence that human milk may confer long-term benefits such as lower risk of certain autoimmune diseases, inflammatory bowel disease and probably some malignancies. Human milk possibly affects components of the metabolic syndrome. Recent studies demonstrate long-term health benefits of lactation also for the mother. A reduced incidence of breast cancer is best documented. An increasing number of studies indicate protection against ovarian cancer, rheumatoid arthritis and type II diabetes.

  13. Safeguarding Confidentiality in Electronic Health Records.

    Science.gov (United States)

    Shenoy, Akhil; Appel, Jacob M

    2017-04-01

    Electronic health records (EHRs) offer significant advantages over paper charts, such as ease of portability, facilitated communication, and a decreased risk of medical errors; however, important ethical concerns related to patient confidentiality remain. Although legal protections have been implemented, in practice, EHRs may be still prone to breaches that threaten patient privacy. Potential safeguards are essential, and have been implemented especially in sensitive areas such as mental illness, substance abuse, and sexual health. Features of one institutional model are described that may illustrate the efforts to both ensure adequate transparency and ensure patient confidentiality. Trust and the therapeutic alliance are critical to the provider-patient relationship and quality healthcare services. All of the benefits of an EHR are only possible if patients retain confidence in the security and accuracy of their medical records.

  14. Health Sciences Patrons Use Electronic Books More than Print Books

    Directory of Open Access Journals (Sweden)

    Robin Elizabeth Miller

    2017-09-01

    Full Text Available A Review of: Li, J. (2016. Is it cost-effective to purchase print books when the equivalent e-book is available? Journal of Hospital Librarianship, 16(1, 40-48. http://dx.doi.org/10.1080/15323269.2016.1118288 Abstract Objective – To compare use of books held simultaneously in print and electronic formats. Design – Case study. Setting – A health sciences library at a public comprehensive university with a medical college in the southern United States. Subjects – Usage data for 60 books held by the library simultaneously in print and electronically. The titles were on standing order in print and considered “core” texts for clinical, instructional, or reference for health sciences faculty, students, and medical residents. Methods – Researchers collected usage data for 60 print titles from the integrated library system and compared the data to COUNTER reports for electronic versions of the same titles, for the period spanning 2010-2014. Main Results – Overall, the 60 e-book titles were used more than the print versions, with the electronic versions used a total of 370,695 times while the print versions were used 93 times during the time period being examined. Conclusion – The use of electronic books outnumbers the use of print books of the same title.

  15. The International Classification of Functioning, Disability and Health (ICF) in Electronic Health Records. A Systematic Literature Review.

    Science.gov (United States)

    Maritz, Roxanne; Aronsky, Dominik; Prodinger, Birgit

    2017-09-20

    The International Classification of Functioning, Disability and Health (ICF) is the World Health Organization's standard for describing health and health-related states. Examples of how the ICF has been used in Electronic Health Records (EHRs) have not been systematically summarized and described yet. To provide a systematic review of peer-reviewed literature about the ICF's use in EHRs, including related challenges and benefits. Peer-reviewed literature, published between January 2001 and July 2015 was retrieved from Medline ® , CINAHL ® , Scopus ® , and ProQuest ® Social Sciences using search terms related to ICF and EHR concepts. Publications were categorized according to three groups: Requirement specification, development and implementation. Information extraction was conducted according to a qualitative content analysis method, deductively informed by the evaluation framework for Health Information Systems: Human, Organization and Technology-fit (HOT-fit). Of 325 retrieved articles, 17 publications were included; 4 were categorized as requirement specification, 7 as development, and 6 as implementation publications. Information regarding the HOT-fit evaluation framework was summarized. Main benefits of using the ICF in EHRs were its unique comprehensive perspective on health and its interdisciplinary focus. Main challenges included the fact that the ICF is not structured as a formal terminology as well as the need for a reduced number of ICF codes for more feasible and practical use. Different approaches and technical solutions exist for integrating the ICF in EHRs, such as combining the ICF with other existing standards for EHR or selecting ICF codes with natural language processing. Though the use of the ICF in EHRs is beneficial as this review revealed, the ICF could profit from further improvements such as formalizing the knowledge representation in the ICF to support and enhance interoperability.

  16. Using the Electronic Health Record in Nursing Research: Challenges and Opportunities.

    Science.gov (United States)

    Samuels, Joanne G; McGrath, Robert J; Fetzer, Susan J; Mittal, Prashant; Bourgoine, Derek

    2015-10-01

    Changes in the patient record from the paper to the electronic health record format present challenges and opportunities for the nurse researcher. Current use of data from the electronic health record is in a state of flux. Novel data analytic techniques and massive data sets provide new opportunities for nursing science. Realization of a strong electronic data output future relies on meeting challenges of system use and operability, data presentation, and privacy. Nurse researchers need to rethink aspects of proposal development. Joining ongoing national efforts aimed at creating usable data output is encouraged as a means to affect system design. Working to address challenges and embrace opportunities will help grow the science in a way that answers important patient care questions. © The Author(s) 2015.

  17. Health Care and Human Trafficking: We are Seeing the Unseen.

    Science.gov (United States)

    Chisolm-Straker, Makini; Baldwin, Susie; Gaïgbé-Togbé, Bertille; Ndukwe, Nneka; Johnson, Pauline N; Richardson, Lynne D

    2016-01-01

    This study aimed to build the evidence base around human trafficking (HT) and health in the U.S. by employing a quantitative approach to exploring the notion that health care providers encounter this population. Furthermore, this study sought to describe the health care settings most frequented by victims of human trafficking. This was an anonymous, retrospective study of survivors of U.S.-based human trafficking. One hundred and seventy-three participants who endured U.S.-based human trafficking were surveyed. The majority (68%, n=117) of participants were seen by a health care provider while being trafficked. Respondents most frequently reported visiting emergency/urgent care practitioners (56%), followed by primary care providers, dentists, and obstetricians/gynecologists (OB/GYNs). While health care providers are serving this patient population, they do not consistently identify them as victims of human trafficking.

  18. An Enterprise Architecture Perspective to Electronic Health Record Based Care Governance.

    Science.gov (United States)

    Motoc, Bogdan

    2017-01-01

    This paper proposes an Enterprise Architecture viewpoint of Electronic Health Record (EHR) based care governance. The improvements expected are derived from the collaboration framework and the clinical health model proposed as foundation for the concept of EHR.

  19. Human Health/Human Factors Considerations in Trans-Lunar Space

    Science.gov (United States)

    Moore, E. Cherice; Howard, Robert; Mendeck, Gavin

    2014-01-01

    The human factors insights of how they are incorporated into the vehicle are crucial towards designing and planning the internal designs necessary for future spacecraft and missions. The adjusted mission concept of supporting the Asteroid Redirect Crewed Mission will drive some human factors changes on how the Orion will be used and will be reassessed so as to best contribute to missions success. Recognizing what the human factors and health functional needs are early in the design process and how to integrate them will improve this and future generations of space vehicles to achieve mission success and continue to minimize risks.

  20. Integration services to enable regional shared electronic health records.

    Science.gov (United States)

    Oliveira, Ilídio C; Cunha, João P S

    2011-01-01

    eHealth is expected to integrate a comprehensive set of patient data sources into a coherent continuum, but implementations vary and Portugal is still lacking on electronic patient data sharing. In this work, we present a clinical information hub to aggregate multi-institution patient data and bridge the information silos. This integration platform enables a coherent object model, services-oriented applications development and a trust framework. It has been instantiated in the Rede Telemática de Saúde (www.RTSaude.org) to support a regional Electronic Health Record approach, fed dynamically from production systems at eight partner institutions, providing access to more than 11,000,000 care episodes, relating to over 350,000 citizens. The network has obtained the necessary clearance from the Portuguese data protection agency.

  1. The sinusoidal lining cells in "normal" human liver. A scanning electron microscopic investigation

    DEFF Research Database (Denmark)

    Horn, T; Henriksen, Jens Henrik Sahl; Christoffersen, P

    1986-01-01

    The scanning electron microscopic was used to study the fenestrations of human liver sinusoids. Thirteen biopsies, where light microscopy and transmission electron microscopy revealed normal sinusoidal architecture, were investigated. The number of fenestrae was calculated in acinar zone 3...

  2. Key challenges of human resources for health in India

    Directory of Open Access Journals (Sweden)

    Priya Sinha

    2016-01-01

    Full Text Available Background and Objective Since independence the efforts have been to strengthen the health infrastructure, its accessibility and coverage. The human resources for health have been an important determinant for system but it has received significance recently. Even government expenditure on health has remained at not more than 1% of Gross Domestic Product which is very less as compared to world standard. Now the biggest challenge is the shortage of skilled human resource for health at all levels in the healthcare delivery system. The article aimed at understanding the current status of human resources for health and initiatives adopted to deal with existing shortage and to highlight factors leading to further shortage and to bring to notice the use of talent management strategy as a retention tool. Review Methodology The review used descriptive research design using secondary sources from journals-articles using key words. The study also used exclusion and inclusion criteria to select the articles. The study was done using extensive review of literature on health sector, health workforce, its availability and scarcity due to attrition/emigration in India. The critical review helped in setting objective for the study. Findings The review of articles provided insight into the current status of health workforce in India. The earlier studies emphasized that gap between demand and supply of human resource for health is mainly due to increasing population and burden of diseases. Studies have now identified other factors leading to further shortage as attrition/emigration of skilled health workforce. Most of the initiatives are mainly directed towards increasing supply of human resources for health to deal with the scarcity and less emphasis to control attrition. Few studies highlighted the use of talent management strategy to deal with the challenges of attrition and emigration that helps in retention and controlling further shortage. Recommendations

  3. Solar radiation and human health

    Energy Technology Data Exchange (ETDEWEB)

    Juzeniene, Asta; Moan, Kristin; Moan, Johan [Department of Radiation Biology, Institute for Cancer Research, The Norwegian Radium Hospital, Oslo University Hospital, Montebello, N-0310 Oslo (Norway); Brekke, Paal [Norwegian Space Centre, PO Box 113, Skoeyen, N-0212 Oslo (Norway); Dahlback, Arne [Department of Physics, University of Oslo, Blindern, 0316 Oslo (Norway); Andersson-Engels, Stefan [Department of Physics, Lund University, PO Box 118, SE-221 00 Lund (Sweden); Reichrath, Joerg [Klinik fuer Dermatologie, Venerologie und Allergologie, Universitaetsklinikum des Saarlandes, D-66421 Homburg/Saar (Germany); Holick, Michael F [Department of Medicine, Section of Endocrinology, Nutrition and Diabetes, Vitamin D, Skin and Bone Research Laboratory, Boston University Medical Center, 85 E. Newton St., M-1013, Boston, MA 02118 (United States); Grant, William B, E-mail: asta.juzeniene@rr-research.no, E-mail: kmoan@hotmail.com, E-mail: paal.brekke@spacecentre.no, E-mail: arne.dahlback@fys.uio.no, E-mail: j.e.moan@fys.uio.no, E-mail: stefan.andersson-engels@fysik.lth.se, E-mail: joerg.reichrath@uks.eu, E-mail: mfholick@bu.edu, E-mail: wbgrant@infionline.net [Sunlight, Nutrition and Health Research Center (SUNARC), PO Box 641603, San Francisco, CA 94164-1603 (United States)

    2011-06-15

    The Sun has played a major role in the development of life on Earth. In Western culture, people are warned against Sun exposure because of its adverse effects: erythema, photoimmunosuppression, photoageing, photocarcinogenesis, cataracts and photokeratitis. However, Sun exposure is also beneficial, since moderate doses give beneficial physiological effects: vitamin D synthesis, reduction of blood pressure and mental health. Shortage of Sun exposure may be even more dangerous to human health than excessive exposure. Avoiding Sun exposure leads to vitamin D deficiency which is associated not only with rickets and osteomalacia, but also with increased risk of cardiovascular disease, multiple sclerosis, rheumatoid arthritis, diabetes, influenza, many types of cancer and adverse pregnancy outcomes. Solar radiation induces nitric oxide release in tissue and immediate pigment darkening which certainly play important roles, although these are still unknown. Action spectra relevant for health are described. We will also review what is known about spectral and intensity variations of terrestrial solar radiation as well as its penetration through the atmosphere and into human skin and tissue.

  4. Solar radiation and human health

    Science.gov (United States)

    Juzeniene, Asta; Brekke, Pål; Dahlback, Arne; Andersson-Engels, Stefan; Reichrath, Jörg; Moan, Kristin; Holick, Michael F.; Grant, William B.; Moan, Johan

    2011-06-01

    The Sun has played a major role in the development of life on Earth. In Western culture, people are warned against Sun exposure because of its adverse effects: erythema, photoimmunosuppression, photoageing, photocarcinogenesis, cataracts and photokeratitis. However, Sun exposure is also beneficial, since moderate doses give beneficial physiological effects: vitamin D synthesis, reduction of blood pressure and mental health. Shortage of Sun exposure may be even more dangerous to human health than excessive exposure. Avoiding Sun exposure leads to vitamin D deficiency which is associated not only with rickets and osteomalacia, but also with increased risk of cardiovascular disease, multiple sclerosis, rheumatoid arthritis, diabetes, influenza, many types of cancer and adverse pregnancy outcomes. Solar radiation induces nitric oxide release in tissue and immediate pigment darkening which certainly play important roles, although these are still unknown. Action spectra relevant for health are described. We will also review what is known about spectral and intensity variations of terrestrial solar radiation as well as its penetration through the atmosphere and into human skin and tissue.

  5. Solar radiation and human health

    International Nuclear Information System (INIS)

    Juzeniene, Asta; Moan, Kristin; Moan, Johan; Brekke, Paal; Dahlback, Arne; Andersson-Engels, Stefan; Reichrath, Joerg; Holick, Michael F; Grant, William B

    2011-01-01

    The Sun has played a major role in the development of life on Earth. In Western culture, people are warned against Sun exposure because of its adverse effects: erythema, photoimmunosuppression, photoageing, photocarcinogenesis, cataracts and photokeratitis. However, Sun exposure is also beneficial, since moderate doses give beneficial physiological effects: vitamin D synthesis, reduction of blood pressure and mental health. Shortage of Sun exposure may be even more dangerous to human health than excessive exposure. Avoiding Sun exposure leads to vitamin D deficiency which is associated not only with rickets and osteomalacia, but also with increased risk of cardiovascular disease, multiple sclerosis, rheumatoid arthritis, diabetes, influenza, many types of cancer and adverse pregnancy outcomes. Solar radiation induces nitric oxide release in tissue and immediate pigment darkening which certainly play important roles, although these are still unknown. Action spectra relevant for health are described. We will also review what is known about spectral and intensity variations of terrestrial solar radiation as well as its penetration through the atmosphere and into human skin and tissue.

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

    Science.gov (United States)

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

    2015-09-01

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

  7. Electronic Document Management: A Human Resource Management Case Study

    Directory of Open Access Journals (Sweden)

    Thomas Groenewald

    2004-11-01

    Full Text Available This case study serve as exemplar regarding what can go wrong with the implementation of an electronic document management system. Knowledge agility and knowledge as capital, is outlined against the backdrop of the information society and knowledge economy. The importance of electronic document management and control is sketched thereafter. The literature review is concluded with the impact of human resource management on knowledge agility, which includes references to the learning organisation and complexity theory. The intervention methodology, comprising three phases, follows next. The results of the three phases are presented thereafter. Partial success has been achieved with improving the human efficacy of electronic document management, however the client opted to discontinue the system in use. Opsomming Die gevalle studie dien as voorbeeld van wat kan verkeerd loop met die implementering van ’n elektroniese dokumentbestuur sisteem. Teen die agtergrond van die inligtingsgemeenskap en kennishuishouding word kennissoepelheid en kennis as kapitaal bespreek. Die literatuurstudie word afgesluit met die inpak van menslikehulpbronbestuur op kennissoepelheid, wat ook die verwysings na die leerorganisasie en kompleksietydsteorie insluit. Die metodologie van die intervensie, wat uit drie fases bestaan, volg daarna. Die resultate van die drie fases word vervolgens aangebied. Slegs gedeelte welslae is behaal met die verbetering van die menslike doeltreffendheid ten opsigte van elektroniese dokumentbestuur. Die klient besluit egter om nie voort te gaan om die huidige sisteem te gebruik nie.

  8. Climate change, human health, and epidemiological transition.

    Science.gov (United States)

    Barrett, Bruce; Charles, Joel W; Temte, Jonathan L

    2015-01-01

    The health of populations depends on the availability of clean air, water, food, and sanitation, exposure to pathogens, toxins and environmental hazards, and numerous genetic, behavioral and social factors. For many thousands of years, human life expectancy was low, and population growth was slow. The development of technology-based civilizations facilitated what Abdel Omran called "epidemiological transition," with increasing life expectancy and rapid population growth. To a large extent, the spectacular growth of human populations during the past two centuries was made possible by the energy extracted from fossil fuels. We have now learned, however, that greenhouse gases from fossil fuel combustion are warming the planet's surface, causing changes in oceanic and atmospheric systems, and disrupting weather and hydrological patterns. Climate change poses unprecedented threats to human health by impacts on food and water security, heat waves and droughts, violent storms, infectious disease, and rising sea levels. Whether or not humanity can reduce greenhouse gas emissions quickly enough to slow climate change to a rate that will allow societies to successfully adapt is not yet known. This essay reviews the current state of relevant knowledge, and points in a few directions that those interested in human health may wish to consider. Copyright © 2014 Elsevier Inc. All rights reserved.

  9. How the marine biotoxins affect human health.

    Science.gov (United States)

    Morabito, Silvia; Silvestro, Serena; Faggio, Caterina

    2018-03-01

    Several marine microalgae produce dangerous toxins very damaging to human health, aquatic ecosystems and coastal resources. These Harmful Algal Blooms (HABs) in recent decades seem greatly increased regarding frequency, severity and biogeographical level, causing serious health risks as a consequence of the consumption of contaminated seafood. Toxins can cause various clinically described syndromes, characterised by a wide range of symptoms: amnesic (ASP), diarrhoetic (DSP), azaspirazid (AZP), neurotoxic (NSP) and paralytic (PSP) shellfish poisonings and ciguatera fish poisoning. The spread of HABs is probably a result of anthropogenic activities and climate change, that influence marine planktonic systems, including global warming, habitat modification, eutrophication and growth of exogenous species in response to human pressures. HABs are a worldwide matter that requests local solutions and international cooperation. This review supplies an overview of HAB phenomena, and, in particular, we describe the major consequences of HABs on human health.

  10. Clinical Trials: A Crucial Key to Human Health Research

    Science.gov (United States)

    ... Past Issues Clinical Trials: A Crucial Key to Human Health Research Past Issues / Summer 2006 Table of Contents ... Javascript on. Photo: PhotoDisc At the forefront of human health research today are clinical trials—studies that use ...

  11. Promotion of health and human functionality

    Directory of Open Access Journals (Sweden)

    Ana Cristhina de Oliveira Brasil

    2013-08-01

    Organization, signatory of Resolution WHA54.21-OMS54.21, which recommends the use of the International Classification of Functioning, Disability and Health (ICF, translated into Portuguese in 2003. The main paradigm that ICF brings is the shift from an approach based on the disease to an approach focused on the human functionality (3. Only in May 2012 the National Health Council (Conselho nacioinal de Saúde – CNS approved the resolution 452 for the Ministry of Health to adopt the ICF, among other uses, as a generator of indicators of human functionality (4. Human functionality, according to the International Classification of Functioning, Disability and Health (ICF of the World Health Organization, is a comprehensive term that designates the elements of the body, its functions and structures, the human activities and participation in the social processes, indicating the positive aspects of the interaction of individuals with certain health conditions and thee context in which he lives with regard to personal and environmental factors (structural and attitudinal (3. However, health information appears incomplete, since data regarding the human functionality is not yet meaningful enough to support the developed policies so that they could accomplish the expected results in the face of the disabilities posed by the deficiencies, limitations in activities and restrictions of participation(5. Given the above, a change in direction is required in the paths of public health policies in Brazil, disposing of the exclusively biological approach to the disease, and starting to see it as a problem produced by the society. Therefore, it is necessary to develop information that record not only the disease but the additional aspects of the individuals´ health status. The human functionality is directly influenced both by the presence of diseases, mainly the chronic ones (featuring the change induced by the epidemiologic transition, as by the occurance of negative context, like the

  12. Promotion of Health and Human Functionality

    Directory of Open Access Journals (Sweden)

    Ana Cristhina de Oliveira Brasil

    2013-03-01

    Organization, signatory of Resolution WHA54.21-OMS54.21, which recommends the use of the International Classification of Functioning, Disability and Health (ICF, translated into Portuguese in 2003. The main paradigm that ICF brings is the shift from an approach based on the disease to an approach focused on the human functionality (3. Only in May 2012 the National Health Council (Conselho nacioinal de Saúde – CNS approved the resolution 452 for the Ministry of Health to adopt the ICF, among other uses, as a generator of indicators of human functionality (4. Human functionality, according to the International Classification of Functioning, Disability and Health (ICF of the World Health Organization, is a comprehensive term that designates the elements of the body, its functions and structures, the human activities and participation in the social processes, indicating the positive aspects of the interaction of individuals with certain health conditions and thee context in which he lives with regard to personal and environmental factors (structural and attitudinal (3. However, health information appears incomplete, since data regarding the human functionality is not yet meaningful enough to support the developed policies so that they could accomplish the expected results in the face of the disabilities posed by the deficiencies, limitations in activities and restrictions of participation(5.Given the above, a change in direction is required in the paths of public health policies in Brazil, disposing of the exclusively biological approach to the disease, and starting to see it as a problem produced by the society. Therefore, it is necessary to develop information that record not only the disease but the additional aspects of the individuals´ health status.The human functionality is directly influenced both by the presence of diseases, mainly the chronic ones (featuring the change induced by the epidemiologic transition, as by the occurance of negative context, like the diverse

  13. Community-based blood pressure measurement by non-health workers using electronic devices: a validation study

    OpenAIRE

    Daniel D. Reidpath; Mei Lee Ling; Shajahan Yasin; Kanason Rajagobal; Pascale Allotey

    2012-01-01

    Introduction: Population monitoring and screening of blood pressure is an important part of any population health strategy. Qualified health workers are expensive and often unavailable for screening. Non-health workers with electronic blood pressure monitors are increasingly used in community-based research. This approach is unvalidated. In a poor, urban community we compared blood pressure measurements taken by non-health workers using electronic devices against qualified health workers usin...

  14. The quest for One Health: Human Resource training aspects

    Directory of Open Access Journals (Sweden)

    Angwara Kiwara

    2014-04-01

    Full Text Available Appropriately trained Human Resources for Health (HRH are key inputs into One Health. ‘… more than 50% of all infectious diseases of humans originate from animals and that, of the emerging diseases about 75% could be traced back to animal origin’ (Rweyemamu et al. 2006. A comprehensive understanding of the social determinants of health, through an appropriate training model for HRH, is a key input. This study aimed to explore if human and veterinary medical schools were using such a model or providing time for this model in their curricula. Specific objectives were to: determine the time that human and veterinary medical schools’ curricula provide for subjects or courses related to the social determinants of health; analyse the curricula contents to establish how they relate to the social determinants of health; and explore how a bio-medical model may influence the graduates’ understanding and practice of One Health. A review of human and veterinary graduate-level medical schools’ curricula in East Africa was performed in April 2013 and May 2013. The findings were: in the curricula, SDH contents for knowledge enhancement about One Health are minimal and that teaching is Germ Theory model-driven and partisan. Out of the total training time for physicians and veterinarians, less than 10% was provided for the social determinants of health-related courses. In conclusion, the curricula and training times provided are inadequate for graduates to fully understand the social determinants of health and their role in One Health. Furthermore, the Germ Theory model that has been adopted addresses secondary causes and is inappropriate. There is a need for more in-depth model. This article suggests that a vicious cycle of ill-health model must be taught.

  15. Site, Sector, Scope: Mapping the Epistemological Landscape of Health Humanities.

    Science.gov (United States)

    Charise, Andrea

    2017-12-01

    This essay presents a critical appraisal of the current state of baccalaureate Health Humanities, with a special focus on the contextual differences currently influencing the implementation of this field in Canada and, to a lesser extent, the United States and United Kingdom. I argue that the epistemological bedrock of Health Humanities goes beyond that generated by its written texts to include three external factors that are especially pertinent to undergraduate education: site (the setting of Health Humanities education), sector (the disciplinary eligibility for funding) and scope (the critical engagement with a program's local context alongside an emergent "core" of Health Humanities knowledge, learning, and practice). Drawing largely from the Canadian context, I discuss how these differences can inform or obstruct this field's development, and offer preliminary recommendations for encouraging the growth of baccalaureate Health Humanities-in Canada and elsewhere-in light of these factors.

  16. Tea and Health: Studies in Humans

    Science.gov (United States)

    Khan, Naghma; Mukhtar, Hasan

    2014-01-01

    Tea, next to water is the cheapest beverage humans consume. Drinking the beverage tea has been considered a health-promoting habit since ancient times. The modern medicinal research is providing a scientific basis for this belief. The evidence supporting the health benefits of tea drinking grows stronger with each new study that is published in the scientific literature. Tea plant Camellia sinensis has been cultivated for thousands of years and its leaves have been used for medicinal purposes. Tea is used as a popular beverage worldwide and its ingredients are now finding medicinal benefits. Encouraging data showing cancer-preventive effects of green tea from cell-culture, animal and human studies have emerged. Evidence is accumulating that black tea may have similar beneficial effects. Tea consumption has also been shown to be useful for prevention of many debilitating human diseases that include maintenance of cardiovascular and metabolic health. Various studies suggest that polyphenolic compounds present in green and black tea are associated with beneficial effects in prevention of cardiovascular diseases, particularly of atherosclerosis and coronary heart disease. In addition, anti-aging, antidiabetic and many other health beneficial effects associated with tea consumption are described. Evidence is accumulating that catechins and theaflavins, which are the main polyphenolic compounds of green and black tea, respectively, are responsible for most of the physiological effects of tea. This article describes the evidences from clinical and epidemiological studies in the prevention of chronic diseases like cancer and cardiovascular diseases and general health promotion associated with tea consumption. PMID:23448443

  17. Electronic Health Record-Driven Workflow for Diagnostic Radiologists.

    Science.gov (United States)

    Geeslin, Matthew G; Gaskin, Cree M

    2016-01-01

    In most settings, radiologists maintain a high-throughput practice in which efficiency is crucial. The conversion from film-based to digital study interpretation and data storage launched the era of PACS-driven workflow, leading to significant gains in speed. The advent of electronic health records improved radiologists' access to patient data; however, many still find this aspect of workflow to be relatively cumbersome. Nevertheless, the ability to guide a diagnostic interpretation with clinical information, beyond that provided in the examination indication, can add significantly to the specificity of a radiologist's interpretation. Responsibilities of the radiologist include, but are not limited to, protocoling examinations, interpreting studies, chart review, peer review, writing notes, placing orders, and communicating with referring providers. Most of the aforementioned activities are not PACS-centric and require a login to one or more additional applications. Consolidation of these tasks for completion through a single interface can simplify workflow, save time, and potentially reduce the incidence of errors. Here, the authors describe diagnostic radiology workflow that leverages the electronic health record to significantly add to a radiologist's ability to be part of the health care team, provide relevant interpretations, and improve efficiency and quality. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  18. Advancing sexual health through human rights: the role of the law.

    Science.gov (United States)

    Kismödi, Eszter; Cottingham, Jane; Gruskin, Sofia; Miller, Alice M

    2015-01-01

    Since the International Conference on Population and Development, definitions of sexuality and sexual health have been greatly elaborated alongside widely accepted recognition that sexual health requires respect, protection and fulfilment of human rights. Considerable progress has also been made in enacting or changing laws that affect sexuality and sexual health, in line with human rights standards. These measures include legal guarantees against non-discrimination and violence, decriminalisation of consensual sexual conduct and guaranteeing availability, accessibility, acceptability and quality of sexual health information and services to all. Such legal actions have had positive effects on health and specifically on sexual health, particularly for marginalised populations. Yet in all regions of the world, laws still exist which jeopardise health, including sexual health, and violate human rights. In order to ensure accountability for the rights and health of their populations, states have an obligation to bring their laws into line with international, regional and national human rights standards. These rights-based legal guarantees, while insufficient alone, are essential for effective systems of accountability, achieving positive sexual health outcomes and the respect and protection of human rights.

  19. Electronic Communication in Africa--the Promotion of Animal Health Information Dissemination.

    Science.gov (United States)

    van der Westhuizen, Erica E.; Miller, E. Stan

    1995-01-01

    Discusses how the Veterinary Science Library at the University of Pretoria (South Africa) promotes electronic communication through various Internet and other network links. Provides a sample of online information sources available to veterinary teams and animal health workers, and a list of electronic addresses for South African libraries and…

  20. School Nurse Role in Electronic School Health Records. Position Statement

    Science.gov (United States)

    Hiltz, Cynthia; Johnson, Katie; Lechtenberg, Julia Rae; Maughan, Erin; Trefry, Sharonlee

    2014-01-01

    It is the position of the National Association of School Nurses (NASN) that Electronic Health Records (EHRs) are essential for the registered professional school nurse (hereinafter referred to as school nurse) to provide efficient and effective care in the school and monitor the health of the entire student population. It is also the position of…

  1. Health and welfare in animals and humans.

    Science.gov (United States)

    Nordenfelt, Lennart

    2011-06-01

    This paper contains a brief comparative analysis of some philosophical and scientific discourses on human and animal health and welfare, focusing mainly on the welfare of sentient animals. The paper sets forth two kinds of proposals for the analysis of animal welfare which do not appear in the contemporary philosophical discussion of human welfare, viz. the coping theory of welfare and the theory of welfare in terms of natural behaviour. These proposals are scrutinized in the light of some similar theories dealing with human health and quality of life. My conclusion is that the coping theory and the natural behaviour theory are not in themselves adequate for the characterization of welfare, either for humans or for sentient animals. I contend, finally, that, in the light of the previous discussion, there are good arguments for a particular set of analyses of both animal and human welfare, viz. the ones that are based on the notions of preference satisfaction and positive subjective experiences.

  2. Towards the Application of Open Source Software in Developing National Electronic Health Record-Narrative Review Article.

    Science.gov (United States)

    Aminpour, Farzaneh; Sadoughi, Farahnaz; Ahmadi, Maryam

    2013-12-01

    Electronic Health Record (EHR) is a repository of patient health information shared among multiple authorized users. As a modern method of storing and processing health information, it is a solution for improving quality, safety and efficiency of patient care and health system. However, establishment of EHR requires a significant investment of time and money. While many of healthcare providers have very limited capital, application of open source software would be considered as a solution in developing national electronic health record especially in countries with low income. The evidence showed that financial limitation is one of the obstacles to implement electronic health records in developing countries. Therefore, establishment of an open source EHR system capable of modifications according to the national requirements seems to be inevitable in Iran. The present study identifies the impact of application of open source software in developing national electronic health record in Iran.

  3. Human Health Screening and Public Health Significance of ...

    Science.gov (United States)

    The source water and treated drinking water from twenty five drinking water treatment plants (DWTPs) across the United States were sampled in 2010 – 2012. Samples were analyzed for 247 contaminants using 15 chemical and microbiological methods. Most of these contaminants are not regulated currently either in drinking water or in discharges to ambient water by the United States Environmental Protection Agency (EPA) or other U.S. regulatory agencies. This analysis shows that there is little public health concern for most of the contaminants detected in treated water from the 25 DWTPs participating in this study. For vanadium, the calculated MOE was less than the screening MOE in two DWTPs. Additional study, for example a national survey may be needed to determine the number of people ingesting vanadium above a level of concern. In addition, the concentrations of lithium found in treated water from several DWTPs are within the range previous research has suggested to have a human health effect. Additional investigation of this issue may also be appropriate. Finally, new toxicological data suggests that exposure to manganese at levels in public water supplies may present a public health concern which may warrant a more robust assessment of this information. This paper provides a screening-level human health risk assessment using the margin of exposure of exposure approach, of contaminants of emerging concern detected in drinking water. As far as we are a

  4. Indicators of human health in ecosystems: what do we measure?

    International Nuclear Information System (INIS)

    Cole, D.C.; Eyles, J.; Gibson, B.L.

    1998-01-01

    Increasingly, scientists are being called upon to assist in the development of indicators for monitoring ecosystem health. For human health indicators, they may draw on environmental exposure, human morbidity/mortality or well-being and sustainability approaches. To improve the rigour of indicators, we propose six scientific criteria for indicator selection: (1) data availability, suitability and representativeness (of populations), (2) indicator validity (face, construct, predictive and convergent) and reliability; (3) indicator responsiveness to change; (4) indicator desegregation capability (across personal and community characteristics); (5) indicator comparability (across populations and jurisdictions); and (6) indicator representativeness (across important dimensions of concern). We comment on our current capacity to adhere to such criteria with examples of measures of environmental exposure, human health and sustainability. We recognize the considerable work still required on documenting environment-human health relationships and on monitoring potential indicators in similar ways over time. Yet we argue that such work is essential in order for science to inform policy decisions which affect the health of ecosystems and human health. (Copyright (c) 1998 Elsevier Science B.V., Amsterdam. All rights reserved.)

  5. Nicotine and the Developing Human: A Neglected Element in the Electronic Cigarette Debate

    OpenAIRE

    England, Lucinda J.; Bunnell, Rebecca E.; Pechacek, Terry F.; Tong, Van T.; McAfee, Tim A.

    2015-01-01

    The elimination of cigarettes and other combusted tobacco products in the U.S. would prevent tens of millions of tobacco-related deaths. It has been suggested that the introduction of less harmful nicotine delivery devices, such as electronic cigarettes or other electronic nicotine delivery systems, will accelerate progress toward ending combustible cigarette use. However, careful consideration of the potential adverse health effects from nicotine itself is often absent from public health deb...

  6. Key challenges of human resources for health in India

    OpenAIRE

    Priya Sinha

    2016-01-01

    Background and Objective Since independence the efforts have been to strengthen the health infrastructure, its accessibility and coverage. The human resources for health have been an important determinant for system but it has received significance recently. Even government expenditure on health has remained at not more than 1% of Gross Domestic Product which is very less as compared to world standard. Now the biggest challenge is the shortage of skilled human resource for health at all le...

  7. Domestic dogs and human health: an overview.

    Science.gov (United States)

    Wells, Deborah L

    2007-02-01

    The domestic dog is one of the most commonly owned, and widely utilized, animals in today's society. This paper provides an overview of research that has explored the relationship between the domestic dog and human well-being. The article initially concentrates on the value of dogs for physical health in humans, exploring the evidence that this species can prevent us from becoming ill, facilitate our recovery from ill-health, and even serve as an early warning system for certain types of underlying ailment including cancer, oncoming seizures and hypoglycaemia. The paper then examines the relationship between dogs and psychological health in humans, exploring the ability of this species to aid the disabled and serve as a therapist to those in institutional settings such as hospitals, residential homes and prisons. Weaknesses in the existing research in this area are highlighted throughout the article. Taken together, the studies reviewed suggest that dogs can have prophylactic and therapeutic value for people.

  8. Human factors in computing systems: focus on patient-centered health communication at the ACM SIGCHI conference.

    Science.gov (United States)

    Wilcox, Lauren; Patel, Rupa; Chen, Yunan; Shachak, Aviv

    2013-12-01

    Health Information Technologies, such as electronic health records (EHR) and secure messaging, have already transformed interactions among patients and clinicians. In addition, technologies supporting asynchronous communication outside of clinical encounters, such as email, SMS, and patient portals, are being increasingly used for follow-up, education, and data reporting. Meanwhile, patients are increasingly adopting personal tools to track various aspects of health status and therapeutic progress, wishing to review these data with clinicians during consultations. These issues have drawn increasing interest from the human-computer interaction (HCI) community, with special focus on critical challenges in patient-centered interactions and design opportunities that can address these challenges. We saw this community presenting and interacting at the ACM SIGCHI 2013, Conference on Human Factors in Computing Systems, (also known as CHI), held April 27-May 2nd, 2013 at the Palais de Congrès de Paris in France. CHI 2013 featured many formal avenues to pursue patient-centered health communication: a well-attended workshop, tracks of original research, and a lively panel discussion. In this report, we highlight these events and the main themes we identified. We hope that it will help bring the health care communication and the HCI communities closer together. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  9. Do Electronic Health Records Help or Hinder Medical Education?

    OpenAIRE

    Peled, Jonathan U.; Sagher, Oren; Morrow, Jay B.; Dobbie, Alison E.

    2009-01-01

    Background to the Debate Background to the debate: Many countries worldwide are digitizing patients' medical records. In the United States, the recent economic stimulus package (?the American Recovery and Reinvestment Act of 2009?), signed into law by President Obama, includes $US17 billion in incentives for health providers to switch to electronic health records (EHRs). The package also includes $US2 billion for the development of EHR standards and best-practice guidelines. What impact will ...

  10. Oceans and Human Health: Microplastics and Harmful Algal Bloom

    International Nuclear Information System (INIS)

    Sombrito, Elvira Z.

    2015-01-01

    Traditionally the focus of research and concern of environmental studies in the marine system is the impact of human activities in the ocean: the sources, distribution and fate of pollutants resulting from human activities. More recently, there has been recognition of the potential direct impact health can come from eating contaminated seafood, swimming in polluted water, and exposure to toxins from harmful algal blooms. This paper will present two areas of concern that illustrates the fact that the health of the oceans and the health of humans go hand in hand: chemical pollution from plastics in the ocean and harmful alga bloom. The nuclear methodologies than can be useful in these areas will also be introduced. It is hoped that through the recognition of the inter-dependence of the health of both humans and the oceans, efforts will be made to restore and preserve the oceans. (author)

  11. The next generation of precision medicine: observational studies, electronic health records, biobanks, and continuous monitoring.

    Science.gov (United States)

    Glicksberg, Benjamin S; Johnson, Kipp W; Dudley, Joel T

    2018-04-12

    Precision medicine can utilize new techniques in order to more effectively translate research findings into clinical practice. In this article, we first explore the limitations of traditional study designs, which stem from (to name a few): massive cost for the assembly of large patient cohorts; non-representative patient data; and the astounding complexity of human biology. Second, we propose that harnessing electronic health records and mobile device biometrics coupled to longitudinal data may prove to be a solution to many of these problems by capturing a "real world" phenotype. We envision that future biomedical research utilizing more precise approaches to patient care will utilize continuous and longitudinal data sources.

  12. 'The medical' and 'health' in a critical medical humanities.

    Science.gov (United States)

    Atkinson, Sarah; Evans, Bethan; Woods, Angela; Kearns, Robin

    2015-03-01

    As befits an emerging field of enquiry, there is on-going discussion about the scope, role and future of the medical humanities. One relatively recent contribution to this debate proposes a differentiation of the field into two distinct terrains, 'medical humanities' and 'health humanities,' and calls for a supersession of the former by the latter. In this paper, we revisit the conceptual underpinnings for a distinction between 'the medical' and 'health' by looking at the history of an analogous debate between 'medical geography' and 'the geographies of health' that has, over the last few years, witnessed a re-blurring of the distinction. Highlighting the value of this debate within the social sciences for the future development of the medical humanities, we call for scholars to take seriously the challenges of critical and cultural theory, community-based arts and health, and the counter-cultural creative practices and strategies of activist movements in order to meet the new research challenges and fulfill the radical potential of a critical medical humanities.

  13. Public Policy and Health Informatics.

    Science.gov (United States)

    Bell, Katherine

    2018-04-05

    To provide an overview of the history of electronic health policy and identify significant laws that influence health informatics. US Department of Health and Human Services. The development of health information technology has influenced the process for delivering health care. Public policy and regulations are an important part of health informatics and establish the structure of electronic health systems. Regulatory bodies of the government initiate policies to ease the execution of electronic health record implementation. These same bureaucratic entities regulate the system to protect the rights of the patients and providers. Nurses should have an overall understanding of the system behind health informatics and be able to advocate for change. Nurses can utilize this information to optimize the use of health informatics and campaign for safe, effective, and efficient health information technology. Copyright © 2018 Elsevier Inc. All rights reserved.

  14. Integration of the enterprise electronic health record and anesthesia information management systems.

    Science.gov (United States)

    Springman, Scott R

    2011-09-01

    Fewer than 5% of anesthesia departments use an electronic medical record (EMR) that is anesthesia specific. Many anesthesia information management systems (AIMS) have been developed with a focus only on the unique needs of anesthesia providers, without being fully integrated into other electronic health record components of the entire enterprise medical system. To understand why anesthesia providers should embrace health information technology (HIT) on a health system-wide basis, this article reviews recent HIT history and reviews HIT concepts. The author explores current developments in efforts to expand enterprise HIT, and the pros and cons of full enterprise integration with an AIMS. Copyright © 2011 Elsevier Inc. All rights reserved.

  15. Macro influencers of electronic health records adoption.

    Science.gov (United States)

    Raghavan, Vijay V; Chinta, Ravi; Zhirkin, Nikita

    2015-01-01

    While adoption rates for electronic health records (EHRs) have improved, the reasons for significant geographical differences in EHR adoption within the USA have remained unclear. To understand the reasons for these variations across states, we have compiled from secondary sources a profile of different states within the USA, based on macroeconomic and macro health-environment factors. Regression analyses were performed using these indicator factors on EHR adoption. The results showed that internet usage and literacy are significantly associated with certain measures of EHR adoption. Income level was not significantly associated with EHR adoption. Per capita patient days (a proxy for healthcare need intensity within a state) is negatively correlated with EHR adoption rate. Health insurance coverage is positively correlated with EHR adoption rate. Older physicians (>60 years) tend to adopt EHR systems less than their younger counterparts. These findings have policy implications on formulating regionally focused incentive programs.

  16. Health Care Consumer's Perception of the Electronic Medical Record

    African Journals Online (AJOL)

    Method: A structured questionnaire was developed, validated and utilized in this quantitative research project. Quantitative data were collected ... Electronic Medical Records (EMR), as a health information technology innovation, has ... EMR will provide a highly effective, reliable, secure, and innovative information system.

  17. Household of care in electronic health information exchange systems

    CSIR Research Space (South Africa)

    Sibiya, Mhlupheki G

    2017-09-01

    Full Text Available by the organisation have presented the protocols and message profiles that can be used for communication among the systems within Electronic Health Information Exchange (HIE)[17, 6]. HIE “allows doctors, nurses, pharmacists, other healthcare providers and patients...

  18. Privacy, security, and the public health researcher in the era of electronic health record research.

    Science.gov (United States)

    Goldstein, Neal D; Sarwate, Anand D

    2016-01-01

    Health data derived from electronic health records are increasingly utilized in large-scale population health analyses. Going hand in hand with this increase in data is an increasing number of data breaches. Ensuring privacy and security of these data is a shared responsibility between the public health researcher, collaborators, and their institutions. In this article, we review the requirements of data privacy and security and discuss epidemiologic implications of emerging technologies from the computer science community that can be used for health data. In order to ensure that our needs as researchers are captured in these technologies, we must engage in the dialogue surrounding the development of these tools.

  19. DETAILED CLINICAL MODELS AND THEIR RELATION WITH ELECTRONIC HEALTH RECORDS.

    OpenAIRE

    Boscá Tomás, Diego

    2016-01-01

    [EN] Healthcare domain produces and consumes big quantities of people's health data. Although data exchange is the norm rather than the exception, being able to access to all patient data is still far from achieved. Current developments such as personal health records will introduce even more data and complexity to the Electronic Health Records (EHR). Achieving semantic interoperability is one of the biggest challenges to overcome in order to benefit from all the information contained in the ...

  20. Electronic Health Records Prospects in Egypt: A Demand-Side Perspective

    OpenAIRE

    Badran; Mona Farid

    2017-01-01

    The present study sheds light on the expected factors that would impact the Electronic Health Records (EHR) service in Egypt from the demand-side perspective, i.e. the health care consumer. This empirical study is motivated by the widespread use of EHR as a method of promoting health services globally, where it is considered as an efficiency enhancing, cost effective technology. Moreover, the healthcare sector in Egypt is gaining momentum, especially that the comprehensive healthcare and soci...

  1. Dynamic Interactions Between Health, Human Capital and Wealth

    Directory of Open Access Journals (Sweden)

    Wei-Bin Zhang

    2018-03-01

    Full Text Available This paper proposes a dynamic economic model with health, human capital and wealth accumulation with elastic labor supply. The economic system consists of one industrial, one health, and one education sector. Our model is a synthesis of four main models in economic theory: Solow’s one-sector neoclassical growth mode, the Uzawa-Lucas two sector model, Arrow’s learning by doing model, and Grossman’s growth model with health. The model also includes Zhang’s idea about creative leisure or learning by consuming. Demand and supply of health service and education are determined by market mechanism. The model describes dynamic interdependence among wealth, health, human capital, economic structure, and time distribution among work, health caring, and education under perfect competition. We simulate the model and examine effects of changes in the propensity to consume health caring, the efficiency of producing health caring, the propensity to receive education, and the propensity to save.

  2. Dust, Climate, and Human Health

    Science.gov (United States)

    Maynard, Nancy G.

    2003-01-01

    Air pollution from both natural and anthropogenic causes is considered to be one of the most serious world-wide environment-related health problems, and is expected to become worse with changes in the global climate. Dust storms from the atmospheric transport of desert soil dust that has been lifted and carried by the winds - often over significant distances - have become an increasingly important emerging air quality issue for many populations. Recent studies have shown that the dust storms can cause significant health impacts from the dust itself as well as the accompanying pollutants, pesticides, metals, salt, plant debris, and other inorganic and organic materials, including viable microorganisms (bacteria, viruses and fungi). For example, thousands of tons of Asian desert sediments, some containing pesticides and herbicides from farming regions, are commonly transported into the Arctic during dust storm events. These chemicals have been identified in animal and human tissues among Arctic indigenous populations. Millions of tons of airborne desert dust are being tracked by satellite imagery, which clearly shows the magnitude as well as the temporal and spatial variability of dust storms across the "dust belt" regions of North Africa, the Middle East, and China. This paper summarizes the most recent findings on the effects of airborne desert dust on human health as well as potential climate influences on dust and health.

  3. The electronic cigarette: potential health benefit or mere business?

    Science.gov (United States)

    De Marco, Cinzia; Invernizzi, Giovanni; Bosi, Sandra; Pozzi, Paolo; Di Paco, Adriano; Mazza, Roberto; Ruprecht, Ario Alberto; Munarini, Elena; Boffi, Roberto

    2013-01-01

    Electronic cigarettes (e-cigarettes) have attracted considerable attention as a possible alternative to tobacco cigarettes, but uncertainties about their impact on health and indoor air quality as well as their commercial success without a clear regulatory framework are arousing concern. We have therefore tried to summarize the health-related implications of the use of e-cigarettes in order to help physicians and health professionals provide accurate information on this device. Given the lack of unequivocal scientific data on their toxicity and safety, we conclude that at the moment there is no reason to approve e-cigarettes as a safe alternative to tobacco smoke.

  4. Machine Learning Methods to Extract Documentation of Breast Cancer Symptoms From Electronic Health Records.

    Science.gov (United States)

    Forsyth, Alexander W; Barzilay, Regina; Hughes, Kevin S; Lui, Dickson; Lorenz, Karl A; Enzinger, Andrea; Tulsky, James A; Lindvall, Charlotta

    2018-02-27

    Clinicians document cancer patients' symptoms in free-text format within electronic health record visit notes. Although symptoms are critically important to quality of life and often herald clinical status changes, computational methods to assess the trajectory of symptoms over time are woefully underdeveloped. To create machine learning algorithms capable of extracting patient-reported symptoms from free-text electronic health record notes. The data set included 103,564 sentences obtained from the electronic clinical notes of 2695 breast cancer patients receiving paclitaxel-containing chemotherapy at two academic cancer centers between May 1996 and May 2015. We manually annotated 10,000 sentences and trained a conditional random field model to predict words indicating an active symptom (positive label), absence of a symptom (negative label), or no symptom at all (neutral label). Sentences labeled by human coder were divided into training, validation, and test data sets. Final model performance was determined on 20% test data unused in model development or tuning. The final model achieved precision of 0.82, 0.86, and 0.99 and recall of 0.56, 0.69, and 1.00 for positive, negative, and neutral symptom labels, respectively. The most common positive symptoms were pain, fatigue, and nausea. Machine-based labeling of 103,564 sentences took two minutes. We demonstrate the potential of machine learning to gather, track, and analyze symptoms experienced by cancer patients during chemotherapy. Although our initial model requires further optimization to improve the performance, further model building may yield machine learning methods suitable to be deployed in routine clinical care, quality improvement, and research applications. Copyright © 2018 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  5. Animal-Assisted Therapy for Improving Human Health

    Directory of Open Access Journals (Sweden)

    Sibel Cevizci

    2009-06-01

    Full Text Available ABSTRACT Animal Assisted Therapy (AAT or Pet Therapy is an adjunctive therapy by taking advantage of human and animal interaction, activate the physiological and psychological mechanisms, initiate positive changes improving health in metabolism. In recent years, this interaction are in use to treat psychological and psychiatric disorders such as stress, depression, loneliness, pervasive developmental disorders affect negatively to human health. Furthermore, AAT has been increasingly used to improve quality of life, hypertension, cardiovascular diseases, chronic illnesses such as cancer and AIDS. The aim of this paper is to identify AAT by reviewing human and animal interaction, evaluate how AAT has a scientific background from past to now. Also, we aim to give some information about the risks, institutional applications, some factors referring AAT’s mechanism of action and chronic diseases, psychological and physical improvements provided with animal assisted therapies. The therapy results will be evaluated more advisable providing AAT is being applied with public health specialist, veterinarian, physician, psychologist, psychiatrist and veterinary public health experts who are monitor applications. Especially, the psychosomatic effects result from physical, emotional and play mechanism of action of HDT can be used for improving quality of life in individuals with chronic diseases. In Turkey, there is no any investigation which have been performed in this scientific field. It is quitely important to evaluate the benefits of this therapy accurately and to select various methods proper to diseases. Consequently, it is obvious that AAT will be considered by the healthcare services as a supportive therapy process for improving human health in Turkey and needs further studies. [TAF Prev Med Bull 2009; 8(3.000: 263-272

  6. Concept of waste and its impact on human health.

    Science.gov (United States)

    Pashkov, Vitalii M; Batyhina, Olena M; Trotska, Maryna V

    Impact of the environment on human health is increasingly being paid attention both at the international level and at the level of individual countries. Among the factors that anyhow can affect it negatively, various objects are distinguished and waste is not of the last consequence. It has different nature of origin, ways of further utilization and a degree of impact on human health and the environment. Its generation, utilization and neutralization are determined by the relevant processes; their research allows continuous improvement and reduction of their negative impact on human health and the environment. To analyze provisions of the international legislation concerning the concept of waste and its classification, as well as its potential impacts on human health and the environment. The study analyzes and uses international legal documents, data of international organizations and scientists' deductions. Furthermore, the study integrates information from scientific journals with scientific methods from the medical and legal point of view. Within the framework of the system approach, as well as analysis and synthesis, the concept of waste, its classification and impact on human health and the environment have been researched. In consequence of the conducted study, it has been found that at the European level, considerable attention is paid to waste in the context of its possible negative impact on human health and the environment. Solution of this problem is carried out with the integrated approach, which is expressed both in enacting statutory acts and amending existing ones, as well as elucidating various aspects at the scientific, methodological, statistical and other levels. Waste in itself has different nature of origin, negative impact, ways of its further utilization. Some kinds of it can be used further in order to achieve other goals and needs that are not related to their generation, others can no longer be used for human benefits taking into account

  7. Sources, behaviour, and environmental and human health risks of high-technology rare earth elements as emerging contaminants.

    Science.gov (United States)

    Gwenzi, Willis; Mangori, Lynda; Danha, Concilia; Chaukura, Nhamo; Dunjana, Nothando; Sanganyado, Edmond

    2018-04-26

    Recent studies show that high-technology rare earth elements (REEs) of anthropogenic origin occur in the environment including in aquatic systems, suggesting REEs are contaminants of emerging concern. However, compared to organic contaminants, there is a lack of comprehensive reviews on the anthropogenic sources, environmental behaviour, and public and ecological health risks of REEs. The current review aims to: (1) identify anthropogenic sources, transfer mechanisms, and environmental behaviour of REEs; (2) highlight the human and ecological health risks of REEs and propose mitigation measures; and (3) identify knowledge gaps and future research directions. Out of the 17 REEs, La, Gd, Ce and Eu are the most studied. The main sources of anthropogenic REE include; medical facilities, petroleum refining, mining and technology industries, fertilizers, livestock feeds, and electronic wastes and recycling plants. REEs are mobilized and transported in the environment by hydrological and wind-driven processes. Ecotoxicological effects include reduced plant growth, function and nutritional quality, genotoxicity and neurotoxicity in animals, trophic bioaccumulation, chronic and acute toxicities in soil organisms. Human exposure to REEs occurs via ingestion of contaminated water and food, inhalation, and direct intake during medical administration. REEs have been detected in human hair, nails, and biofluids. In humans, REEs cause nephrogenic systemic fibrosis and severe damage to nephrological systems associated with Gd-based contrast agents, dysfunctional neurological disorder, fibrotic tissue injury, oxidative stress, pneumoconiosis, cytotoxicity, anti-testicular effects, and male sterility. Barring REEs in medical devices, epidemiological evidence directly linking REEs in the environment to human health conditions remains weak. To minimize health risks, a conceptual framework and possible mitigation measures are highlighted. Future research is needed to better understand

  8. Diversity of extracellular vesicles in human ejaculates revealed by cryo-electron microscopy

    Directory of Open Access Journals (Sweden)

    Johanna L. Höög

    2015-11-01

    Full Text Available Human ejaculates contain extracellular vesicles (EVs, that to a large extent are considered to originate from the prostate gland, and are often denominated “prostasomes.” These EVs are important for human fertility, for example by promoting sperm motility and by inducing immune tolerance of the female immune system to the spermatozoa. So far, the EVs present in human ejaculate have not been studied in their native state, inside the seminal fluid without prior purification and isolation procedures. Using cryo-electron microscopy and tomography, we performed a comprehensive inventory of human ejaculate EVs. The sample was neither centrifuged, fixed, filtered or sectioned, nor were heavy metals added. Approximately 1,500 extracellular structures were imaged and categorized. The extracellular environment of human ejaculate was found to be diverse, with 5 major subcategories of EVs and 6 subcategories of extracellular membrane compartments, including lamellar bodies. Furthermore, 3 morphological features, including electron density, double membrane bilayers and coated surface, are described in all subcategories. This study reveals that the extracellular environment in human ejaculate is multifaceted. Several novel morphological EV subcategories are identified and clues to their cellular origin may be found in their morphology. This inventory is therefore important for developing future experimental approaches, and to interpret previously published data to understand the role of EVs for human male fertility.

  9. Endocrine distrupting chemicals and human health: The plausibility ...

    African Journals Online (AJOL)

    The plausibility of research results on DDT and reproductive health ... cals in the environment and that human health is inextri- cably linked to the health of .... periods of folliculo-genesis or embryo-genesis that increases risk for adverse effects.

  10. Examining the Relationship between Electronic Health Record Interoperability and Quality Management

    Science.gov (United States)

    Purcell, Bernice M.

    2013-01-01

    A lack of interoperability impairs data quality among health care providers' electronic health record (EHR) systems. The problem is whether the International Organization for Standardization (ISO) 9000 principles relate to the problem of interoperability in implementation of EHR systems. The purpose of the nonexperimental quantitative research…

  11. Evolution of Medication Administration Workflow in Implementing Electronic Health Record System

    Science.gov (United States)

    Huang, Yuan-Han

    2013-01-01

    This study focused on the clinical workflow evolutions when implementing the health information technology (HIT). The study especially emphasized on administrating medication when the electronic health record (EHR) systems were adopted at rural healthcare facilities. Mixed-mode research methods, such as survey, observation, and focus group, were…

  12. Can Social Cognitive Theories Help Us Understand Nurses' Use of Electronic Health Records?

    Science.gov (United States)

    Strudwick, Gillian; Booth, Richard; Mistry, Kartini

    2016-04-01

    Electronic health record implementations have accelerated in clinical settings around the world in an effort to improve patient safety and enhance efficiencies related to care delivery. As the largest group of healthcare professionals globally, nurses play an important role in the use of these records and ensuring their benefits are realized. Social cognitive theories such as the Theory of Reasoned Action, Theory of Planned Behaviour, and the Technology Acceptance Model have been developed to explain behavior. Given that variation in nurses' electronic health record utilization may influence the degree to which benefits are realized, the aim of this article is to explore how the use of these social cognitive theories may assist organizations implementing electronic health records to facilitate deeper-level adoption of this type of clinical technology.

  13. The effect of electronic health record software design on resident documentation and compliance with evidence-based medicine.

    Science.gov (United States)

    Rodriguez Torres, Yasaira; Huang, Jordan; Mihlstin, Melanie; Juzych, Mark S; Kromrei, Heidi; Hwang, Frank S

    2017-01-01

    This study aimed to determine the role of electronic health record software in resident education by evaluating documentation of 30 elements extracted from the American Academy of Ophthalmology Dry Eye Syndrome Preferred Practice Pattern. The Kresge Eye Institute transitioned to using electronic health record software in June 2013. We evaluated the charts of 331 patients examined in the resident ophthalmology clinic between September 1, 2011, and March 31, 2014, for an initial evaluation for dry eye syndrome. We compared documentation rates for the 30 evidence-based elements between electronic health record chart note templates among the ophthalmology residents. Overall, significant changes in documentation occurred when transitioning to a new version of the electronic health record software with average compliance ranging from 67.4% to 73.6% (p Electronic Health Record A had high compliance (>90%) in 13 elements while Electronic Health Record B had high compliance (>90%) in 11 elements. The presence of dialog boxes was responsible for significant changes in documentation of adnexa, puncta, proptosis, skin examination, contact lens wear, and smoking exposure. Significant differences in documentation were correlated with electronic health record template design rather than individual resident or residents' year in training. Our results show that electronic health record template design influences documentation across all resident years. Decreased documentation likely results from "mouse click fatigue" as residents had to access multiple dialog boxes to complete documentation. These findings highlight the importance of EHR template design to improve resident documentation and integration of evidence-based medicine into their clinical notes.

  14. Practical Applications of Cosmic Ray Science: Spacecraft, Aircraft, Ground Based Computation and Control Systems and Human Health and Safety

    Science.gov (United States)

    Atwell, William; Koontz, Steve; Normand, Eugene

    2012-01-01

    In this paper we review the discovery of cosmic ray effects on the performance and reliability of microelectronic systems as well as on human health and safety, as well as the development of the engineering and health science tools used to evaluate and mitigate cosmic ray effects in earth surface, atmospheric flight, and space flight environments. Three twentieth century technological developments, 1) high altitude commercial and military aircraft; 2) manned and unmanned spacecraft; and 3) increasingly complex and sensitive solid state micro-electronics systems, have driven an ongoing evolution of basic cosmic ray science into a set of practical engineering tools (e.g. ground based test methods as well as high energy particle transport and reaction codes) needed to design, test, and verify the safety and reliability of modern complex electronic systems as well as effects on human health and safety. The effects of primary cosmic ray particles, and secondary particle showers produced by nuclear reactions with spacecraft materials, can determine the design and verification processes (as well as the total dollar cost) for manned and unmanned spacecraft avionics systems. Similar considerations apply to commercial and military aircraft operating at high latitudes and altitudes near the atmospheric Pfotzer maximum. Even ground based computational and controls systems can be negatively affected by secondary particle showers at the Earth's surface, especially if the net target area of the sensitive electronic system components is large. Accumulation of both primary cosmic ray and secondary cosmic ray induced particle shower radiation dose is an important health and safety consideration for commercial or military air crews operating at high altitude/latitude and is also one of the most important factors presently limiting manned space flight operations beyond low-Earth orbit (LEO).

  15. Gut-Bioreactor and Human Health in Future.

    Science.gov (United States)

    Purohit, Hemant J

    2018-03-01

    Gut-microbiome provides the complementary metabolic potential to the human system. To understand the active participation and the performance of the microbial community in human health, the concept of gut as a plug-flow reactor with the fed-batch mode of operation can provide better insight. The concept suggests the virtual compartmentalized gut with sequential stratification of the microbial community in response to a typical host genotype. It also provides the analysis plan for gut microbiome; and its relevance in developing health management options under the identified clinical conditions.

  16. Impacts of Climate Change on Human Health in the United ...

    Science.gov (United States)

    Climate change threatens human health and well-being in the United States. To address this growing threat, the Interagency Group on Climate Change and Human Health (CCHHG), a working group of the U.S. Global Change Research Program’s (USGCRP), has developed this assessment as part of the ongoing efforts of the USGCRP’s National Climate Assessment (NCA) and as called for under the President’s Climate Action Plan. The authors of this assessment have compiled and assessed current research on human health impacts of climate change and summarized the current “state of the science” for a number of key impact areas. This assessment provides a comprehensive update to the most recent detailed technical assessment for the health impacts of climate change, 2008 Synthesis and Assessment Product 4.6 (SAP 4.6) Analyses of the Effects of Global Change on Human Health and Welfare and Human Systems (CCSP 2008). It also updates and builds upon the health chapter of the third NCA (Melillo et al. 2014). The lead and coordinating Federal agencies for the USGCRP Climate and Health Assessment are the Centers for Disease Control and Prevention (CDC), Environmental Protection Agency (EPA), National Institute of Health (NIH), and National Oceanic and Atmospheric Administration (NOAA). Available at https://health2016.globalchange.gov/ The interagency U.S. Global Change Research Program (USGCRP) has developed this assessment as part of the ongoing efforts of their National C

  17. Introduction to radiation and human health

    International Nuclear Information System (INIS)

    Anon.

    1981-01-01

    This introductory chapter presents an overview of topics that are examined throughout the book. There are brief discussions on basic scientific notation, epidemiology, risk assessment, and the use of assumptions and approximations in scientific research. The book presents evidence that ionizing radiation causes a variety of human health hazards. The health hazards evaluated in detail are cancer and chromosomal damage

  18. The past, present, and future of soils and human health studies

    Science.gov (United States)

    Brevik, E. C.; Sauer, T. J.

    2015-01-01

    The idea that human health is tied to the soil is not a new one. As far back as circa 1400 BC the Bible depicts Moses as understanding that fertile soil was essential to the well-being of his people. In 400 BC the Greek philosopher Hippocrates provided a list of things that should be considered in a proper medical evaluation, including the properties of the local ground. By the late 1700s and early 1800s, American farmers had recognized that soil properties had some connection to human health. In the modern world, we recognize that soils have a distinct influence on human health. We recognize that soils influence (1) food availability and quality (food security), (2) human contact with various chemicals, and (3) human contact with various pathogens. Soils and human health studies include investigations into nutrient supply through the food chain and routes of exposure to chemicals and pathogens. However, making strong, scientific connections between soils and human health can be difficult. There are multiple variables to consider in the soil environment, meaning traditional scientific studies that seek to isolate and manipulate a single variable often do not provide meaningful data. The complete study of soils and human health also involves many different specialties such as soil scientists, toxicologists, medical professionals, anthropologists, etc. These groups do not traditionally work together on research projects, and do not always effectively communicate with one another. Climate change and how it will affect the soil environment/ecosystem going into the future is another variable affecting the relationship between soils and health. Future successes in soils and human health research will require effectively addressing difficult issues such as these.

  19. Health and Human Rights : In Search of the Legal Dimension

    NARCIS (Netherlands)

    Toebes, Brigit

    2015-01-01

    Abstract: – This paper explores the legal contours of the field of ‘health and human rights’ as a new and emerging field of human rights law. After an analysis of its conceptual foundations, it explains illustrates how health and human rights evolved from a phase of standard-setting to a field that

  20. Electronic Health Record for Temporomandibular Joint Disorders – Support in Therapeutic Process

    Czech Academy of Sciences Publication Activity Database

    Hippmann, R.; Nagy, Miroslav; Dostálová, T.; Zvárová, Jana; Seydlová, M.; Feltlová, E.

    2010-01-01

    Roč. 6, č. 1 (2010), s. 27-32 ISSN 1801-5603 R&D Projects: GA MŠk(CZ) 1M06014 Institutional research plan: CEZ:AV0Z10300504 Keywords : electronic health record * automatic speech recognition * dental cross * temporomandibular joint * temporomandibular joint disorders * structured data entry * dentistry * data model * text-to-speech system * Research Diagnostic Criteria for TMD Subject RIV: IN - Informatics, Computer Science http://www.ejbi.org/en/ejbi/article/25-en- electronic - health - record -for-temporomandibular-joint-disorders-support-in-therapeutic-process.html

  1. Patient experiences with full electronic access to health records and clinical notes through the My HealtheVet Personal Health Record Pilot: qualitative study.

    Science.gov (United States)

    Woods, Susan S; Schwartz, Erin; Tuepker, Anais; Press, Nancy A; Nazi, Kim M; Turvey, Carolyn L; Nichol, W Paul

    2013-03-27

    Full sharing of the electronic health record with patients has been identified as an important opportunity to engage patients in their health and health care. The My HealtheVet Pilot, the initial personal health record of the US Department of Veterans Affairs, allowed patients and their delegates to view and download content in their electronic health record, including clinical notes, laboratory tests, and imaging reports. A qualitative study with purposeful sampling sought to examine patients' views and experiences with reading their health records, including their clinical notes, online. Five focus group sessions were conducted with patients and family members who enrolled in the My HealtheVet Pilot at the Portland Veterans Administration Medical Center, Oregon. A total of 30 patients enrolled in the My HealtheVet Pilot, and 6 family members who had accessed and viewed their electronic health records participated in the sessions. Four themes characterized patient experiences with reading the full complement of their health information. Patients felt that seeing their records positively affected communication with providers and the health system, enhanced knowledge of their health and improved self-care, and allowed for greater participation in the quality of their care such as follow-up of abnormal test results or decision-making on when to seek care. While some patients felt that seeing previously undisclosed information, derogatory language, or inconsistencies in their notes caused challenges, they overwhelmingly felt that having more, rather than less, of their health record information provided benefits. Patients and their delegates had predominantly positive experiences with health record transparency and the open sharing of notes and test results. Viewing their records appears to empower patients and enhance their contributions to care, calling into question common provider concerns about the effect of full record access on patient well-being. While shared

  2. Human Dignity, Misthanasia, Public Health and Bioethics in Brazil

    Directory of Open Access Journals (Sweden)

    Anna Silvia Penteado Setti da Rocha

    2017-10-01

    Full Text Available This paper aims to reflect on human dignity and misthanasia in the public health system in Brazil. For this, concepts, document reviews and public data about the condition of the Brazilian population’s access to public health were all used. The indicators show the health inequalities in the country, with the north and northeast at a disadvantage both in terms of access to health and the number of available professionals. Thus, the most underserved population tends to continue to be excluded from society and impaired with respect to their human dignity.

  3. Protecting patients’ electronic health records using enhanced active bundles

    NARCIS (Netherlands)

    Salih, R.M.; Lilien, L.T.; Ben Othmane, L.; Arriaga, R.; Matic, A.

    2012-01-01

    We propose a solution that provides protection for patients' electronic health/medical records disseminated among different authorized healthcare information systems. The solution is known as Active Bundles using a Trusted Third Party (ABTTP). It is based on the use of trusted third parties, and the

  4. Human Rights-Based Approaches to Mental Health: A Review of Programs.

    Science.gov (United States)

    Porsdam Mann, Sebastian; Bradley, Valerie J; Sahakian, Barbara J

    2016-06-01

    The incidence of human rights violations in mental health care across nations has been described as a "global emergency" and an "unresolved global crisis." The relationship between mental health and human rights is complex and bidirectional. Human rights violations can negatively impact mental health. Conversely, respecting human rights can improve mental health. This article reviews cases where an explicitly human rights-based approach was used in mental health care settings. Although the included studies did not exhibit a high level of methodological rigor, the qualitative information obtained was considered useful and informative for future studies. All studies reviewed suggest that human-rights based approaches can lead to clinical improvements at relatively low costs. Human rights-based approaches should be utilized for legal and moral reasons, since human rights are fundamental pillars of justice and civilization. The fact that such approaches can contribute to positive therapeutic outcomes and, potentially, cost savings, is additional reason for their implementation. However, the small sample size and lack of controlled, quantitative measures limit the strength of conclusions drawn from included studies. More objective, high quality research is needed to ascertain the true extent of benefits to service users and providers.

  5. Health Impacts from Human Interaction with the Environment

    Science.gov (United States)

    Hasan, S. E.

    2008-12-01

    Humans have produced far greater impact on the environment than any other living form. The impact has been so significant-particularly during the past 50 years-that a new word, Anthrposphere has started appearing in recent literature. It is now being used along with the four major components of the system earth to underscore humans' influence on the environment. Human activities have produced a myriad of impacts on the environment that span the scale from local to global. The slow process that brought humanity to the present environmental crisis began with the Industrial Revolution and has greatly accelerated since the World War II. The past 50 years mark a unique period in human history that is characterized by rapid technological advances and unprecedented population growth. While the use of technology has been very effective in meeting the needs of the growing population, it has also produced serious impact on the environment. Large scale exploitation of mineral, fuel, water, forest, and marine resources has led to severe environmental degradation; and the resulting pollution of air, water, and land has caused serious consequences to human and ecological health. The presentation deals with the adverse impact on human health associated with mining, dam and reservoir construction, improper waste management, use of fossil fuels, and climate change. Case studies are included to illustrate health impacts from metal and coal mining; dam and reservoir construction and preponderance of disease vectors; pollution caused by improper waste disposal and the resulting incidence of cancer and other diseases; and emergence of vector-borne diseases at hitherto unknown locations, cardiovascular and respiratory track ailments, and increased morbidity and mortality triggered by elevated temperatures associated with climate change. A brief discussion of possible measures to mitigate the health consequences is also included in the presentation.

  6. Educational actions in human communication health: telehealth contributions in primary care

    Directory of Open Access Journals (Sweden)

    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.

  7. Impact of environmental radiation on human health

    International Nuclear Information System (INIS)

    Shekhawat, Jyotsna

    2012-01-01

    A clean environment is essential for human health because the interaction between the environment and human health shows the complexity. Air pollution, less water quality, noise etc directly affects the health. Climate change, depletion of ozone layer, loss of biodiversity and degradation of land can also affect human health. Most of the modern technologies produce radiations in the environment having both beneficial and harmful effects through radioactive material. Natural radioactive sources include Cosmic radiation comes from the sun and outer space is absorbed by the atmosphere, a small amount reaches the earth's surface to which we are exposed. The exposure to this type of radiation is higher for people living above sea level. Radon is produced through the decay of uranium and thorium that are found naturally in the earth's crust. Primordial and terrestrial radiation are present in rocks and soils and occur when naturally radioactive isotopes of uranium, thorium and potassium decay within the earth's crust. Artificial (or man-made) radioactive sources include Fallout radiation, which results from past atmospheric nuclear bomb tests (1950s and 1960s many test explosions). Each environmental change, whether occurring as a natural phenomenon or through human intervention, changes the ecological balance and context within which disease hosts or vectors and parasites breed, develop, transmit disease. Today, radiation is a common used in medicine to diagnose illnesses, research to treat diseases and industry to generate electricity in nuclear power reactors. Radiation is energy that moves through space or matter at a very high speed. This energy can be in the form of particles, such as alpha or beta particles, which are emitted from radioisotopes. Radioactive Material is material that contains an unstable atomic nucleus releases radiation in the process of changing to a stable form. There are two types of health effects from radiation - threshold and non threshold

  8. Electronic Health Information Legal Epidemiology Data Set 2014

    Data.gov (United States)

    U.S. Department of Health & Human Services — Authors: Cason Schmit, JD, Gregory Sunshine, JD, Dawn Pepin, JD, MPH, Tara Ramanathan, JD, MPH, Akshara Menon, JD, MPH, Matthew Penn, JD, MLIS This legal data set...

  9. Human and veterinary medicine: the priority for public health synergies

    Directory of Open Access Journals (Sweden)

    Adriano Mantovani

    2008-12-01

    Full Text Available The concepts of ‘one medicine’ and 'one ‘health’ are supported and visualised as a tree (medicine, placed on the fertile soil (basic sciences, which divides into the two major branches of human and veterinary medicine, connected by the large branch of public health; minor branches (specialisations depart from the three larger ones. The synergy between human and veterinary medicine is not only a must for public health, but also implies ethical considerations. The basic reasons requiring synergy are found in the common sharing of the environment, in the use of animal products by humans, in the common culture and in the many problems to be faced together. The long list of adversities requiring synergy is topped by zoonoses (intended both in the classic and in the extended sense and food safety that extends to many other items connected with nutrition, environment, human/animal coexistence and the management of public health; the entire quality of human life is affected. Human and veterinary medicine have a strong cultural background (many subject matters in common, but unfortunately the undergraduate and postgraduate education programme (with few important exceptions do not offer training in cooperation. The synergy between human and veterinary medicines is an indicator of 'good public health practice' and any obstacles to this collaboration should be identified and eliminated. The logo for a public health founded on synergy is drawn as an umbrella formed by the medical and veterinary activities, protecting the population (consumers and producers, the animals and their products and the environment from the possible adversities linked to health.

  10. Potential of human health in the modern conditions

    Directory of Open Access Journals (Sweden)

    O. V. Dobryden

    2016-03-01

    Full Text Available This article proves that man’s relationship to their health  in each case have varying traits under the influence of sociocultural, psychological and physiological factors  which the world outlook is created from childhood, which implies the appropriate type of behavior that is fixed through the media and social authorities. It is established that scientific knowledge should not be against a man, and should enhance the power of man over nature, but can be transformed into a powerful weapon against humanity. It is noted that science is neutral in terms of values. Will it carry a positive or negative charge to human health depends on the social and cultural markers specific historical era and behavior of the individual. It was found that in addition to the economic crisis, which requires long-term joint economic and political transformations, the most important factor and more accessible to maintaining high adaptive potential health functions at all levels is valeological literacy social subjects and, therefore, imperative the systematic distribution of hygiene recommendations is a significant component of preventive medicine. With the growth of social and technological factors with their aggressive effect on psychophysiological state of man is seen timely more  talk even not about health in general, but should talk about  potential health, which underlines  the  difficulties adaptive and protective processes and susceptibility factors and resistance to pathological changes in the human body. All the more so when we following the formal standards of medicine is unlikely, unfortunately, we be found absolutely healthy people. Under the proposed potential health understood as a set of quantitative and qualitative structural and functional characteristics of the organism, which determine the level of adaptation and protection of human capabilities in adverse conditions, internal and external environment. It is proposed to examine potential

  11. Evaluating the adoption of an Electronic Patient Medicine module in health care

    DEFF Research Database (Denmark)

    Jensen, Tina Blegind; Andersen, Povl Erik Rostgård

    , and care of patients. One of the modules of the EHR system is the Electronic Patient Medicine (EPM) module which is considered an important means for reducing medical errors. In the literature, focus is primarily on those medical errors that are reduced when introducing EPM modules, whereas there is scarce......Introduction: In recent years, there has been an increased demand to exploit the possibilities of Information Technology (IT) in health care. In many hospitals, focus is on Electronic Health care Records (EHRs) which are depicted as central technologies in supporting the examination, treatment...

  12. COST action TD1407: network on technology-critical elements (NOTICE)--from environmental processes to human health threats.

    Science.gov (United States)

    Cobelo-García, A; Filella, M; Croot, P; Frazzoli, C; Du Laing, G; Ospina-Alvarez, N; Rauch, S; Salaun, P; Schäfer, J; Zimmermann, S

    2015-10-01

    The current socio-economic, environmental and public health challenges that countries are facing clearly need common-defined strategies to inform and support our transition to a sustainable economy. Here, the technology-critical elements (which includes Ga, Ge, In, Te, Nb, Ta, Tl, the Platinum Group Elements and most of the rare-earth elements) are of great relevance in the development of emerging key technologies-including renewable energy, energy efficiency, electronics or the aerospace industry. In this context, the increasing use of technology-critical elements (TCEs) and associated environmental impacts (from mining to end-of-life waste products) is not restricted to a national level but covers most likely a global scale. Accordingly, the European COST Action TD1407: Network on Technology-Critical Elements (NOTICE)-from environmental processes to human health threats, has an overall objective for creating a network of scientists and practitioners interested in TCEs, from the evaluation of their environmental processes to understanding potential human health threats, with the aim of defining the current state of knowledge and gaps, proposing priority research lines/activities and acting as a platform for new collaborations and joint research projects. The Action is focused on three major scientific areas: (i) analytical chemistry, (ii) environmental biogeochemistry and (iii) human exposure and (eco)-toxicology.

  13. Future human health research directions for the Canadian Northern Contaminants Program

    Science.gov (United States)

    Donaldson, Shawn G.; Curren, Meredith S.; Adlard, Bryan; Provost, Jonathan; Leech, Tara; Tikhonov, Constantine; Feeley, Mark; Tomlinson, Scott; Shearer, Russel

    2013-01-01

    Studies conducted in the mid-1980s and early 1990s demonstrated that persistent organic pollutants (POPs) and metals were reaching the Arctic ecosystem at unexpectedly high levels, many of which had no Arctic or Canadian sources. Epidemiological and toxicological studies in Canada and in other countries have found that these contaminants may pose a risk to human health. The objective of this paper is to provide the foundation for the discussion on future northern human health research under the Northern Contaminants Program (NCP) in Canada. This short discussion of human health priorities will help guide a path forward for future northern human health research in Canada to address on-going and new health concerns related to contaminants exposure in the Canadian Arctic. PMID:24282784

  14. Attitude Towards Health Information Privacy and Electronic Health Records Among Urban Sri Lankan Adults.

    Science.gov (United States)

    Tissera, Shaluni R; Silva, S N

    2016-01-01

    Sri Lanka is planning to move towards an Electronic Health Record (EHR) system. This research argues that the public preparedness should be considered in order to implement a functioning and an effective EHR system in a country. When asked about how concerned the participants were about the security of their health records, 40.5% stated they were concerned and 38.8% were very concerned. They were asked to rate the 'level of trust' they have on health institutes in Sri Lanka on a scale from 1 to 10 (1 lowest level of trust and 10 highest), 66.1% rated at level 5 or less.

  15. Electronic tools for health information exchange: an evidence-based analysis.

    Science.gov (United States)

    2013-01-01

    As patients experience transitions in care, there is a need to share information between care providers in an accurate and timely manner. With the push towards electronic medical records and other electronic tools (eTools) (and away from paper-based health records) for health information exchange, there remains uncertainty around the impact of eTools as a form of communication. To examine the impact of eTools for health information exchange in the context of care coordination for individuals with chronic disease in the community. A literature search was performed on April 26, 2012, using OVID MEDLINE, OVID MEDLINE In-Process and Other Non-Indexed Citations, OVID EMBASE, EBSCO Cumulative Index to Nursing & Allied Health Literature (CINAHL), the Wiley Cochrane Library, and the Centre for Reviews and Dissemination database, for studies published until April 26, 2012 (no start date limit was applied). A systematic literature search was conducted, and meta-analysis conducted where appropriate. Outcomes of interest fell into 4 categories: health services utilization, disease-specific clinical outcomes, process-of-care indicators, and measures of efficiency. The quality of the evidence was assessed individually for each outcome. Expert panels were assembled for stakeholder engagement and contextualization. Eleven articles were identified (4 randomized controlled trials and 7 observational studies). There was moderate quality evidence of a reduction in hospitalizations, hospital length of stay, and emergency department visits following the implementation of an electronically generated laboratory report with recommendations based on clinical guidelines. The evidence showed no difference in disease-specific outcomes; there was no evidence of a positive impact on process-of-care indicators or measures of efficiency. A limited body of research specifically examined eTools for health information exchange in the population and setting of interest. This evidence included a

  16. COMMENTARY: GLOBALIZATION, HEALTH SECTOR REFORM, AND THE HUMAN RIGHT TO HEALTH: IMPLICATIONS FOR FUTURE HEALTH POLICY.

    Science.gov (United States)

    Schuftan, Claudio

    2015-01-01

    The author here distills his long-time personal experience with the deleterious effects of globalization on health and on the health sector reforms embarked on in many of the more than 50 countries where he has worked in the last 25 years. He highlights the role that the "human right to health" framework can and should play in countering globalization's negative effects on health and in shaping future health policy. This is a testimonial article.

  17. The Successful Implementation of Electronic Health Records at Small Rural Hospitals

    Science.gov (United States)

    Richardson, Daniel

    2016-01-01

    Electronic health records (EHRs) have been in use since the 1960s. U.S. rural hospital leaders and administrators face significant pressure to implement health information technology because of the American Recovery and Reinvestment Act of 2009. However, some leaders and managers of small rural hospital lack strategies to develop and implement…

  18. The use of animals as a surveillance tool for monitoring environmental health hazards, human health hazards and bioterrorism.

    Science.gov (United States)

    Neo, Jacqueline Pei Shan; Tan, Boon Huan

    2017-05-01

    This review discusses the utilization of wild or domestic animals as surveillance tools for monitoring naturally occurring environmental and human health hazards. Besides providing early warning to natural hazards, animals can also provide early warning to societal hazards like bioterrorism. Animals are ideal surveillance tools to humans because they share the same environment as humans and spend more time outdoors than humans, increasing their exposure risk. Furthermore, the biologically compressed lifespans of some animals may allow them to develop clinical signs more rapidly after exposure to specific pathogens. Animals are an excellent channel for monitoring novel and known pathogens with outbreak potential given that more than 60 % of emerging infectious diseases in humans originate as zoonoses. This review attempts to highlight animal illnesses, deaths, biomarkers or sentinel events, to remind human and veterinary public health programs that animal health can be used to discover, monitor or predict environmental health hazards, human health hazards, or bioterrorism. Lastly, we hope that this review will encourage the implementation of animals as a surveillance tool by clinicians, veterinarians, ecosystem health professionals, researchers and governments. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  19. Climate Change, Soils, and Human Health

    Science.gov (United States)

    Brevik, Eric C.

    2013-04-01

    According to the Intergovernmental Panel on Climate Change, global temperatures are expected to increase 1.1 to 6.4 degrees C during the 21st century and precipitation patterns will be altered by climate change (IPCC, 2007). Soils are intricately linked to the atmospheric/climate system through the carbon, nitrogen, and hydrologic cycles. Altered climate will, therefore, have an effect on soil processes and properties. Studies into the effects of climate change on soil processes and properties are still incomplete, but have revealed that climate change will impact soil organic matter dynamics including soil organisms and the multiple soil properties that are tied to organic matter, soil water, and soil erosion. The exact direction and magnitude of those impacts will be dependent on the amount of change in atmospheric gases, temperature, and precipitation amounts and patterns. Recent studies give reason to believe at least some soils may become net sources of atmospheric carbon as temperatures rise; this is particularly true of high latitude regions with permanently frozen soils. Soil erosion by both wind and water is also likely to increase. These soil changes will lead to both direct and indirect impacts on human health. Possible indirect impacts include temperature extremes, food safety and air quality issues, increased and/or expanded disease incidences, and occupational health issues. Potential direct impacts include decreased food security and increased atmospheric dust levels. However, there are still many things we need to know more about. How climate change will affect the nitrogen cycle and, in turn, how the nitrogen cycle will affect carbon sequestration in soils is a major research need, as is a better understanding of soil water-CO2 level-temperature relationships. Knowledge of the response of plants to elevated atmospheric CO2 given limitations in nutrients like nitrogen and phosphorus and how that affects soil organic matter dynamics is a critical

  20. Risks and concerns regarding transgenic food and human health

    Directory of Open Access Journals (Sweden)

    Orlando Acosta

    2002-07-01

    Full Text Available The transgenic technology in agriculture has recently been in the center of an intense debate between two radically opposite points of view. Some non-government organizations (NGO consider this technology as dangerous for human health, environment and economics of developing countries. On the contrary, the scientific community has been publicly supportive of this technology, suggesting that education is the key to gaining the public acceptance. Although genetically modified (GM plants for food use might have the potential to provide benefits in food quality, nutrition, health and environment, GM plants need additional considerations related with biosafety. Despite there is not evidence that GM foods are more dangerous to human health than conventional food it is necessary to test GM food following the best scientific methodology available. This review focuses on the potential effects that GM food might have on human health.

  1. Responding to the health needs of survivors of human trafficking: a systematic review.

    Science.gov (United States)

    Hemmings, Stacey; Jakobowitz, Sharon; Abas, Melanie; Bick, Debra; Howard, Louise M; Stanley, Nicky; Zimmerman, Cathy; Oram, Sian

    2016-07-29

    Despite the multiple physical and psychological health consequences associated with human trafficking, there is little evidence-based guidance available for health providers on assessing and meeting the health needs of trafficked people. We aimed to review literature that provided guidance or research on care provision for people who had been trafficked. We conducted a systematic review and qualitative analysis of peer-reviewed and grey literature. Data sources included electronic databases, reference list screening, citation tracking, and expert recommendations. Documents were included if they reported on: 1) male or females (adults or children) who were currently or had previously been trafficked; 2) health interventions or service provision; 3) primary, secondary, tertiary or specialist post-trafficking services; and 4) World Bank high income countries. Two reviewers independently screened and quality appraised documents. Framework analysis was used to analyse extracted data. Forty-four documents were included, 19 of which reported findings of primary studies and nine of which exclusively addressed children. Evidence to inform the identification, referral and care of trafficked people is extremely limited. Within current literature on survivor identification, key indicators included signs of physical and sexual abuse, absence of documentation, and being accompanied by a controlling companion. Findings highlighted the importance of interviewing possible victims in private, using professional interpreters, and building trust. For provision of care, key themes included the importance of comprehensive needs assessments, adhering to principles of trauma-informed care, and cultural sensitivity. Further prominent themes were the necessity of multi-agency working strategies and well-defined referral pathways. Human trafficking survivors require healthcare that is trauma-informed and culturally sensitive to their particular needs. Coordination is needed between health

  2. Exploring Workarounds Related to Electronic Health Record System Usage: A Study Protocol

    NARCIS (Netherlands)

    Blijleven, Vincent; Koelemeijer, Kitty; Jaspers, Monique

    2017-01-01

    Health care providers resort to informal temporary practices known as workarounds for handling exceptions to normal workflow that are unintentionally imposed by electronic health record (EHR) systems. Although workarounds may seem favorable at first sight, they are generally suboptimal and may

  3. Nitrite in feed: From Animal health to human health

    Energy Technology Data Exchange (ETDEWEB)

    Cockburn, Andrew [Institute for Research on Environment and Sustainability, Devonshire Building, University of Newcastle upon Tyne, Newcastle upon Tyne, NE17RU (United Kingdom); Brambilla, Gianfranco [Istituto Superiore di Sanità, Toxicological chemistry unit, Viale Regina Elena 299, 00161 Rome (Italy); Fernández, Maria-Luisa [Departamento de Medio Ambiente, Instituto Nacional de Investigación y Tecnología Agraria y Alimentaria (INIA), Ministerio de Ciencia e Innovación, Carretera de la Coruña, 28040 Madrid (Spain); Arcella, Davide [Unit on Data Collection and Exposure, European Food Safety Authority, Largo N. Palli 5/A43100 Parma (Italy); Bordajandi, Luisa R. [Unit on Contaminants in the Food chain, European Food Safety Authority, Largo N. Palli 5/A, 43100 Parma (Italy); Cottrill, Bruce [Policy Delivery Group, Animal Health and Welfare, ADAS, Wolverhampton (United Kingdom); Peteghem, Carlos van [University of Gent, Harelbekestraat 72, 9000 Gent (Belgium); Dorne, Jean-Lou, E-mail: jean-lou.dorne@efsa.europa.eu [Unit on Contaminants in the Food chain, European Food Safety Authority, Largo N. Palli 5/A, 43100 Parma (Italy)

    2013-08-01

    Nitrite is widely consumed from the diet by animals and humans. However the largest contribution to exposure results from the in vivo conversion of exogenously derived nitrate to nitrite. Because of its potential to cause to methaemoglobin (MetHb) formation at excessive levels of intake, nitrite is regulated in feed and water as an undesirable substance. Forages and contaminated water have been shown to contain high levels of nitrate and represent the largest contributor to nitrite exposure for food-producing animals. Interspecies differences in sensitivity to nitrite intoxication principally result from physiological and anatomical differences in nitrite handling. In the case of livestock both pigs and cattle are relatively susceptible. With pigs this is due to a combination of low levels of bacterial nitrite reductase and hence potential to reduce nitrite to ammonia as well as reduced capacity to detoxify MetHb back to haemoglobin (Hb) due to intrinsically low levels of MetHb reductase. In cattle the sensitivity is due to the potential for high dietary intake and high levels of rumen conversion of nitrate to nitrite, and an adaptable gut flora which at normal loadings shunts nitrite to ammonia for biosynthesis. However when this escape mechanism gets overloaded, nitrite builds up and can enter the blood stream resulting in methemoglobinemia. Looking at livestock case histories reported in the literature no-observed-effect levels of 3.3 mg/kg body weight (b.w.) per day for nitrite in pigs and cattle were estimated and related to the total daily nitrite intake that would result from complete feed at the EU maximum permissible level. This resulted in margins of safety of 9-fold and 5-fold for pigs and cattle, respectively. Recognising that the bulkiness of animal feed limits their consumption, these margins in conjunction with good agricultural practise were considered satisfactory for the protection of livestock health. A human health risk assessment was also

  4. Nitrite in feed: From Animal health to human health

    International Nuclear Information System (INIS)

    Cockburn, Andrew; Brambilla, Gianfranco; Fernández, Maria-Luisa; Arcella, Davide; Bordajandi, Luisa R.; Cottrill, Bruce; Peteghem, Carlos van; Dorne, Jean-Lou

    2013-01-01

    Nitrite is widely consumed from the diet by animals and humans. However the largest contribution to exposure results from the in vivo conversion of exogenously derived nitrate to nitrite. Because of its potential to cause to methaemoglobin (MetHb) formation at excessive levels of intake, nitrite is regulated in feed and water as an undesirable substance. Forages and contaminated water have been shown to contain high levels of nitrate and represent the largest contributor to nitrite exposure for food-producing animals. Interspecies differences in sensitivity to nitrite intoxication principally result from physiological and anatomical differences in nitrite handling. In the case of livestock both pigs and cattle are relatively susceptible. With pigs this is due to a combination of low levels of bacterial nitrite reductase and hence potential to reduce nitrite to ammonia as well as reduced capacity to detoxify MetHb back to haemoglobin (Hb) due to intrinsically low levels of MetHb reductase. In cattle the sensitivity is due to the potential for high dietary intake and high levels of rumen conversion of nitrate to nitrite, and an adaptable gut flora which at normal loadings shunts nitrite to ammonia for biosynthesis. However when this escape mechanism gets overloaded, nitrite builds up and can enter the blood stream resulting in methemoglobinemia. Looking at livestock case histories reported in the literature no-observed-effect levels of 3.3 mg/kg body weight (b.w.) per day for nitrite in pigs and cattle were estimated and related to the total daily nitrite intake that would result from complete feed at the EU maximum permissible level. This resulted in margins of safety of 9-fold and 5-fold for pigs and cattle, respectively. Recognising that the bulkiness of animal feed limits their consumption, these margins in conjunction with good agricultural practise were considered satisfactory for the protection of livestock health. A human health risk assessment was also

  5. Electronic health records: a valuable tool for dental school strategic planning.

    Science.gov (United States)

    Filker, Phyllis J; Cook, Nicole; Kodish-Stav, Jodi

    2013-05-01

    The objective of this study was to investigate if electronic patient records have utility in dental school strategic planning. Electronic health records (EHRs) have been used by all predoctoral students and faculty members at Nova Southeastern University's College of Dental Medicine (NSU-CDM) since 2006. The study analyzed patient demographic and caries risk assessment data from October 2006 to May 2011 extracted from the axiUm EHR database. The purpose was to determine if there was a relationship between high oral health care needs and patient demographics, including gender, age, and median income of the zip code where they reside in order to support dental school strategic planning including the locations of future satellite clinics. The results showed that about 51 percent of patients serviced by the Broward County-based NSU-CDM oral health care facilities have high oral health care needs and that about 60 percent of this population resides in zip codes where the average income is below the median income for the county ($41,691). The results suggest that EHR data can be used adjunctively by dental schools when proposing potential sites for satellite clinics and planning for future oral health care programming.

  6. An electronic health record for infertility clinics | Coetsee | South ...

    African Journals Online (AJOL)

    Objective. To design a user-friendly electronic health record system for infertility clinics (EHRIC) to capture quality data that will allow advanced audit and practice analysis, and to use the captured data for the South African Register of Assisted Reproductive Techniques (SARA) database and as a clinical research function.

  7. Human rights of drug users according to public health professionals in Brazil.

    Science.gov (United States)

    Ventura, Carla A A; Mendes, Isabel A C; Trevizan, Maria A; Rodrigues, Driéli P

    2013-03-01

    Health is a basic human right, and drug use represents a severe influence on people's health. This qualitative study aimed to understand how health professionals in a public health-care team working with drug users in a city of the state of São Paulo, Brazil, perceive the human rights of these users and how these rights are being respected in health care. Data were collected through semistructured interviews with 10 health professionals at the service under analysis. A thematic analysis of the interviews reveals the professionals' difficulty to define the concept of human right and contextualize these rights in their work environment. A deeper understanding of the right to health, however, represents an important premise for a more humanized care practice in health services to drug users.

  8. Human rights in patient care and public health-a common ground.

    Science.gov (United States)

    Peled-Raz, Maya

    2017-01-01

    Medical law and public health law have both served extensively as instruments of health protection and promotion-yet both are limited in their effect and scope and do not sufficiently cover nor supply a remedy to systematic, rather than anecdotal, mistreatments in the health care system. A possible solution to this deficiency may be found in the human rights in patient care legal approach. The concept of human rights in patient care is a reframing of international human rights law, as well as constitutional thought and tools, into a coherent approach aimed at the protection and furthering of both personal and communal health. It applies human rights discourse and human rights law onto the patient care setting while moving away from the narrow consumeristic view of health care delivery. By applying human rights in patient care approach, both national and international courts may and should serve as policy influencing instruments, protecting the rights of the most vulnerable and prejudiced against groups, which are want of a remedy through traditional patients' rights legal schemes.

  9. Acceptance and Usage of Electronic Health Record Systems in Small Medical Practices

    Science.gov (United States)

    Tannan, Ritu

    2012-01-01

    One of the objectives of the U.S. government has been the development of a nationwide health information infrastructure, including adoption and use of an electronic health records (EHR) system. However, a 2008 survey conducted by the National Center for Health Statistics indicated a 41.5% usage of the EHR system by physicians in office-based…

  10. Practical Applications of Cosmic Ray Science: Spacecraft, Aircraft, Ground-Based Computation and Control Systems, and Human Health and Safety

    Science.gov (United States)

    Atwell, William; Koontz, Steve; Normand, Eugene

    2012-01-01

    Three twentieth century technological developments, 1) high altitude commercial and military aircraft; 2) manned and unmanned spacecraft; and 3) increasingly complex and sensitive solid state micro-electronics systems, have driven an ongoing evolution of basic cosmic ray science into a set of practical engineering tools needed to design, test, and verify the safety and reliability of modern complex technological systems. The effects of primary cosmic ray particles and secondary particle showers produced by nuclear reactions with the atmosphere, can determine the design and verification processes (as well as the total dollar cost) for manned and unmanned spacecraft avionics systems. Similar considerations apply to commercial and military aircraft operating at high latitudes and altitudes near the atmospheric Pfotzer maximum. Even ground based computational and controls systems can be negatively affected by secondary particle showers at the Earth s surface, especially if the net target area of the sensitive electronic system components is large. Finally, accumulation of both primary cosmic ray and secondary cosmic ray induced particle shower radiation dose is an important health and safety consideration for commercial or military air crews operating at high altitude/latitude and is also one of the most important factors presently limiting manned space flight operations beyond low-Earth orbit (LEO). In this paper we review the discovery of cosmic ray effects on the performance and reliability of microelectronic systems as well as human health and the development of the engineering and health science tools used to evaluate and mitigate cosmic ray effects in ground-based atmospheric flight, and space flight environments. Ground test methods applied to microelectronic components and systems are used in combinations with radiation transport and reaction codes to predict the performance of microelectronic systems in their operating environments. Similar radiation transport

  11. Health information technology: integration of clinical workflow into meaningful use of electronic health records.

    Science.gov (United States)

    Bowens, Felicia M; Frye, Patricia A; Jones, Warren A

    2010-10-01

    This article examines the role that clinical workflow plays in successful implementation and meaningful use of electronic health record (EHR) technology in ambulatory care. The benefits and barriers of implementing EHRs in ambulatory care settings are discussed. The researchers conclude that widespread adoption and meaningful use of EHR technology rely on the successful integration of health information technology (HIT) into clinical workflow. Without successful integration of HIT into clinical workflow, clinicians in today's ambulatory care settings will continue to resist adoption and implementation of EHR technology.

  12. Identifying patients with hypertension: a case for auditing electronic health record data.

    Science.gov (United States)

    Baus, Adam; Hendryx, Michael; Pollard, Cecil

    2012-01-01

    Problems in the structure, consistency, and completeness of electronic health record data are barriers to outcomes research, quality improvement, and practice redesign. This nonexperimental retrospective study examines the utility of importing de-identified electronic health record data into an external system to identify patients with and at risk for essential hypertension. We find a statistically significant increase in cases based on combined use of diagnostic and free-text coding (mean = 1,256.1, 95% CI 1,232.3-1,279.7) compared to diagnostic coding alone (mean = 1,174.5, 95% CI 1,150.5-1,198.3). While it is not surprising that significantly more patients are identified when broadening search criteria, the implications are critical for quality of care, the movement toward the National Committee for Quality Assurance's Patient-Centered Medical Home program, and meaningful use of electronic health records. Further, we find a statistically significant increase in potential cases based on the last two or more blood pressure readings greater than or equal to 140/90 mm Hg (mean = 1,353.9, 95% CI 1,329.9-1,377.9).

  13. Health and human rights a South African perspective.

    Science.gov (United States)

    Naidoo, Sudeshni

    2014-01-01

    General statements of basic entitlements are established as a guide for potential laws and regulations protecting human rights. Human rights are those claimed to belong to every individual regardless of nationality or position within society. The historical evolution of human rights relative to health in the Republic of South Africa is discussed.

  14. Human trafficking: review of educational resources for health professionals.

    Science.gov (United States)

    Ahn, Roy; Alpert, Elaine J; Purcell, Genevieve; Konstantopoulos, Wendy Macias; McGahan, Anita; Cafferty, Elizabeth; Eckardt, Melody; Conn, Kathryn L; Cappetta, Kate; Burke, Thomas F

    2013-03-01

    Human trafficking is an increasingly well-recognized human rights violation that is estimated to involve more than 2 million victims worldwide each year. The health consequences of this issue bring victims into contact with health systems and healthcare providers, thus providing the potential for identification and intervention. A robust healthcare response, however, requires a healthcare workforce that is aware of the health impact of this issue; educated about how to identify and treat affected individuals in a compassionate, culturally aware, and trauma-informed manner; and trained about how to collaborate efficiently with law enforcement, case management, and advocacy partners. This article describes existing educational offerings about human trafficking designed for a healthcare audience and makes recommendations for further curriculum development. A keyword search and structured analysis of peer-reviewed and gray literature, conducted in 2011 and 2012, yielded 27 items that provide basic guidance to health professionals on human trafficking. The 27 resources differed substantially in format, length, scope, and intended audience. Topic areas covered by these resources included trafficking definitions and scope, health consequences, victim identification, appropriate treatment, referral to services, legal issues, and security. None of the educational resources has been rigorously evaluated. There is a clear need to develop, implement, and evaluate high-quality education and training programs that focus on human trafficking for healthcare providers. Copyright © 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  15. Bisphenol A and human health: a review of the literature.

    Science.gov (United States)

    Rochester, Johanna R

    2013-12-01

    There is growing evidence that bisphenol A (BPA) may adversely affect humans. BPA is an endocrine disruptor that has been shown to be harmful in laboratory animal studies. Until recently, there were relatively few epidemiological studies examining the relationship between BPA and health effects in humans. However, in the last year, the number of these studies has more than doubled. A comprehensive literature search found 91 studies linking BPA to human health; 53 published within the last year. This review outlines this body of literature, showing associations between BPA exposure and adverse perinatal, childhood, and adult health outcomes, including reproductive and developmental effects, metabolic disease, and other health effects. These studies encompass both prenatal and postnatal exposures, and include several study designs and population types. While it is difficult to make causal links with epidemiological studies, the growing human literature correlating environmental BPA exposure to adverse effects in humans, along with laboratory studies in many species including primates, provides increasing support that environmental BPA exposure can be harmful to humans, especially in regards to behavioral and other effects in children. Copyright © 2013 Elsevier Inc. All rights reserved.

  16. [Human resources for health in Chile: the reform's pending challenge].

    Science.gov (United States)

    Méndez, Claudio A

    2009-09-01

    Omission of human resources from health policy development has been identified as a barrier in the health sector reform's adoption phase. Since 2002, Chile's health care system has been undergoing a transformation based on the principles of health as a human right, equity, solidarity, efficiency, and social participation. While the reform has set forth the redefinition of the medical professions, continuing education, scheduled accreditation, and the introduction of career development incentives, it has not considered management options tailored to the new setting, a human resources strategy that has the consensus of key players and sector policy, or a process for understanding the needs of health care staff and professionals. However, there is still time to undo the shortcomings, in large part because the reform's implementation phase only recently has begun. Overcoming this challenge is in the hands of the experts charged with designing public health strategies and policies.

  17. [National Policy of Humanization and education of health care professionals: integrative review].

    Science.gov (United States)

    Barbosa, Guilherme Correa; Meneguim, Silmara; Lima, Silvana Andréa Molina; Moreno, Vania

    2013-01-01

    The National Policy of Humanization aims at innovations in health production, management and care with emphasis on permanent education for workers in the Unified Public Health System and training of university students in the health care field. This study aimed to know, through an integrative review of the literature, the scientific production about the National Policy of Humanization and education of health care professionals, from 2002 to 2010. Ten articles were analyzed in thematic strand through three axes: humanization and users caring, humanization and the work process, humanization and training. The articles point to the need to overcome the biological conception, valuing cultural aspects of users. The work process is marked by the devaluation of workers and by users deprived of their rights. The training of health professionals is grounded in health services where the prevailing standards are practices that hinder innovative attitudes.

  18. Progress in increasing electronic reporting of laboratory results to public health agencies--United States, 2013.

    Science.gov (United States)

    2013-09-27

    Electronic reporting of laboratory results to public health agencies can improve public health surveillance for reportable diseases and conditions by making reporting more timely and complete. Since 2010, CDC has provided funding to 57 state, local, and territorial health departments through the Epidemiology and Laboratory Capacity for Infectious Diseases cooperative agreement to assist with improving electronic laboratory reporting (ELR) from clinical and public health laboratories to public health agencies. As part of this agreement, CDC and state and large local health departments are collaborating to monitor ELR implementation in the United States by developing data from each jurisdiction regarding total reporting laboratories, laboratories sending ELR by disease category and message format, and the number of ELR laboratory reports compared with the total number of laboratory reports. At the end of July 2013, 54 of the 57 jurisdictions were receiving at least some laboratory reports through ELR, and approximately 62% of 20 million laboratory reports were being received electronically, compared with 54% in 2012. Continued progress will require collaboration between clinical laboratories, laboratory information management system (LIMS) vendors, and public health agencies.

  19. Integrating cancer genomic data into electronic health records

    Directory of Open Access Journals (Sweden)

    Jeremy L. Warner

    2016-10-01

    Full Text Available Abstract The rise of genomically targeted therapies and immunotherapy has revolutionized the practice of oncology in the last 10–15 years. At the same time, new technologies and the electronic health record (EHR in particular have permeated the oncology clinic. Initially designed as billing and clinical documentation systems, EHR systems have not anticipated the complexity and variety of genomic information that needs to be reviewed, interpreted, and acted upon on a daily basis. Improved integration of cancer genomic data with EHR systems will help guide clinician decision making, support secondary uses, and ultimately improve patient care within oncology clinics. Some of the key factors relating to the challenge of integrating cancer genomic data into EHRs include: the bioinformatics pipelines that translate raw genomic data into meaningful, actionable results; the role of human curation in the interpretation of variant calls; and the need for consistent standards with regard to genomic and clinical data. Several emerging paradigms for integration are discussed in this review, including: non-standardized efforts between individual institutions and genomic testing laboratories; “middleware” products that portray genomic information, albeit outside of the clinical workflow; and application programming interfaces that have the potential to work within clinical workflow. The critical need for clinical-genomic knowledge bases, which can be independent or integrated into the aforementioned solutions, is also discussed.

  20. Feasibility of utilizing a commercial eye tracker to assess electronic health record use during patient simulation.

    Science.gov (United States)

    Gold, Jeffrey Allen; Stephenson, Laurel E; Gorsuch, Adriel; Parthasarathy, Keshav; Mohan, Vishnu

    2016-09-01

    Numerous reports describe unintended consequences of electronic health record implementation. Having previously described physicians' failures to recognize patient safety issues within our electronic health record simulation environment, we now report on our use of eye and screen-tracking technology to understand factors associated with poor error recognition during an intensive care unit-based electronic health record simulation. We linked performance on the simulation to standard eye and screen-tracking readouts including number of fixations, saccades, mouse clicks and screens visited. In addition, we developed an overall Composite Eye Tracking score which measured when, where and how often each safety item was viewed. For 39 participants, the Composite Eye Tracking score correlated with performance on the simulation (p = 0.004). Overall, the improved performance was associated with a pattern of rapid scanning of data manifested by increased number of screens visited (p = 0.001), mouse clicks (p = 0.03) and saccades (p = 0.004). Eye tracking can be successfully integrated into electronic health record-based simulation and provides a surrogate measure of cognitive decision making and electronic health record usability. © The Author(s) 2015.

  1. Disassociation for electronic health record privacy.

    Science.gov (United States)

    Loukides, Grigorios; Liagouris, John; Gkoulalas-Divanis, Aris; Terrovitis, Manolis

    2014-08-01

    The dissemination of Electronic Health Record (EHR) data, beyond the originating healthcare institutions, can enable large-scale, low-cost medical studies that have the potential to improve public health. Thus, funding bodies, such as the National Institutes of Health (NIH) in the U.S., encourage or require the dissemination of EHR data, and a growing number of innovative medical investigations are being performed using such data. However, simply disseminating EHR data, after removing identifying information, may risk privacy, as patients can still be linked with their record, based on diagnosis codes. This paper proposes the first approach that prevents this type of data linkage using disassociation, an operation that transforms records by splitting them into carefully selected subsets. Our approach preserves privacy with significantly lower data utility loss than existing methods and does not require data owners to specify diagnosis codes that may lead to identity disclosure, as these methods do. Consequently, it can be employed when data need to be shared broadly and be used in studies, beyond the intended ones. Through extensive experiments using EHR data, we demonstrate that our method can construct data that are highly useful for supporting various types of clinical case count studies and general medical analysis tasks. Copyright © 2014 Elsevier Inc. All rights reserved.

  2. Human Resources for Health Challenges in Nigeria and Nurse Migration.

    Science.gov (United States)

    Salami, Bukola; Dada, Foluke O; Adelakun, Folake E

    2016-05-01

    The emigration of sub-Saharan African health professionals to developed Western nations is an aspect of increasing global mobility. This article focuses on the human resources for health challenges in Nigeria and the emigration of nurses from Nigeria as the country faces mounting human resources for health challenges. Human resources for health issues in Nigeria contribute to poor population health in the country, alongside threats from terrorism, infectious disease outbreaks, and political corruption. Health inequities within Nigeria mirror the geographical disparities in human resources for health distribution and are worsened by the emigration of Nigerian nurses to developed countries such as the United States and the United Kingdom. Nigerian nurses are motivated to emigrate to work in healthier work environments, improve their economic prospects, and advance their careers. Like other migrant African nurses, they experience barriers to integration, including racism and discrimination, in receiving countries. We explore the factors and processes that shape this migration. Given the forces of globalization, source countries and destination countries must implement policies to more responsibly manage migration of nurses. This can be done by implementing measures to retain nurses, promote the return migration of expatriate nurses, and ensure the integration of migrant nurses upon arrival in destination countries. © The Author(s) 2016.

  3. Taming the EHR (Electronic Health Record) - There is Hope

    Science.gov (United States)

    DiAngi, YT; Longhurst, CA; Payne, TH

    2016-01-01

    With increasing diffusion of EHR technology over the last half decade, clinician burnout is rising. As healthcare is a complex and highly regulated field, the rapid and mass adoption of EHR technology has created disruption for highly skilled workers such as clinicians. Although, much has been written about dissatisfaction with the EHR (electronic health record), a paucity of immediate solutions exists in the literature. This article suggests three actionable steps health systems and clinicians can make to expedite gains from and mitigate the effect of the EHR on clinical practice. PMID:27830215

  4. [Health consequences of smoking electronic cigarettes are poorly described].

    Science.gov (United States)

    Tøttenborg, Sandra Søgaard; Holm, Astrid Ledgaard; Wibholm, Niels Christoffer; Lange, Peter

    2014-09-01

    Despite increasing popularity, health consequences of vaping (smoking electronic cigarettes, e-cigarettes) are poorly described. Few studies suggest that vaping has less deleterious effects on lung function than smoking conventional cigarettes. One large study found that e-cigarettes were as efficient as nicotine patches in smoking cessation. The long-term consequences of vaping are however unknown and while some experts are open towards e-cigarettes as a safer way of satisfying nicotine addiction, others worry that vaping in addition to presenting a health hazard may lead to an increased number of smokers of conventional cigarettes.

  5. The effect of electronic health record software design on resident documentation and compliance with evidence-based medicine.

    Directory of Open Access Journals (Sweden)

    Yasaira Rodriguez Torres

    Full Text Available This study aimed to determine the role of electronic health record software in resident education by evaluating documentation of 30 elements extracted from the American Academy of Ophthalmology Dry Eye Syndrome Preferred Practice Pattern. The Kresge Eye Institute transitioned to using electronic health record software in June 2013. We evaluated the charts of 331 patients examined in the resident ophthalmology clinic between September 1, 2011, and March 31, 2014, for an initial evaluation for dry eye syndrome. We compared documentation rates for the 30 evidence-based elements between electronic health record chart note templates among the ophthalmology residents. Overall, significant changes in documentation occurred when transitioning to a new version of the electronic health record software with average compliance ranging from 67.4% to 73.6% (p 90% in 13 elements while Electronic Health Record B had high compliance (>90% in 11 elements. The presence of dialog boxes was responsible for significant changes in documentation of adnexa, puncta, proptosis, skin examination, contact lens wear, and smoking exposure. Significant differences in documentation were correlated with electronic health record template design rather than individual resident or residents' year in training. Our results show that electronic health record template design influences documentation across all resident years. Decreased documentation likely results from "mouse click fatigue" as residents had to access multiple dialog boxes to complete documentation. These findings highlight the importance of EHR template design to improve resident documentation and integration of evidence-based medicine into their clinical notes.

  6. Electronic Health Record-Related Safety Concerns: A Cross-Sectional Survey of Electronic Health Record Users

    Science.gov (United States)

    Pajunen, Tuuli; Saranto, Kaija; Lehtonen, Lasse

    2016-01-01

    Background The rapid expansion in the use of electronic health records (EHR) has increased the number of medical errors originating in health information systems (HIS). The sociotechnical approach helps in understanding risks in the development, implementation, and use of EHR and health information technology (HIT) while accounting for complex interactions of technology within the health care system. Objective This study addresses two important questions: (1) “which of the common EHR error types are associated with perceived high- and extreme-risk severity ratings among EHR users?”, and (2) “which variables are associated with high- and extreme-risk severity ratings?” Methods This study was a quantitative, non-experimental, descriptive study of EHR users. We conducted a cross-sectional web-based questionnaire study at the largest hospital district in Finland. Statistical tests included the reliability of the summative scales tested with Cronbach’s alpha. Logistic regression served to assess the association of the independent variables to each of the eight risk factors examined. Results A total of 2864 eligible respondents provided the final data. Almost half of the respondents reported a high level of risk related to the error type “extended EHR unavailability”. The lowest overall risk level was associated with “selecting incorrectly from a list of items”. In multivariate analyses, profession and clinical unit proved to be the strongest predictors for high perceived risk. Physicians perceived risk levels to be the highest (Prisk levels (PeLearning courses on EHR-use was associated with lower risk for some of the risk factors. Conclusions Based on a large number of Finnish EHR users in hospitals, this study indicates that HIT safety hazards should be taken very seriously, particularly in operating rooms, procedure units, emergency departments, and intensive care units/critical care units. Health care organizations should use proactive and

  7. Ethical considerations in internet use of electronic protected health information.

    Science.gov (United States)

    Polito, Jacquelyn M

    2012-03-01

    Caregivers, patients, and their family members are increasingly reliant on social network websites for storing, communicating, and referencing medical information. The Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule seeks balance by protecting the privacy of patients' health information and assuring that this information is available to those who need it to provide health care. Though federal and state governments have created laws and policies to safeguard patient privacy and confidentiality, the laws are inadequate against the rapid and innovative use of electronic health websites. As Internet use broadens access to information, health professionals must be aware that this information is not always secure. We must identify and reflect on medical ethics issues and be accountable for maintaining privacy for the patient.

  8. Depleted Uranium and Human Health.

    Science.gov (United States)

    Faa, Armando; Gerosa, Clara; Fanni, Daniela; Floris, Giuseppe; Eyken, Peter V; Lachowicz, Joanna I; Nurchi, Valeria M

    2018-01-01

    Depleted uranium (DU) is generally considered an emerging pollutant, first extensively introduced into environment in the early nineties in Iraq, during the military operation called "Desert Storm". DU has been hypothesized to represent a hazardous element both for soldiers exposed as well as for the inhabitants of the polluted areas in the war zones. In this review, the possible consequences on human health of DU released in the environment are critically analyzed. In the first part, the chemical properties of DU and the principal civil and military uses are summarized. A concise analysis of the mechanisms underlying absorption, blood transport, tissue distribution and excretion of DU in the human body is the subject of the second part of this article. The following sections deal with pathological condition putatively associated with overexposure to DU. Developmental and birth defects, the Persian Gulf syndrome, and kidney diseases that have been associated to DU are the arguments treated in the third section. Finally, data regarding DU exposure and cancer insurgence will be critically analyzed, including leukemia/lymphoma, lung cancer, uterine cervix cancer, breast cancer, bladder cancer and testicular cancer. The aim of the authors is to give a contribution to the debate on DU and its effects on human health and disease. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  9. Development of an electronic claim system based on an integrated electronic health record platform to guarantee interoperability.

    Science.gov (United States)

    Kim, Hwa Sun; Cho, Hune; Lee, In Keun

    2011-06-01

    We design and develop an electronic claim system based on an integrated electronic health record (EHR) platform. This system is designed to be used for ambulatory care by office-based physicians in the United States. This is achieved by integrating various medical standard technologies for interoperability between heterogeneous information systems. The developed system serves as a simple clinical data repository, it automatically fills out the Centers for Medicare and Medicaid Services (CMS)-1500 form based on information regarding the patients and physicians' clinical activities. It supports electronic insurance claims by creating reimbursement charges. It also contains an HL7 interface engine to exchange clinical messages between heterogeneous devices. The system partially prevents physician malpractice by suggesting proper treatments according to patient diagnoses and supports physicians by easily preparing documents for reimbursement and submitting claim documents to insurance organizations electronically, without additional effort by the user. To show the usability of the developed system, we performed an experiment that compares the time spent filling out the CMS-1500 form directly and time required create electronic claim data using the developed system. From the experimental results, we conclude that the system could save considerable time for physicians in making claim documents. The developed system might be particularly useful for those who need a reimbursement-specialized EHR system, even though the proposed system does not completely satisfy all criteria requested by the CMS and Office of the National Coordinator for Health Information Technology (ONC). This is because the criteria are not sufficient but necessary condition for the implementation of EHR systems. The system will be upgraded continuously to implement the criteria and to offer more stable and transparent transmission of electronic claim data.

  10. Potential value of electronic prescribing in health economic and outcomes research

    Directory of Open Access Journals (Sweden)

    Catherine E Cooke

    2010-11-01

    Full Text Available Catherine E Cooke1, Brian J Isetts2, Thomas E Sullivan3, Maren Fustgaard4, Daniel A Belletti51PosiHealth Inc., Ellicott City, MD, USA; 2Department of Pharmaceutical Care and Health Systems, University of Minnesota College of Pharmacy, Minneapolis, MN, USA; 3Women’s Health Center, Danvers, MA, USA; 4Assistant Director for Regional Outcomes Research, 5Associate Director for Regional Outcomes Research, Novartis Pharmaceuticals Corporation, East Hanover, NJ, USAAbstract: Improving access and quality while reducing expenditures in the United States health system is expected to be a priority for many years. The use of health information technology (HIT, including electronic prescribing (eRx, is an important initiative in efforts aimed at improving safety and outcomes, increasing quality, and decreasing costs. Data from eRx has been used in studies that document reductions in medication errors, adverse drug events, and pharmacy order-processing time. Evaluating programs and initiatives intended to improve health care can be facilitated through the use of HIT and eRx. eRx data can be used to conduct research to answer questions about the outcomes of health care products, services, and new clinical initiatives with the goal of providing guidance for clinicians and policy makers. Given the recent explosive growth of eRx in the United States, the purpose of this manuscript is to assess the value and suggest enhanced uses and applications of eRx to facilitate the role of the practitioner in contributing to health economics and outcomes research.Keywords: electronic prescribing, outcomes research, health information technology

  11. Electronic Health Records: VAs Efforts Raise Concerns about Interoperability Goals and Measures, Duplication with DOD, and Future Plans

    Science.gov (United States)

    2016-07-13

    ELECTRONIC HEALTH RECORDS VA’s Efforts Raise Concerns about Interoperability Goals and Measures, Duplication with DOD...Agencies, Committee on Appropriations, U.S. Senate July 13, 2016 ELECTRONIC HEALTH RECORDS VA’s Efforts Raise Concerns about Interoperability Goals...initiatives with the Department of Defense (DOD) that were intended to advance the ability of the two departments to share electronic health records ,

  12. A systematic review of portable electronic technology for health education in resource-limited settings.

    Science.gov (United States)

    McHenry, Megan S; Fischer, Lydia J; Chun, Yeona; Vreeman, Rachel C

    2017-08-01

    The objective of this study is to conduct a systematic review of the literature of how portable electronic technologies with offline functionality are perceived and used to provide health education in resource-limited settings. Three reviewers evaluated articles and performed a bibliography search to identify studies describing health education delivered by portable electronic device with offline functionality in low- or middle-income countries. Data extracted included: study population; study design and type of analysis; type of technology used; method of use; setting of technology use; impact on caregivers, patients, or overall health outcomes; and reported limitations. Searches yielded 5514 unique titles. Out of 75 critically reviewed full-text articles, 10 met inclusion criteria. Study locations included Botswana, Peru, Kenya, Thailand, Nigeria, India, Ghana, and Tanzania. Topics addressed included: development of healthcare worker training modules, clinical decision support tools, patient education tools, perceptions and usability of portable electronic technology, and comparisons of technologies and/or mobile applications. Studies primarily looked at the assessment of developed educational modules on trainee health knowledge, perceptions and usability of technology, and comparisons of technologies. Overall, studies reported positive results for portable electronic device-based health education, frequently reporting increased provider/patient knowledge, improved patient outcomes in both quality of care and management, increased provider comfort level with technology, and an environment characterized by increased levels of technology-based, informal learning situations. Negative assessments included high investment costs, lack of technical support, and fear of device theft. While the research is limited, portable electronic educational resources present promising avenues to increase access to effective health education in resource-limited settings, contingent

  13. Voice-supported Electronic Health Record for Temporomandibular Joint Disorders

    Czech Academy of Sciences Publication Activity Database

    Hippmann, R.; Dostálová, T.; Zvárová, Jana; Nagy, Miroslav; Seydlová, M.; Hanzlíček, Petr; Kříž, P.; Šmídl, L.; Trmal, J.

    2010-01-01

    Roč. 49, č. 2 (2010), s. 168-172 ISSN 0026-1270 R&D Projects: GA MŠk(CZ) 1M06014 Institutional research plan: CEZ:AV0Z10300504 Keywords : electronic health record * structured data entry * dentistry * temporomandibular joint disorder Subject RIV: IN - Informatics, Computer Science Impact factor: 1.472, year: 2010

  14. Medical Guidelines Presentation and Comparing with Electronic Health Record

    Czech Academy of Sciences Publication Activity Database

    Veselý, Arnošt; Zvárová, Jana; Peleška, Jan; Buchtela, David; Anger, Z.

    2006-01-01

    Roč. 75, č. 3-4 (2006), s. 240-245 ISSN 1386-5056 R&D Projects: GA AV ČR 1ET200300413 Institutional research plan: CEZ:AV0Z10300504 Keywords : medical guidelines * electronic health record * GLIF model * reminder facility Subject RIV: IN - Informatics, Computer Science Impact factor: 1.726, year: 2006

  15. The Human-Nature Relationship and Its Impact on Health: A Critical Review.

    Science.gov (United States)

    Seymour, Valentine

    2016-01-01

    Within the past four decades, research has been increasingly drawn toward understanding whether there is a link between the changing human-nature relationship and its impact on people's health. However, to examine whether there is a link requires research of its breadth and underlying mechanisms from an interdisciplinary approach. This article begins by reviewing the debates concerning the human-nature relationship, which are then critiqued and redefined from an interdisciplinary perspective. The concept and chronological history of "health" is then explored, based on the World Health Organization's definition. Combining these concepts, the human-nature relationship and its impact on human's health are then explored through a developing conceptual model. It is argued that using an interdisciplinary perspective can facilitate a deeper understanding of the complexities involved for attaining optimal health at the human-environmental interface.

  16. Climate change and human health

    International Nuclear Information System (INIS)

    Sanderson, G.

    1991-01-01

    Changes in the earth's climate, stemming from the greenhouse effect, are highly likely to damage human health. As well as the disruptions to food and fresh water supplies, there is the prospect of major diseases flourishing in warmer conditions, in addition the decrease in the ozone layer is causing an increased incidence of skin cancer

  17. Managing information technology human resources in health care.

    Science.gov (United States)

    Mahesh, Sathiadev; Crow, Stephen M

    2012-01-01

    The health care sector has seen a major increase in the use of information technology (IT). The increasing permeation of IT into the enterprise has resulted in many non-IT employees acquiring IT-related skills and becoming an essential part of the IT-enabled enterprise. Health care IT employees work in a continually changing environment dealing with new specializations that are often unfamiliar to other personnel. The widespread use of outsourcing and offshoring in IT has introduced a third layer of complexity in the traditional hierarchy and its approach to managing human resources. This article studies 3 major issues in managing these human resources in an IT-enabled health care enterprise and recommends solutions to the problem.

  18. Evaluating Motivation for the Use of an Electronic Health Record Simulation Game.

    Science.gov (United States)

    McLeod, Alexander; Hewitt, Barbara; Gibbs, David; Kristof, Caitlin

    2017-01-01

    Experiential learning via simulation offers a variety of benefits including reduced risks, repetitive exposure, and mastery of complex processes. How to motivate people to engage in and enjoy playing games is an important concept in the creation of serious games focused on learning new skills. This study sought to determine the motivators that increase users' pleasurable experience when playing an electronic health record simulation game. To examine how intrinsic and extrinsic motivation affected both engagement and enjoyment, we surveyed students of health professions at one university. Results indicate that while both forms of motivation are significant in increasing engagement and enjoyment, extrinsic motivation such as badges, points, and scoreboards were much more important than internal motivations for our participants. These findings have implications for the development of an electronic health record simulation game.

  19. Enabling Patient Control of Personal Electronic Health Records Through Distributed Ledger Technology.

    Science.gov (United States)

    Cunningham, James; Ainsworth, John

    2017-01-01

    The rise of distributed ledger technology, initiated and exemplified by the Bitcoin blockchain, is having an increasing impact on information technology environments in which there is an emphasis on trust and security. Management of electronic health records, where both conformation to legislative regulations and maintenance of public trust are paramount, is an area where the impact of these new technologies may be particularly beneficial. We present a system that enables fine-grained personalized control of third-party access to patients' electronic health records, allowing individuals to specify when and how their records are accessed for research purposes. The use of the smart contract based Ethereum blockchain technology to implement this system allows it to operate in a verifiably secure, trustless, and openly auditable environment, features crucial to health information systems moving forward.

  20. Benefits of Implementing and Improving Collection of Sexual Orientation and Gender Identity Data in Electronic Health Records.

    Science.gov (United States)

    Bosse, Jordon D; Leblanc, Raeann G; Jackman, Kasey; Bjarnadottir, Ragnhildur I

    2018-06-01

    Individuals in lesbian, gay, bisexual, and transgender communities experience several disparities in physical and mental health (eg, cardiovascular disease and depression), as well as difficulty accessing care that is compassionate and relevant to their unique needs. Access to care is compromised in part due to inadequate information systems that fail to capture identity data. Beginning in January 2018, meaningful use criteria dictate that electronic health records have the capability to collect data related to sexual orientation and gender identity of patients. Nurse informaticists play a vital role in the process of developing new electronic health records that are sensitive to the needs and identities of the lesbian, gay, bisexual, and transgender communities. Improved collection of sexual orientation and gender identity data will advance the identification of health disparities experienced by lesbian, gay, bisexual, and transgender populations. More inclusive electronic health records will allow providers to monitor risk behavior, assess progress toward the reduction of disparities, and provide healthcare that is patient and family centered. Concrete suggestions for the modification of electronic health record systems are presented, as well as how nurse informaticists may be able to bridge gaps in provider knowledge and discomfort through interprofessional collaboration when implementing changes in electronic health records.

  1. Experience and lessons from health impact assessment for human rights impact assessment.

    Science.gov (United States)

    Salcito, Kendyl; Utzinger, Jürg; Krieger, Gary R; Wielga, Mark; Singer, Burton H; Winkler, Mirko S; Weiss, Mitchell G

    2015-09-16

    As globalisation has opened remote parts of the world to foreign investment, global leaders at the United Nations and beyond have called on multinational companies to foresee and mitigate negative impacts on the communities surrounding their overseas operations. This movement towards corporate impact assessment began with a push for environmental and social inquiries. It has been followed by demands for more detailed assessments, including health and human rights. In the policy world the two have been joined as a right-to-health impact assessment. In the corporate world, the right-to-health approach fulfils neither managers' need to comprehensively understand impacts of a project, nor rightsholders' need to know that the full suite of their human rights will be safe from violation. Despite the limitations of a right-to-health tool for companies, integration of health into human rights provides numerous potential benefits to companies and the communities they affect. Here, a detailed health analysis through the human rights lens is carried out, drawing on a case study from the United Republic of Tanzania. This paper examines the positive and negative health and human rights impacts of a corporate operation in a low-income setting, as viewed through the human rights lens, considering observations on the added value of the approach. It explores the relationship between health impact assessment (HIA) and human rights impact assessment (HRIA). First, it considers the ways in which HIA, as a study directly concerned with human welfare, is a more appropriate guide than environmental or social impact assessment for evaluating human rights impacts. Second, it considers the contributions HRIA can make to HIA, by viewing determinants of health not as direct versus indirect, but as interrelated.

  2. Human resource leadership: the key to improved results in health

    Directory of Open Access Journals (Sweden)

    O'Neil Mary L

    2008-06-01

    Full Text Available Abstract This article is the lead article in the Human Resources for Health journal's first quarterly feature. The series of seven articles has been contributed by Management Sciences for Health (MSH under the theme of leadership and management in public health and will be published article by article over the next few weeks. The journal has invited Dr Manuel M. Dayrit, Director of the WHO Department of Human Resources for Health and former Minister of Health for the Philippines to launch the feature with an opening editorial to be found in the journal's blog. This opening article describes the human resource challenges that managers around the world report and analyses why solutions often fail to be implemented. Despite rising attention to the acute shortage of health care workers, solutions to the human resource (HR crisis are difficult to achieve, especially in the poorest countries. Although we are aware of the issues and have developed HR strategies, the problem is that some old systems of leading and managing human resources for health do not work in today's context. The Leadership Development Program (LDP is grounded on the belief that good leadership and management can be learned and practiced at all levels. The case studies in this issue were chosen to illustrate results from using the LDP at different levels of the health sector. The LDP makes a profound difference in health managers' attitudes towards their work. Rather than feeling defeated by a workplace climate that lacks motivation, hope, and commitment to change, people report that they are mobilized to take action to change the status quo. The lesson is that without this capacity at all levels, global policy and national HR strategies will fail to make a difference.

  3. Radiation dosimetry in human bone using electron paramagnetic resonance

    International Nuclear Information System (INIS)

    Breen, S.L.

    1995-01-01

    Accurate measurements of dose in bone are required in order to improve the dosimetry of systemic radiotherapy for osseous metastases. Bone is an integrating dosimeter which records the radiation history of the skeleton. During irradiation, electrons become trapped in the crystalline component of bone mineral (hydroxyapatite). The traps are very stable; at room temperature, emptying of the traps occurs with a half-life of many years. The population of trapped unpaired electrons is proportional to the radiation dose administered to the bone and can be measured in excised bone samples using electron paramagnetic resonance (EPR). EPR spectra of synthetic hydroxyapatite, irradiated with Co-60, were obtained at room temperature and at 77 K. At room temperature, the radiation-induced signal, with a g-value of 2.001 ± 0.001 increased linearly with absorbed dose above a lower threshold of 3 Gy, up to doses of 200 Gy. In contrast with pure hydroxyapatite, EPR spectra of excised human bone showed a broad 'native' signal, due to the organic component of bone, which masks the dosimetrically important signal. This native signal is highly variable from sample to sample and precludes the use of EPR as an absolute dosimetry technique. However, after subtraction of the background signal, irradiated human bone showed a linear response with a lower limit of measurement similar to that of synthetic hydroxyapatite. Bone is an in vivo linear dosimeter which can be exploited to develop accurate estimates of the radiation dose delivered during systemic radiotherapy and teletherapy. However, improved sensitivity of the EPR dosimetry technique is necessary before it can be applied reliably in clinical situations. (author)

  4. A statistical dynamics approach to the study of human health data: Resolving population scale diurnal variation in laboratory data

    International Nuclear Information System (INIS)

    Albers, D.J.; Hripcsak, George

    2010-01-01

    Statistical physics and information theory is applied to the clinical chemistry measurements present in a patient database containing 2.5 million patients' data over a 20-year period. Despite the seemingly naive approach of aggregating all patients over all times (with respect to particular clinical chemistry measurements), both a diurnal signal in the decay of the time-delayed mutual information and the presence of two sub-populations with differing health are detected. This provides a proof in principle that the highly fragmented data in electronic health records has potential for being useful in defining disease and human phenotypes.

  5. A knowledge-based taxonomy of critical factors for adopting electronic health record systems by physicians: a systematic literature review

    Directory of Open Access Journals (Sweden)

    Martínez-García Ana I

    2010-10-01

    Full Text Available Abstract Background The health care sector is an area of social and economic interest in several countries; therefore, there have been lots of efforts in the use of electronic health records. Nevertheless, there is evidence suggesting that these systems have not been adopted as it was expected, and although there are some proposals to support their adoption, the proposed support is not by means of information and communication technology which can provide automatic tools of support. The aim of this study is to identify the critical adoption factors for electronic health records by physicians and to use them as a guide to support their adoption process automatically. Methods This paper presents, based on the PRISMA statement, a systematic literature review in electronic databases with adoption studies of electronic health records published in English. Software applications that manage and process the data in the electronic health record have been considered, i.e.: computerized physician prescription, electronic medical records, and electronic capture of clinical data. Our review was conducted with the purpose of obtaining a taxonomy of the physicians main barriers for adopting electronic health records, that can be addressed by means of information and communication technology; in particular with the information technology roles of the knowledge management processes. Which take us to the question that we want to address in this work: "What are the critical adoption factors of electronic health records that can be supported by information and communication technology?". Reports from eight databases covering electronic health records adoption studies in the medical domain, in particular those focused on physicians, were analyzed. Results The review identifies two main issues: 1 a knowledge-based classification of critical factors for adopting electronic health records by physicians; and 2 the definition of a base for the design of a conceptual

  6. A knowledge-based taxonomy of critical factors for adopting electronic health record systems by physicians: a systematic literature review.

    Science.gov (United States)

    Castillo, Víctor H; Martínez-García, Ana I; Pulido, J R G

    2010-10-15

    The health care sector is an area of social and economic interest in several countries; therefore, there have been lots of efforts in the use of electronic health records. Nevertheless, there is evidence suggesting that these systems have not been adopted as it was expected, and although there are some proposals to support their adoption, the proposed support is not by means of information and communication technology which can provide automatic tools of support. The aim of this study is to identify the critical adoption factors for electronic health records by physicians and to use them as a guide to support their adoption process automatically. This paper presents, based on the PRISMA statement, a systematic literature review in electronic databases with adoption studies of electronic health records published in English. Software applications that manage and process the data in the electronic health record have been considered, i.e.: computerized physician prescription, electronic medical records, and electronic capture of clinical data. Our review was conducted with the purpose of obtaining a taxonomy of the physicians main barriers for adopting electronic health records, that can be addressed by means of information and communication technology; in particular with the information technology roles of the knowledge management processes. Which take us to the question that we want to address in this work: "What are the critical adoption factors of electronic health records that can be supported by information and communication technology?". Reports from eight databases covering electronic health records adoption studies in the medical domain, in particular those focused on physicians, were analyzed. The review identifies two main issues: 1) a knowledge-based classification of critical factors for adopting electronic health records by physicians; and 2) the definition of a base for the design of a conceptual framework for supporting the design of knowledge

  7. Climate change, human health, and biomedical research: analysis of the National Institutes of Health research portfolio.

    Science.gov (United States)

    Jessup, Christine M; Balbus, John M; Christian, Carole; Haque, Ehsanul; Howe, Sally E; Newton, Sheila A; Reid, Britt C; Roberts, Luci; Wilhelm, Erin; Rosenthal, Joshua P

    2013-04-01

    According to a wide variety of analyses and projections, the potential effects of global climate change on human health are large and diverse. The U.S. National Institutes of Health (NIH), through its basic, clinical, and population research portfolio of grants, has been increasing efforts to understand how the complex interrelationships among humans, ecosystems, climate, climate variability, and climate change affect domestic and global health. In this commentary we present a systematic review and categorization of the fiscal year (FY) 2008 NIH climate and health research portfolio. A list of candidate climate and health projects funded from FY 2008 budget appropriations were identified and characterized based on their relevance to climate change and health and based on climate pathway, health impact, study type, and objective. This analysis identified seven FY 2008 projects focused on climate change, 85 climate-related projects, and 706 projects that focused on disease areas associated with climate change but did not study those associations. Of the nearly 53,000 awards that NIH made in 2008, approximately 0.17% focused on or were related to climate. Given the nature and scale of the potential effects of climate change on human health and the degree of uncertainty that we have about these effects, we think that it is helpful for the NIH to engage in open discussions with science and policy communities about government-wide needs and opportunities in climate and health, and about how NIH's strengths in human health research can contribute to understanding the health implications of global climate change. This internal review has been used to inform more recent initiatives by the NIH in climate and health.

  8. Soft Electronics Enabled Ergonomic Human-Computer Interaction for Swallowing Training

    Science.gov (United States)

    Lee, Yongkuk; Nicholls, Benjamin; Sup Lee, Dong; Chen, Yanfei; Chun, Youngjae; Siang Ang, Chee; Yeo, Woon-Hong

    2017-04-01

    We introduce a skin-friendly electronic system that enables human-computer interaction (HCI) for swallowing training in dysphagia rehabilitation. For an ergonomic HCI, we utilize a soft, highly compliant (“skin-like”) electrode, which addresses critical issues of an existing rigid and planar electrode combined with a problematic conductive electrolyte and adhesive pad. The skin-like electrode offers a highly conformal, user-comfortable interaction with the skin for long-term wearable, high-fidelity recording of swallowing electromyograms on the chin. Mechanics modeling and experimental quantification captures the ultra-elastic mechanical characteristics of an open mesh microstructured sensor, conjugated with an elastomeric membrane. Systematic in vivo studies investigate the functionality of the soft electronics for HCI-enabled swallowing training, which includes the application of a biofeedback system to detect swallowing behavior. The collection of results demonstrates clinical feasibility of the ergonomic electronics in HCI-driven rehabilitation for patients with swallowing disorders.

  9. Mechanically Compliant Electronic Materials for Wearable Photovoltaics and Human-Machine Interfaces

    Science.gov (United States)

    O'Connor, Timothy Francis, III

    Applications of stretchable electronic materials for human-machine interfaces are described herein. Intrinsically stretchable organic conjugated polymers and stretchable electronic composites were used to develop stretchable organic photovoltaics (OPVs), mechanically robust wearable OPVs, and human-machine interfaces for gesture recognition, American Sign Language Translation, haptic control of robots, and touch emulation for virtual reality, augmented reality, and the transmission of touch. The stretchable and wearable OPVs comprise active layers of poly-3-alkylthiophene:phenyl-C61-butyric acid methyl ester (P3AT:PCBM) and transparent conductive electrodes of poly(3,4-ethylenedioxythiophene)-poly(styrenesulfonate) (PEDOT:PSS) and devices could only be fabricated through a deep understanding of the connection between molecular structure and the co-engineering of electronic performance with mechanical resilience. The talk concludes with the use of composite piezoresistive sensors two smart glove prototypes. The first integrates stretchable strain sensors comprising a carbon-elastomer composite, a wearable microcontroller, low energy Bluetooth, and a 6-axis accelerometer/gyroscope to construct a fully functional gesture recognition glove capable of wirelessly translating American Sign Language to text on a cell phone screen. The second creates a system for the haptic control of a 3D printed robot arm, as well as the transmission of touch and temperature information.

  10. Government leadership in addressing public health priorities: strides and delays in electronic laboratory reporting in the United States.

    Science.gov (United States)

    Gluskin, Rebecca Tave; Mavinkurve, Maushumi; Varma, Jay K

    2014-03-01

    For nearly a decade, interest groups, from politicians to economists to physicians, have touted digitization of the nation's health information. One frequently mentioned benefit is the transmission of information electronically from laboratories to public health personnel, allowing them to rapidly analyze and act on these data. Switching from paper to electronic laboratory reports (ELRs) was thought to solve many public health surveillance issues, including workload, accuracy, and timeliness. However, barriers remain for both laboratories and public health agencies to realize the full benefits of ELRs. The New York City experience highlights several successes and challenges of electronic reporting and is supported by peer-reviewed literature. Lessons learned from ELR systems will benefit efforts to standardize electronic medical records reporting to health departments.

  11. Ecosystem Approaches to Human Health Graduate Training Awards ...

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

    IDRC's Ecosystem Approaches to Human Health (Ecohealth) program initiative ... Each grant will consist of CA $15 000 for field research and up to CA $4 000 for ... Nutrition, health policy, and ethics in the age of public-private partnerships.

  12. Privacy, consent, and the electronic mental health record: The Person vs. the System.

    Science.gov (United States)

    Clemens, Norman A

    2012-01-01

    As electronic health record systems become widely adopted and proposals are advanced to integrate mental health with general health systems, there is mounting pressure to include mental health information on the same basis as general health information without any requirement for active, individual patient consent to do so. A prime example is the current effort to change the Mental Health Information Act of the District of Columbia, which has, up till now, stood as a model for protection of the privacy of patients with mental illness, the requirement of informed consent for disclosure of health information, and delimitation of minimum necessary disclosure. Mental health information is exceptionally sensitive and potentially damaging if privacy is breached, which makes patients reluctant to seek treatment if they cannot be assured of confidentiality. In addition, there have been spectacular breaches of the security of large electronic health record databases. A subtle but more likely threat is the possibility that mental health information in networks could be fully accessible to all of the patient's providers in a network, not just those for whom it would be necessary to the patient's care. In the 1996 Supreme Court decision in Jaffee v. Redmond, the high court recognized that confidentiality is essential for patients to engage in effective psychotherapy, and HIPAA maintains that special status in the protection of psychotherapy notes as well as explicitly stating that it defers to state laws that are more protective of confidentiality than is HIPAA itself. Highly sensitive information also exists in mental health records aside from psychotherapy notes. Any change in the laws that govern informed consent for disclosure of mental health information must take these factors into account. Specifically, the author opposes any change that would assume tacit consent to release mental health information through an electronic health information exchange in the absence of a

  13. Land Use Transition and Human Health in the context of Climate ...

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

    Land Use Transition and Human Health in the context of Climate Change in the Eastern Himalayas. Land use change is ... it at the communal level. The overall goal is to reduce the vulnerability of mountain people to health issues caused by land use change using ecosystem approaches to human health (Ecohealth).

  14. Human Rights and the Political Economy of Universal Health Care

    Science.gov (United States)

    2016-01-01

    Abstract Health system financing is a critical factor in securing universal health care and achieving equity in access and payment. The human rights framework offers valuable guidance for designing a financing strategy that meets these goals. This article presents a rights-based approach to health care financing developed by the human right to health care movement in the United States. Grounded in a human rights analysis of private, market-based health insurance, advocates make the case for public financing through progressive taxation. Financing mechanisms are measured against the twin goals of guaranteeing access to care and advancing economic equity. The added focus on the redistributive potential of health care financing recasts health reform as an economic policy intervention that can help fulfill broader economic and social rights obligations. Based on a review of recent universal health care reform efforts in the state of Vermont, this article reports on a rights-based public financing plan and model, which includes a new business tax directed against wage disparities. The modeling results suggest that a health system financed through equitable taxation could produce significant redistributive effects, thus increasing economic equity while generating sufficient funds to provide comprehensive health care as a universal public good. PMID:28559677

  15. Human rights principles in developing and updating policies and laws on mental health

    OpenAIRE

    Schulze, M.

    2016-01-01

    The World Health Organization's Mental Health Action Plan 2013?2020 stipulates human rights as a cross-cutting principle (WHO, 2013) and foresees global targets to update policies as well as mental health laws in line with international and regional human rights instruments. The international human rights agreements repeatedly refer to health, including mental health. The most pertinent provisions related to mental health are enshrined in the 2006 Convention on the Rights of Persons with Disa...

  16. Quantifying altitude of human habitation in studies of human health using geographical name server data

    Directory of Open Access Journals (Sweden)

    Stephen Thielke

    2016-11-01

    Full Text Available Almost all studies examining the effects of altitude on human health have estimated the geographical altitude of defined regions, yet the primary interest lies in where people live, not the land around them. Populations are not homogenously distributed across altitudes. We propose a straightforward and computationally simple method for estimating the average altitude of habitation within the regional units for which health statistics are typically reported (such as counties. The United States Board on Geographical Names database contains records for over 2.7 million places, which can be processed to select places that are associated with human habitation. These points can easily be averaged by region yielding a representative altitude of human habitation within city, county, state regions, or by longitude and latitude zones. We provide an example of using this approach in a study of human health, and compare it with three other previously used methods of estimating altitude for counties.

  17. An economic perspective on oceans and human health

    NARCIS (Netherlands)

    Legat, Audrey; French, Veronica; McDonough, Niall

    2016-01-01

    Human health and wellbeing are intrinsically connected to our seas and oceans through a complex relationship comprising both positive and negative influences. Although significant public health impacts result from this relationship, the economic implications are rarely analysed. We reviewed the

  18. Human trafficking and exploitation: A global health concern.

    Science.gov (United States)

    Zimmerman, Cathy; Kiss, Ligia

    2017-11-01

    In this collection review, Cathy Zimmerman and colleague introduce the PLOS Medicine Collection on Human Trafficking, Exploitation and Health, laying out the magnitude of the global trafficking problem and offering a public health policy framework to guide responses to trafficking.

  19. Implementing electronic health records in hospitals : a systematic literature review

    NARCIS (Netherlands)

    Boonstra, A.; Versluis, Arie; Vos, J.F.J.

    2014-01-01

    Background: The literature on implementing Electronic Health Records (EHR) in hospitals is very diverse. The objective of this study is to create an overview of the existing literature on EHR implementation in hospitals and to identify generally applicable findings and lessons for implementers.

  20. Educating Health Professionals about the Electronic Health Record (EHR: Removing the Barriers to Adoption

    Directory of Open Access Journals (Sweden)

    Paule Bellwood

    2011-03-01

    Full Text Available In the healthcare industry we have had a significant rise in the use of electronic health records (EHRs in health care settings (e.g. hospital, clinic, physician office and home. There are three main barriers that have arisen to the adoption of these technologies: (1 a shortage of health professional faculty who are familiar with EHRs and related technologies, (2 a shortage of health informatics specialists who can implement these technologies, and (3 poor access to differing types of EHR software. In this paper we outline a novel solution to these barriers: the development of a web portal that provides facility and health professional students with access to multiple differing types of EHRs over the WWW. The authors describe how the EHR is currently being used in educational curricula and how it has overcome many of these barriers. The authors also briefly describe the strengths and limitations of the approach.

  1. Electronic Health Records in the Cloud: Improving Primary Health Care Delivery in South Africa.

    Science.gov (United States)

    Cilliers, Liezel; Wright, Graham

    2017-01-01

    In South Africa, the recording of health data is done manually in a paper-based file, while attempts to digitize healthcare records have had limited success. In many countries, Electronic Health Records (EHRs) has developed in silos, with little or no integration between different operational systems. Literature has provided evidence that the cloud can be used to 'leapfrog' some of these implementation issues, but the adoption of this technology in the public health care sector has been very limited. This paper aims to identify the major reasons why the cloud has not been used to implement EHRs for the South African public health care system, and to provide recommendations of how to overcome these challenges. From the literature, it is clear that there are technology, environmental and organisational challenges affecting the implementation of EHRs in the cloud. Four recommendations are provided that can be used by the National Department of Health to implement EHRs making use of the cloud.

  2. Testing the Electronic Personal Health Record Acceptance Model by Nurses for Managing Their Own Health

    Science.gov (United States)

    Trinkoff, A.M.; Storr, C.L.; Wilson, M.L.; Gurses, A.P.

    2015-01-01

    Summary Background To our knowledge, no evidence is available on health care professionals’ use of electronic personal health records (ePHRs) for their health management. We therefore focused on nurses’ personal use of ePHRs using a modified technology acceptance model. Objectives To examine (1) the psychometric properties of the ePHR acceptance model, (2) the associations of perceived usefulness, ease of use, data privacy and security protection, and perception of self as health-promoting role models to nurses’ own ePHR use, and (3) the moderating influences of age, chronic illness and medication use, and providers’ use of electronic health record (EHRs) on the associations between the ePHR acceptance constructs and ePHR use. Methods A convenience sample of registered nurses, those working in one of 12 hospitals in the Maryland and Washington, DC areas and members of the nursing informatics community (AMIA and HIMSS), were invited to respond to an anonymous online survey; 847 responded. Multiple logistic regression identified associations between the model constructs and ePHR use, and the moderating effect. Results Overall, ePHRs were used by 47%. Sufficient reliability for all scales was found. Three constructs were significantly related to nurses’ own ePHR use after adjusting for covariates: usefulness, data privacy and security protection, and health-promoting role model. Nurses with providers that used EHRs who perceived a higher level of data privacy and security protection had greater odds of ePHR use than those whose providers did not use EHRs. Older nurses with a higher self-perception as health-promoting role models had greater odds of ePHR use than younger nurses. Conclusions Nurses who use ePHRs for their personal health might promote adoption by the general public by serving as health-promoting role models. They can contribute to improvements in patient education and ePHR design, and serve as crucial resources when working with their

  3. Health and Human Rights: New challenges for social responsiveness

    Directory of Open Access Journals (Sweden)

    Leslie London

    2009-11-01

    Full Text Available South Africa’s struggle against apartheid discrimination, including struggles in the health sector, laid the basis for a vibrant engagement of staff and students in human rights research, teaching and outreach in the Health Sciences Faculty at the University of Cape Town (UCT. This article provides a brief overview of this background context, then shows how this engagement has continued with new challenges emerging in the post-apartheid democratic period. Teaching at undergraduate and postgraduate levels has been complemented by a programme of ‘Training the Trainers’ in health and human rights. The programme targets teachers of health professionals at institutions in South and Southern Africa, resulting in national adoption of human rights competencies as an essential component of health professionals’ skills base. Research has also extended lessons learnt from the apartheid period into work with vulnerable groups, such as rural farm workers and the deaf, and seeks to build the capacity of marginal populations to change the conditions of their vulnerability in order to realize their rights. Partnerships with civil society organisations have been a strong thread, creating new knowledge and new ways of joint work towards realizing the right to health, including advocacy engagement in civil society movements and regional networks. Further, a focus on health professionals’ practice, in terms of dealing with potential dual loyalty conflicts and their role as gatekeepers in the health services on matters of patients’ rights, has shaped the research agenda. This article illustrates how knowledge production for the public good extends beyond notions of enhancing economic productivity for national development and provides a base for transdisciplinary and transinstitutional engagement. Additionally, non-traditional forms of knowledge networking and transfer have also been explored, including engagement with policy-makers and health managers

  4. Developing an Interface to Order and Document Health Education Videos in the Electronic Health Record.

    Science.gov (United States)

    Wojcik, Lauren

    2015-01-01

    Transitioning to electronic health records (EHRs) provides an opportunity for health care systems to integrate educational content available on interactive patient systems (IPS) with the medical documentation system. This column discusses how one hospital simplified providers' workflow by making it easier to order educational videos and ensure that completed education is documented within the medical record. Integrating the EHR and IPS streamlined the provision of patient education, improved documentation, and supported the organization in meeting core requirements for Meaningful Use.

  5. Human Factors, Habitability and Environmental Health and the Human Integration Design Handbook. Volume 2

    Science.gov (United States)

    Houbec, Keith; Tillman, Barry; Connolly, Janis

    2010-01-01

    For decades, Space Life Sciences and NASA as an Agency have considered NASA-STD-3000, Man-Systems Integration Standards, a significant contribution to human spaceflight programs and to human-systems integration in general. The document has been referenced in numerous design standards both within NASA and by organizations throughout the world. With research program and project results being realized, advances in technology and new information in a variety of topic areas now available, the time arrived to update this extensive suite of requirements and design information. During the past several years, a multi-NASA center effort has been underway to write the update to NASA-STD-3000 with standards and design guidance that would be applicable to all future human spaceflight programs. NASA-STD-3001 - Volumes 1 and 2 - and the Human Integration Design Handbook (HIDH) were created. Volume 1, Crew Health, establishes NASA s spaceflight crew health standards for the pre-flight, in-flight, and post-flight phases of human spaceflight. Volume 2, Human Factors, Habitability and Environmental Health, focuses on the requirements of human-system integration and how the human crew interacts with other systems, and how the human and the system function together to accomplish the tasks for mission success. The HIDH is a compendium of human spaceflight history and knowledge, and provides useful background information and research findings. And as the HIDH is a stand-alone companion to the Standards, the maintenance of the document has been streamlined. This unique and flexible approach ensures that the content is current and addresses the fundamental advances of human performance and human capabilities and constraints research. Current work focuses on the development of new sections of Volume 2 and collecting updates to the HIDH. The new sections in development expand the scope of the standard and address mission operations and support operations. This effort is again collaboration

  6. The right to health of prisoners in international human rights law.

    Science.gov (United States)

    Lines, Rick

    2008-01-01

    This paper explores the health rights of prisoners as defined in international law, and the mechanisms that have been used to ensure the rights of persons in detention to realise the highest attainable standard of health. It examines this right as articulated within United Nations and regional human rights treaties, non-binding or so-called soft law instruments from international organisations and the jurisprudence of international human rights bodies. It explores the use of economic, social and cultural rights mechanisms, and those within civil and political rights, as they engage the right to health of prisoners, and identifies the minimum legal obligations of governments in order to remain compliant with human rights norms as defined within the international case law. In addressing these issues, this article adopts a holistic approach to the definition of the highest attainable standard of health. This includes a consideration of adequate standards of general medical care, including preventative health and mental health services. It also examines the question of environmental health, and those poor conditions of detention that may exacerbate health decline, disease transmission, mental illness or death. The paper examines the approach to prison health of the United Nations human rights system and its various monitoring bodies, as well as the regional human rights systems in Europe, Africa and the Americas. Based upon this analysis, the paper draws conclusions on the current fulfilment of the right to health of prisoners on an international scale, and proposes expanded mechanisms under the UN Convention against Torture and Other Cruel, Inhuman or Degrading Treatment to monitor and promote the health rights of prisoners at the international and domestic levels.

  7. Ethics and the electronic health record in dental school clinics.

    Science.gov (United States)

    Cederberg, Robert A; Valenza, John A

    2012-05-01

    Electronic health records (EHRs) are a major development in the practice of dentistry, and dental schools and dental curricula have benefitted from this technology. Patient data entry, storage, retrieval, transmission, and archiving have been streamlined, and the potential for teledentistry and improvement in epidemiological research is beginning to be realized. However, maintaining patient health information in an electronic form has also changed the environment in dental education, setting up potential ethical dilemmas for students and faculty members. The purpose of this article is to explore some of the ethical issues related to EHRs, the advantages and concerns related to the use of computers in the dental operatory, the impact of the EHR on the doctor-patient relationship, the introduction of web-based EHRs, the link between technology and ethics, and potential solutions for the management of ethical concerns related to EHRs in dental schools.

  8. Eco-Health Linkages: evidence base and socio-economic considerations for linking ecosystem goods and services to human health

    Science.gov (United States)

    Ecosystem goods and services (EGS) are thought to play a role in protecting human health, but the empirical evidence directly linking EGS to human health outcomes is limited, and our ability to detect Eco-Health linkages is confounded by socio-economic factors. These limitations ...

  9. Using Simulations to Improve Electronic Health Record Use, Clinician Training and Patient Safety: Recommendations From A Consensus Conference.

    Science.gov (United States)

    Mohan, Vishnu; Woodcock, Deborah; McGrath, Karess; Scholl, Gretchen; Pranaat, Robert; Doberne, Julie W; Chase, Dian A; Gold, Jeffrey A; Ash, Joan S

    2016-01-01

    A group of informatics experts in simulation, biomedical informatics, patient safety, medical education, and human factors gathered at Corbett, Oregon on April 30 and May 1, 2015. Their objective: to create a consensus statement on best practices for the use of electronic health record (EHR) simulations in education and training, to improve patient safety, and to outline a strategy for future EHR simulation work. A qualitative approach was utilized to analyze data from the conference and generate recommendations in five major categories: (1) Safety, (2) Education and Training, (3) People and Organizations, (4) Usability and Design, and (5) Sociotechnical Aspects.

  10. Usability Testing of a National Substance Use Screening Tool Embedded in Electronic Health Records.

    Science.gov (United States)

    Press, Anne; DeStio, Catherine; McCullagh, Lauren; Kapoor, Sandeep; Morley, Jeanne; Conigliaro, Joseph

    2016-07-08

    Screening, brief intervention, and referral to treatment (SBIRT) is currently being implemented into health systems nationally via paper and electronic methods. The purpose of this study was to evaluate the integration of an electronic SBIRT tool into an existing paper-based SBIRT clinical workflow in a patient-centered medical home. Usability testing was conducted in an academic ambulatory clinic. Two rounds of usability testing were done with medical office assistants (MOAs) using a paper and electronic version of the SBIRT tool, with two and four participants, respectively. Qualitative and quantitative data was analyzed to determine the impact of both tools on clinical workflow. A second round of usability testing was done with the revised electronic version and compared with the first version. Personal workflow barriers cited in the first round of testing were that the electronic health record (EHR) tool was disruptive to patient's visits. In Round 2 of testing, MOAs reported favoring the electronic version due to improved layout and the inclusion of an alert system embedded in the EHR. For example, using the system usability scale (SUS), MOAs reported a grade "1" for the statement, "I would like to use this system frequently" during the first round of testing but a "5" during the second round of analysis. The importance of testing usability of various mediums of tools used in health care screening is highlighted by the findings of this study. In the first round of testing, the electronic tool was reported as less user friendly, being difficult to navigate, and time consuming. Many issues faced in the first generation of the tool were improved in the second generation after usability was evaluated. This study demonstrates how usability testing of an electronic SBRIT tool can help to identify challenges that can impact clinical workflow. However, a limitation of this study was the small sample size of MOAs that participated. The results may have been biased to

  11. Soy and Gut Microbiota: Interaction and Implication for Human Health.

    Science.gov (United States)

    Huang, Haiqiu; Krishnan, Hari B; Pham, Quynhchi; Yu, Liangli Lucy; Wang, Thomas T Y

    2016-11-23

    Soy (Glycine max) is a major commodity in the United States, and soy foods are gaining popularity due to their reported health-promoting effects. In the past two decades, soy and soy bioactive components have been studied for their health-promoting/disease-preventing activities and potential mechanisms of action. Recent studies have identified gut microbiota as an important component in the human body ecosystem and possibly a critical modulator of human health. Soy foods' interaction with the gut microbiota may critically influence many aspects of human development, physiology, immunity, and nutrition at different stages of life. This review summarizes current knowledge on the effects of soy foods and soy components on gut microbiota population and composition. It was found, although results vary in different studies, in general, both animal and human studies have shown that consumption of soy foods can increase the levels of bifidobacteria and lactobacilli and alter the ratio between Firmicutes and Bacteroidetes. These changes in microbiota are consistent with reported reductions in pathogenic bacteria populations in the gut, thereby lowering the risk of diseases and leading to beneficial effects on human health.

  12. Digital video analysis of health professionals' interactions with an electronic whiteboard

    DEFF Research Database (Denmark)

    Rasmussen, Rasmus; Kushniruk, Andre

    2013-01-01

    As hospital departments continue to introduce electronic whiteboards in real clinical settings a range of human factor issues have emerged and it has become clear that there is a need for improved methods for designing and testing these systems. In this study, we employed a longitudinal and natur......As hospital departments continue to introduce electronic whiteboards in real clinical settings a range of human factor issues have emerged and it has become clear that there is a need for improved methods for designing and testing these systems. In this study, we employed a longitudinal...... and naturalistic method in the usability evaluation of an electronic whiteboard system. The goal of the evaluation was to explore the extent to which usability issues experienced by users change as they gain more experience with the system. In addition, the paper explores the use of a new approach to collection...... and analysis of continuous digital video recordings of naturalistic "live" user interactions. The method developed and employed in the study included recording the users' interactions with system during actual use using screen-capturing software and analyzing these recordings for usability issues...

  13. Electronic Health Record in Occupational Medicine: Specific Aspects and Requirements of Data Structuring and Standardization

    Directory of Open Access Journals (Sweden)

    Dorin TRIFF

    2009-07-01

    Full Text Available The service of occupational medicine of a specific economic agent, as integrated part of the System of Labor Health and Safety, requires efficient, well-organized information management through standardized and computerized data processing and exploitation. Legal requirements and practical aspects of information management in occupational medicine trigger necessary operational modifications in the Electronic Health File. The goal of the paper is to present basic requirements of structuring the electronic health file and the necessary standards in recording specific data.

  14. Genetically modified plants and human health.

    Science.gov (United States)

    Key, Suzie; Ma, Julian K-C; Drake, Pascal Mw

    2008-06-01

    Genetically modified (or GM) plants have attracted a large amount of media attention in recent years and continue to do so. Despite this, the general public remains largely unaware of what a GM plant actually is or what advantages and disadvantages the technology has to offer, particularly with regard to the range of applications for which they can be used. From the first generation of GM crops, two main areas of concern have emerged, namely risk to the environment and risk to human health. As GM plants are gradually being introduced into the European Union there is likely to be increasing public concern regarding potential health issues. Although it is now commonplace for the press to adopt 'health campaigns', the information they publish is often unreliable and unrepresentative of the available scientific evidence. We consider it important that the medical profession should be aware of the state of the art, and, as they are often the first port of call for a concerned patient, be in a position to provide an informed opinion. This review will examine how GM plants may impact on human health both directly - through applications targeted at nutrition and enhancement of recombinant medicine production - but also indirectly, through potential effects on the environment. Finally, it will examine the most important opposition currently facing the worldwide adoption of this technology: public opinion.

  15. The Electronic Health Literacy and Utilization of Technology for Health in a Remote Hawaiian Community: Lana'i.

    Science.gov (United States)

    Witten, Nash Ak; Humphry, Joseph

    2018-03-01

    The Lana'i Community Health Center (LCHC) like other health care organizations, is striving to implement technology-enabled care (TEC) in the clinical setting. TEC includes such technological innovations as patient portals, mobile phone applications, wearable health sensors, and telehealth. This study examines the utilization of communication technology by members of the Lana'i community and LCHC staff and board members in the home and in their daily lives and evaluates the community's electronic health literacy. Quantitative surveys and qualitative focus groups were utilized. These revealed that members of the Lana'i community and LCHC staff and board members regularly utilize technology, in the form of smart cell phones, WiFi, and internet texting. This community has integrated technology into their daily lives, even though they live on an isolated island with 3,102 people; however, despite this integration, the electronic health literacy of this population appears insufficient for proper understanding and utilization of TEC, limiting the potential of patient portals or remote monitoring of patient generated data for chronic disease prevention and management without additional education and mentoring. It is therefore in the best interest of the LCHC and other health organizations wishing to implement TEC in a rural community such as Lana'i to include a strong educational component with use of TEC, and perhaps establish a mentor/partnership program for the highly-challenged patient.

  16. Meeting Report: Threats to Human Health and Environmental Sustainability in the Pacific Basin

    Science.gov (United States)

    Arnold, Robert G.; Carpenter, David O.; Kirk, Donald; Koh, David; Armour, Margaret-Ann; Cebrian, Mariano; Cifuentes, Luis; Khwaja, Mahmood; Ling, Bo; Makalinao, Irma; Paz-y-Miño, César; Peralta, Genandrialine; Prasad, Rajendra; Singh, Kirpal; Sly, Peter; Tohyama, Chiharu; Woodward, Alistair; Zheng, Baoshan; Maiden, Todd

    2007-01-01

    The coastal zone of the Pacific Rim is home for about one-third of the world’s population. Disproportionate growth of Far Eastern economies has produced a disproportionate share of related environmental difficulties. As the region searches for acceptable compromises between growth and environmental quality, its influence on global environmental health is certain to increase. Consequences of global environmental change such as habitat alteration, storms, and sealevel rise will be particularly acute among Pacific Rim nations. Adverse health effects from arsenic exposure in Pacific Rim nations have been used to justify drinking water standards in the United States and elsewhere. As global manufacturing in the Pacific Rim increases, the centroid of global air quality and waste management issues will shift further toward Far Eastern nations. The Eleventh International Conference of the Pacific Basin Consortium (PBC) was held in September 2005 in Honolulu, Hawaii. The purpose of the conference was to bring together individuals to discuss regional challenges to sustainable growth. The historic emphasis of the conference on hazardous wastes in relation to human health makes the PBC an ideal forum for discussing technical aspects of sustainable economic growth in the Pacific region. That role is reflected in the 2005 PBC conference themes, which included management of arsenic in potable waters, air quality, climate change, pesticides, mercury, and electronics industry waste—each with emphasis on relationships to human health. Arsenic management exemplifies the manner in which the PBC can focus interdisciplinary discussion in a single technical area. The conference program provided talks on arsenic toxicology, treatment technologies, management of arsenic-bearing residuals from water treatment, and the probable societal costs and benefits of arsenic management. PMID:18087598

  17. Meeting report: threats to human health and environmental sustainability in the pacific basin.

    Science.gov (United States)

    Arnold, Robert G; Carpenter, David O; Kirk, Donald; Koh, David; Armour, Margaret-Ann; Cebrian, Mariano; Cifuentes, Luis; Khwaja, Mahmood; Ling, Bo; Makalinao, Irma; Paz-Y-Miño, César; Peralta, Genandrialine; Prasad, Rajendra; Singh, Kirpal; Sly, Peter; Tohyama, Chiharu; Woodward, Alistair; Zheng, Baoshan; Maiden, Todd

    2007-12-01

    The coastal zone of the Pacific Rim is home for about one-third of the world's population. Disproportionate growth of Far Eastern economies has produced a disproportionate share of related environmental difficulties. As the region searches for acceptable compromises between growth and environmental quality, its influence on global environmental health is certain to increase. Consequences of global environmental change such as habitat alteration, storms, and sea level rise will be particularly acute among Pacific Rim nations. Adverse health effects from arsenic exposure in Pacific Rim nations have been used to justify drinking water standards in the United States and elsewhere. As global manufacturing in the Pacific Rim increases, the centroid of global air quality and waste management issues will shift further toward Far Eastern nations. The Eleventh International Conference of the Pacific Basin Consortium (PBC) was held in September 2005 in Honolulu, Hawaii. The purpose of the conference was to bring together individuals to discuss regional challenges to sustainable growth. The historic emphasis of the conference on hazardous wastes in relation to human health makes the PBC an ideal forum for discussing technical aspects of sustainable economic growth in the Pacific region. That role is reflected in the 2005 PBC conference themes, which included management of arsenic in potable waters, air quality, climate change, pesticides, mercury, and electronics industry waste-each with emphasis on relationships to human health. Arsenic management exemplifies the manner in which the PBC can focus interdisciplinary discussion in a single technical area. The conference program provided talks on arsenic toxicology, treatment technologies, management of arsenic-bearing residuals from water treatment, and the probable societal costs and benefits of arsenic management.

  18. Human trafficking and exploitation: A global health concern.

    Directory of Open Access Journals (Sweden)

    Cathy Zimmerman

    2017-11-01

    Full Text Available In this collection review, Cathy Zimmerman and colleague introduce the PLOS Medicine Collection on Human Trafficking, Exploitation and Health, laying out the magnitude of the global trafficking problem and offering a public health policy framework to guide responses to trafficking.

  19. Human Health Consequences of Use of Antimicrobial Agents in Aquaculture

    DEFF Research Database (Denmark)

    Heuer, Ole Eske; Kruse, H.; Grave, K.

    2009-01-01

    industry in many regions of the world and the widespread, intensive, and often unregulated use of antimicrobial agents in this area of animal production, efforts are needed to prevent development and spread of antimicrobial resistance in aquaculture to reduce the risk to human health....... in aquaculture, several are classified by the World Health Organisation as critically important for use in humans. Occurrence of resistance to these antimicrobial agents in human pathogens severely limits the therapeutic options in human infections. Considering the rapid growth and importance of aquaculture...... gene transfer and reach human pathogens, or drug-resistant pathogens from the aquatic environment may reach humans directly. Horizontal gene transfer may occur in the aquaculture environment, in the food chain, or in the human intestinal tract. Among the antimicrobial agents commonly used...

  20. Climate Change, Human Health, and Biomedical Research: Analysis of the National Institutes of Health Research Portfolio

    Science.gov (United States)

    Balbus, John M.; Christian, Carole; Haque, Ehsanul; Howe, Sally E.; Newton, Sheila A.; Reid, Britt C.; Roberts, Luci; Wilhelm, Erin; Rosenthal, Joshua P.

    2013-01-01

    Background: According to a wide variety of analyses and projections, the potential effects of global climate change on human health are large and diverse. The U.S. National Institutes of Health (NIH), through its basic, clinical, and population research portfolio of grants, has been increasing efforts to understand how the complex interrelationships among humans, ecosystems, climate, climate variability, and climate change affect domestic and global health. Objectives: In this commentary we present a systematic review and categorization of the fiscal year (FY) 2008 NIH climate and health research portfolio. Methods: A list of candidate climate and health projects funded from FY 2008 budget appropriations were identified and characterized based on their relevance to climate change and health and based on climate pathway, health impact, study type, and objective. Results: This analysis identified seven FY 2008 projects focused on climate change, 85 climate-related projects, and 706 projects that focused on disease areas associated with climate change but did not study those associations. Of the nearly 53,000 awards that NIH made in 2008, approximately 0.17% focused on or were related to climate. Conclusions: Given the nature and scale of the potential effects of climate change on human health and the degree of uncertainty that we have about these effects, we think that it is helpful for the NIH to engage in open discussions with science and policy communities about government-wide needs and opportunities in climate and health, and about how NIH’s strengths in human health research can contribute to understanding the health implications of global climate change. This internal review has been used to inform more recent initiatives by the NIH in climate and health. PMID:23552460

  1. Using indicators to determine the contribution of human rights to public health efforts

    Science.gov (United States)

    Ferguson, Laura

    2009-01-01

    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

  2. Electronic cigarettes: patterns of use, health effects, use in smoking cessation and regulatory issues.

    Science.gov (United States)

    Rahman, Muhammad Aziz; Hann, Nicholas; Wilson, Andrew; Worrall-Carter, Linda

    2014-01-01

    Electronic cigarettes (e-cigarettes) are battery-powered devices that vaporize a liquid solution to deliver a dose of inhaled nicotine to the user. There is ongoing debate regarding their regulation. This comprehensive narrative review aimed to discuss key issues including usage patterns, health effects, efficacy in smoking cessation and regulatory concerns with a view to informing future regulation and research agendas. PubMed, Scopus and Web of Science databases were searched using the terms (electronic cigarettes OR e-cigarettes) for articles in English, relevant to humans and published during January 2009-January 2014. The literature search revealed 37 relevant articles. Findings suggest that e-cigarettes are mostly used by middle-aged current smokers, particularly males, to help them for quitting or for recreation. E-cigarettes contain very low levels of multiple toxic substances such as formaldehyde and acrolein, but these levels are many times lower than those found in cigarettes. They were found to have effectiveness in aiding smoking cessation to a limited degree. Debate continues regarding regulating their use for cessation versus heavy restrictions to control recreational use on the basis that it perpetuates nicotine addiction. The cytotoxicity and long term health effects of e-cigarettes are unknown. Nevertheless the e-cigarette market continues to expand, largely driven by middle-aged smokers who claim to be using e-cigarettes in an attempt to reduce or quit smoking. E-cigarettes may have some potential as smoking cessation aids and, in the researchers' view, should therefore be subject to further research and regulation similar to other nicotine replacement therapies.

  3. Risk assessment of integrated electronic health records.

    Science.gov (United States)

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

    2010-01-01

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

  4. Attitudes and behaviors related to introduction of Electronic Health Record (EHR among Shiraz University students in 2014

    Directory of Open Access Journals (Sweden)

    Mohtaram Nematollahi

    2015-07-01

    Full Text Available Introduction: Electronic Health Record contains all the information related to the health of citizens, from before birth to death have been consistently over time is electronically stored and will be available without regard to location or time all or part of it to authorized persons. The acceptance of EHR by citizens is important in successful implementation of it. The aim of this study was to determine the attitudes and behaviors related to the introduction of electronic health records among Shiraz university student. Method:The present study is a cross-sectional descriptive survey. The study population consisted of all Shiraz University students. The data gathering tool was a questionnaire and data were analyzed in SPSS v.16 software, using descriptive statistical tests. Also, the samples, i.e. 384 students, were selected through convenient sampling. Results: The results showed that most of the students kept their medical records at home to show them to a specialist and only 15% of them were familiar with the Electronic Health Records term. The use of Electronic Health Records for Maintenance of drug prescriptions was of the most importance. Conclusion: Among the students who are educated class and the source of change, the university students’ familiarity with Electronic Health Records is too low and most of them were not even familiar with its name and it is very important to implement this system familiarize the users on how to use it sufficiently

  5. Updated Human Health Risk Analyses for Chlorpyrifos

    Science.gov (United States)

    EPA has revised the human health hazard assessment and drinking water exposure assessment for chlorpyrifos that supported our October 2015 proposal to revoke all food residue tolerances for chlorpyrifos.

  6. Bridging international law and rights-based litigation: mapping health-related rights through the development of the Global Health and Human Rights Database.

    Science.gov (United States)

    Meier, Benjamin Mason; Cabrera, Oscar A; Ayala, Ana; Gostin, Lawrence O

    2012-06-15

    The O'Neill Institute for National and Global Health Law at Georgetown University, the World Health Organization, and the Lawyers Collective have come together to develop a searchable Global Health and Human Rights Database that maps the intersection of health and human rights in judgments, international and regional instruments, and national constitutions. Where states long remained unaccountable for violations of health-related human rights, litigation has arisen as a central mechanism in an expanding movement to create rights-based accountability. Facilitated by the incorporation of international human rights standards in national law, this judicial enforcement has supported the implementation of rights-based claims, giving meaning to states' longstanding obligations to realize the highest attainable standard of health. Yet despite these advancements, there has been insufficient awareness of the international and domestic legal instruments enshrining health-related rights and little understanding of the scope and content of litigation upholding these rights. As this accountability movement evolves, the Global Health and Human Rights Database seeks to chart this burgeoning landscape of international instruments, national constitutions, and judgments for health-related rights. Employing international legal research to document and catalogue these three interconnected aspects of human rights for the public's health, the Database's categorization by human rights, health topics, and regional scope provides a comprehensive means of understanding health and human rights law. Through these categorizations, the Global Health and Human Rights Database serves as a basis for analogous legal reasoning across states to serve as precedents for future cases, for comparative legal analysis of similar health claims in different country contexts, and for empirical research to clarify the impact of human rights judgments on public health outcomes. Copyright © 2012 Meier, Nygren

  7. Capturing structured, pulmonary disease-specific data elements in electronic health records.

    Science.gov (United States)

    Gronkiewicz, Cynthia; Diamond, Edward J; French, Kim D; Christodouleas, John; Gabriel, Peter E

    2015-04-01

    Electronic health records (EHRs) have the potential to improve health-care quality by allowing providers to make better decisions at the point of care based on electronically aggregated data and by facilitating clinical research. These goals are easier to achieve when key, disease-specific clinical information is documented as structured data elements (SDEs) that computers can understand and process, rather than as free-text/natural-language narrative. This article reviews the benefits of capturing disease-specific SDEs. It highlights several design and implementation considerations, including the impact on efficiency and expressivity of clinical documentation and the importance of adhering to data standards when available. Pulmonary disease-specific examples of collection instruments are provided from two commonly used commercial EHRs. Future developments that can leverage SDEs to improve clinical quality and research are discussed.

  8. [Effects of volcanic eruptions on human health in Iceland. Review].

    Science.gov (United States)

    Gudmundsson, Gunnar; Larsen, Guðrun

    2016-01-01

    Volcanic eruptions are common in Iceland and have caused health problems ever since the settlement of Iceland. Here we describe volcanic activity and the effects of volcanic gases and ash on human health in Iceland. Volcanic gases expelled during eruptions can be highly toxic for humans if their concentrations are high, irritating the mucus membranes of the eyes and upper respiratory tract at lower concentrations. They can also be very irritating to the skin. Volcanic ash is also irritating for the mucus membranes of the eyes and upper respiratory tract. The smalles particles of volcanic ash can reach the alveoli of the lungs. Described are four examples of volcanic eruptions that have affected the health of Icelanders. The eruption of Laki volcanic fissure in 1783-1784 is the volcanic eruption that has caused the highest mortality and had the greatest effects on the well-being of Icelanders. Despite multiple volcanic eruptions during the last decades in Iceland mortality has been low and effects on human health have been limited, although studies on longterm effects are lacking. Studies on the effects of the Eyjafjallajökul eruption in 2010 on human health showed increased physical and mental symptoms, especially in those having respiratory disorders. The Directorate of Health in Iceland and other services have responded promptly to recurrent volcanic eruptions over the last few years and given detailed instructions on how to minimize the effects on the public health. Key words: volcanic eruptions, Iceland, volcanic ash, volcanic gases, health effects, mortality. Correspondence: Gunnar Guðmundsson, ggudmund@landspitali.is.

  9. Health care and human rights: against the split duty gambit.

    Science.gov (United States)

    Sreenivasan, Gopal

    2016-08-01

    There are various grounds on which one may wish to distinguish a right to health care from a right to health. In this article, I review some old grounds before introducing some new grounds. But my central task is to argue that separating a right to health care from a right to health has objectionable consequences. I offer two main objections. The domestic objection is that separating the two rights prevents the state from fulfilling its duty to maximise the health it provides each citizen from its fixed health budget. The international objection is that separating a human right to health care fails the moral requirement that, for any given moral human right, the substance to which any two right-holders are entitled be of an equal standard.

  10. New approaches in human health risk assessment.

    Science.gov (United States)

    Abass, Khaled; Carlsen, Anders; Rautio, Arja

    2016-01-01

    Studies on the precise impact of environmental pollutants on human health are difficult to undertake and interpret, because many genetic and environmental factors influence health at the same time and to varying degrees. Our chapter in the AMAP report was based on new approaches to describe risks and future needs. In this paper, we will introduce the issues associated with risk assessment of single chemicals, and present suggestions for future studies as well as a summary of lessons learned during the health-related parts of the European Union-funded FP7 project ArcRisk (Arctic Health Risks: Impacts on health in the Arctic and Europe owing to climate-induced changes in contaminant cycling, 2009-2014; www.arcrisk.eu).

  11. Patients want granular privacy control over health information in electronic medical records.

    Science.gov (United States)

    Caine, Kelly; Hanania, Rima

    2013-01-01

    To assess patients' desire for granular level privacy control over which personal health information should be shared, with whom, and for what purpose; and whether these preferences vary based on sensitivity of health information. A card task for matching health information with providers, questionnaire, and interview with 30 patients whose health information is stored in an electronic medical record system. Most patients' records contained sensitive health information. No patients reported that they would prefer to share all information stored in an electronic medical record (EMR) with all potential recipients. Sharing preferences varied by type of information (EMR data element) and recipient (eg, primary care provider), and overall sharing preferences varied by participant. Patients with and without sensitive records preferred less sharing of sensitive versus less-sensitive information. Patients expressed sharing preferences consistent with a desire for granular privacy control over which health information should be shared with whom and expressed differences in sharing preferences for sensitive versus less-sensitive EMR data. The pattern of results may be used by designers to generate privacy-preserving EMR systems including interfaces for patients to express privacy and sharing preferences. To maintain the level of privacy afforded by medical records and to achieve alignment with patients' preferences, patients should have granular privacy control over information contained in their EMR.

  12. 75 FR 62684 - Health Insurance Reform; Announcement of Maintenance Changes to Electronic Data Transaction...

    Science.gov (United States)

    2010-10-13

    ... 0938-AM50 Health Insurance Reform; Announcement of Maintenance Changes to Electronic Data Transaction Standards Adopted Under the Health Insurance Portability and Accountability Act of 1996 AGENCY: Office of... of the Health Insurance Portability and Accountability Act of 1996 standards made by the Designated...

  13. 75 FR 8085 - National Institutes of Health Guidelines for Human Stem Cell Research

    Science.gov (United States)

    2010-02-23

    ... Health Guidelines for Human Stem Cell Research SUMMARY: The National Institutes of Health (NIH) is requesting public comment on a revision to the definition of human embryonic stem cells (hESCs) in the ``National Institutes of Health Guidelines for Human Stem Cell Research'' (Guidelines). On July 7, 2009, NIH...

  14. 75 FR 13137 - National Institutes of Health Guidelines for Human Stem Cell Research

    Science.gov (United States)

    2010-03-18

    ... Health Guidelines for Human Stem Cell Research SUMMARY: The National Institutes of Health (NIH) is extending the public comment period on a revision to the definition of human embryonic stem cells (hESCs) in the ``National Institutes of Health Guidelines for Human Stem Cell Research'' (Guidelines). Due to a...

  15. A novel system architecture for the national integration of electronic health records: a semi-centralized approach.

    Science.gov (United States)

    AlJarullah, Asma; El-Masri, Samir

    2013-08-01

    The goal of a national electronic health records integration system is to aggregate electronic health records concerning a particular patient at different healthcare providers' systems to provide a complete medical history of the patient. It holds the promise to address the two most crucial challenges to the healthcare systems: improving healthcare quality and controlling costs. Typical approaches for the national integration of electronic health records are a centralized architecture and a distributed architecture. This paper proposes a new approach for the national integration of electronic health records, the semi-centralized approach, an intermediate solution between the centralized architecture and the distributed architecture that has the benefits of both approaches. The semi-centralized approach is provided with a clearly defined architecture. The main data elements needed by the system are defined and the main system modules that are necessary to achieve an effective and efficient functionality of the system are designed. Best practices and essential requirements are central to the evolution of the proposed architecture. The proposed architecture will provide the basis for designing the simplest and the most effective systems to integrate electronic health records on a nation-wide basis that maintain integrity and consistency across locations, time and systems, and that meet the challenges of interoperability, security, privacy, maintainability, mobility, availability, scalability, and load balancing.

  16. Implications of global warming on human health

    International Nuclear Information System (INIS)

    Singh, R.K.; Syam, P.V.S.

    1997-01-01

    Due to the build up of green house gases in atmosphere, less heat escapes through the atmosphere promoting global warming. This may result in world wide droughts, sea-level rise inundating islands and coastal countries, cataclysmic hurricanes etc. Human health as a result of these changes, will be affected both physiologically and psychologically. Physiological effects may be more pronounced in cases occurring due to changes in rainfall and temperature patterns, food production amounts, water availability, etc. Psychological impact may be more in cases of catastrophes like floods, hurricanes or famine. In this paper, an attempt has been made to highlight the implications of global warming on human health due to temperature change. Food production changes and ultra-violet radiation effects and cataclysmic disaster effects. (author)

  17. Improving patient-centered communication while using an electronic health record: Report from a curriculum evaluation.

    Science.gov (United States)

    Fogarty, Colleen T; Winters, Paul; Farah, Subrina

    2016-05-01

    Researchers and clinicians are concerned about the impact of electronic health record use and patient-centered communication. Training about patient-centered clinical communication skills with the electronic health record may help clinicians adapt and remain patient-centered. We developed an interactive workshop eliciting challenges and opportunities of working with the electronic health record in clinical practice, introduction of specific patient-centered behaviors and mindful practice techniques, and video demonstrating contrasts in common behavior and "better practices." One hundred thirty-nine resident physicians and faculty supervisors in five residency training programs at the University of Rochester Medical Center participated in the workshops. Participants were asked to complete an 11-item survey of behaviors related to their use of the electronic health record prior to training and after attending training. We used paired t-tests to assess changes in self-reported behavior from pre-intervention to post-intervention. We trained 139 clinicians in the workshops; 110 participants completed the baseline assessment and 39 completed both the baseline and post-intervention assessment. Data from post-curriculum respondents found a statistically significant increase in "I told the patient when turning my attention from the patient to the computer," from 60% of the time prior to the training to 70% of the time after. Data from our program evaluation demonstrated improvement in one communication behavior. Sample size limited the detection of other changes; further research should investigate effective training techniques for patient-centered communication while using the electronic health record. © The Author(s) 2016.

  18. Utilization and impact of electronic and print media on the patients’ health status: Physicians’ perspectives

    Directory of Open Access Journals (Sweden)

    Sadia Shakeel

    2017-01-01

    Full Text Available Aims: Despite an increased popularity of print and electronic media applications, there is a paucity of data reflecting doctors’ opinions regarding efficient utilization of these resources for the betterment of public health. Hence, this study aimed to investigate the perception of physicians toward the effect of electronic and print media on the health status of patients. Setting and Design: The current research is a cross-sectional study conducted from January 2015 to July 2015. The study population comprised physicians rendering their services in different hospitals of Karachi, Pakistan, selected by the nonprobability convenience sampling technique. In this study, 500 questionnaires were distributed through email or direct correspondence. Methods and Materials: Physicians’ perception toward the impact of electronic and print media on the health status of patients was assessed with a 20-item questionnaire. Different demographic characteristics, such as age, gender, institution, position, and experience of respondents, were recorded. Quantitative data were analyzed with the use of Statistical Package for Social Sciences, version 20.0 (SPSS, Chicago, IL. The association of the demographic characteristics of the responses of physicians was determined by one-way ANOVA using 0.05 level of significance. Results: In this study, 254 physicians provided consent to show their responses for research purposes. A response rate of 50.8% was obtained. Nearly one-third of the respondents negated that patients get health benefit using electronic and print media. The majority did not consider electronic and print media as lifestyle-modifying factors. Physicians thought that patients particularly do not rely on mass media for acquiring health information and consider healthcare professionals as unswerving information resource. Conclusions: Mass media can be productive resources to augment awareness among patients, although physicians seem unconvinced about

  19. Utilization and Impact of Electronic and Print Media on the Patients' Health Status: Physicians' Perspectives.

    Science.gov (United States)

    Shakeel, Sadia; Nesar, Shagufta; Rahim, Najia; Iffat, Wajiha; Ahmed, Hafiza Fouzia; Rizvi, Mehwish; Jamshed, Shazia

    2017-01-01

    Despite an increased popularity of print and electronic media applications, there is a paucity of data reflecting doctors' opinions regarding efficient utilization of these resources for the betterment of public health. Hence, this study aimed to investigate the perception of physicians toward the effect of electronic and print media on the health status of patients. The current research is a cross-sectional study conducted from January 2015 to July 2015. The study population comprised physicians rendering their services in different hospitals of Karachi, Pakistan, selected by the nonprobability convenience sampling technique. In this study, 500 questionnaires were distributed through email or direct correspondence. Physicians' perception toward the impact of electronic and print media on the health status of patients was assessed with a 20-item questionnaire. Different demographic characteristics, such as age, gender, institution, position, and experience of respondents, were recorded. Quantitative data were analyzed with the use of Statistical Package for Social Sciences, version 20.0 (SPSS, Chicago, IL). The association of the demographic characteristics of the responses of physicians was determined by one-way ANOVA using 0.05 level of significance. In this study, 254 physicians provided consent to show their responses for research purposes. A response rate of 50.8% was obtained. Nearly one-third of the respondents negated that patients get health benefit using electronic and print media. The majority did not consider electronic and print media as lifestyle-modifying factors. Physicians thought that patients particularly do not rely on mass media for acquiring health information and consider healthcare professionals as unswerving information resource. Mass media can be productive resources to augment awareness among patients, although physicians seem unconvinced about the extended usage of print/electronic media.

  20. Overview of human health in the Arctic: conclusions and recommendations.

    Science.gov (United States)

    Donaldson, Shawn; Adlard, Bryan; Odland, Jon Øyvind

    2016-01-01

    This article is intended to provide an overview of the key conclusions, knowledge gaps and key recommendations based on the recent 2015 Arctic human health assessment under the Arctic Monitoring and Assessment Program. This assessment was based primarily on data from human health monitoring and research studies and peer-reviewed literature published since the last assessment in 2009.

  1. Point-of-care cluster randomized trial in stroke secondary prevention using electronic health records.

    Science.gov (United States)

    Dregan, Alex; van Staa, Tjeerd P; McDermott, Lisa; McCann, Gerard; Ashworth, Mark; Charlton, Judith; Wolfe, Charles D A; Rudd, Anthony; Yardley, Lucy; Gulliford, Martin C; Trial Steering Committee

    2014-07-01

    The aim of this study was to evaluate whether the remote introduction of electronic decision support tools into family practices improves risk factor control after first stroke. This study also aimed to develop methods to implement cluster randomized trials in stroke using electronic health records. Family practices were recruited from the UK Clinical Practice Research Datalink and allocated to intervention and control trial arms by minimization. Remotely installed, electronic decision support tools promoted intensified secondary prevention for 12 months with last measure of systolic blood pressure as the primary outcome. Outcome data from electronic health records were analyzed using marginal models. There were 106 Clinical Practice Research Datalink family practices allocated (intervention, 53; control, 53), with 11 391 (control, 5516; intervention, 5875) participants with acute stroke ever diagnosed. Participants at trial practices had similar characteristics as 47,887 patients with stroke at nontrial practices. During the intervention period, blood pressure values were recorded in the electronic health records for 90% and cholesterol values for 84% of participants. After intervention, the latest mean systolic blood pressure was 131.7 (SD, 16.8) mm Hg in the control trial arm and 131.4 (16.7) mm Hg in the intervention trial arm, and adjusted mean difference was -0.56 mm Hg (95% confidence interval, -1.38 to 0.26; P=0.183). The financial cost of the trial was approximately US $22 per participant, or US $2400 per family practice allocated. Large pragmatic intervention studies may be implemented at low cost by using electronic health records. The intervention used in this trial was not found to be effective, and further research is needed to develop more effective intervention strategies. http://www.controlled-trials.com. Current Controlled Trials identifier: ISRCTN35701810. © 2014 American Heart Association, Inc.

  2. Human rights from the grassroots up: Vermont's campaign for universal health care.

    Science.gov (United States)

    McGill, Mariah

    2012-06-15

    In 2008, the Vermont Workers' Center launched the "Healthcare Is a Human Right Campaign," a grassroots campaign to secure the creation of a universal health care system in Vermont. Campaign organizers used a human rights framework to mobilize thousands of voters in support of universal health care. In response to this extraordinary grassroots effort, the state legislature passed health care legislation that incorporates human rights principles into Vermont law and provides a framework for universal health care. The United States has often lagged behind other nations in recognizing economic, social, and cultural (ESC) rights, including the right to health. Nonetheless, activists have begun to incorporate ESC rights into domestic advocacy campaigns, and state and local governments are beginning to respond where the federal government has not. Vermont serves as a powerful example of how a human rights framework can inform health care policy and inspire grassroots campaigns in the United States. This three-part article documents the Vermont Workers' Center campaign and discusses the impact that human rights activity at the grassroots level may have on attitudes towards ESC rights in the United States. The first part describes the Vermont health care crisis and explains why the center adopted international human rights principles for their campaign. The article then goes on to discuss the three-year campaign and analyze the health care reform bill that the Vermont legislature passed. Finally, the article discusses the campaign's local and national impact. Copyright © 2012 McGill.

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

    Science.gov (United States)

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

  4. Impact of climate change on human health and health systems in Tanzania: a review.

    Science.gov (United States)

    Mboera, Leonard E G; Mayala, Benjamin K; Kweka, Eliningaya J; Mazigo, Humphrey D

    2011-12-01

    Climate change (CC) has a number of immediate and long-term impacts on the fundamental determinants of human health. A number of potential human health effects have been associated either directly or indirectly with global climate change. Vulnerability to the risks associated with CC may exacerbate ongoing socio-economic challenges. The objective of this review was to analyse the potential risk and vulnerability in the context of climate-sensitive human diseases and health system in Tanzania. Climate sensitive vector- and waterborne diseases and other health related problems and the policies on climate adaptation in Tanzania during the past 50 years are reviewed. The review has shown that a number of climate-associated infectious disease epidemics have been reported in various areas of the country; mostly being associated with increase in precipitation and temperature. Although, there is no single policy document that specifically addresses issues of CC in the country, the National Environmental Management Act of 1997 recognizes the importance of CC and calls for the government to put up measures to address the phenomenon. A number of strategies and action plans related to CC are also in place. These include the National Biodiversity Strategy and Action Plan, the National Action Programme, and the National Bio-safety Framework. The government has put in place a National Climate Change Steering Committee and the National Climate Change Technical Committee to oversee and guide the implementation of CC activities in the country. Recognizing the adverse impacts of natural disasters and calamities, the government established a Disaster Management Division under the Prime Minister's Office. Epidemic Preparedness and Response Unit of the Ministry of Health and Social Welfare is responsible for emergency preparedness, mostly disease outbreaks. However, specific climate changes associated with human health issues are poorly addressed in the MoHSW strategies and the national

  5. Bidirectional RNN for Medical Event Detection in Electronic Health Records.

    Science.gov (United States)

    Jagannatha, Abhyuday N; Yu, Hong

    2016-06-01

    Sequence labeling for extraction of medical events and their attributes from unstructured text in Electronic Health Record (EHR) notes is a key step towards semantic understanding of EHRs. It has important applications in health informatics including pharmacovigilance and drug surveillance. The state of the art supervised machine learning models in this domain are based on Conditional Random Fields (CRFs) with features calculated from fixed context windows. In this application, we explored recurrent neural network frameworks and show that they significantly out-performed the CRF models.

  6. Governance and human resources for health

    NARCIS (Netherlands)

    Dieleman, Marjolein; Hilhorst, Thea

    2011-01-01

    Despite an increase in efforts to address shortage and performance of Human Resources for Health (HRH), HRH problems continue to hamper quality service delivery. We believe that the influence of governance is undervalued in addressing the HRH crisis, both globally and at country level. This thematic

  7. Impacts of Gut Bacteria on Human Health and Diseases

    Science.gov (United States)

    Zhang, Yu-Jie; Li, Sha; Gan, Ren-You; Zhou, Tong; Xu, Dong-Ping; Li, Hua-Bin

    2015-01-01

    Gut bacteria are an important component of the microbiota ecosystem in the human gut, which is colonized by 1014 microbes, ten times more than the human cells. Gut bacteria play an important role in human health, such as supplying essential nutrients, synthesizing vitamin K, aiding in the digestion of cellulose, and promoting angiogenesis and enteric nerve function. However, they can also be potentially harmful due to the change of their composition when the gut ecosystem undergoes abnormal changes in the light of the use of antibiotics, illness, stress, aging, bad dietary habits, and lifestyle. Dysbiosis of the gut bacteria communities can cause many chronic diseases, such as inflammatory bowel disease, obesity, cancer, and autism. This review summarizes and discusses the roles and potential mechanisms of gut bacteria in human health and diseases. PMID:25849657

  8. Community-based blood pressure measurement by non-health workers using electronic devices: a validation study

    Directory of Open Access Journals (Sweden)

    Daniel D. Reidpath

    2012-06-01

    Full Text Available Introduction: Population monitoring and screening of blood pressure is an important part of any population health strategy. Qualified health workers are expensive and often unavailable for screening. Non-health workers with electronic blood pressure monitors are increasingly used in community-based research. This approach is unvalidated. In a poor, urban community we compared blood pressure measurements taken by non-health workers using electronic devices against qualified health workers using mercury sphygmomanometers. Method: Fifty-six adult volunteers participated in the research. Data were collected by five qualified health workers, and six non-health workers. Participants were randomly allocated to have their blood pressure measured on four consecutive occasions by alternating a qualified health worker with a non-health worker. Descriptive statistics and graphs, and mixed effects linear models to account for the repeated measurement were used in the analysis. Results: Blood pressure readings by non-health workers were more reliable than those taken by qualified health workers. There was no significant difference between the readings taken by qualified health workers and those taken by non-health workers for systolic blood pressure. Non-health workers were, on average, 5–7 mmHg lower in their measures of blood pressure than the qualified health workers (95%HPD: −2.9 to −10.0 for diastolic blood pressure. Conclusion: The results provide empirical evidence that supports the practice of non-health workers using electronic devices for BP measurement in community-based research and screening. Non-health workers recorded blood pressures that differed from qualified health workers by no more than 10 mmHg. The approach is promising, but more research is needed to establish the generalisability of the results.

  9. Human Trafficking: A Review for Mental Health Professionals

    Science.gov (United States)

    Yakushko, Oksana

    2009-01-01

    This article provides a review of current research on human trafficking for mental health practitioners and scholars. In addition to an overview of definitions, causes and processes of trafficking, the article highlights mental health consequences of trafficking along with suggestions for treatment of survivors. Directions for counseling services,…

  10. Using data from ambient assisted living and smart homes in electronic health records.

    Science.gov (United States)

    Knaup, P; Schöpe, L

    2014-01-01

    This editorial is part of the Focus Theme of Methods of Information in Medicine on "Using Data from Ambient Assisted Living and Smart Homes in Electronic Health Records". To increase efficiency in the health care of the future, data from innovative technology like it is used for ambient assisted living (AAL) or smart homes should be available for individual health decisions. Integrating and aggregating data from different medical devices and health records enables a comprehensive view on health data. The objective of this paper is to present examples of the state of the art in research on information management that leads to a sustainable use and long-term storage of health data provided by innovative assistive technologies in daily living. Current research deals with the perceived usefulness of sensor data, the participatory design of visual displays for presenting monitoring data, and communication architectures for integrating sensor data from home health care environments with health care providers either via a regional health record bank or via a telemedical center. Integrating data from AAL systems and smart homes with data from electronic patient or health records is still in an early stage. Several projects are in an advanced conceptual phase, some of them exploring feasibility with the help of prototypes. General comprehensive solutions are hardly available and should become a major issue of medical informatics research in the near future.

  11. Human rights and correctional health policy: a view from Europe.

    Science.gov (United States)

    Rogan, Mary

    2017-03-13

    Purpose Correctional healthcare should promote the protection of human rights. The purpose of this paper is to bring a discussion of human rights into debates on how such policy should be best organized. Design/methodology/approach The paper achieves its aim by providing an analysis of European prison law and policy in the area of prison health, through assessing decisions of the European Court of Human Rights, as well as policies created by the European Committee for the Prevention of Torture. Findings The paper describes the position of the European Court of Human Rights on the topics of access to healthcare, ill health and release from prison, mental illness in prison, and the duty to provide rehabilitative programming for those seeking to reduce their level of "risk." It also argues that human rights law can be a source of practical reform, and that legal frameworks have much to offer healthcare leaders seeking to uphold the dignity of those in their care. Originality/value This paper will provide a rare example of the engagement of human rights law with correctional health policy. It provides practical recommendations arising out of an analysis of European human rights law in the area of prisons.

  12. Research Award: Ecosystems and Human Health (Ecohealth ...

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

    Jean-Claude Dumais

    2012-09-12

    Sep 12, 2012 ... Research Award: Ecosystems and Human Health (Ecohealth) ... Your proposal should demonstrate an understanding of the ... demonstrated ability to work independently, and strong written and oral communications skills are ...

  13. Managing terminology assets in Electronic Health Records.

    Science.gov (United States)

    Abrams, Kelly; Schneider, Sue; Scichilone, Rita

    2009-01-01

    Electronic Health Record (EHR)systems rely on standard terminologies and classification systems that require both Information Technology (IT) and Information Management (IM) skills. Convergence of perspectives is necessary for effective terminology asset management including evaluation for use, maintenance and intersection with software applications. Multiple terminologies are necessary for patient care communication and data capture within EHRs and other information management tasks. Terminology asset management encompasses workflow and operational context as well as IT specifications and software application run time requirements. This paper identifies the tasks, skills and collaboration of IM and IT approaches for terminology asset management.

  14. Electronic Versus Manual Data Processing: Evaluating the Use of Electronic Health Records in Out-of-Hospital Clinical Research

    Science.gov (United States)

    Newgard, Craig D.; Zive, Dana; Jui, Jonathan; Weathers, Cody; Daya, Mohamud

    2011-01-01

    Objectives To compare case ascertainment, agreement, validity, and missing values for clinical research data obtained, processed, and linked electronically from electronic health records (EHR), compared to “manual” data processing and record abstraction in a cohort of out-ofhospital trauma patients. Methods This was a secondary analysis of two sets of data collected for a prospective, population-based, out-of-hospital trauma cohort evaluated by 10 emergency medical services (EMS) agencies transporting to 16 hospitals, from January 1, 2006 through October 2, 2007. Eighteen clinical, operational, procedural, and outcome variables were collected and processed separately and independently using two parallel data processing strategies, by personnel blinded to patients in the other group. The electronic approach included electronic health record data exports from EMS agencies, reformatting and probabilistic linkage to outcomes from local trauma registries and state discharge databases. The manual data processing approach included chart matching, data abstraction, and data entry by a trained abstractor. Descriptive statistics, measures of agreement, and validity were used to compare the two approaches to data processing. Results During the 21-month period, 418 patients underwent both data processing methods and formed the primary cohort. Agreement was good to excellent (kappa 0.76 to 0.97; intraclass correlation coefficient 0.49 to 0.97), with exact agreement in 67% to 99% of cases, and a median difference of zero for all continuous and ordinal variables. The proportions of missing out-of-hospital values were similar between the two approaches, although electronic processing generated more missing outcomes (87 out of 418, 21%, 95% CI = 17% to 25%) than the manual approach (11 out of 418, 3%, 95% CI = 1% to 5%). Case ascertainment of eligible injured patients was greater using electronic methods (n = 3,008) compared to manual methods (n = 629). Conclusions In this

  15. Health and human rights: a statistical measurement framework using household survey data in Uganda.

    Science.gov (United States)

    Wesonga, Ronald; Owino, Abraham; Ssekiboobo, Agnes; Atuhaire, Leonard; Jehopio, Peter

    2015-05-03

    Health is intertwined with human rights as is clearly reflected in the right to life. Promotion of health practices in the context of human rights can be accomplished if there is a better understanding of the level of human rights observance. In this paper, we evaluate and present an appraisal for a possibility of applying household survey to study the determinants of health and human rights and also derive the probability that human rights are observed; an important ingredient into the national planning framework. Data from the Uganda National Governance Baseline Survey were used. A conceptual framework for predictors of a hybrid dependent variable was developed and both bivariate and multivariate statistical techniques employed. Multivariate post estimation computations were derived after evaluations of the significance of coefficients of health and human rights predictors. Findings, show that household characteristics of respondents considered in this study were statistically significant (p human rights observance. For example, a unit increase of respondents' schooling levels results in an increase of about 34% level of positively assessing human rights observance. Additionally, the study establishes, through the three models presented, that household assessment of health and human rights observance was 20% which also represents how much of the entire continuum of human rights is demanded. Findings propose important evidence for monitoring and evaluation of health in the context human rights using household survey data. They provide a benchmark for health and human rights assessments with a focus on international and national development plans to achieve socio-economic transformation and health in society.

  16. Mining Electronic Health Records using Linked Data.

    Science.gov (United States)

    Odgers, David J; Dumontier, Michel

    2015-01-01

    Meaningful Use guidelines have pushed the United States Healthcare System to adopt electronic health record systems (EHRs) at an unprecedented rate. Hospitals and medical centers are providing access to clinical data via clinical data warehouses such as i2b2, or Stanford's STRIDE database. In order to realize the potential of using these data for translational research, clinical data warehouses must be interoperable with standardized health terminologies, biomedical ontologies, and growing networks of Linked Open Data such as Bio2RDF. Applying the principles of Linked Data, we transformed a de-identified version of the STRIDE into a semantic clinical data warehouse containing visits, labs, diagnoses, prescriptions, and annotated clinical notes. We demonstrate the utility of this system though basic cohort selection, phenotypic profiling, and identification of disease genes. This work is significant in that it demonstrates the feasibility of using semantic web technologies to directly exploit existing biomedical ontologies and Linked Open Data.

  17. Technical Limitations of Electronic Health Records in Community Health Centers: Implications on Ambulatory Care Quality

    Science.gov (United States)

    West, Christopher E.

    2010-01-01

    Research objectives: This dissertation examines the state of development of each of the eight core electronic health record (EHR) functionalities as described by the IOM and describes how the current state of these functionalities limit quality improvement efforts in ambulatory care settings. There is a great deal of literature describing both the…

  18. The human face of health disparities.

    Science.gov (United States)

    Green, Alexander R

    2003-01-01

    In the last 20 years, the issue of disparities in health between racial/ethnic groups has moved from the realm of common sense and anecdote to the realm of science. Hard, cold data now force us to consider what many had long taken for granted. Not only does health differ by race/ethnicity, but our health care system itself is deeply biased. From lack of diversity in the leadership and workforce, to ethnocentric systems of care, to biased clinical decision-making, the American health care system is geared to treat the majority, while the minority suffers. The photos shown here are of patients and scenes that recall some of the important landmarks in research on racial/ethnic disparities in health. The purpose is to put faces and humanity onto the numbers. While we now have great bodies of evidence upon which to lobby for change, in the end, each statistic still represents a personal tragedy or an individual triumph.

  19. Human rights, public health and medicinal cannabis use

    OpenAIRE

    Bone, Melissa; Seddon, Toby

    2015-01-01

    This paper explores the interplay between the human rights and drug control frameworks, and critiques case law on medicinal cannabis use to demonstrate that a bona fide human rights perspective allows for a broader conception of ‘health’. This broad conception, encompassing both medicalised and social constructionist definitions, can inform public health policies relating to medicinal cannabis use. The paper also demonstrates how a human rights lens can alleviate a core tension between the St...

  20. Raisins in human health: A review

    Directory of Open Access Journals (Sweden)

    Restani Patrizia

    2016-01-01

    Full Text Available In the last years, the scientific research in the field of non-alcoholic grape products has increased significantly. Raisins are often evaluated negatively from the nutritional point of view, mainly for their high sugar content. On the other hand, some in vitroand in vivostudies have suggested that raisins could have healthy effects due to their positive phytochemical profile. The aim of this work was the collection of scientific studies performed in humans to assess critically the health-promoting effects of raisins, as a part of the normal/Mediterranean diet. In most cases, the beneficial effects of raisins have been assessed in intervention studies focused on cardiovascular area, diabetes and oral health, where a decrease in postprandial glycemia and insulinemia both in diabetic and healthy subjects has been observed. The positive effects were generally evident after a short-term consumption of about 70 g/die of raisins in comparison to a similar quantity of snacks or glucose solution. Surprisingly, some positive findings were shown in oral health. On these bases several findings support the suitability of raisins as a source of healthy compounds for human diet, but limits in the data published till now clearly support the need of new specifically designed trials.