Managerial attitude to the implementation of quality management systems in Lithuanian support treatment and nursing hospitals

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Lydeka Zigmas

2006-09-01

Full Text Available Abstract Background The regulations of the Quality Management System (QMS implementation in health care organizations were approved by the Lithuanian Ministry of Health in 1998. Following the above regulations, general managers of health care organizations had to initiate the QMS implementation in hospitals. As no research on the QMS implementation has been carried out in Lithuanian support treatment and nursing hospitals since, the objective of this study is to assess its current stage from a managerial perspective. Methods A questionnaire survey of general managers of Lithuanian support treatment and nursing hospitals was carried out in the period of January through March 2005. Majority of the items included in the questionnaire were measured on a seven-point Likert scale. During the survey, a total of 72 questionnaires was distributed, out of which 58 filled-in ones were returned (response rate 80.6 per cent; standard sampling error 0.029 at 95 per cent level of confidence. Results Quality Management Systems were found operating in 39.7 per cent of support treatment and nursing hospitals and currently under implementation in 46.6 per cent of hospitals (13.7% still do not have it. The mean of the respondents' perceived QMS significance is 5.8 (on a seven-point scale. The most critical issues related to the QMS implementation include procedure development (5.5, lack of financial resources (5.4 and information (5.1, and development of work guidelines (4.6, while improved responsibility and power sharing (5.2, better service quality (5.1 and higher patient satisfaction (5.1 were perceived by the respondents as the key QMS benefits. The level of satisfaction with the QMS among the management of the surveyed hospitals is mediocre (3.6. However it was found to be higher among respondents who were more competent in quality management, were familiar with ISO 9000 standards, and had higher numbers of employees trained in quality management. Conclusion

Analysis of Lithuanian Direct Investment into European Union Countries

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Evelina Zigmantavičiūtė

2015-05-01

Full Text Available In this paper the valuation of macroeconomic factors influencing the Lithuanian direct investment into European Union was conducted. The problem of this paper is the different chosen macroeconomic factors influencing foreign direct investment. The object of this paper is Lithuanian direct investment. The methods of this paper include: comparative literature analysis, correlation regression analysis, paired regression analysis. After conducting a research of dependency of Lithuanian direct investment to EU countries from price changes, government sector income, gross domestic product, inflation, jobless rate results, it is found that gross domestic product and government sector income have the most influence on the changes of Lithuanian direct investment.

Collaboration in the provision of mental health care services

DEFF Research Database (Denmark)

Jaruseviciene, L.; Valius, L.; Lazarus, J.V.

2012-01-01

collaboration with mental health teams were a lack of GPs'confidence in their communication skills and ability to diagnose the most frequent mental disorders, prompt referral to mental health team specialists, low estimation of the prevalence of non-managed mental disorders, and location of mental health team......Background. General practitioners (GPs) often become the first point of care for mental health issues. Improved collaboration between GPs and mental health teams can make a GP's mental health services more efficient. Objective. The aim of this study was to assess the collaboration between GPs...... and mental health team members and determine predictors for better collaboration. Methods. In this cross-sectional study, a 41- item questionnaire was distributed to a random sample of 797 Lithuanian GPs. The purpose of this questionnaire was to obtain knowledge about current practices of GPs in providing...

Idiomaticity of English Business Terms and Their Equivalents in Lithuanian

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Pavel Skorupa

2011-04-01

Full Text Available The paper presents the survey of idiomatic English business terms and their Lithuanian equivalents. The study was based on the theory of idioms and idiomaticity, highlighting the idea that idiomaticity can affect single words, word combinations, and longer text passages. Idiomatic business terms were taken from different English and Lithuanian general and special dictionaries, course books, as well as business texts. The analyzed terms were classified into distinct groups according to their meaning. The key problem encountered was the lack of Lithuanian translation equivalents to certain idiomatic English business terms. Possible Lithuanian translation was provided.

Time trends in social differences in nutrition habits of a Lithuanian population: 1994-2010

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Kriaucioniene Vilma

2012-03-01

Full Text Available Abstract Background During the post-communist transition period, political, economic, and social changes affected the lifestyles of the Lithuanian population, including their nutritional habits. However, people of lower socio-economic position were more vulnerable to these changes. The aim of the present study was to evaluate the trends in selected food habits of the Lithuanian adult population by their level of education and place of residence from 1994 to 2010. Methods The data were obtained from nine biannual cross-sectional postal surveys of Lithuanian health behaviours, beginning in 1994. Each survey used a randomly selected nationally representative sample of 3000 inhabitants aged 20-64 drawn from the population register. In total, 7358 men and 9796 women participated in these surveys. Questions about food consumption were included within all health behaviour questionnaires. Results During the transition period, use of vegetable oil in cooking and the frequency of consumption of fresh vegetables increased, use of butter on bread decreased, and the proportion of women drinking high-fat milk declined. Lithuanians with higher education reported more frequent use of vegetable oil in cooking as well as daily consumption of fresh vegetables than those with a lower level of education. Consumption of high-fat milk was inversely associated with educational background. In addition, the proportion of persons spreading butter on bread increased with higher education level. The greatest urban-rural difference was observed in high-fat milk consumption. The increase in the use of vegetable oil in cooking, and the reduction of spreading butter on bread was more evident among less educated and rural inhabitants. Meanwhile, a greater proportion of the rural population, compared to urban, reduced their use of butter on bread. Daily consumption of fresh vegetables increased most among highly educated Lithuanians. Conclusions The data from our study indicate

Evoliution of Castle Palaces in Lithuanian Renaissance

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Inga Genytė

2012-05-01

Full Text Available The article author examines the problem of architecture history associated with the evolution of castle palaces in the current territory of Lithuania in the Lithuanian Renaissance period. The article is based on research papers thematically close to the publication, other literature and archive documents. After prehistory review of castle palaces at a theoretical level and clarifying the conditions for their occurrence, significant development trends of castle palaces during the Renaissance period in current Lithuania territory is revealed. At the beginning of the sixteenth century, Italian, Flemish and Flanders Renaissance reached Lithuania and merged with the local tradition; in the light of the Lithuanian Renaissance castle palaces reached their prosperity period in Lithuania. Castle palaces were distinguished by the diversity of their structural and architectural forms, relatively meaningful connection between function and artistic expression and a sustainable link with the components of environment.Article in Lithuanian

Analysis of Volunteer Soldiers‘ Attitudes to Service in the Lithuanian Military

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Vileikienė Eglė

2015-12-01

Full Text Available The article presents an analysis of volunteer soldiers as a link between the Lithuanian military and society, their attitudes towards military service and their motivation to serve in the Lithuanian army. The authors looked at soldiers’ dedication to defend their Homeland and motives for serving in the Lithuanian army, presenting an assessment of the situation in the ranks and their overall satisfaction with military service. Volunteer soldiers’ expectations are also discussed, as well as their motives to remain in service, plus there are also recommendations for attracting new soldier recruits. The article concludes with the statement that Lithuanian volunteer soldiers are an important unifying link between the Lithuanian army and society, and can significantly contribute to the formation of the image of the soldier’s profession in society. Besides the social status that comes with military service and the satisfaction of financial needs, volunteer soldiers are exclusively characterised by strong patriotic feelings which determine their motivation to serve and defend their Homeland. The article’s findings rest on data from the complex sociological research study “Motivation to serve in the Ministry of Defence Volunteer Forces of the Lithuanian Military” which was conducted in April–November, 2014 by the Strategic Research Centre at the Institute of Military Science of the General Jonas Žemaitis Military Academy of Lithuania.

Lithuanian Nuclear Safety Advisory Committee - 1993-2003

International Nuclear Information System (INIS)

Medeliene, D.

2003-01-01

Brief overview of the Lithuanian Nuclear Safety Advisory Committee (LNSAC) activities is presented. LNSAC was established in May 1993, main task is to advise the Lithuanian government on industrial and regulatory matters of nuclear safety. One of the most of important tasks was to exert pressure on the Government so that it allocates sufficient funds from the national budget for setting up a national regulatory body. Statements of the members of LNSAC are presented. In the CD minutes of the meetings of the LNSAC in 1993-2003 and official documents regulating Committee activities are included

Corporate social responsibility's discourse in lithuanian business press

OpenAIRE

Marčenkovas, Marius

2014-01-01

The object of this master work is corporate social responsibility's (CSR) discourse. The purpose of this work is to analyze how Lithuanian business press presents CSR topic. The main tasks to reach this purpose are: overview and compare CSR definitions; analyze media impact to CSR; analyze and summarize CSR discourse in Lithuanian business press. Literature analysis, synthesis and comparative methods were used to drawn conclusions. After the literature analysis of such scientists as Ph. Kotle...

Sugar amount analysis in food from Lithuanian food market

OpenAIRE

Gudauskaitė, Milda

2015-01-01

When taking too much simple sugar, especially sucrose, harmful health effects occur: more tooth decay occurs, the excess sugar coverts into fat, digestive system gets irritated, increase of weight, possibility in increasing of developing cancer cells, pancreatic and other misbalances in the endocrine organs. Thesis goal: to perform sugar amount analysis in Lithuanian food market Analysis methodology. Assessing the amount of sugar (g/100g) there was analyzed 147 major food la...

Lithuanian speaking childrens' bilingualism. language situation and policy

OpenAIRE

Paškauskaitė, Ieva

2017-01-01

Lithuanian Speaking Childrens' Bilingualism. Language Situation and Policy The purpose of this study is to investigate the language situation of Lithuanian speaking children in Sweden and its causes. This study is specifically concerned with the subjects of bilingualism and family language policy: language strategies and methods. The concept of bilingualism is complex and can be defined in different ways, therefore this study is based on a table which was introduced by T. Skutnabb-Kangas in 1...

Lithuanian Energy Institute: Annual Report '98

International Nuclear Information System (INIS)

Mishkinis, V.; Ushpuras, E.; Poshkas, P.

1999-01-01

Among main achievements of 1998 the huge and important set of research works concerning the second Ignalina NPP safety improvement programme and its preparation-ration for obtaining a licence should be mentioned. The total value of works carried out for this purpose reached about 2 million Lt. Intense preparations were carried out and new works were initiated linked to handling spent nuclear fuel and radioactive wastes and to the future shutdown and dismantling of the NPP. This is a very important and long term objective and its success will depend greatly on our level of preparations and readiness for this complex process. The Institute will make its decisive and substantial contribution to it. Much time and many efforts were dedicated to improvement of the Lithuanian Energy Strategy Project and its adjustments in consultations with representatives of various institutions. Discussions on this important political expanded widely over Lithuanian borders while preparation and analysis of information for it was the main concern of our energy economists. In 1998 institutes' metrological base was expanded and improved still further. As a result, Heat - Equipment Research and Testing Laboratory was acknowledged attestation confirming it being the main Lithuanian metrological laboratory in the field of measurement fluid and gas flow rate and heat amount (author)

[Associations between mortality and alcohol consumption in Lithuanian population].

Science.gov (United States)

Grabauskas, Vilius; Prochorskas, Remigijus; Veryga, Aurelijus

2009-01-01

The objective of the study was to assess alcohol-related mortality that potentially might explain an increasing trend in overall mortality of Lithuanian population, which started after 2000 and peaked in 2005. An empiric analysis of national mortality and other statistical data as well as their international comparisons. An analysis of available data clearly indicates that a decline in mortality in 1998-2000, i.e. during the beginning of the National Programme of Health, as well as its increase in 2001 and 2005 were predominantly determined by cause-specific deaths of two groups: deaths from diseases of the circulatory system (mainly ischemic heart disease) and alcohol consumption-related deaths (liver cirrhosis, accidental poisoning by alcohol, accidents, etc.). A certain proportion of deaths, which were caused by alcohol, were wrongly assigned to the deaths from diseases of the circulatory system due to uncertainties in filling-in death certificates. By approximate estimates, at least one-quarter of increase in all-cause mortality between 2002-2004 and 2005-2007 could be explained by an increase in alcohol consumption, accounting for additional 880 deaths on average per year. In the year 2007, 12.6% (n=5760) of all deaths were somehow related to alcohol consumption. A comparative analysis demonstrated that mortality and alcohol consumption trends were going in parallel over the last decade. The systemic decline in mortality observed in Lithuania from 1995 stopped in 2000 after a decrease in alcohol taxes, which resulted in an increase in alcohol accessibility and consumption. An average annual increase in alcohol consumption over the period of 2001-2004 was 7%; it increased up to 17% in 2005 and accounted for 12% annual increase on average within 2005-2007. Negative trends in alcohol-related morbidity and mortality in Lithuanian population most notably registered in 2001 and 2005 were largely influenced by uncontrollable increase in alcohol consumption over the

CONSTRUCTING SERVICE DISCOURSES IN LITHUANIAN FAMILY SOCIAL WORK

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Roberta Motiečienė

2016-09-01

Full Text Available In this paper, family social work is constructed through the analysis of social service discourses from the social workers’ perspective. Recent research shows how social workers are dealing with complex and fluid issues, as well as the societal uncertainty in their work with families (e.g., Spratt, 2009; Menéndez et al., 2015. Based on earlier studies, it is vital to analyse family social work in different contextual settings. Societal, political and organisational contexts affect the preconditions of social work, but social work also needs to operate within structures (e.g., Pohjola et al., 2014. This paper provides insights into the Lithuanian family social work. The focus is on what kinds of features construct Socialinis darbas su šeima Roberta Motiečienė, Merja Laitinen 12 family social work by analysing social workers’ discourses. This analysis continues the research of Eidukevičiūtė (2013, who analysed family social work practices in transitional Lithuanian society. This researcher aimed to deepen the knowledge about child protection services in Lithuania, the father’s role in child care and the mother’s performance in it. According to Eidukevičiūtė (2013, social workers are still struggling in the field of family social work. This study continues the research tradition in the field of family social work, paying attention to the different contextual settings where family social work is conducted. The Lithuanian government has stated that family policy is a key component of its mandate where (Social Report, 2014. The Council of Social Work plays a very important role in providing guidance on how to implement the government’s policy in the field of family social work. The European Commission Council (2015 provides recommendations for the implementation of the 2015 National Reform Programme, which should concentrate on the people (30% of the total population who are at risk of poverty. The council recommends working on

Weaves and Colours of Lithuanian Folk Skirts Fabrics

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Eglė KUMPIKAITĖ

2013-09-01

Full Text Available In the article weaves and colours of Lithuanian folk skirts fabrics are analysed. The investigation objects are the skirts from funds of three Lithuanian Museums: 258 skirts from National M. K. Čiurlionis Museum of Art, 85 skirts from Lithuanian Open Air Museum and 16 skirts from A. and A. Tamošaitis gallery “Židinys”. Distribution of skirts fabrics according to weaves was estimated, and it shows, that fabrics of plain weave are most widespread (53 %, combined and twill weaves are less popular (19 % and 18 %, respectively. The weaves of fabrics are determined during investigation and plans of weave were made proposing recommendations for manufacturing of similar fabrics. Also distribution of colours and number of colours in the fabrics were analysed. The biggest number of colours is in fabrics of simple weaves (plain and twill, and the most characteristic are green, red, black and blue colours. DOI: http://dx.doi.org/10.5755/j01.ms.19.3.5240

On the development of past habitual from iterative in Lithuanian

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Jurgis Pakerys

2018-02-01

Full Text Available Lithuanian has regular past habitual forms with the suffix -dav-, which can be explained as an originally iterative suffix -dau- restricted to the past tense (Fraenkel 1936. Dialectal and Old Lithuanian, in addition to -dav-, also feature habituals with the suffixes -lav- and -dlav-, which could have followed the same path of development (Fraenkel 1936, as evidenced by a number of diverse languages (Bybee et al. 1994. Using an electronic edition of Lietuvių kalbos žodynas (The Dictionary of Lithuanian as the data source, a limited number of possible iteratives with -dau- and other related suffixes were found, which has led to two main conclusions. (1 Habituals were restricted to the past tense before the appearance of the first written Lithuanian texts (mid-16th c. and the present and the infinitive stems went out of use. If this had not been the case, more corresponding verbal formations should have remained. (2 Iteratives with the habitual-to-be suffixes had to be productive to some extent in the dialects, which grammaticalized them as past habituals. If these formations had been productive in all dialects of Lithuanian, more iteratives should have been found in the areas that did not grammaticalize them as past habituals. It is also suggested that the form-frequency correspondence principle (Haspelmath 2008, 2014, 2017 should have operated in the formation of the Lithuanian habitual. Longer suffixes were chosen to mark habitual situations as a less frequent subtype of iterative situations and habitual forms were restricted to the past tense because habituality is one of the default (more frequent readings of the present and hence the habituals in the past tend to be marked explicitly (Bybee et al. 1994.

DISCOURSES AND DEPICTIONS OF HOLOCAUST EDUCATION IN LITHUANIAN HISTORY TEXTBOOKS (1992-2012

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AKVILĖ NAUDŽIŪNIENĖ

2017-09-01

Full Text Available The topic of the Holocaust is a relatively new issue in Lithuanian historical education – only with the regained independence from the Soviet Union in 1990 did Lithuanians have a chance include the Holocaust theme into the main school curriculum. Of course, its development through the first two decades have not been steady and even – in the beginning of the creation of the new educational system the Holocaust did not receive so much attention as in later years with the relation to integration with the European Union (2004 and development of historical studies on the Holocaust within the Lithuanian academic community. This article aims to analyse the representation of the Holocaust in Lithuanian educational system during the first two decades after Lithuania regained its independence. So the main basis of empirical data will be all history textbooks for Lithuanian school education (from the 5th grade to the last, 12th grade published in the period of 1992-2012, and educational programmes presented by the State`s Ministry of Education and Science. In order to objectively evaluate the Lithuanian situation regarding Holocaust education the article will discuss and compare the main trends of Holocaust education development in neighbouring countries, which also suffered from Holocaust and could not freely speak about the issue during the Communist regime.

World tendences of civil aviation development and the enlargement of the Lithuanian civil aviation

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J. Butkevičius

2006-06-01

Full Text Available The article deals with global trends in civil aviation, such as: liberalisation of aviation market, globalisation of airlines, privatisation of airlines and invasion of low cost airlines into the market. Also the influence of these trends on the Lithuanian civil aviation activities has been defined. The Lithuanian civil aviation activities have been analysed: activities of international airports, passenger and cargo carriers, passenger routes and passenger flows, transportation market and airplane fleet. The problems of the Lithuanian civil aviation activities have been identified and suggestions for the development of the Lithuanian civil aviation activities have been proposed.

Pecularities of French Pronoun on Usage in Lithuanian Scientific Discourse

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Lina Dubikaltytė-Raugalienė

2015-12-01

Full Text Available Scientists studying personal identifiers in French scientific discourse incorporate the personal indefinite pronoun “on” into the paradigm. The semantics of the pronoun depends on the genre of scientific discourse. The pronoun “on” can acquire four meanings denoting or including the author. The current paper, based on two databases of native French and Lithuanian authors’ articles, aims at comparing the tendencies of the pronoun “on” usage and its functions in scientific discourse. The analyses has shown that the Lithuanian authors use the personal pronoun almost twice less frequently to mark an author or authors’ denotative or inclusive meaning. In the articles of Lithuanian authors, the pronoun “on” performs fewer pragmatic functions than in scientific discourse of French authors.

"Sunrise" and "Sunset" of Lithuanian Agencies

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Vitalis NAKROŠIS

2011-12-01

Full Text Available Based on the transformative approach, the NPM and post-NPM models this article explains the proliferation, autonomy, control and innovative behavior of Lithuanian agencies and other public sector organizations in the 1990-2010 period. While the expansion of governmental functions during Lithuania’s transition to democracy and its accession to the EU brought agencification in 1990-2004, the adoption of government-wide organizational reforms during the economic crisis marked the start of de-agencification in 2009- 2010. The degree of autonomy and control of the Lithuanian public sector organizations is largely explained by their legal basis and political salience of their tasks. Finally, in line with the post-NPM model, structural capacities and participation in networks have a strong impact on innovative behavior of these organizations.

Liquidity Risk and its Management in Lithuanian Banking System

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Erika Bareikaitė

2014-04-01

Full Text Available Banks are the main part of financial sector in each economy and strength of banking system becomes vital for ensuringfavourable economic stability and growth. Recent failure of two commercial banks in Lithuania showed that managershaven’t evaluated liquidity risk or haven’t dealt with it properly. The tasks of the paper are to investigate Lithuanian banksposition towards liquidity risk, analyse what kind of management tools banks use for ensuring favourable position towardsliquidity and to explore the liquidity influence to profitability in Lithuanian banking sector. The article examines liquidity andits management processes in Lithuanian banking sector. Description of liquidity importance is presented. Liquidity risk and itsmeasurement as well as the ways of managing the above mentioned risk is analysed in the article. In order to analyse the relationshipbetween liquidity risk and profitability of banks, analysis of scientific literature, research synthesis and generalizationshave been made.

On Quality Intensification Expression Means in German And Lithuanian

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Ernesta Račienė

2013-12-01

Full Text Available The paper presents the analysis of German Adjectives’ derivational means, which intensify the meaning of quality, and which are compared with functional equivalents in Lithuanian. The intensification of quality is treated as the functional semantic category, implemented in various language levels. This semantics may be expressed morphologically, by lexical and syntactic means, as well as by stress and intonation. The German language has many first components of compound adjectives, representing the intensification of quality, such as: stock-, blitz-, hoch-, brand-, grund-, etc. The rendering function of this semantics is typical of German adjectives prefixes erz-, ur- as well as prefixes of foreign origin super-, ultra-, extra-, mega-, hyper-, top-. In the Lithuanian language, the intensifying meaning of quality is realized by syntactic com-pounds, while on the morphological level it can be conveyed by diminutive suffixes. The paper presents the comparison of German and Lithuanian quality intensification expression means in order to highlight typological similarities and differences.

Acculturation and adaptation among Lithuanian workers in Norway (a case study)

OpenAIRE

Kmite, Liuda Jr

2011-01-01

Migration and intercultural relations In a new culture, migrants experience acculturation. Through acculturation migrants may choose which acculturation strategy to use. In 2010, emigration from Lithuania increased four times. Lithuanians account for several per cent of all migrants in Norway. The study aims to assess the acculturation strategies which Lithuanian workers in Rogaland area (Norway) adopt.

A net presentation of Lithuanian sentences containing verbal forms with the grammatical suffix -dav-

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Danuta Roszko

2014-09-01

Full Text Available A net presentation of Lithuanian sentences containing verbal forms with the grammatical suffix -dav- In the article the authors make an attempt to present the meaning of Lithuanian sentences containing verbal forms with the grammatical suffix -dav- (the so-called iterative past tense forms by means of Petri nets. The authors gradually develop the net to such complexity that it makes it possible to avoid interpretative similarities to other Lithuanian verbal forms.

The development of Corporate social responsibility in Lithuanian food industry

OpenAIRE

Navickas, Valentinas; Kontautienė, Rima

2014-01-01

The authors of the article analyze the development of corporate social responsibility in Lithuanian food industry. By emphasize the importance of food industry as one of the largest manufacturing group in Lithuania and its strong impact and high dependence on the economy, the environment and on society, implementation of principles and practice of corporate social responsibility is of high relevance for this sector. The paper deals with the main indicators of Lithuanian food industry in...

Customer satisfaction with mobile operators’ services in Lithuanian rural areas

OpenAIRE

Pilelienė, Lina; Grigaliūnaitė, Viktorija

2017-01-01

In tough competitive conditions of Lithuanian mobile services market, customer satisfaction becomes one of the most important factors for customer retention and attraction. Lithuanian mobile market can be described as being in a maturity stage of its life-cycle: the prices and services of different mobile operators are quite similar. However, the network coverage and signal strength differs – main differences can be observed in rural areas of the country. Therefore, the scientific...

THE CLITICS IN STANDARD LITHUANIAN

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Asta Kazlauskienė

2015-04-01

Full Text Available A Lithuanian word is quite an autonomous prosodic unit. Nevertheless, in some cases a word loses stress, connects to an adjacent word, and becomes a part of a succeeding or preceding word. The aim of this research is to establish and describe the prosodic autonomy of the Lithuanian language word and its determinants. The database for this analysis consists of some audio recordings of novels, which were used in this study (11 h 20 min, 22 speakers. A computational programme was designed by Prof. Dr. G. Raškinis. The empirical data showed that the words with clitics comprise about ¼ of all the words. The data analysis suggests that the word autonomy depends on many factors: phonetic structure (monosyllabic words often lose their stress, morphological features (uninflected parts of speech, especially prepositions, often do not have a stress, the structure of a sentence (a potential clitic can get a stress in an elliptic sentence, pragmatic intentions (a word with a phrase stress will get a lexical stress, and the pressure of the rhythm (a potential clitic can keep stress due to the succeeding unstressed syllable. The latter factor is important for the rhythm of the speech for two reasons. First, a clitic can eliminate a stress clash, which might be formed if both words had stresses. Second, if clitic is connected to the word with a first stressed syllable, the second syllable would become stressed. Such word is articulated easier than the word which begins with a stressed syllable. However, the rhythm does not have a major impact on the word autonomy in the Lithuanian language. The phonetic structure and morphological features have the most significant influence on the prosodic autonomy of a word.

Factors related to gender differences in toothbrushing among Lithuanian middle-aged university employees.

Science.gov (United States)

Sakalauskienė, Zana; Vehkalahti, Miira M; Murtomaa, Heikki; Mačiulskienė, Vita

2011-01-01

BACKGROUND AND OBJECTIVES. Many previous studies showed clear gender differences in the percentages of adults reporting toothbrushing more than once a day. This study evaluated the factors determining gender differences in toothbrushing among Lithuanian middle-aged university employees. MATERIAL AND METHODS. A questionnaire survey was anonymously conducted among 35- to 44-year-old employees (n=862) of four universities in Lithuania in 2005. The response rate was 64% (n=553). Data covered toothbrushing frequency, habitual dental attendance, dental health attitudes and knowledge, and subject's background information. RESULTS. Of all respondents, 68% reported brushing their teeth more than once a day (73% of women and 49% of men, Pimportant to them and poor oral health as injurious to general health. Of all respondents, 44% indicated that "Lack of time is the main reason for incomplete oral self-care" (61% of men and 40% of women, Pimportance of good dental health to them (OR, 1.6; 95% CI, 1.1-2.4; P=0.02) among women and statement that "Poor oral health can be injurious to general health" (OR, 2.6; 95% CI, 1.2-5.5; P=0.01) and checkup-based habitual dental attendance (OR, 2.4; 95% CI, 1.0-5.9; P=0.06) among men. CONCLUSIONS. Due to different determinants affecting toothbrushing frequency among men and women, different oral health motivation programs by gender should be developed.

THE STRUCTURE OF MORPHEMES OF LITHUANIAN VERBS

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Asta Kazlauskienė

2013-04-01

Full Text Available The aim of this research was to establish and describe the most important phonemic patterns of Lithuanian verb morphemes. The investigation was based on a corpus of 30,000 verb types (verbs and their forms. All words in the corpus were stressed and phonetically transcribed. A computer program was developed to extract statistics out of this corpus. The results indicate that monosyllabic morphemes dominate in Lithuanian. They comprise 97%, 99%, 98%, and 97% of all verb roots, prefixes, derivational suffixes, and endings respectively. Inflectional suffixes and the reflexive affix are exclusively monosyllabic. Pronominal inflection endings are either disyllabic (97% or trisyllabic. There is a high variety of vowelconsonant patterns among verbs: the verb root is represented by 91 patterns, prefixes by 8 patterns, derivational suffixes by 18 patterns, inflectional suffixes by 7 patterns, inflectional endings by 9 patterns, endings of pronominal participles by 7 patterns, and the reflexive affix by 3 different patterns. The consonant-vowel-consonant (CVC pattern appeared to be the most frequent among verb roots (45%, the CV pattern was the most frequent among prefixes (59%, the VC pattern was the most frequent among derivational suffixes (46%, and V pattern was the most frequent among inflectional endings of Lithuanian verbs (76%. In many cases, the root of a verb contains both initial and final consonants (82%. Because of this and because of the tendency to avoid hiatus in Lithuanian, the root can be adjoined by vowel-final prefixes and vowel-initial suffixes or inflectional endings. This appears to be the case, as prefixes are mostly open (80%, and both derivational suffixes (90% and all inflectional endings begin with vowels. Inflectional suffixes do not follow this regularity. Only one-third of them start with a vowel. The hypothesis that the phonemic structure of a verb root might determine the corresponding patterns of its adjoining affixes seems

The main provisions of the Lithuanian National Energy Strategy

International Nuclear Information System (INIS)

Miskinis, V.; Galinis, A.

2006-01-01

The aim of this paper is to set out findings from analysis of the Lithuanian economy and energy sector development and to discuss the main provisions of the draft of the updated National Energy Strategy. The paper presents a short description of tendencies in the Lithuanian economy and energy sector during transition to a free market economy. A significant reduction of final and primary energy intensity in Lithuania is confirmed by analysis based on data published in the recent national and international publications. Positive changes in the energy sector, favourable for implementation of market economy, are discussed. The methodology applied for analysis of the energy sector development and for preparation of the National Energy Strategy is presented. Strategic objectives of the Lithuanian energy sector, the measures to provide for a higher energy security and guidelines for the energy sector development are presented as well. The main provisions in the draft of the updated National Energy Strategy are established taking into consideration the obligations of Lithuania presented in the Treaty of Accession to the EU, the EU directives and other international documents. (author)

Lithuanian Publisher’s Needs for Training

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Arūnas Gudinavičius

2016-12-01

Full Text Available The survey on the training and professional development needs of Lithuanian publishers was designed and conducted. The pilot research showed that publishers in Lithuania have an interest in professional training. According to the results, the need for training among the employees of Lithuanian publishing houses depends on the previous training experience: the more training courses the employee had before, the greater need for training he/she expresses. 82% of publishing house employees from four different fields agreed and strongly agreed on the need for training. Very few employees would like to pay for training by themselves. The identified need for training appears to reflect the nature of the problems encountered in the publishing field in Lithuania: Copyright, Law & Rights is the most wanted training topic among managing directors. The list of preferred topics for training can be used as the grounds for creating a supply of publishing training courses.

Tendencies in translation of sport terms from English into Lithuanian

OpenAIRE

Trakšelis, Arnoldas

2018-01-01

Novelty of the topic – this topic is relatively new because there is no Lithuanian author who has analysed the translation of sport terms from English into Lithuanian in particular. Only some works produced by foreign writers can be found in which the translation of a specific sport branch is analysed more briefly. Relevancy of the topic – sport was started thousands of years BCE and along came a related terminology. During the years the terms of popular sport branches were translated fro...

Comparative study of the qualitative features of the Lithuanian and Latvian monophthongs

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Juris Grigorjevs

2015-09-01

Full Text Available In the present article, a comparative study of the spectral characteristics and distinctive qualitative features of monophthongs of the contemporary Baltic Standard languages pronounced in isolation is described. On the one hand vowels pronounced in isolation do not represent a pronunciation in everyday speech, while on the other hand their production is probably the closest to the acoustic and auditory monophthong targets determined by our mental prototypes. This type of production represents natural hyper-articulation and differs from production of the cardinal vowels. Lithuanian and Latvian monophthongs have been studied and compared using the same methods and equipment that permit a reliable comparison of phonetic inventories (quality similarities and differences of both languages. For this paper recordings of six native Lithuanian and six native Latvian male informants (having faultless articulation were used (1944 items were selected and analyzed in total. All informants are speakers of standard language. In this study the standard language is considered as a standardized language (generally the most formal version of the language used for the needs of public life and culture. Reviewing interrelations between vowels of a single language (Lithuanian or Latvian, the mean data acquired in this study is compared with the data of some previous studies. To compare the general tendencies of the relations between Lithuanian and corresponding Latvian long and short monophthongs pronounced in isolation more precisely, the following acoustic parameters (numeric values were calculated: acuteness (graveness, flatness, compactness, and tenseness. The results of the present study confirm the general tendency that qualitative characteristics of the Lithuanian long and corresponding short vowels differ to a great extent. However the quality of Latvian monophthongs produced in isolation varies very little and statistical analysis of the spectral

“Natural coordination” and the origin of the Lithuanian conjunction beĩ ‘and’.

OpenAIRE

Norbert Ostrowski

2018-01-01

Productivity of the Lithuanian conjunction beĩ ‘and’, marker of so called „natural coordination”, is strictly connected to the area of Lithuania Minor (former East Prussia). Lithuanian beĩ comes from conflation of the common Baltic conjunction bè ‘and’ and an additive particle ir ‘also’. The conflated form *beir has been further reduced to beĩ in accordance with Lithuanian phonotactic rules that do not tolerate group VRR (V = Vocal, R = Resonant). There are some traces that suggest that Lithu...

Lithuanian mammal fauna review

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Linas Balciauskas

1996-12-01

Full Text Available Abstract Data on Lithuania mammal fauna are presented. From 78 mammal species recorded in Lithuania, 7 were seen only in the 17-18th centuries, two species are extinct. Recent Lithuanian mammal fauna contains 68 species. Five of them are observed occasionally. 63 mammal species are permant inhabitants, 18 included in the Red Data Book, mostly bats and dormice. 8 mammal species were introduced or reintroduced. Population tendencies of game animals are also considered.

Input of Lithuanian science into nuclear safety improvement, coordination of technical support organizations

International Nuclear Information System (INIS)

Maksimovas, G.

1999-01-01

VATESI in its activities is very much supported by Lithuanian scientific and technical organizations which are doing expertise of safety analyses of Ignalina NPP. Description of these organizations is presented. Broad international cooperation and assistance programs is underway helping Lithuanians scientific organizations to build own capacity in making nuclear safety research

Research NoteEffect of drought and fires on the quality of water in Lithuanian rivers

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G. Sakalauskiene

2003-01-01

Full Text Available In August and September 2002, concentrations of heavy metals (copper, lead, and zinc were 21-74% more than in previous years in Lithuanian rivers. Such a sudden increase in heavy metal pollution reduces the value of any water body for fishing or recreation and poses a potential risk to the environment and to human health. Droughts in the summer of 2002 led to forest and peat bog fires all over Lithuania and may have caused the increase in concentrations of heavy metals detected in Lithuanian rivers in August 2002. The fires could have changed the pH in the top layers of the soil, overcome geochemical barriers in the soil and enabled heavy metals to migrate from the soil to the groundwater and from river bottom sediments to the surface water. Keywords: heavy metals, river water quality, Lithuania

The historical aspects and current issues of the development of Russian-Lithuanian economic relations

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Kretinin Gennady

2012-12-01

Full Text Available This article focuses on development of Russian-Lithuanian economic ties. The research and practical significance of this study lies in the identification of the sources of modern Russian-Lithuanian economic cooperation and the prospects of future mutually beneficial economic relations. The first attempt at establishing economic relations was made in 1919. However, young Lithuanian Republic gravitated towards the West, severing ties with the Russian market. However, the initiatives of Lithuanian authorities did not result in successful state building, and the economic situation remained unchanged. The USSR leadership made an effort to improve the living conditions in post-war Lithuania. There were some mistakes made in the relations with the local population that resulted in Lithuanians’ resistance to sovietisation. However, in the conditions of post-war restoration of national economy and acute deficit of material and human resources, the Soviet leadership managed not only to reform and develop a socialistic economy in Lithuania but also to turn it into an industrial republic with developed agriculture and modern manufacturing facilities, whose major industries manufactured products used in nuclear and space technologies, aviation and navigation. The research shows that the post-Soviet period led to a dramatic change in Russian-Lithuanian economic relations; however, these relations retained potential for future development.

Lithuanian way of reforms to electricity market

International Nuclear Information System (INIS)

Bacauskas, A.

2002-01-01

Lithuania has inherited a structure of the energy industry, which originally has been developed not for the country, as an independent state, but according to the provisions of the former USSR energy policy, covering energy demand of whole region, including the Baltic countries, Belarus and the Kaliningrad region of Russia. The Lithuanian power system is interconnected by high voltage power lines and operates in parallel with Latvian, Estonian, Russian and Belarus power systems. During twelve years of independence the power sector passed significant changes from a vertically integrated monopoly to some separate power companies and meets EU requirements to an internal electricity market. The main issues of reforms: transparency of costs, commercial relations in power sector, fulfilment of the Electricity Directive 96/92/EU. The Lithuanian electricity market is small and inefficient. Current reforms of a power sector are directed to create the common Baltic electricity market. (author)

How different contexts of social capital are associated with self-rated health among Lithuanian high-school students

Science.gov (United States)

Novak, Dario; Emeljanovas, Arunas; Mieziene, Brigita; Štefan, Lovro; Kawachi, Ichiro

2018-01-01

ABSTRACT Background. Adolescents’ self-rated health is related to a number of sociodemographic and socio-economic factors, health-related behaviors, and their social environment. The impact of the latter is still not well explored. An adolescent’s social environment is represented by the social capital, i.e. social resources that they can access. The relationships between various contexts of social capital (family, neighborhood, peers, and school) and self-rated health among adolescents are still unclear. Objective. This study aims to examine the relationships between various social capital contexts and self-rated health in Lithuanian adolescents. Methods. The current cross-sectional study includes a nationally representative sample of 1863 adolescents (51.4% were girls) aged 14–18 years. The indicators of self-rated health as well as indicators of social capital in family, neighborhood, and school contexts were assessed. The results of the relationships between self-rated health and contexts of social capital were calculated controlling for the following covariates: physical activity, psychological distress, gender, body mass index, and family socioeconomic status. Results. Results indicate that there are significant relationships between good self-rated health and a higher level of family support, neighborhood trust, and vertical school trust. In the final logistic regression model, while controlling for all covariates, a higher level of family support and neighborhood trust remain significant predictors of good self-rated health. Conclusions. Family support and neighborhood trust are important correlates of self-rated health in adolescents. PMID:29871556

How different contexts of social capital are associated with self-rated health among Lithuanian high-school students.

Science.gov (United States)

Novak, Dario; Emeljanovas, Arunas; Mieziene, Brigita; Štefan, Lovro; Kawachi, Ichiro

2018-01-01

Adolescents' self-rated health is related to a number of sociodemographic and socio-economic factors, health-related behaviors, and their social environment. The impact of the latter is still not well explored. An adolescent's social environment is represented by the social capital, i.e. social resources that they can access. The relationships between various contexts of social capital (family, neighborhood, peers, and school) and self-rated health among adolescents are still unclear. This study aims to examine the relationships between various social capital contexts and self-rated health in Lithuanian adolescents. The current cross-sectional study includes a nationally representative sample of 1863 adolescents (51.4% were girls) aged 14-18 years. The indicators of self-rated health as well as indicators of social capital in family, neighborhood, and school contexts were assessed. The results of the relationships between self-rated health and contexts of social capital were calculated controlling for the following covariates: physical activity, psychological distress, gender, body mass index, and family socioeconomic status. Results indicate that there are significant relationships between good self-rated health and a higher level of family support, neighborhood trust, and vertical school trust. In the final logistic regression model, while controlling for all covariates, a higher level of family support and neighborhood trust remain significant predictors of good self-rated health. Family support and neighborhood trust are important correlates of self-rated health in adolescents.

Lithuanian Metrics as a Source on the History of the Turkic States of Eastern Europe »

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V.V. Trepavlov

2015-12-01

Full Text Available Lithuanian Metrica contains a lot of information on the Turkic khanates of Eastern Europe of the 15th–16th centuries. It consists mainly of documents related to foreign relations of the Polish-Lithuanian State and covers its contacts primarily with the Crimean Yurt. In Lithuanian Metrica can be also found valuable information about the Great Horde and the Nogai Horde. Information reflecting contacts of Vilna and Cracow with Kazan and Astrakhan khanates is also presented in metrica although very fragmentary. The Polish-Lithuanian State inherited policy of Vilnius rulers in relation to the khans. This policy emerged in the era of the weakening and disintegration of the Golden Horde during the reign of the Grand Dukes Algirdas and, especially, Vytautas and was expressed in the form of patronage of deposed Tokhtamysh and his children. Later it continued in contacts with the Crimean Girays and (until the beginning of the 16th century with the khans of Great Horde. In respect of the Golden Horde, the documents of Lithuanian Metrica contain separate memories of participants of diplomatic correspondence concerning order that once existed in this State. In general, such memories occur both as references to the deeds and decrees of the former Horde’s “tsars” justifying the legitimacy of the current policies, and as norms of relations adopted at the time, presented as a model to be followed by descendants. The memory of the Horde-Lithuanian relations of the 13th – the first half of the 15th centuries are reflected in the materials of Lithuanian Metrica in the form of an equally abstract references to the relationship that existed in the times of ancestors. Tatar and Polish-Lithuanian side constantly referred to the relationship of the “brotherhood”, i.e. status equality, which were established between the Grand Duke Algirdas and Vitautas and king Casimierz on the one hand, and the Horde khans on the other. The documents contained in

ESOTERIC IN CONTEMPORARY LITHUANIAN PROSE

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Ieva Naikienė

2018-04-01

Full Text Available This article focuses on esotericism in contemporary Lithuanian prose. For the revelation of this topic, Donaldas Kajokas’ novel Ežeras ir kiti jį lydintys asmenys (The Lake and Other Escort Members, 2003 and Jurga Ivanauskaitė’s novel Placebas (Placebo, 2012 have been chosen. The analysed writings reveal the point of view of contemporary Lithuanian writers about esoteric beliefs. In this article, esotericism is related with persons’ feelings but is excluded from occult and parapsychology fields such as alchemy, cabbala, Tarot, etc. This work focuses on the idea that an individual, who has only a few senses, cannot reach actuality. On the other hand, the possibility of acquiring those senses is not rejected. In addition, obtaining those senses would help to reach higher, over-sensational worlds and in that way to discover personal correlation with forms of multiple personal identities. This article establishes an idea that awareness of higher worlds/spheres unlocks the possibilities of revealing the main core of human (as micro-cosmos and the Universe (as macro-cosmos. The possibility to perceive oneself as a micro-cosmos discloses not only personal identity, but also the value of Other’s entity and inevitable entities stratifying.

EVALUATION OF LITHUANIAN CONSUMERS’ ATTITUDES TO GENETICALLY MODIFIED FOOD

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Ingrida Lukošiut&#

2017-03-01

Full Text Available The aim of this investigation is to present the results obtained during the survey of Lithuanian consumers in order to identify their attitudes towards food with genetically modified organisms (GMO. Investigating the consumers approach to genetically modified (GM food, the following were considered: consumers’ opinions on GMO were analyzed, their knowledge about the presence of food containing GMO on the Lithuanian market, the mandatory GM food labelling, the behavior to a transgenic product while shopping, as well as consumers’ willingness to purchase such products. Data were gathered through a survey of 1000 Lithuanian residents. The empirical results indicated that the majority of the respondents’ attitudes towards food containing GMO are negative. The older consumers with less income are more against GM food compared to younger, wealthier households. 72% of consumers know that if the food contains GMO it must be indicated on the label. However, many consumers who oppose GMO do not try to avoid paying attention to the components of the product listed on its label. Only about a quarter of consumers while buying a product look for such information. This indicates that consumers are not really interested in whether or not the product contains GMO

Country Report: Citizenship Education: Lithuanian Mapping

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Irena Zaleskene

2011-10-01

Full Text Available Some theoretical concepts of globalisation and citizenship are discussed in the article as well as changing role of citizenship education in transforming Lithuanian Society. The author points out that many problems in contemporary Lithuanian society arise from the fact that the relationship between individuals and the state is changing fundamentally. The state should broaden “positive” choices and support an individual by ensuring principles of equality in basic human rights and access to opportunities. On the other hand, an individual has to take the responsibility for his/her own life becoming a decisive factor in choosing personal life style and in building up civic community. In this respect, it is expected that Citizenship Education would lay an important role in educating competence and attitudes towards own responsibilities, in educating mental and practical skills for positive civic participation. Current status and new approaches of citizenship education in Lithuania are presented in the light of international developments. The article concludes that changing role of citizenship education has significant implications for professional development of teachers and for the national teacher training system as a whole.

The View of Lithuanian Statehood Held by the Polish Underground during 1939-1944

OpenAIRE

Bubnys, Arūnas

2006-01-01

The article investigates the attitudes of Polish underground actors towards the statehood of Lithuania, its territorial integrity, and Lithuanian-Polish relations during the World War II. The author draws the conclusion that Polish underground political structures expressed a hostile and prejudiced attitude towards Lithuania. All the blame and responsibility for bad mutual relations is put on Lithuania and Lithuanians. Polish underground actors living in Vilnija were extremely hostile towards...

Lithuanian Investors' Behaviour During Financial Crisis

OpenAIRE

Bikas, Egidijus; Kavaliauskas, Andrius

2010-01-01

Based on research of academic literature, this article analyses Lithuanian investors' behaviour during financial crisis. The article summarizes the newest finance science subjects, theories of behavioural finance, and works of various scientists, in order to find cognitive and emotional investors' deviations from rational behaviour, and also to better understand and explain how emotions and environment valuation mistakes influence investors and their decision-making. Emotional nature of inves...

Confidentiality and parental involvement in adolescent sexual and reproductive health care

DEFF Research Database (Denmark)

Jaruseviciene, Lina; Lazarus, Jeff; Zaborskis, Apolinaras

2011-01-01

AIM: We surveyed Lithuanian general practitioners' (GPs) views on the importance of confidentiality for adolescents and on their practices in informing parents about sexual and reproductive health consultations with this age group. METHODS: In this cross-sectional study, a 41-item questionnaire...... was sent to a random sample of 607 Lithuanian GPs. The purpose of this questionnaire was to gain knowledge about current practices of GPs in informing parents on the importance of confidentiality as well as in protecting the privacy of minors. GPs' knowledge of the current legal age limit...... consulting on general sexual issues, more than 70% stated that they would guarantee their minor patients confidentiality. However, when cases involved sexually transmitted infections or pregnancy, nearly the same percentage said they would inform the parents. 62.3% of GPs incorrectly believed that the law...

FPGA-Based Implementation of Lithuanian Isolated Word Recognition Algorithm

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Tomyslav Sledevič

2013-05-01

Full Text Available The paper describes the FPGA-based implementation of Lithuanian isolated word recognition algorithm. FPGA is selected for parallel process implementation using VHDL to ensure fast signal processing at low rate clock signal. Cepstrum analysis was applied to features extraction in voice. The dynamic time warping algorithm was used to compare the vectors of cepstrum coefficients. A library of 100 words features was created and stored in the internal FPGA BRAM memory. Experimental testing with speaker dependent records demonstrated the recognition rate of 94%. The recognition rate of 58% was achieved for speaker-independent records. Calculation of cepstrum coefficients lasted for 8.52 ms at 50 MHz clock, while 100 DTWs took 66.56 ms at 25 MHz clock.Article in Lithuanian

Information disclosure in corporate social responsibility reports. The case of Lithuanian companies

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Sviesa Leitoniene

2016-09-01

Full Text Available Though the phenomenon of corporate social responsibility (CSR is closely scrutinized in studies of both Lithuanian and foreign scholars, the problem is the quality of social information disclosed in social re-sponsibility reports. The objective of this article is to analyse the quality of disclosed information in CRS reports of Lithuanian companies. The characteristics of quality of information were comparability, relia-bility, objectivity and sustainability. The research demonstrated that in Lithuania, CSR reports provide unreliable information, which is only partly comparable and objective, however, relatively sustainable.

Information disclosure in corporate social responsibility reports. The case of Lithuanian companies

Directory of Open Access Journals (Sweden)

Sviesa Leitoniene

2016-09-01

Full Text Available Though the phenomenon of corporate social responsibility (CSR is closely scrutinized in studies of both Lithuanian and foreign scholars, the problem is the quality of social information disclosed in social re- sponsibility reports. The objective of this article is to analyse the quality of disclosed information in CRS reports of Lithuanian companies. The characteristics of quality of information were comparability, relia- bility, objectivity and sustainability. The research demonstrated that in Lithuania, CSR reports provide unreliable information, which is only partly comparable and objective, however, relatively sustainable.

Letter Frequency Analysis of Lithuanian and Other Languages Using the Latin Alphabet

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Gintautas Grigas

2015-12-01

Full Text Available It is important to evaluate specificities of alphabets, particularly the letter frequencies while designing keyboards, analyzing texts, designing games based on alphabets, and doing some text mining. In order to adequately compare lettter frequences of Lithuanian language to other languages in the Internet space, Wikipedia source was selected which content is common to different languages. The method of letter frequency jumps is used. The main attention is paid to the analysis of letter frequencies at the boundary between native letters and foreign letters used in Lithuanian and other languages.

Stochastic programming framework for Lithuanian pension payout modelling

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Audrius Kabašinskas

2014-12-01

Full Text Available The paper provides a scientific approach to the problem of selecting a pension fund by taking into account some specific characteristics of the Lithuanian Republic (LR pension accumulation system. The decision making model, which can be used to plan a long-term pension accrual of the Lithuanian Republic (LR citizens, in an optimal way is presented. This model focuses on factors that influence the sustainability of the pension system selection under macroeconomic, social and demographic uncertainty. The model is formalized as a single stage stochastic optimization problem where the long-term optimal strategy can be obtained based on the possible scenarios generated for a particular participant. Stochastic programming methods allow including the pension fund rebalancing moment and direction of investment, and taking into account possible changes of personal income, changes of society and the global financial market. The collection of methods used to generate scenario trees was found useful to solve strategic planning problems.

The translation of idioms in children’s cartoons: A comparative analysis of English dialogues and Lithuanian subtitles

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Ligita Judickaitė-Pašvenskienė

2014-04-01

Full Text Available The article is focused on the translation of English idioms in the Lithuanian subtitles of children’s cartoons. The aims of the article are to find out whether the element of meaning or the composition of meaning and form gets preference in the Lithuanian translation; to present the perception and use of the term idiom in English and Lithuanian; and to show the processes which take place during the translation of English idioms containing proper nouns. The article is a case study and refers to the analysis of five children’s cartoons.

Lithuanian women actively participate in WIN

International Nuclear Information System (INIS)

Medeliene, D.

1999-01-01

WIN (Women in Nuclear) now has 900 members from 43 countries. Lithuanian women working at different institutions related with nuclear energy joined this international organization three years ago. Most of these women are working at the Ignalina NPP. It was women employed at the plant who became the first members of the national WIN team. The team has recently grown considerably. The new members are also mostly from the Ignalina NPP (author)

The Visual and the mythical-poetic interpretations of sky luminaries in Lithuanian traditional textiles

OpenAIRE

Tumėnas, Vytautas

2008-01-01

This paper analyses some interconnected aspects of Lithuanian folk astronomy. The same mythical-poetic images linking sky luminaries, things in the natural world, and mythological beings as well as human beings are present in Lithuanian mythical-poetic folklore and in the names of textile ornamentations. Their semiotic net generally comprises flowers, plants, wild and domestic animals, celestial luminaries and mythical people as well as human beings and their artefacts. The investigation of i...

Public expectations concerning confidentiality protection of adolescents' sexual and reproductive health care in Lithuania

DEFF Research Database (Denmark)

Jaruseviciene, Lina; Zaborskis, Apolinaras; Lazarus, Jeffrey Victor

2014-01-01

OBJECTIVE: An adolescent's right to confidential healthcare is protected by international law and professional consensus. However, parental and social support for confidential sexual and reproductive health (SRH) services, in particular, varies greatly. This study documents Lithuanian residents......' expectations with regard to confidentiality protection for adolescents in this domain, and explores the factors related to the diversity of these expectations. METHODS: Two national surveys of Lithuanian residents completed in 2005 and 2012 using anonymous questionnaires. Participants rated their expectations...... for confidentiality using a five-point Likert scale for eight types of SRH consultations. RESULTS: Public anticipation for confidentiality depended on whether issues related to sexual behaviour or to its consequences were addressed during adolescent consultation. Only younger respondents had higher expectations...

Evaluation of the Impact of the EU Structural Support on the Competitiveness of Lithuanian Economics

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Rita Remeikiene

2016-06-01

Full Text Available Increasing amounts of the EU structural support in Lithuania require theoretical and practical research to disclose the determinants that have a significant impact on the competitiveness of Lithuanian economics. The purpose of this article is to evaluate the impact of the EU structural support on the competitiveness of Lithuanian economics. The methods of the research include systematic and comparative analysis of the scientific literature, expert evaluation and linear regression. The research disclosed the main determinants of country’s competitiveness. The results have revealed that EU structural support has the most significant impact on Lithuanian engineering and technological infrastructure. The impact of the support on country’s macroeconomic, scientific and social environment can also be considered as significant. The EU structural support has medium strong impact on education and business environment conditions in Lithuania. It has been established that, in the field of business advancement, Lithuanian should be rated as medium competitive. Hence, the increase in country’s competitiveness by employing EU structural funds should be treated as one of priority aims. In addition, responsible authorities should perform with higher efficiency seeking for higher competitiveness of the country.

Research NoteEffect of drought and fires on the quality of water in Lithuanian rivers

OpenAIRE

Sakalauskiene, G.; Ignatavicius, G.

2003-01-01

In August and September 2002, concentrations of heavy metals (copper, lead, and zinc) were 21-74% more than in previous years in Lithuanian rivers. Such a sudden increase in heavy metal pollution reduces the value of any water body for fishing or recreation and poses a potential risk to the environment and to human health. Droughts in the summer of 2002 led to forest and peat bog fires all over Lithuania and may have caused the increase ...

THE RHET ORIC OF TRAVEL: PERSUASION TOOLS IN THE LITHUANIAN TRAVEL LITERATURE

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Gabrielė Gibavičienė

2018-04-01

Full Text Available Rhetoric which in the context of this research is seen not only as a structure of text but also as a structure of thought is presented in the article as a new universal way of researching Lithuanian travel literature discourse. Three popular Lithuanian travel books are chosen for this research – Kelionė į Jeruzalę (Journey to Jerusalem, 1601 by Mikalojus Kristupas Radvila Našlaitėlis, Svečiuose pas 40 tautų (At the Company of 40 Nations, 1935–1936 by Matas Šalčius, and Sapnuoju, kad einu (Dreaming the Path, 2014 by Jokūbas Vilius Tūras. The article presents the research of three persuasion tools ethos, logos and pathos in Lithuanian travel literature and how they are involved in successful communication process. The article reveals exactly how trusting the author and presenting actual traveller’s experience is connected with stimulating audience’s emotions and what part in this process is taken by the journey itself. The article also analyses how the enthymeme is involved in achieving persuasion and how it captures traveller’s views, communication guidelines and common features of different travel texts.

The Development of the Standard Lithuanian Language: Ecolinguistic Approach

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Vaida Buivydienė

2014-06-01

Full Text Available The theory of standard languages is closely linked with the standardization policy and prevailing ideology. The language ideology comprises its value, experience and convictions related to language usage and its dis - course being influenced at institutional, local and global levels. Recently, in the last decades, foreign linguists have linked the theories of the development of standard lan- guages and their ideologies with an ecolinguistic approach towards language standardization phenomena. The article is based on Einar Haugen ’s theory about the development of standard languages and ecolinguistic statements and presents the stages of developing the standard language as well as the factors having an influ - ence on them. In conclusion, a strong political and social impact has been made on the development of the standard Lithuanian language. The stages of the progress of the standard Lithuanian language have rapidly changed each other, some have been held very close to one another and some still have been taken part.

Evaluation of the Impact of Outsourcing on the Performance of Lithuanian Electricity Industry

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Ligita Gasparėnienė

2016-01-01

Full Text Available The article is aimed at evaluation of the impact of outsourcing on the performance of Lithuanian electricity industry. Research methods include systematic analysis of the scientific literature and expert evaluation. Theoretical analysis of the literature has enabled to identify the most significant outsourcing determinants, which have the impact on the performance of electricity industry, and the main outsourcing-related risks for the companies operating in this industry. The results of the empirical research have revealed the effects of various outsourcing determinants on the performance of Lithuanian electricity industry as well as negative outcomes of outsourcing application in the researched industry.

Assessment of the Knowledge Acquisition Process in Lithuanian Insurance Sector

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Jurgita Raudeliūnienė

2014-06-01

Full Text Available Under the development of favourable globalization conditions, the demand for and importance of knowledge in the insurance sector are rapidly growing, which is characterized by the variety of insurance services and offered products as well as by a permanent change in efforts to efficiently meet the needs of society. Therefore, knowledge is becoming a unique factor that leads to the increased exclusivity of the organization in this particular sector when the recently acquired knowledge helps the employees of the company with efficiently performing work activities and creating for consumer advantages that can be hardly imitated by other insurance organizations. However, the process of knowledge acquisition will be worthless without efficient instruments for assessing the procedures leading to obtaining the necessary knowledge on demand and time. Every insurance organization in Lithuania tries to acquire the necessary knowledge on time in the most convenient way; however, researchers and business representatives feel a lack of tools for assessing and improving the knowledge acquisition process. According to scientific literature, a lack of complexity evaluating the knowledge acquisition process creates a precondition for developing instruments for the assessment of this process. The object of research is the evaluation of the knowledge acquisition process in the organizations of Lithuanian insurance sector. The goal of the article is to offer an integrated instrument of the knowledge acquisition process for the organization working in Lithuanian insurance sector. To achieve this goal, the following tasks have been implemented: the analysis of the theoretical aspects of the factors and methods of the knowledge acquisition process; the establishment of the factors specific to organizations in Lithuanian insurance sector for the purposes of assessing the knowledge acquisition process; the identification of the problematic areas of the knowledge

Employment of Lithuanian Statistical Data Into Tax-Benefit Micro-Simulation Models

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Viginta Ivaškaitė-Tamošiūnė

2013-01-01

Full Text Available In this study, we aim to assess the “best fit” of the existing Lithuanian micro-datasets for constructing a national micro-simulation model. Specifically, we compare and evaluate the potential of two (state level representative micro-data surveys in terms of their potential to simulate Lithuanian (direct taxes, social contributions and social benefits. Both selected datasets contain rich information on the socio-economic and demographical conditions of the country: the Household Budget Survey (HBS for the years 2004 and 2005 and the European Community Statistics on Income and Living Conditions (EU-SILC in Lithuania for the year 2005. The selected databases offer the most comprehensive range of income and other socio-demographic attributes, needed for simulation of tax and contributions’ payers/amounts and benefits’ recipients/amounts. The evaluation of the dataset capacity to simulate these measures is done by a comparative statistical analysis. Among the comparative categories are definitions (of households, incomes, survey collection modes, level of aggregation of various variables, demographic and incomes variables and corresponding numbers (amounts. The comparative analysis of the HBS and EU-SILC datasets shows, that despite embedded differences and shortages regarding simulation capacities of both surveys, these datasets contain valuable and sufficient information for the purpose of simulation of Lithuanian tax-benefit policies. In general a conclusion could be drawn, that HBS offers higher possibilities of simulating the Lithuanian tax-benefit system. This dataset contains more detailed national income categories (i.e. recipients of maternity/paternity insurance, diverse pensions, etc.— information on which is not available in the EU-SILC. The latter dataset does not contain national policy system specific components, but offer information on income aggregates, such all old-age pensions, social exclusion benefits, etc

Public expectations concerning confidentiality protection of adolescents' sexual and reproductive health care in Lithuania: findings of the surveys conducted in 2005 and 2012.

Science.gov (United States)

Jaruseviciene, Lina; Zaborskis, Apolinaras; Lazarus, Jeffrey Victor

2014-04-01

An adolescent's right to confidential healthcare is protected by international law and professional consensus. However, parental and social support for confidential sexual and reproductive health (SRH) services, in particular, varies greatly. This study documents Lithuanian residents' expectations with regard to confidentiality protection for adolescents in this domain, and explores the factors related to the diversity of these expectations. Two national surveys of Lithuanian residents completed in 2005 and 2012 using anonymous questionnaires. Participants rated their expectations for confidentiality using a five-point Likert scale for eight types of SRH consultations. Public anticipation for confidentiality depended on whether issues related to sexual behaviour or to its consequences were addressed during adolescent consultation. Only younger respondents had higher expectations for confidentiality in both contexts. Public expectations regarding confidentiality were less demanding in 2012 than in 2005. The expectation of confidentiality protection was greater for topics related to sexual behaviour than for the consequences of sexual behaviour, such as pregnancy, abortion or a sexually transmitted infection. This implies a need for targeted information strategies for the general population and explicit guidance for physicians on when and for whom care should remain confidential.

Difficulties in emotion regulation and risky driving among Lithuanian drivers.

Science.gov (United States)

Šeibokaitė, Laura; Endriulaitienė, Auksė; Sullman, Mark J M; Markšaitytė, Rasa; Žardeckaitė-Matulaitienė, Kristina

2017-10-03

Risky driving is a common cause of traffic accidents and injuries. However, there is no clear evidence of how difficulties in emotion regulation contribute to risky driving behavior, particularly in small post-Soviet countries. The present study aimed to investigate the relationship between difficulties in emotion regulation and self-reported risky driving behavior in a sample of Lithuanian drivers. A total of 246 nonprofessional Lithuanian drivers participated in a cross-sectional survey. Difficulties in emotion regulation were assessed using the Difficulties in Emotion Regulation Scale (DERS; Gratz and Roemer 2004), and risky driving behavior was assessed using the Manchester Driver Behaviour Questionnaire (DBQ; Lajunen et al. 2004). Males scored higher than females in aggressive violations and ordinary violations. Females scored higher for the nonacceptance of emotional responses, whereas males had more difficulties with emotional awareness than females. More difficulties in emotion regulation were positively correlated with driving errors, lapses, aggressive violations, and ordinary violations for both males and females. Structural equation modeling showed that difficulties in emotion regulation explained aggressive and ordinary violations more clearly than lapses and errors. When controlling for interactions among the distinct regulation difficulties, difficulties with impulse control and difficulties engaging in goal-directed behavior predicted risky driving. Furthermore, nonacceptance of emotional responses and limited access to emotion regulation strategies were related to less violations and more driving errors. Emotion regulation difficulties were associated with the self-reported risky driving behaviors of Lithuanian drivers. This provides useful hints for improving driver training programs in order to prevent traffic injuries.

The Financing and Personnel of the Lithuanian Army

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Jokubauskas Vytautas

2015-12-01

Full Text Available In 2014, at the beginning of the crisis in Ukraine and Russia‘s aggression against this neighboring country, Lithuania became concerned about the strengthening of its military capabilities, augmenting the National Defense System (NDS budget by almost 50% in two years. This may be considered unprecedented, if seen against the background of the presidential elections and those to the European Parliament, the fiscal discipline, the introduction of euro, as well as Russia‘s economic sanctions, the political decision in the course of 2014 on increasing the defense assignation by 130 million litas and in 2015 the increase by planned additional 356 million litas. This article analyzes two closely related problems of the Lithuanian NDS capabilities. First of all, changes in the NDS financing are explored in the context of permanent agreements of Lithuanian political parties concerning the allocation of 2% of the GDP for defense. This is followed by the discussion of the issues of military personnel staffing and training of the reserve as well as future challenges. This research contributes to the assessment of the critical NDS financing and staffing not only within academic circles but particularly among politicians and society in general. Additionally, it contributes to the awareness of the problems the army encountered in seeking to implement the objective set for it: to ensure the military security of the state. In the presence of the emerging threats in the region, this is of particularly great significance to the demilitarized and pacifist society of Lithuania. The article aims at identifying financing and personnel planning problems throughout a quarter of the century, ranging from the restoration of the Army of the Republic of Lithuania to 2014 inclusively. At the same time, the study encourages a discussion by the academic community on issues of the military security of the Lithuanian State and provides analyses as well as possible

Psychometric Properties of the Intolerance of Uncertainty Scale (IUS in a Lithuanian-speaking population

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Augustinas Rotomskis

2014-03-01

Full Text Available Research suggests that intolerance of uncertainty may be important in understanding worry and may play a key role in the etiology and maintenance of worry. Intolerance of uncertainty is measured using the Intolerance of Uncertainty Scale (IUS, which has been shown to be reliable and valid in many studies. The aim of the present study was to develop a Lithuanian version of this instrument. 228 university students completed the scale. The Lithuanian version of the IUS was found to have good psychometric properties. The IUS showed high internal consistency and good test-retest reliability over a five-week period, and good convergent and divergent validity when assessed with measures of trait anxiety, situational anxiety, and depression. Factor analysis indicated that the IUS has a two-factor structure that represents the beliefs that “uncertainty about the future is unfair” and that “uncertainty has negative behavioral and self-referent implications”. In conclusion, it was found that the Lithuanian version of the IUS is a sound scale for assessing intolerance of uncertainty.

Research Note
Effect of drought and fires on the quality of water in Lithuanian rivers

OpenAIRE

G. Sakalauskiene; G. Sakalauskiene; G. Ignatavicius

2003-01-01

In August and September 2002, concentrations of heavy metals (copper, lead, and zinc) were 21-74% more than in previous years in Lithuanian rivers. Such a sudden increase in heavy metal pollution reduces the value of any water body for fishing or recreation and poses a potential risk to the environment and to human health. Droughts in the summer of 2002 led to forest and peat bog fires all over Lithuania and may have caused the increase in concentrations of heavy metals detected in ...

Research Note
Effect of drought and fires on the quality of water in Lithuanian rivers

OpenAIRE

Sakalauskiene , G.; Ignatavicius , G.

2003-01-01

International audience; In August and September 2002, concentrations of heavy metals (copper, lead, and zinc) were 21-74% more than in previous years in Lithuanian rivers. Such a sudden increase in heavy metal pollution reduces the value of any water body for fishing or recreation and poses a potential risk to the environment and to human health. Droughts in the summer of 2002 led to forest and peat bog fires all over Lithuania and may have caused the increase in concentrations of heavy metal...

Employment of Lithuanian Statistical Data Into Tax-Benefit Micro-Simulation Models

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Viginta Ivaškaitė-Tamošiūnė

2012-07-01

Full Text Available In this study, we aim to assess the “best fit” of the existing Lithuanian micro-datasets for constructing a national micro-simulation model. Specifically, we compare and evaluate the potential of two (state level representative micro-data surveys in terms of their potential to simulate Lithuanian (direct taxes, social contributions and social benefits. Both selected datasets contain rich information on the socio-economic and demographical conditions of the country: the Household Budget Survey (HBS for the years 2004 and 2005 and the European Community Statistics on Income and Living Conditions (EU-SILC in Lithuania for the year 2005. The selected databases offer the most comprehensive range of income and other socio-demographic attributes, needed for simulation of tax and contributions’ payers/amounts and benefits’ recipients/amounts. The evaluation of the dataset capacity to simulate these measures is done by a comparative statistical analysis. Among the comparative categories are definitions (of households, incomes, survey collection modes, level of aggregation of various variables, demographic and incomes variables and corresponding numbers (amounts.The comparative analysis of the HBS and EU-SILC datasets shows, that despite embedded differences and shortages regarding simulation capacities of both surveys, these datasets contain valuable and sufficient information for the purpose of simulation of Lithuanian tax-benefit policies.In general a conclusion could be drawn, that HBS offers higher possibilities of simulating the Lithuanian tax-benefit system. This dataset contains more detailed national income categories (i.e. recipients of maternity/paternity insurance, diverse pensions, etc.— information on which is not available in the EU-SILC. The latter dataset does not contain national policy system specific components, but offer information on income aggregates, such all old-age pensions, social exclusion benefits, etc. Additionally

Measuring systemic performance of the Lithuanian government

OpenAIRE

Nakrošis, Vitalis

2008-01-01

This paper seeks assessing the dynamics of Lithuania's governmental perfor­mance and comparing it to other countries. It draws on a simple logical model, linking the inputs of the government to its outputs and outcomes. It was found that performance of the Lithuanian government is average and even poor, if compared with the EU aver­age or such countries as Estonia and Ireland. This is despite the fact the public mode of production is rather expensive in Lithuania and the number of public empl...

The colours in Lithuanian and French proverbs

OpenAIRE

Kosova, Svetlana; Klanauskaitė, Paula

2015-01-01

The aim of the article is a comparison of Lithuanian and French proverbs by choosing the names of colours as the main aspect. This is to some extent a new way of analysing proverbs with colour as the key word. Seven main aspects of proverbs are mentioned in the article supported by an analysis and comparison of proverbs in both languages. Two different dictionaries have been used for the research: K. Grigas, L. Kudirkienė, R. Kašetienė, G. Radvilas ir D. Zaikauskienė Lietuvių P...

The Analysis of Development in Lithuanian Economy and Business

OpenAIRE

Jakutis, Algirdas

2006-01-01

In this article development tendencies of Lithuanian economy and business are analyzed. The paper examines the most important causes of gross domestic product changes since restoration of Lithuania's independence. Processes of privatization, their influence on business are analyzed. A brief analysis of development trends of small and medium-sized business in presented. Business development process is analyzed, technological indicators suggested. The article considers business financing issues...

Implementation of CLIL in Lithuanian Secondary Schools: a Case Study

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Vilma Bijeikienė

2015-06-01

Full Text Available In view of the existing research into the implementation of CLIL in Lithuania, it can be claimed that this wellestablished and globally applied teaching and learning methodology has already had some due appreciation in Lithuanian secondary schools. Nevertheless, there still exist numerous obstacles to the broader and more intensive application of CLIL which is strongly lagging behind in comparison to many other countries in Europe and world-wide. The present study aims at exploring the rich experience in CLIL implementation accumulated by Šiauliai Didždvario gymnasium and examining their multifaceted CLIL module which could be an important source of knowledge and practical know-how for other Lithuanian secondary education institutions planning to start implementing CLIL. The research follows a synthesis of qualitative and quantitative methodology including interviews with CLIL teachers, students and school administration. The study results in a SWOT analysis of implementing CLIL in Lithuania on the basis of CLIL practices at Šiauliai Didždvario gymnasium and sets forth some guidelines for its further advancement.

A Note on the Lithuanian 2nd Sg. Ending "-ai."

Science.gov (United States)

Schmalstieg, William R.

1980-01-01

Discusses an attempt by Chr. S. Stang to establish a proto-Lithuanian present paradigm for the verb "megti" (to like), questioning the existence of the second singular form "-ai." Argues that the few examples of this form, all from a single Bible translation source, afford shaky support for its existence. (Executive Office of the AABS, 231 Miller…

Relation between traumatic experience and post-traumatic symptomatics in Lithuanian Afghanistan war veterans with post-traumatic stress disorder

OpenAIRE

Domanskaitė Gota, Vėjūnė; Gailienė, Danutė; Kazlauskas, Evaldas

2009-01-01

The aim of this paper is to assess what potential traumatic life-events and experiences are related to PTSD in the Lithuanian Afghanistan war veterans (N = 174). [...]. The following variables were investigated: demographics, traumatic life-events or conditions, PTSD and sub-clinical level of PTSD.The Lithuanian Afghanistan war veterans with PTSD and sub-clinical level of PTSD reported significantly more lifetime traumatic events and conditions. The average number of traumatic events per man ...

Changing role of management accounting : Lithuanian experience case studies

OpenAIRE

Valančienė, Loreta; Gimžauskienė, Edita

2007-01-01

Concepts and methods used in management accounting are similar all over the world. However, national studies suggest that a variable environment of organization has a direct impact on changes in management accounting. The aim of the article was to show how the role of management accounting changed in Lithuanian organizations after the implementation of systems for activity based cost management (ABCM) and balanced scorecard (BSC). The study results obtained suggest that the role of management...

Authorship attribution and author profiling of Lithuanian literary texts

OpenAIRE

Kapočiūtė-Dzikienė, Jurgita; Utka, Andrius; Šarkutė, Ligita

2015-01-01

In this work we are solving authorship attribution and author profiling tasks (by focusing on the age and gender dimensions) for the Lithuanian language. This paper reports the first results on literary texts, which we compared to the results, previously obtained with different functional styles and language types (i.e., parliamentary transcripts and forum posts). Using the Naïve Bayes Multinomial and Support Vector Machine methods we investigated an impact of...

Istoricheskie aspekty razvitija rossijsko-litovskih jekonomicheskih otnoshenij i sovremennost' [The historical aspects and current issues of the development of Russian-Lithuanian economic relations

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Kretinin Gannady

2012-01-01

Full Text Available This article focuses on development of Russian-Lithuanian economic ties. The research and practical significance of this study lies in the identification of the sources of modern Russian-Lithuanian economic cooperation and the prospects of future mutually beneficial economic relations. The first attempt at establishing economic relations was made in 1919. However, young Lithuanian Republic gravitated towards the West, severing ties with the Russian market. However, the initiatives of Lithuanian authorities did not result in successful state building, and the economic situation remained unchanged. The USSR leadership made an effort to improve the living conditions in post-war Lithuania. There were some mistakes made in the relations with the local population that resulted in Lithuanians’ resistance to sovietisation. However, in the conditions of post-war restoration of national economy and acute deficit of material and human resources, the Soviet leadership managed not only to reform and develop a socialistic economy in Lithuania but also to turn it into an industrial republic with developed agriculture and modern manufacturing facilities, whose major industries manufactured products used in nuclear and space technologies, aviation and navigation. The research shows that the post-Soviet period led to a dramatic change in Russian-Lithuanian economic relations; however, these relations retained potential for future development.

Problematic computer game use as expression of Internet addiction and its association with self-rated health in the Lithuanian adolescent population.

Science.gov (United States)

Ustinavičienė, Ruta; Škėmienė, Lina; Lukšienė, Dalia; Radišauskas, Ričardas; Kalinienė, Gintarė; Vasilavičius, Paulius

2016-01-01

Computers and the Internet have become an integral part of today's life. Problematic gaming is related to adolescent's health. The aim of our study was to evaluate the prevalence of Internet addiction among 13-18-year-old schoolchildren and its relation to sex, age, and time spent playing computer games, game type, and subjective health evaluation. A total of 1806 schoolchildren aged 13-18 years were interviewed. The evaluation of Internet addiction was conducted by the Diagnostic Questionnaire according to Young's methodology. The relation between the choice of computer games type, time spent while playing computer games and respondents' Internet addiction were assessed by using multivariate logistic regression analysis. One-tenth (10.6%) of the boys and 7.7% of the girls aged 13-18 years were Internet addicted. Internet addiction was associated with the type of computer game (action or combat vs. logic) among boys (OR=2.42; 95% CI, 1.03-5.67) and with the amount of time spent playing computer games per day during the last month (≥5 vs. <5h) among girls (OR=2.10; 95% CI, 1.19-3.70). The boys who were addicted to the Internet were more likely to rate their health poorer in comparison to their peers who were not addicted to the Internet (OR=2.48; 95% CI, 1.33-4.62). Internet addiction was significantly associated with poorer self-rated health among boys. Copyright © 2016 The Lithuanian University of Health Sciences. Production and hosting by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

Main trends of energy savings in dwelling houses for Lithuanian conditions

Energy Technology Data Exchange (ETDEWEB)

Stankevicius, V.; Karbauskaite, J.; Dapkus, G. [Institute of Architecture and construction (Lithuania)

1995-12-31

Incentive measures for efficient consumption of energy in buildings in Lithuania, were presented. Statistics have shown that the average annual building heat losses are 350 kW/sq.m of heated area. It was estimated, that if every building was insulated according to the requirements of the Lithuanian National Building Code, the annual energy savings would be in the order of 50 to 60 percent. Essential energy saving measures with due regard to Lithuania`s current financial and technical resources were detailed. It was suggested that installing energy efficient windows would be the cheapest and most effective measure to begin energy conservation. The addition of effective insulation of external walls would be a favoured but more costly measure, especially as far as insulating existing houses is concerned. The pay-back period of adding extra insulation was also described, although this option is not of the highest priority. It was suggested that a system of special incentives, if offered by the Lithuanian government, could prove to be powerful motivators to carry out these energy saving measures. 2 tabs., 1 fig.

Renewable energy in the Lithuanian heating sector

International Nuclear Information System (INIS)

Konstantinaviciute, Inga; Bobinaite, Viktorija; Tarvydas, Dalius; Gatautis, Ramunas

2013-01-01

The paper analyses the role of renewable energy sources (RES) in the Lithuanian heating sector and the existing support measures. RES consumption has been continuously growing in Lithuania. During the period of 2000–2009, RES used for heat production in the district heating sector increased more than 4 times. Wood and wood products have been the most widely used RES for heat production (RES-H). The lower prices were one of the main reasons which motivated district heating companies to switch fuel to biomass. At the same time subsidies, soft loans, EU Structural Funds for 2007–2013 and some fiscal measures, which are currently available for RES-H promotion, also have some impact on the increase of RES consumption. However, seeking to achieve a 23% national RES target, additional support measures are essential. A qualitative analysis based on the selected set of criteria and consultation with stakeholders showed that energy policy package for RES promotion in the Lithuanian heating sector could encompass the following measures: tax relieves (differentiated VAT and personal income tax breaks), subsidies, soft loans, standardization, support for research, development and demonstration. These measures are market-oriented and meet cost efficiency and low transaction costs criteria. - Highlights: • Existing support measures are not strongly motivating market players. • In order to meet ambitious 23% targets consistent promotion policy package is required. • The proposed package could consist of 4 instruments: tax related, soft loans, standardization and support for RD and D. • The proposed support measures are market oriented and meets cost efficiency and low transaction costs criteria. • There is no single measure that is fairly suitable to support RES-H

Periodontal status in 18-year-old Lithuanian adolescents: An epidemiological study

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Eglė Bendoraitienė

2017-01-01

Conclusions: The results of our study showed that the periodontal and oral hygiene status of 18-year-old Lithuanian population could be characterized as poor. In total, 77.1% of the study participants were found to have periodontal conditions such as gum bleeding, dental calculus, and shallow pockets. The anterior teeth of the mandible were most frequently affected.

The “Father’s Sons”: The Elite of the Kazan Khanate in the Lithuanian Metrica

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V.V. Trepavlov

2017-09-01

Full Text Available Research objective: Analysis of the phrase otetskie deti (“father’s sons” in the Register Book of the Lithuanian metrics (Lithuanian Metrica as designations of the military service class of the Kazan khanate. Research materials: The 7th Register Book of the Lithuanian Metrica, Russian chronicles, the chronicles of Kïrïmi and Ötemish-Hajji, the works of S. Herberstein, A. Kurbsky, Maciej of Miechów, Mahmud al-Kashgari, A. Olearius. Results and novelty of the research: The 7th Register Book of the Lithuanian Metrics contains a translation of a message from the Crimean khan, Muhammad Giray, to the Polish King and Lithuanian Grand Duke Sigizmund I. In this letter, there is a reiteration of the requests of the inhabitants of the Kazan Khanate addressed to Muhammad Giray to send them one of his relatives to reign over them. The Kazanians wrote that they had twenty thousand otetskie deti (“father’s sons” and countless Mordovians and Cheremisses, all of whom were ready to submit (to be “slaves” to the ruler of the Crimea. The author of the article seeks the meaning of this term and looks for a putative Turkic equivalent to the exp­ression otetskie deti as well as the reasons for the presence of the Mordovians and Cheremisses in this document. The word “otetskii” (paternal had a wide range of usages in the Russian language of the 16th century – in the State of Muscovy and the Grand Duchy of Lithuania. One of its meanings was “belonging to an ancient, noble family”. The instances quoted by the author show a socio-cultural universality, which combined paternity, noble origin and elite status in a single notion. The author hypothesizes that the phrase “otetskie deti” in the Russian translation could replace the concept of “Tatars” in its social meaning, as a symbol of the military strata of the population of the Kazan khanate. Mention of the Mordovians and the Cheremisses in the Kazan message reflected the positive

Lithuanian Population Aging Factors Analysis

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Agnė Garlauskaitė

2015-05-01

Full Text Available The aim of this article is to identify the factors that determine aging of Lithuania’s population and to assess the influence of these factors. The article shows Lithuanian population aging factors analysis, which consists of two main parts: the first describes the aging of the population and its characteristics in theoretical terms. Second part is dedicated to the assessment of trends that influence the aging population and demographic factors and also to analyse the determinants of the aging of the population of Lithuania. After analysis it is concluded in the article that the decline in the birth rate and increase in the number of emigrants compared to immigrants have the greatest impact on aging of the population, so in order to show the aging of the population, a lot of attention should be paid to management of these demographic processes.

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

Science.gov (United States)

Petrochuk, M A; Javalgi, R G

1996-01-01

Health care reform has become the dominant domestic policy issue in the United States. President Clinton, and the Democratic leaders in the House and Senate have all proposed legislation to reform the system. Regardless of the plan which is ultimately enacted, health care delivery will be radically changed. Health care marketers, given their perspective, have a unique opportunity to ensure their own institutions' success. Organizational, managerial, and marketing strategies can be employed to deal with the changes which will occur. Marketers can utilize personal strategies to remain proactive and successful during an era of health care reform. As outlined in this article, responding to the health care reform changes requires strategic urgency and action. However, the strategies proposed are practical regardless of the version of health care reform legislation which is ultimately enacted.

Seasonal Trends in Lithuanian Stock Market

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Žaneta Simanavičienė

2013-11-01

Full Text Available Purpose of the article is to disentangle different calendar effects which leave efficiency holes in Lithuanian market. This paper presents and tests if commonly described seasonal patterns exist in Lithuanian stock market. Analysis of three different sections: period-of-the-year; week-of-the-month and day-of-the-week, suggests that calendar effects do exist in this market. The multitude of explanations for the seasonal effect leaves the reader confused about its primary cause(s: is it tax-loss selling, window dressing, information, bid-ask bounce, or a combination of these causes? The confusion arises, in part, because evidence has generally been presented in support of a particular hypothesis though the same evidence may be consistent with another hypothesis. Methodology/methods are logical and systemic analysis of research literature based on the comparative and generalization methods as well as statistical methods. Scientific aim of the article is the lack of arguments questioning if market prices operating system is fully effective. Novelty of the paper is to the answer to the question what seasonal anomalies are also present in the stock market of new open economy countries. Findings show that using this modified strategy investor could achieve 20.7% compounded annual growth rate versus 7.8% achieved using simply holding stocks throughout. The hypothesis asserts that returns generally will be greater following the “January effect”. There is limited amount of data for constructing robust seasonal strategies so we modified Buy and Hold strategy with simple rules of using best and worst months to show how they influence OMXV index performance. In the conclusions, empirical results using stock index returns for 2000 - 2010 support the hypothesis in Lithuaian stock market. Abnormal activity of OMXV index’s performance is found in the end of summer and throughout autumn. August is best performer of the year while October is

COMMUNITY HEALTH & PRIMARY HEALTH CARE

African Journals Online (AJOL)

care policy which was intended to make health care which of the two alternative methods of health care available to individuals and families in the financing options of free health or DRF was community at very little or no cost at all. However, preferred by the community members within most health facilities would appear to ...

The Analysis of English and Lithuanian Idioms and the Problems of Their Translation

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Jelena Suchanova

2013-12-01

Full Text Available The paper considers the problems associated with comprehension and translation of idioms within the framework of the theory of linguistic relativity and the translation theories. The main statements of these theories used for explaining the difficulties of idioms’ translation from/into the English or Lithuanian language are presented. The considered problems are analysed from various perspectives. Case studies, demonstrating different nomination principles used in English and Lithuanian due to different approaches of the native speakers of these languages to the same objects or ‘pieces’ of reality are provided. The comparative analysis of English and Lithuanian idioms as the most interesting and peculiar expressions of a language, showing its unique character, is performed and the arising difficulties and the available techniques of idioms’ translation are demonstrated, taking into account the main statements of the theories of linguistic relativity and translation. Special attention is paid to idioms, whose main ideas are expressed differently in the considered languages and, therefore, present many difficulties to non-native speakers. The influence of traditions, culture, the environment and other factors on the form and contents of the idioms in each of the considered languages is also shown. The analysis performed demonstrates the effectiveness of the theory of linguistic relativity in explaining the nature and causes of the arising comprehension and translation problems, as well as its possibilities to give a translator a native speaker’s insight and help him\\her avoid some typical errors. The recommendations of how to make a translation of idioms more accurate and authentic by using the appropriate translation techniques are also given.

What Makes Health Care Special?: An Argument for Health Care Insurance.

Science.gov (United States)

Horne, L Chad

2017-01-01

While citizens in a liberal democracy are generally expected to see to their basic needs out of their own income shares, health care is treated differently. Most rich liberal democracies provide their citizens with health care or health care insurance in kind. Is this "special" treatment justified? The predominant liberal account of justice in health care holds that the moral importance of health justifies treating health care as special in this way. I reject this approach and offer an alternative account. Health needs are not more important than other basic needs, but they are more unpredictable. I argue that citizens are owed access to insurance against health risks to provide stability in their future expectations and thus to protect their capacities for self-determination.

The "True and fair view" concept in Lithuanian accounting regulation

OpenAIRE

Rudžionienė, Kristina; Christauskas, Česlovas

2010-01-01

The "true and fair view" concept is very popular in the professional accountants’ language. After theoretical analysis of the "true and fair view" concept it was made research how understanding of this concept was created in Lithuanian accounting regulation. The stated purpose of financial statements is taken from the United Kingdom, and is different in the particular formulation. Additionally, it is not explained anywhere what it is and how to reach it. There are not specifically defined qua...

Professional burnout and its correlates in Lithuanian neurosurgeons.

Science.gov (United States)

Pranckeviciene, Aiste; Tamasauskas, Arimantas; Deltuva, Vytenis Pranas; Bunevicius, Adomas

2016-08-01

This study aimed to evaluate prevalence and severity of professional burnout in a sample of Lithuanian neurosurgeons and to analyze its personal, interpersonal, and organizational correlates. Thirty-one out of 79 (response rate 39 %) Lithuanian neurosurgeons participated in the study. Professional burnout was evaluated using the Maslach Burnout Inventory - General Survey. Participants also answered questions about professional stressors, sources of professional dissatisfaction, life-style factors, sickness absenteeism/presenteeism, and professional practice. The majority of neurosurgeons were between 41 and 60 years of age (48 %), were married (97 %), had children (84 %). Most neurosurgeons had 20 or more years of professional experience (54.9 %), worked from 41 to 60 h per week (58 %), and performed up to 150 surgeries per year (77.4 %). Eight (26 %) neurosurgeons reported a high level of emotional exhaustion, five (16 %) reported high level of cynicism, and eight (26 %) reported low professional efficacy. Correlation analyses revealed that higher number of surgeries per year, more hours devoted to clinical work, opportunities for professional development, intellectual challenges at work, appreciation by the patients and prestige of the profession were related to lower level of burnout. Greater general workload, unpredictability of the work schedule, lack of necessary technical equipment, dissatisfaction with colleagues, and uncertainty about the future were related to a higher level of burnout. Burnout was reported by one-quarter of neurosurgeons who chose to participate in the study. Personal, interpersonal, and organizational factors arising while fulfilling professional duties were important correlates of neurosurgeons' burnout. Due to the moderate response rate, our results should be interpreted with caution. Larger studies evaluating burnout among European neurosurgeons are needed.

Prevalence of C282Y, H63D, and S65C mutations in hereditary HFE-hemochromatosis gene in Lithuanian population.

Science.gov (United States)

Kucinskas, Laimutis; Juzenas, Simonas; Sventoraityte, Jurgita; Cedaviciute, Ruta; Vitkauskiene, Astra; Kalibatas, Vytenis; Kondrackiene, Jurate; Kupcinskas, Limas

2012-04-01

HFE-hemochromatosis is a common autosomal recessive disease caused by HFE gene mutations and characterized as iron overload and failure of different organs. The aim of this study was to determine the prevalence of C282Y (c.845 G>A), H63D (c.187 C>G), and S65C (c.193A>T) alleles of HFE gene in the Lithuanian population. One thousand and eleven healthy blood donors of Lithuanian nationality were examined in four different ethnic Lithuanian regions to determine HFE gene alleles and genotype frequencies. The samples of DNA were analyzed for the presence of restriction fragment length polymorphism and validated by DNA sequencing. Among 1,011 blood donors tested, the frequency of C282Y, H63D, and S65C alleles were 2.6%, 15.9%, and 1.9%, respectively. One third of the tested subjects (n = 336) had at least one of the C282Y or H63D HFE gene mutations. The screening of Lithuanian blood donors has detected 13 (1.3%) subjects with a genotype C282Y/C282Y or C282Y/H63D responsible for the development of HFE-hemochromatosis. The prevalence of C282Y mutation was significantly higher among the inhabitants of Zemaitija (Somogitia) at the Baltic Sea area (5.9%) in comparison to the regions of continental part of Lithuania (2.4% in Dzukija, 2.3% in Aukstaitija, and 2% in Suvalkija, p HFE gene mutations in ethnic Lithuanians showed that the frequencies of H63D, C282Y, and S65C of HFE gene alleles are similar to the other North-Eastern Europeans, especially in the Baltic region (Estonia, Latvia), Poland, and part of Russia (Moscow region).

Associations of family-centered care with health care outcomes for children with special health care needs.

Science.gov (United States)

Kuo, Dennis Z; Bird, T Mac; Tilford, J Mick

2011-08-01

The objective of this study is to examine the association of family-centered care (FCC) with specific health care service outcomes for children with special health care needs (CSHCN). The study is a secondary analysis of the 2005-2006 National Survey of Children with Special Health Care Needs. Receipt of FCC was determined by five questions regarding how well health care providers addressed family concerns in the prior 12 months. We measured family burden by reports of delayed health care, unmet need, financial costs, and time devoted to care; health status, by stability of health care needs; and emergency department and outpatient service use. All statistical analyses used propensity score-based matching models to address selection bias. FCC was reported by 65.6% of respondents (N = 38,915). FCC was associated with less delayed health care (AOR: 0.56; 95% CI: 0.48, 0.66), fewer unmet service needs (AOR: 0.53; 95% CI: 0.47, 0.60), reduced odds of ≥1 h/week coordinating care (AOR: 0.83; 95% CI: 0.74, 0.93) and reductions in out of pocket costs (AOR: 0.88; 95% CI: 0.80, 0.96). FCC was associated with more stable health care needs (AOR: 1.11; 95% CI: 1.01, 1.21), reduced odds of emergency room visits (AOR: 0.90; 95% CI: 0.82, 0.99) and increased odds of doctor visits (AOR: 1.25; 95% CI: 1.14, 1.37). Our study demonstrates associations of positive health and family outcomes with FCC. Realizing the health care delivery benefits of FCC may require additional encounters to build key elements of trust and partnership.

Lithuanian requirements for ageing management of systems and components important to safety of nuclear power plant

International Nuclear Information System (INIS)

Ramanauskiene, A.

2000-01-01

In this paper the Lithuanian requirements for ageing management of systems and components important to safety of Ignalina nuclear power plant (two RBMK-1500 water-cooled graphite moderated channel-type power reactors) are presented

Globalization drivers and their impact on Lithuanian economic growth and development

OpenAIRE

Jatuliavičienė, Gražina; Kučinskienė, Marija

2005-01-01

The accelerating changes of business environment raise the necessity of new perception of economic development in long-term perspective and evaluation of the globalization of markets, which has been manifesting itself quite rapidly. The driving force behind the globalization processes, which are encouraged by the growing market needs and reducing trade barriers between national economies, is the global economy. Is the present-day position of Lithuanian companies, when entering the new global ...

Visualization of consumption in Lithuanian advertising graphics in the interwar year

OpenAIRE

Povilionytė, Rima

2003-01-01

During the interwar, Lithuanian advertising was mostly developed in periodic press; advertisements in periodic press became a part of everyday life for various social classes. Visual side of graphical design of advertising strongly affected consciousness of consumers, but artistic and aesthetic value of it often was treated as an instrument of achieving commercial objectives. Thus, more interesting artistic solutions were chosen in exceptional cases only. In response to the requirement of the...

Klausimų forma ir funkcijos lietuvių ir rusų vaikiškojoje kalboje. Forms and functions of interrogatives in Lithuanian and Russian motherese

Directory of Open Access Journals (Sweden)

Ingrida Balčiūnienė

2011-01-01

Full Text Available The paper focuses on adult interrogatives, which appear to be among the most frequent and typical ways of communicating with young children. The main objective of the investigation is to identify and compare the variety and distribution of interrogatives in Lithuanian and Russian motherese. The analysis is based on the data of a longitudinal observation of a Lithuanian girl Monika (2;0–2;8 and a Russian boy Vanja (2;0–2;8. The transcribed corpus of conversations between children and their parents was annotated for a multipurpose automatic linguistic analysis using tools of the program CHILDES (Child Language Data Exchange System, MacWhinney 1991. Despite several differences (the general number of questions, and the dominant forms of indirect correction, it can be stated that interrogatives in both Russian and Lithuanian motherese are generally used for the same conversational strategies; the communicative strategies in the two languages seem to be similar or even identical. Moreover, during the observation period, the conversational strategies in both Russian and Lithuanian motherese developed in a similar way. This calls for a general conclusion that a correlation between parental conversational strategy and the type of language can be identified.

Lithuanian female physicists: Reality and plans for the future

Science.gov (United States)

Šatkovskienė, Dalia; Giriunienė, Ramutė; Ruželė, Živilė; Rutkunienė, Živilė

2013-03-01

Changes in the issue of women in physics in Lithuanian in the three years since the 3rd IUPAP International Conference on Women in Physics are discussed on the basis of statistics as well as an exploratory study recently conducted among women physicists. The situation has changed slowly since 2008. However, the study shows that women physicists more clearly understand the inequities and the need for changes, including an active European Union mainstreaming policy targeted to ensure gender equality in the sciences, which gives hope for accelerating changes. Continued plans for improving women physicists' situation in Lithuania are discussed.

Association of HFE gene C282Y and H63D mutations with liver cirrhosis in the Lithuanian population.

Science.gov (United States)

Juzėnas, Simonas; Kupčinskas, Juozas; Valantienė, Irena; Šumskienė, Jolanta; Petrenkienė, Vitalija; Kondrackienė, Jūrate; Kučinskas, Laimutis; Kiudelis, Gediminas; Skiecevičienė, Jurgita; Kupčinskas, Limas

2016-01-01

Liver cirrhosis is the end-stage disease of chronic liver injury. Due to differences in the natural course of chronic liver diseases, identification of genetic factors that influence individual outcomes is warranted. HFE-linked hereditary hemochromatosis (HH) predisposes disease progression to cirrhosis; however, the role of heterozygous C282Y or H63D mutations in the development of cirrhosis in the presence of other etiological factors is still debated. The aim of this study was to determine the association between heterozygous C282Y and H63D mutations and non-HH liver cirrhosis in Lithuanian population. The patient cohort consisted of 209 individuals. Diagnosis of cirrhosis was confirmed by clinical, laboratory parameters, liver biopsy, and radiological imaging. Control samples were obtained from 1005 randomly selected unrelated healthy individuals. HFE gene mutations were determined using the PCR-RFLP method. The most common causes of cirrhosis were hepatitis C (33.9%), hepatitis B (13.6%), and alcohol (25.8%). C282Y allele was associated with the presence of cirrhosis (OR=2.07; P=0.005); this was also observed under recessive model for C282Y (OR=2.06, P=0.008). The prevalence of C282Y allele was higher in cirrhotic men than in controls (7.0% vs. 2.8%, P=0.002). The carriage of H63D risk allele (OR=1.54; P=0.02), heterozygous C282Y/wt and homozygous H63D/H63D genotypes were associated with liver cirrhosis in males (OR=2.48, P=0.008, and OR=4.13, P=0.005, respectively). Heterozygous C282Y mutation of the HFE gene was associated with liver cirrhosis in the Lithuanian population. In gender-related analysis, heterozygous C282Y and homozygous H63D mutations were linked to liver cirrhosis in men, not in women. Copyright © 2016 The Lithuanian University of Health Sciences. Production and hosting by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

"A constant struggle to receive mental health care": health care professionals' acquired experience of barriers to mental health care services in Rwanda.

Science.gov (United States)

Rugema, Lawrence; Krantz, Gunilla; Mogren, Ingrid; Ntaganira, Joseph; Persson, Margareta

2015-12-16

In Rwanda, many people are still mentally affected by the consequences of the genocide and yet mental health care facilities are scarce. While available literature explains the prevalence and consequences of mental disorders, there is lack of knowledge from low-income countries on health care seeking behavior due to common mental disorders. Therefore, this study sought to explore health care professionals' acquired experiences of barriers and facilitators that people with common mental disorders face when seeking mental health care services in Rwanda. A qualitative approach was applied and data was collected from six focus group discussions (FGDs) conducted in October 2012, including a total of 43 health care professionals, men and women in different health professions. The FGDs were performed at health facilities at different care levels. Data was analyzed using manifest and latent content analysis. The emerging theme "A constant struggle to receive mental health care for mental disorders" embraced a number of barriers and few facilitators at individual, family, community and structural levels that people faced when seeking mental health care services. Identified barriers people needed to overcome were: Poverty and lack of family support, Fear of stigmatization, Poor community awareness of mental disorders, Societal beliefs in traditional healers and prayers, Scarce resources in mental health care and Gender imbalance in care seeking behavior. The few facilitators to receive mental health care were: Collaboration between authorities and organizations in mental health and having a Family with awareness of mental disorders and health insurance. From a public health perspective, this study revealed important findings of the numerous barriers and the few facilitating factors available to people seeking health for mental disorders. Having a supportive family with awareness of mental disorders who also were equipped with a health insurance was perceived as vital for

ADDITIONS TO THE RETROSPECTIVE BIBLIOGRAPHY OF LITHUANIAN BOOKS AND THEIR SOURCES

Directory of Open Access Journals (Sweden)

Kaunas, Domas

2006-12-01

Full Text Available The bibliographers of the Lithuanian National Martynas Maþvydas Library have written an open letter to the public asking to provide data about additions to the retrospective bibliography of oldLithuanian publications published in Vilnius in 1969. This act was inspired by the Consorcium of European Research Libraries that started a project of database of the Hand Press Books publishedin 1455–1830. Lithuanian National Library is conducting retroconversion of the retrospective bibliography and provide data to the international database. This task will also lead to the creationof an original database of books and an electronic publication of it on CD-ROM. The specialists expect that bibliophiles and collectors will help to identify the additional publications. The requestto investigate personal libraries looking for the books published before 1864 was made. The data on them should be sent to the creators of the bibliography. This article is a response to the call of bibliographers. It provides information about rare books collected in the personal library of the author. They allow to make changes of the scope of the bibliography and correct some bibliographic records. The data is organised according to the importance and subject: a additions to the retrospective bibliography of books, b copies of the books registered and described in the bibliography using sources, c additional data to some bibliographic descriptions, d unknown copies of rare books, e valuable copies of books. This article also pursues a methodological purpose. It presents the personally acquired experience of data retrieval, acquisition and classification forsuppllementing of the retrospective bibliography as well as the methods of making and arguing the assumptions inevitable in the history of a book. The author believes that the registration of oldbooks from personal libraries in bibliographies is an important task of accounting of the cultural heritage. It is very important

The Main Drivers of Environmentally Responsible Behaviour in Lithuanian Households

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Dalia Streimikiene

2015-08-01

Full Text Available Preserving environmental and natural resources is one of the most important challenges for ensuring the sustainability of well-being over time. One can notice that measuring of environmental indicators related to environmentally responsible behaviour is complicated and demanding task. It is also important to define the main drivers of environmentally responsible development. The objective of this paper is to provide comparatives analysis of indicators of environmentally responsible behaviour in the Baltic States by comparing and assessing them in terms of the EU-28 average and to present the main drivers of environmentally responsible behaviour in Lithuania. Environmentally responsible behaviour is related to resource and energy savings, use of renewable energy sources, waste sorting and recycling, wastewater disposal etc. Comparative assessment of environmentally responsible behaviour indicators in the Baltic States indicated that all these indicators are bellow the EU-average, except the use of renewable energy sources. The main drivers of consumption behaviour in Lithuania were assessed by applying households surveys in order to define the major issues of concern and to develop relevant policies targeting these issues. Age, gender, education, and income of Lithuanian residents do not have impact on environmentally responsible behaviour in Lithuanian households (energy saving, buying energy efficient electric appliances, willingness to pay electricity from renewable energy sources use of biofuels. Only environmental awareness has impact on energy saving behaviour at home and use of biofuels in cars and waste recycle.

Electronics and Lithuanian Terminology

Directory of Open Access Journals (Sweden)

Stasys Zajankauskas

2011-04-01

Full Text Available It is found that the vacuum triode, transistor, monolithic circuit and microprocessor were the most important inventions of traditional electronics. Thus, the origins of the traditional electronics should be associated with the invention of the vacuum triode, but not with the invention of vacuum diode. It is shown that the science of electronics is not as young as computer science or up-to-date information technologies: electronics, including active electronics, had already celebrated the centenary, and the period of 2004–2008 is the period of numerous already solid jubilees. Thus, the terminology of electronics is not at initial stage of evolution as well – general terms should be already systematized and normalized. However, Lithuanian terms for electronic devices invented before tens of years and terms for old-defined notions associated with these devices are still varying, some are worsened. Especially, the incorrectly motivated terms used for variations of transistors and microcircuits are analyzed in the article. It is motivated which terms are preferable, systematic and exact. The paper is dedicated to the 50th anniversary of monolithic circuit, as well as the 60th anniversary of transistor, the 40th jubilee of microprocessor and centenary of electronics.

Advancing LGBT Health Care Policies and Clinical Care Within a Large Academic Health Care System: A Case Study.

Science.gov (United States)

Ruben, Mollie A; Shipherd, Jillian C; Topor, David; AhnAllen, Christopher G; Sloan, Colleen A; Walton, Heather M; Matza, Alexis R; Trezza, Glenn R

2017-01-01

Culturally competent health care is especially important among sexual and gender minority patients because poor cultural competence contributes to health disparities. There is a need to understand how to improve health care quality and delivery for lesbian, gay, bisexual, and transgender (LGBT) veterans in particular, because they have unique physical and mental health needs as both LGBT individuals and veterans. The following article is a case study that focuses on the policy and clinical care practices related to LGBT clinical competency, professional training, and ethical provision of care for veteran patients in the VA Boston Healthcare System. We apply Betancourt et al.'s (2003) cultural competence framework to outline the steps that VA Boston Healthcare System took to increase cultural competency at the organizational, structural, and clinical level. By sharing our experiences, we aim to provide a model and steps for other health care systems and programs, including other VA health care systems, large academic health care systems, community health care systems, and mental health care systems, interested in developing LGBT health initiatives.

Diagnosis of compliance of health care product processing in Primary Health Care

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Camila Eugenia Roseira

Full Text Available ABSTRACT Objective: identify the compliance of health care product processing in Primary Health Care and assess possible differences in the compliance among the services characterized as Primary Health Care Service and Family Health Service. Method: quantitative, observational, descriptive and inferential study with the application of structure, process and outcome indicators of the health care product processing at ten services in an interior city of the State of São Paulo - Brazil. Results: for all indicators, the compliance indices were inferior to the ideal levels. No statistically significant difference was found in the indicators between the two types of services investigated. The health care product cleaning indicators obtained the lowest compliance index, while the indicator technical-operational resources for the preparation, conditioning, disinfection/sterilization, storage and distribution of health care products obtained the best index. Conclusion: the diagnosis of compliance of health care product processing at the services assessed indicates that the quality of the process is jeopardized, as no results close to ideal levels were obtained at any service. In addition, no statistically significant difference in these indicators was found between the two types of services studied.

Health care operations management

NARCIS (Netherlands)

Carter, M.W.; Hans, Elias W.; Kolisch, R.

2012-01-01

Health care operations management has become a major topic for health care service providers and society. Operations research already has and further will make considerable contributions for the effective and efficient delivery of health care services. This special issue collects seven carefully

Holistic health care: Patients' experiences of health care provided by an Advanced Practice Nurse.

Science.gov (United States)

Eriksson, Irene; Lindblad, Monica; Möller, Ulrika; Gillsjö, Catharina

2018-02-01

Advanced Practice Nurse (APN) is a fairly new role in the Swedish health care system. To describe patients' experiences of health care provided by an APN in primary health care. An inductive, descriptive qualitative approach with qualitative open-ended interviews was chosen to obtain descriptions from 10 participants regarding their experiences of health care provided by an APN. The data were collected during the spring 2012, and a qualitative approach was used for analyze. The APNs had knowledge and skills to provide safe and secure individual and holistic health care with high quality, and a respectful and flexible approach. The APNs conveyed trust and safety and provided health care that satisfied the patients' needs of accessibility and appropriateness in level of care. The APNs way of providing health care and promoting health seems beneficial in many ways for the patients. The individual and holistic approach that characterizes the health care provided by the APNs is a key aspect in the prevailing change of health care practice. The transfer of care and the increasing number of older adults, often with a variety of complex health problems, call for development of the new role in this context. © 2017 The Authors. International Journal of Nursing Practice Published by John Wiley & Sons Australia, Ltd.

Oral Health Care Delivery Within the Accountable Care Organization.

Science.gov (United States)

Blue, Christine; Riggs, Sheila

2016-06-01

The accountable care organization (ACO) provides an opportunity to strategically design a comprehensive health system in which oral health works within primary care. A dental hygienist/therapist within the ACO represents value-based health care in action. Inspired by health care reform efforts in Minnesota, a vision of an accountable care organization that integrates oral health into primary health care was developed. Dental hygienists and dental therapists can help accelerate the integration of oral health into primary care, particularly in light of the compelling evidence confirming the cost-effectiveness of care delivered by an allied workforce. A dental insurance Chief Operating Officer and a dental hygiene educator used their unique perspectives and experience to describe the potential of an interdisciplinary team-based approach to individual and population health, including oral health, via an accountable care community. The principles of the patient-centered medical home and the vision for accountable care communities present a paradigm shift from a curative system of care to a prevention-based system that encompasses the behavioral, social, nutritional, economic, and environmental factors that impact health and well-being. Oral health measures embedded in the spectrum of general health care have the potential to ensure a truly comprehensive healthcare system. Published by Elsevier Inc.

Health Care Delivery.

Science.gov (United States)

Starfield, Barbara

1987-01-01

The article reviews emerging health care delivery options for handicapped children. Cost structures, quality of care, and future prospects are considered for Health Maintenance Organizations, Preferred Provider Organizations, Tax Supported Direct Service Programs, Hospital-Based Services, and Ambulatory Care Organizations. (Author/DB)

An Integrative Behavioral Health Care Model Using Automated SBIRT and Care Coordination in Community Health Care.

Science.gov (United States)

Dwinnells, Ronald; Misik, Lauren

2017-10-01

Efficient and effective integration of behavioral health programs in a community health care practice emphasizes patient-centered medical home principles to improve quality of care. A prospective, 3-period, interrupted time series study was used to explore which of 3 different integrative behavioral health care screening and management processes were the most efficient and effective in prompting behavioral health screening, identification, interventions, and referrals in a community health practice. A total of 99.5% ( P < .001) of medical patients completed behavioral health screenings; brief intervention rates nearly doubled to 83% ( P < .001) and 100% ( P < .001) of identified at-risk patients had referrals made using a combination of electronic tablets, electronic medical record, and behavioral health care coordination.

The Shifting Landscape of Health Care: Toward a Model of Health Care Empowerment

Science.gov (United States)

2011-01-01

In a rapidly changing world of health care information access and patients’ rights, there is limited conceptual infrastructure available to understand how people approach and engage in treatment of medical conditions. The construct of health care empowerment is defined as the process and state of being engaged, informed, collaborative, committed, and tolerant of uncertainty regarding health care. I present a model in which health care empowerment is influenced by an interplay of cultural, social, and environmental factors; personal resources; and intrapersonal factors. The model offers a framework to understand patient and provider roles in facilitating health care empowerment and presents opportunities for investigation into the role of health care empowerment in multiple outcomes across populations and settings, including inquiries into the sources and consequences of health disparities. PMID:21164096

[Health care networks].

Science.gov (United States)

Mendes, Eugênio Vilaça

2010-08-01

The demographic and epidemiologic transition resulting from aging and the increase of life expectation means an increment related to chronic conditions. The healthcare systems contemporary crisis is characterized by the organization of the focus on fragmented systems turned to the acute conditions care, in spite of the chronic conditions prevalence, and by the hierarchical structure without communication flow among the different health care levels. Brazil health care situation profile is now presenting a triple burden of diseases, due to the concomitant presence of infectious diseases, external causes and chronic diseases. The solution is to restore the consistence between the triple burden of diseases on the health situation and the current system of healthcare practice, with the implantation of health care networks. The conclusion is that there are evidences in the international literature on health care networks that these networks may improve the clinical quality, the sanitation results and the user's satisfaction and the reduction of healthcare systems costs.

COMMUNITY HEALTH & PRIMARY HEALTH CARE

African Journals Online (AJOL)

the_monk

Journal of Community Medicine and Primary Health Care. 26 (1) 12-20 .... large proportions of the population work in the poor people use health care services far less than. 19 ... hypertension, cancers and road traffic accidents) below 1 dollar ...

Creativity Enhancement in Lithuanian Furniture Manufacturing Business According to International Business Development

Directory of Open Access Journals (Sweden)

Rita Zybartaitė

2014-04-01

Full Text Available This article analyzes Lithuanian furniture manufacturing business perceptions towards creativity, and creativityenhancement behavior according to its international development. Firstly article focuses on international business development,substantiate need of creativity for international business development, outline creativity influencing factors which operateat individual, team and organizational levels and recommendations how to enhance creativity in methodical way. Secondly,article describes a problem of empirical research, methodology of used methods and instruments, and presents results of surveyresearch.

Stable isotopes in Lithuanian bioarcheological material

Science.gov (United States)

Skipityte, Raminta; Jankauskas, Rimantas; Remeikis, Vidmantas

2015-04-01

Investigation of bioarcheological material of ancient human populations allows us to understand the subsistence behavior associated with various adaptations to the environment. Feeding habits are essential to the survival and growth of ancient populations. Stable isotope analysis is accepted tool in paleodiet (Schutkowski et al, 1999) and paleoenvironmental (Zernitskaya et al, 2014) studies. However, stable isotopes can be useful not only in investigating human feeding habits but also in describing social and cultural structure of the past populations (Le Huray and Schutkowski, 2005). Only few stable isotope investigations have been performed before in Lithuanian region suggesting a quite uniform diet between males and females and protein intake from freshwater fish and animal protein. Previously, stable isotope analysis has only been used to study a Stone Age population however, more recently studies have been conducted on Iron Age and Late medieval samples (Jacobs et al, 2009). Anyway, there was a need for more precise examination. Stable isotope analysis were performed on human bone collagen and apatite samples in this study. Data represented various ages (from 5-7th cent. to 18th cent.). Stable carbon and nitrogen isotope analysis on medieval populations indicated that individuals in studied sites in Lithuania were almost exclusively consuming C3 plants, C3 fed terrestrial animals, and some freshwater resources. Current investigation demonstrated social differences between elites and country people and is promising in paleodietary and daily life reconstruction. Acknowledgement I thank prof. dr. G. Grupe, Director of the Anthropological and Palaeoanatomical State Collection in Munich for providing the opportunity to work in her laboratory. The part of this work was funded by DAAD. Antanaitis-Jacobs, Indre, et al. "Diet in early Lithuanian prehistory and the new stable isotope evidence." Archaeologia Baltica 12 (2009): 12-30. Le Huray, Jonathan D., and Holger

Digital health care--the convergence of health care and the Internet.

Science.gov (United States)

Frank, S R

2000-04-01

The author believes that interactive media (the Internet and the World Wide Web) and associated applications used to access those media (portals, browsers, specialized Web-based applications) will result in a substantial, positive, and measurable impact on medical care faster than any previous information technology or communications tool. Acknowledging the dynamic environment, the author classifies "pure" digital health care companies into three business service areas: content, connectivity, and commerce. Companies offering these services are attempting to tap into a host of different markets within the health care industry including providers, payers, pharmaceutical and medical products companies, employers, distributors, and consumers. As the fastest growing medium in history, and given the unique nature of health care information and the tremendous demand for content among industry professionals and consumers, the Internet offers a more robust and targeted direct marketing opportunity than traditional media. From the medical consumer's standpoint (i.e., the patient) the author sees the Internet as performing five critical functions: (1) Disseminate information, (2) Aid informed decision making, (3) Promote health, (4) Provide a means for information exchange and support--the community concept, and (5) Increase self-care and manage demand for health services, lowering direct medical costs. The author firmly submits the Web will provide overall benefits to the health care economy as health information consumers manage their own health problems that might not directly benefit from an encounter with a health professional. Marrying the Internet to other interactive technologies, including voice recognition systems and telephone-based triage lines among others, holds the promise of reducing unnecessary medical services.

Consumer Directed Health Care

OpenAIRE

John Goodman

2006-01-01

Consumer driven health care (CDHC) is a potential solution to two perplexing problems: (1) How to choose between health care and other uses of money, and (2) how to allocate resources in an industry where normal market forces have been systemically suppressed. In the consumer-driven model, consumers occupy the primary decision-making role regarding the health care that they receive. From an employee benefits perspective, consumer driven health care in the broadest sense may refer to limited e...

Mental health care roles of non-medical primary health and social care services.

Science.gov (United States)

Mitchell, Penny

2009-02-01

Changes in patterns of delivery of mental health care over several decades are putting pressure on primary health and social care services to increase their involvement. Mental health policy in countries like the UK, Australia and New Zealand recognises the need for these services to make a greater contribution and calls for increased intersectoral collaboration. In Australia, most investment to date has focused on the development and integration of specialist mental health services and primary medical care, and evaluation research suggests some progress. Substantial inadequacies remain, however, in the comprehensiveness and continuity of care received by people affected by mental health problems, particularly in relation to social and psychosocial interventions. Very little research has examined the nature of the roles that non-medical primary health and social care services actually or potentially play in mental health care. Lack of information about these roles could have inhibited development of service improvement initiatives targeting these services. The present paper reports the results of an exploratory study that examined the mental health care roles of 41 diverse non-medical primary health and social care services in the state of Victoria, Australia. Data were collected in 2004 using a purposive sampling strategy. A novel method of surveying providers was employed whereby respondents within each agency worked as a group to complete a structured survey that collected quantitative and qualitative data simultaneously. This paper reports results of quantitative analyses including a tentative principal components analysis that examined the structure of roles. Non-medical primary health and social care services are currently performing a wide variety of mental health care roles and they aspire to increase their involvement in this work. However, these providers do not favour approaches involving selective targeting of clients with mental disorders.

Operations management in health care.

Science.gov (United States)

Henderson, M D

1995-01-01

Health care operations encompass the totality of those health care functions that allow those who practice health care delivery to do so. As the health care industry undergoes dramatic reform, so will the jobs of those who manage health care delivery systems. Although health care operations managers play one of the most vital and substantial roles in the new delivery system, the criteria for their success (or failure) are being defined now. Yet, the new and vital role of the operations manager has been stunted in its development, which is primarily because of old and outdated antipathy between hospital administrators and physicians. This article defines the skills and characteristics of today's health care operations managers.

Petroleum and Health Care: Evaluating and Managing Health Care's Vulnerability to Petroleum Supply Shifts

Science.gov (United States)

Bednarz, Daniel; Bae, Jaeyong; Pierce, Jessica

2011-01-01

Petroleum is used widely in health care—primarily as a transport fuel and feedstock for pharmaceuticals, plastics, and medical supplies—and few substitutes for it are available. This dependence theoretically makes health care vulnerable to petroleum supply shifts, but this vulnerability has not been empirically assessed. We quantify key aspects of petroleum use in health care and explore historical associations between petroleum supply shocks and health care prices. These analyses confirm that petroleum products are intrinsic to modern health care and that petroleum supply shifts can affect health care prices. In anticipation of future supply contractions lasting longer than previous shifts and potentially disrupting health care delivery, we propose an adaptive management approach and outline its application to the example of emergency medical services. PMID:21778473

Country of origin (COO) effect in cereal products: A comparative study of Danish and Lithuanian consumers

DEFF Research Database (Denmark)

Krutulyte, Rasa; Costa, Ana I.A.; Grunert, Klaus G.

2005-01-01

This paper presents the results of a survey which aimed at uncovering the influence of COO information on the perceptions of 281 Danish and Lithuanian consumers regarding several cereal foods and their marketing characteristics, such as price, place-of-purchase, brand, packaging, and labelling. P...

Resilient health care

DEFF Research Database (Denmark)

Hollnagel, E.; Braithwaite, J.; Wears, R. L.

Health care is everywhere under tremendous pressure with regard to efficiency, safety, and economic viability - to say nothing of having to meet various political agendas - and has responded by eagerly adopting techniques that have been useful in other industries, such as quality management, lean...... production, and high reliability. This has on the whole been met with limited success because health care as a non-trivial and multifaceted system differs significantly from most traditional industries. In order to allow health care systems to perform as expected and required, it is necessary to have...... engineering's unique approach emphasises the usefulness of performance variability, and that successes and failures have the same aetiology. This book contains contributions from acknowledged international experts in health care, organisational studies and patient safety, as well as resilience engineering...

Differences in Health Care Needs, Health Care Utilization, and Health Care Outcomes Among Children With Special Health Care Needs in Ohio: A Comparative Analysis Between Medicaid and Private Insurance.

Science.gov (United States)

Sarkar, Madhurima; Earley, Elizabeth R; Asti, Lindsey; Chisolm, Deena J

This study explores comparative differentials in health care needs, health care utilization, and health status between Medicaid and private/employer-sponsored insurance (ESI) among a statewide population of children with special health care needs (CSHCN) in Ohio. We used data from the 2012 Ohio Medicaid Assessment Survey to examine CSHCN's health care needs, utilization, status, and health outcomes by insurance type. Adjusted multivariable logistic regression models were used to explore associations between public and private health insurance, as well as the utilization and health outcome variables. Bivariate analyses indicate that the Medicaid population had higher care coordination needs (odds ratio [OR] = 1.6; 95% confidence interval [CI], 1.1-2.2) as well as need for mental/educational health care services (OR = 1.5; 95% CI; 1.1-2.0). They also reported higher unmet dental care needs (OR = 2.2; 95% CI, 1.2-4.0), higher emergency department (ED) utilization (OR = 2.3; 95% CI, 1.7-3.2), and worse overall health (OR = 0.6; 95% CI, 0.4-0.7), oral health (OR = 0.4; 95% CI, 0.3-0.5), and vision health (OR = 0.4; 95% CI, 0.2-0.6). After controlling for demographic variables, CSHCN with Medicaid insurance coverage were more likely to need mental health and education services (adjusted odds ratio [AOR] = 1.8; 95% CI; 1.2-2.6), had significantly more ED visits (AOR = 2.3; 95% CI, 1.5-3.5), and were less likely to have excellent overall health (AOR = 0.64; 95% CI, 0.4-0.9), oral health (AOR = 0.43; 95% CI, 0.3-0.7), and vision health (AOR = 0.38; 95% CI, 0.2-0.6) than those with private insurance/ESI. The CSHCN population is a highly vulnerable population. While Ohio's Medicaid provides greater coverage to CSHCN, disparities continue to exist within access and services that Medicaid provides versus the ones provided by private insurance/ESI.

Modern Lithuanian foreign policy: the adjustment of traditional policy

Directory of Open Access Journals (Sweden)

Batorshina Irina

2011-12-01

Full Text Available The authors consider the core areas of Lithuanian foreign policy. Special attention is paid to the adjustment of the major foreign policy vector, which concentrated earlier on the cooperation with the United States of America and strategic partnership with the Republic of Poland. The article analyses the attempts of Lithuanian president Dalia Grybauskaitė to formulate the so-called «new foreign policy» based on the multivector approach to the intergovernmental cooperation. This research is timely because of an increasing influence of small states on foreign policy decision-making within the European Union. It emphasizes the need to analyse foreign policy priorities of the Baltic States and Central and Eastern European countries and to identify the dominant trends in the international policy in the region in order to forecast further development at European and global levels. This objective is achieved with the help of an integrated approach with elements of interdisciplinary research. Special attention is paid to the comparative-historical approach, which facilitates the analysis of the relations between the Republic of Lithuania and the neighbouring states and its principal partners. Alongside traditional methods of historical research, this work employs such methods as participant observation, content and event analysis, and simultaneous and comparative analysis. The research and practical significance of this work is explained by its emphasis on the need to apply an additional theoretical framework to studies into the foreign policy initiatives of the Republic of Lithuania in the international arena. While earlier they were determined by the value (democratic approach, which was a reflection of American realism, today an increasingly important factor is the personality of the president, who does not always positively influence the changing policy of the country. The results of the research contribute substantially to the understanding of

[Academician Vladas Lasas -- distinguished Lithuanian scientist, organizer and educator].

Science.gov (United States)

Padegimas, Bernardas; Abraitis, Romualdas

2002-01-01

The material of this publication is dedicated to the memory of Professor Vladas Lasas, honored scientist of Lithuania, member of Lithuanian Academy of Sciences and corresponding member of the Academy of Medicine of the USSR. V. Lasas was born on January 13th, 1892, on a farmstead in Rokiskis region, Lithuania. He died on January 2nd, 1966 in Kaunas. V. Lasas studied medicine at the Faculty of Medicine of Tartu (Dorpat) University and graduated from it in 1918. In 1921 he was invited to deliver lectures on physiology at the newly organized Higher Courses in Kaunas. During 1920-1924 he attended higher educational establishments of Prague, Berlin, Lausanne and Paris. In 1924 V. Lasas worked on probation in Lausanne under supervision of famous scientist M. Arthus, the founder of experimental allergy--anaphylaxis, in the field of experimental anaphylaxis, desensibilization, enteral sensibilization and resorption of native albumins, transfer of allergic state from mother to fetus, the role of interoceptors and biologically active substances in the formation and development of anaphylaxis. Over 40 scientific papers were published and 12 doctoral these were maintained, dealing with these problems. From 1924 to 1940 and from 1944 to 1946 V. Lasas acted as dean of the Faculty of Medicine at Kaunas University. During this period he displayed great organizational talent, and on his initiative three basic clinical buildings were built for the Faculty of Medicine. In 1946 V. Lasas was elected as academician and appointed as secretary-in-charge of natural mathematical and applied science of the Academy of Sciences of Lithuania. V. Lasas was the founder and longstanding chairman of the Lithuanian Physiological Society. Alone and with coauthors he has published 16 original textbooks. The list of his bibliography accounts to 229 publications.

Mathematics Education Problems and Attempts to Solve Them in Nowadays Lithuanian School

OpenAIRE

Malaukytė Ieva

2017-01-01

The decreasing number of the Lithuanian residents has strong impact on the educational system: the number of pupils is decreasing, the schools are getting closed. School is considered to be the provider of educational services, so it is necessary to search, how to preserve and attract clients – pupils. The growing competition induces search for distinctiveness among the schools. According to the theory of generations of William Strauss and Neil Howe, now we have to educate representatives of ...

Behavioral health and health care reform models: patient-centered medical home, health home, and accountable care organization.

Science.gov (United States)

Bao, Yuhua; Casalino, Lawrence P; Pincus, Harold Alan

2013-01-01

Discussions of health care delivery and payment reforms have largely been silent about how behavioral health could be incorporated into reform initiatives. This paper draws attention to four patient populations defined by the severity of their behavioral health conditions and insurance status. It discusses the potentials and limitations of three prominent models promoted by the Affordable Care Act to serve populations with behavioral health conditions: the Patient-Centered Medical Home, the Health Home initiative within Medicaid, and the Accountable Care Organization. To incorporate behavioral health into health reform, policymakers and practitioners may consider embedding in the reform efforts explicit tools-accountability measures and payment designs-to improve access to and quality of care for patients with behavioral health needs.

Intergenerational Transmission of Resilience? Sense of Coherence Is Associated between Lithuanian Survivors of Political Violence and Their Adult Offspring.

Science.gov (United States)

Kazlauskas, Evaldas; Gailiene, Danute; Vaskeliene, Ieva; Skeryte-Kazlauskiene, Monika

2017-01-01

Little is known about intergeneration effects on mental health in the families of survivors of political oppression of communist regime in Central and Eastern Europe. We aimed to explore post-traumatic stress in the second generation of the Lithuanian survivors of political violence, and analyze links between parental and adult offsprings' sense of coherence in the families exposed to political violence during the oppressive communist regime in Lithuania. A total of 110 matched pairs of communist regime political violence survivors (mean age = 73.22 years) and their adult offspring (mean age = 44.65 years) participated in this study. Life-time traumatic experiences and sense of coherence were measured in both parents and their offspring. Post-traumatic stress symptoms were assessed in the second generation of survivors. We found a high vulnerability in the second generation of the Lithuanian families of political violence survivors, with a 29% of probable PTSD in the second generation based on self-report measures. A significant positive correlation between parental and adult offsprings' sense of coherence was found. Post-traumatic stress symptoms were associated negatively with a sense of coherence in the second generation. Our study indicates the links between parental and the second generation's sense of coherence in the families of survivors of political violence. The study raises broader questions about the intergenerational aspects of resilience. Further studies are needed to explore the links between parental and child sense of coherence in other samples.

Reorganization of the Lithuanian State Power System

International Nuclear Information System (INIS)

Paskevicius, V.

1995-01-01

This article deals with preasent situation in energy sector in Lithuania. All power plants with installed capacity of 2561 MW, except Ignalina Nuclear Power Plant (3000 MW) belongs to Lithuanian State Power System (LSPS) as well transmission and distribution networks. In 1989-1991 Lithuania generated approximately 29TWh of electricity annually from which 12TWh LSPS exported to neighbouring countries. After 1990 in the transitional period from planned economy to the marked one, the economic situation in the country became complicated. The electricity demand has fallen nearly 40%. Due to the similar situation in neighboring countries the electricity export has decreased too. The article presents the distribution of electric power output in 1994 by power plants; electric power consumption and output of power plants in Lithuania from 1940 to 1994 is also included. Some aspects of regional cooperation of tree Baltic countries in energy area is touched too. 3 figs

Health care in the Netherlands.

NARCIS (Netherlands)

Weel, C. van; Schers, H.J.; Timmermans, A.

2012-01-01

This article analyzes Dutch experiences of health care reform--in particular in primary care--with emphasis on lessons for current United States health care reforms. Recent major innovations were the introduction of private insurance based on the principles of primary care-led health care and

The Obama health care plan: what it means for mental health care of older adults.

Science.gov (United States)

Sorrell, Jeanne M

2009-01-01

Health care was an important issue for both the Obama and McCain election campaigns. Now that Barack Obama is poised to serve as the 44th President of the United States, many health care providers are focused on what Obama's administration will mean for new health care initiatives. This article focuses specifically on aspects of the Obama and Biden health care plan that affects mental health care for older adults.

Antenatal and obstetric care in Afghanistan--a qualitative study among health care receivers and health care providers.

Science.gov (United States)

Rahmani, Zuhal; Brekke, Mette

2013-05-06

Despite attempts from the government to improve ante- and perinatal care, Afghanistan has once again been labeled "the worst country in which to be a mom" in Save the Children's World's Mothers' Report. This study investigated how pregnant women and health care providers experience the existing antenatal and obstetric health care situation in Afghanistan. Data were obtained through one-to-one semi-structured interviews of 27 individuals, including 12 women who were pregnant or had recently given birth, seven doctors, five midwives, and three traditional birth attendants. The interviews were carried out in Kabul and the village of Ramak in Ghazni Province. Interviews were taped, transcribed, and analyzed according to the principles of Giorgi's phenomenological analysis. Antenatal care was reported to be underused, even when available. Several obstacles were identified, including a lack of knowledge regarding the importance of antenatal care among the women and their families, financial difficulties, and transportation problems. The women also reported significant dissatisfaction with the attitudes and behavior of health personnel, which included instances of verbal and physical abuse. According to the health professionals, poor working conditions, low salaries, and high stress levels contributed to this matter. Personal contacts inside the hospital were considered necessary for receiving high quality care, and bribery was customary. Despite these serious concerns, the women expressed gratitude for having even limited access to health care, especially treatment provided by a female doctor. Health professionals were proud of their work and enjoyed the opportunity to help their community. This study identified several obstacles which must be addressed to improve reproductive health in Afghanistan. There was limited understanding of the importance of antenatal care and a lack of family support. Financial and transportation problems led to underuse of available care

Improving eye care in the primary health care setting

Directory of Open Access Journals (Sweden)

M de Wet

2000-09-01

Full Text Available One of the challenges facing primary health care in South Africa is the delivery of quality eye care to all South Africans. In this regard the role of the primary health care worker, as the first point of contact, is crucial. This paper reports on the problems primary health care workers experience in providing quality eye care in Region B of the Free State. Problems identified by those involved in the study include the cumbersome referral system, the unavailability of appropriate medicine at clinics, the insufficient knowledge of primary health care workers regarding eye conditions and the lack of communication between the various eye care service providers. Suggestions to address the problems identified included more in-service training of primary health care workers regarding eye conditions, liaison with NGO’s providing eye care, decentralisation of services and the establishment of an eye care committee in the region.

Respiratory Home Health Care

Science.gov (United States)

... Us Home > Healthy Living > Living With Lung Disease > Respiratory Home Health Care Font: Aerosol Delivery Oxygen Resources ... Teenagers Living With Lung Disease Articles written by Respiratory Experts Respiratory Home Health Care Respiratory care at ...

Marketing health care to employees: the structure of employee health care plan satisfaction.

Science.gov (United States)

Mascarenhas, O A

1993-01-01

Providing cost-contained comprehensive quality health care to maintain healthy and productive employees is a challenging problem for all employers. Using a representative panel of metropolitan employees, the author investigates the internal and external structure of employee satisfaction with company-sponsored health care plans. Employee satisfaction is differentiated into four meaningful groups of health care benefits, whereas its external structure is supported by the traditional satisfaction paradigms of expectation-disconfirmation, attribution, and equity. Despite negative disconfirmation, employees register sufficiently high health care satisfaction levels, which suggests some useful strategies that employers may consider implementing.

Rural health care bypass behavior: how community and spatial characteristics affect primary health care selection.

Science.gov (United States)

Sanders, Scott R; Erickson, Lance D; Call, Vaughn R A; McKnight, Matthew L; Hedges, Dawson W

2015-01-01

(1) To assess the prevalence of rural primary care physician (PCP) bypass, a behavior in which residents travel farther than necessary to obtain health care, (2) To examine the role of community and non-health-care-related characteristics on bypass behavior, and (3) To analyze spatial bypass patterns to determine which rural communities are most affected by bypass. Data came from the Montana Health Matters survey, which gathered self-reported information from Montana residents on their health care utilization, satisfaction with health care services, and community and demographic characteristics. Logistic regression and spatial analysis were used to examine the probability and spatial patterns of bypass. Overall, 39% of respondents bypass local health care. Similar to previous studies, dissatisfaction with local health care was found to increase the likelihood of bypass. Dissatisfaction with local shopping also increases the likelihood of bypass, while the number of friends in a community, and commonality with community reduce the likelihood of bypass. Other significant factors associated with bypass include age, income, health, and living in a highly rural community or one with high commuting flows. Our results suggest that outshopping theory, in which patients bundle services and shopping for added convenience, extends to primary health care selection. This implies that rural health care selection is multifaceted, and that in addition to perceived satisfaction with local health care, the quality of local shopping and levels of community attachment also influence bypass behavior. © 2014 National Rural Health Association.

Informing the Lithuanian public about the decommissioning of Unit 1 at Ignalina NPP

International Nuclear Information System (INIS)

Medeliene, D.; Alvers, M.

2001-01-01

The final decision about decommissioning of Unit 1 at Ignalina NPP by 2005 was taken when the Lithuanian Parliament approved the National Energy Strategy in 1999. In 2000 the Board of the European Bank of Research and Development (EBRD) approved the establishment of the Ignalina International Decommissioning Support Fund and the International Donors' Conference took place in Vilnius. Sweden's longterm co-operation with Lithuania in the area of nuclear safety started already in 1992, soon after the country had regained its independence. SIP (Swedish International Project Nuclear Safety) administers this bilateral assistance. Public information has been included in the Swedish programme since the establishment of the Information Centre at INPP and is also a part of the bilateral decommissioning support. SIP finances a series of TV-programmes on a national channel and the local cable TV in Visaginas (the town close to Ignalina NPP) about various aspects of decommissioning. The Lithuanian regulatory authority VATESI uses its experience in public relations to inform about the situation related with decommissioning. The authority organizes 'Open Doors' days and press conferences to provide objective and trustworthy information. The reaction of the viewers to the TV-programmes were very positive and Sweden will continue the support to the information programme in Lithuania. (author)

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

Science.gov (United States)

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

2016-02-01

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

Toward a 21st-century health care system: Recommendations for health care reform

NARCIS (Netherlands)

K. Arrow (Kenneth); A. Auerbach (Alan); J. Bertko (John); L.P. Casalino (Lawrence Peter); F.J. Crosson (Francis); A. Enthoven (Alain); E. Falcone; R.C. Feldman; V.R. Fuchs (Victor); A.M. Garber (Alan); M.R. Gold (Marthe Rachel); D.A. Goldman; G.K. Hadfield (Gillian); M.A. Hall (Mark Ann); R.I. Horwitz (Ralph); M. Hooven; P.D. Jacobson (Peter); T.S. Jost (Timothy Stoltzfus); L.J. Kotlikoff; J. Levin (Jonathan); S. Levine (Sharon); R. Levy; K. Linscott; H.S. Luft; R. Mashal; D. McFadden (Daniel); D. Mechanic (David); D. Meltzer (David); J.P. Newhouse (Joseph); R.G. Noll (Roger); J.B. Pietzsch (Jan Benjamin); P. Pizzo (Philip); R.D. Reischauer (Robert); S. Rosenbaum (Sara); W. Sage (William); L.D. Schaeffer (Leonard Daniel); E. Sheen; B.N. Silber (Bernie Michael); J. Skinner (Jonathan Robert); S.M. Shortell (Stephen); S.O. Thier (Samuel); S. Tunis (Sean); L. Wulsin Jr.; P. Yock (Paul); G.B. Nun; S. Bryan (Stirling); O. Luxenburg (Osnat); W.P.M.M. van de Ven (Wynand); J. Cooper (Jim)

2009-01-01

textabstractThe coverage, cost, and quality problems of the U.S. health care system are evident. Sustainable health care reform must go beyond financing expanded access to care to substantially changing the organization and delivery of care. The FRESH-Thinking Project (www.fresh-thinking.org) held a

Integrating Community Health Workers (CHWs) into Health Care Organizations.

Science.gov (United States)

Payne, Julianne; Razi, Sima; Emery, Kyle; Quattrone, Westleigh; Tardif-Douglin, Miriam

2017-10-01

Health care organizations increasingly employ community health workers (CHWs) to help address growing provider shortages, improve patient outcomes, and increase access to culturally sensitive care among traditionally inaccessible or disenfranchised patient populations. Scholarly interest in CHWs has grown in recent decades, but researchers tend to focus on how CHWs affect patient outcomes rather than whether and how CHWs fit into the existing health care workforce. This paper focuses on the factors that facilitate and impede the integration of the CHWs into health care organizations, and strategies that organizations and their staff develop to overcome barriers to CHW integration. We use qualitative evaluation data from 13 awardees that received Health Care Innovation Awards from the Centers of Medicare and Medicaid Innovation to enhance the quality of health care, improve health outcomes, and reduce the cost of care using programs involving CHWs. We find that organizational capacity, support for CHWs, clarity about health care roles, and clinical workflow drive CHW integration. We conclude with practical recommendations for health care organizations interested in employing CHWs.

Health care employee perceptions of patient-centered care.

Science.gov (United States)

Balbale, Salva Najib; Turcios, Stephanie; LaVela, Sherri L

2015-03-01

Given the importance of health care employees in the delivery of patient-centered care, understanding their unique perspectives is essential for quality improvement. The purpose of this study was to use photovoice to evaluate perceptions and experiences around patient-centered care among U.S. Veterans Affairs (VA) health care employees. We asked participants to take photographs of salient features in their environment related to patient-centered care. We used the photographs to facilitate dialogue during follow-up interviews. Twelve VA health care employees across two VA sites participated in the project. Although most participants felt satisfied with their work environment and experiences at the VA, they identified several areas for improvement. These included a need for more employee health and wellness initiatives and a need for enhanced opportunities for training and professional growth. Application of photovoice enabled us to learn about employees' unique perspectives around patient-centered care while engaging them in an evaluation of care delivery. © The Author(s) 2014.

Cluster models, factors and characteristics for the competitive advantage of Lithuanian Maritime sector

OpenAIRE

Viederytė, Rasa; Didžiokas, Rimantas

2014-01-01

Paper analyses several cluster models on the basis of competitiveness: Nine-factor model, Double diamond model, Funnel model of cluster determinants, Destination Competitiveness and sustainability models, which are related to Porter’s Diamond model and concentrate to the classical one - adopt M. Porter’s Diamond model methodology to the evaluation of Lithuanian Maritime sector’s clustering on the basis of competitiveness. Despite the advances in cluster research, this model remains a complex ...

Controversies in faith and health care.

Science.gov (United States)

Tomkins, Andrew; Duff, Jean; Fitzgibbon, Atallah; Karam, Azza; Mills, Edward J; Munnings, Keith; Smith, Sally; Seshadri, Shreelata Rao; Steinberg, Avraham; Vitillo, Robert; Yugi, Philemon

2015-10-31

Differences in religious faith-based viewpoints (controversies) on the sanctity of human life, acceptable behaviour, health-care technologies and health-care services contribute to the widespread variations in health care worldwide. Faith-linked controversies include family planning, child protection (especially child marriage, female genital mutilation, and immunisation), stigma and harm reduction, violence against women, sexual and reproductive health and HIV, gender, end-of-life issues, and faith activities including prayer. Buddhism, Christianity, Hinduism, Islam, Judaism, and traditional beliefs have similarities and differences in their viewpoints. Improved understanding by health-care providers of the heterogeneity of viewpoints, both within and between faiths, and their effect on health care is important for clinical medicine, public-health programmes, and health-care policy. Increased appreciation in faith leaders of the effect of their teachings on health care is also crucial. This Series paper outlines some faith-related controversies, describes how they influence health-care provision and uptake, and identifies opportunities for research and increased interaction between faith leaders and health-care providers to improve health care. Copyright © 2015 Elsevier Ltd. All rights reserved.

Health-care users, key community informants and primary health care workers' views on health, health promotion, health assets and deficits: qualitative study in seven Spanish regions.

Science.gov (United States)

Pons-Vigués, Mariona; Berenguera, Anna; Coma-Auli, Núria; Pombo-Ramos, Haizea; March, Sebastià; Asensio-Martínez, Angela; Moreno-Peral, Patricia; Mora-Simón, Sara; Martínez-Andrés, Maria; Pujol-Ribera, Enriqueta

2017-06-13

Although some articles have analysed the definitions of health and health promotion from the perspective of health-care users and health care professionals, no published studies include the simultaneous participation of health-care users, primary health care professionals and key community informants. Understanding the perception of health and health promotion amongst these different stakeholders is crucial for the design and implementation of successful, equitable and sustainable measures that improve the health and wellbeing of populations. Furthermore, the identification of different health assets and deficits by the different informants will generate new evidence to promote healthy behaviours, improve community health and wellbeing and reduce preventable inequalities. The objective of this study is to explore the concept of health and health promotion and to compare health assets and deficits as identified by health-care users, key community informants and primary health care workers with the ultimate purpose to collect the necessary data for the design and implementation of a successful health promotion intervention. A descriptive-interpretive qualitative research was conducted with 276 participants from 14 primary care centres of 7 Spanish regions. Theoretical sampling was used for selection. We organized 11 discussion groups and 2 triangular groups with health-care users; 30 semi-structured interviews with key community informants; and 14 discussion groups with primary health care workers. A thematic content analysis was carried out. Health-care users and key community informants agree that health is a complex, broad, multifactorial concept that encompasses several interrelated dimensions (physical, psychological-emotional, social, occupational, intellectual, spiritual and environmental). The three participants' profiles consider health promotion indispensable despite defining it as complex and vague. In fact, most health-care users admit to having

Association of functional limitation with health care needs and experiences of children with special health care needs.

Science.gov (United States)

Nageswaran, Savithri; Silver, Ellen Johnson; Stein, Ruth E K

2008-05-01

The goal was to evaluate whether having a functional limitation was associated with health care needs and experiences of children with special health care needs. We used caregivers' responses in the National Survey of Children with Special Health Care Needs (2001). Functional limitation was categorized as severe, some, or no limitation. We performed analyses of the relationships of functional limitation to measures of health care needs and experiences. Children with special health care needs with severe functional limitation were more likely to have received specialized educational services, to have had physician visits, and to have needed health services, compared with those with no limitation. They had significantly greater odds of delayed care, unmet health care and care-coordination needs, referral problems, dissatisfaction, and difficulty using health services, compared with those without limitation. Caregivers of children with special health care needs with severe limitation were twice as likely as those with no limitation to report that providers did not spend enough time, listen carefully, provide needed information, and make family members partners in the child's care. Compared with children with special health care needs without limitation, those with severe limitation had worse health insurance experiences, in terms of insurance coverage, copayments, being able to see needed providers, and problems with health insurance. The impact on families (financial problems, need to provide home care, or need to stop or to cut work) of children with special health care needs with severe functional limitation was much greater than the impact on families of children with special health care needs without limitation. For most measures examined, results for some limitation were between those for severe limitation and no limitation. Functional limitation is significantly associated with the health care needs and experiences of children with special health care needs.

Health Care Efficiencies: Consolidation and Alternative Models vs. Health Care and Antitrust Regulation - Irreconcilable Differences?

Science.gov (United States)

King, Michael W

2017-11-01

Despite the U.S. substantially outspending peer high income nations with almost 18% of GDP dedicated to health care, on any number of statistical measurements from life expectancy to birth rates to chronic disease, 1 the U.S. achieves inferior health outcomes. In short, Americans receive a very disappointing return on investment on their health care dollars, causing economic and social strain. 2 Accordingly, the debates rage on: what is the top driver of health care spending? Among the culprits: poor communication and coordination among disparate providers, paperwork required by payors and regulations, well-intentioned physicians overprescribing treatments, drugs and devices, outright fraud and abuse, and medical malpractice litigation. Fundamentally, what is the best way to reduce U.S. health care spending, while improving the patient experience of care in terms of quality and satisfaction, and driving better patient health outcomes? Mergers, partnerships, and consolidation in the health care industry, new care delivery models like Accountable Care Organizations and integrated care systems, bundled payments, information technology, innovation through new drugs and new medical devices, or some combination of the foregoing? More importantly, recent ambitious reform efforts fall short of a cohesive approach, leaving fundamental internal inconsistencies across divergent arms of the federal government, raising the issue of whether the U.S. health care system can drive sufficient efficiencies within the current health care and antitrust regulatory environments. While debate rages on Capitol Hill over "repeal and replace," only limited attention has been directed toward reforming the current "fee-for-service" model pursuant to which providers are paid for volume of care rather than quality or outcomes. Indeed, both the Patient Protection and Affordable Care Act ("ACA") 3 and proposals for its replacement focus primarily on the reach and cost of providing coverage for

Benchmarking HIV health care

DEFF Research Database (Denmark)

Podlekareva, Daria; Reekie, Joanne; Mocroft, Amanda

2012-01-01

ABSTRACT: BACKGROUND: State-of-the-art care involving the utilisation of multiple health care interventions is the basis for an optimal long-term clinical prognosis for HIV-patients. We evaluated health care for HIV-patients based on four key indicators. METHODS: Four indicators of health care we...... document pronounced regional differences in adherence to guidelines and can help to identify gaps and direct target interventions. It may serve as a tool for assessment and benchmarking the clinical management of HIV-patients in any setting worldwide....

Costs of health care across primary care models in Ontario.

Science.gov (United States)

Laberge, Maude; Wodchis, Walter P; Barnsley, Jan; Laporte, Audrey

2017-08-01

The purpose of this study is to analyze the relationship between newly introduced primary care models in Ontario, Canada, and patients' primary care and total health care costs. A specific focus is on the payment mechanisms for primary care physicians, i.e. fee-for-service (FFS), enhanced-FFS, and blended capitation, and whether providers practiced as part of a multidisciplinary team. Utilization data for a one year period was measured using administrative databases for a 10% sample selected at random from the Ontario adult population. Primary care and total health care costs were calculated at the individual level and included costs from physician services, hospital visits and admissions, long term care, drugs, home care, lab tests, and visits to non-medical health care providers. Generalized linear model regressions were conducted to assess the differences in costs between primary care models. Patients not enrolled with a primary care physicians were younger, more likely to be males and of lower socio-economic status. Patients in blended capitation models were healthier and wealthier than FFS and enhanced-FFS patients. Primary care and total health care costs were significantly different across Ontario primary care models. Using the traditional FFS as the reference, we found that patients in the enhanced-FFS models had the lowest total health care costs, and also the lowest primary care costs. Patients in the blended capitation models had higher primary care costs but lower total health care costs. Patients that were in multidisciplinary teams (FHT), where physicians are also paid on a blended capitation basis, had higher total health care costs than non-FHT patients but still lower than the FFS reference group. Primary care and total health care costs increased with patients' age, morbidity, and lower income quintile across all primary care payment types. The new primary care models were associated with lower total health care costs for patients compared to the

The retailing of health care.

Science.gov (United States)

Paul, T; Wong, J

1984-01-01

A number of striking parallels between recent developments in health care marketing and changes in the retailing industry exist. The authors have compared retailing paradigms to the area on health care marketing so strategists in hospitals and other health care institutions can gain insight from these parallels. Many of the same economic, demographic, technological and lifestyle forces may be at work in both the health care and retail markets. While the services or products offered in health care are radically different from those of conventional retail markets, the manner in which the products and services are positioned, priced or distributed is surprisingly similar.

The Military Health Care System May Have the Potential to Prevent Health Care Disparities.

Science.gov (United States)

Pierre-Louis, Bosny J; Moore, Angelo D; Hamilton, Jill B

2015-09-01

The existence of health disparities in military populations has become an important topic of research. However, to our knowledge, this is the first study to examine health disparities, as related to access to care and health status, among active duty soldiers and their families. Specifically, the purpose of this analysis was to evaluate whether health disparities exist in access to care and health outcomes of patient satisfaction, physical health status, and mental health status according to race, gender, and sponsor rank in the population of active duty soldiers and their family members. In this cross-sectional study, active duty army soldiers and family members were recruited from either one particular army health clinic where they received their health care or from an adjacent shopping center frequented by eligible participants. Data were collected using validated measures to assess concepts of access to care and health status. Statistical analysis, including one-way analysis of variance (ANOVA) was performed to investigate differences in study outcome measures across four key demographic subgroups: race, gender, sponsor rank, and component (active soldier or family member). A total of 200 participants completed the study questionnaires. The sample consisted of 45.5 % soldiers and 54.5 % family members, with 88.5 % reporting a sponsor rank in the category of junior or senior enlisted rank. Mean scores for access to care did not differ significantly for the groups race/ethnicity (p = 0.53), gender (p = 0.14), and sponsor rank (p = 0.10). Furthermore, no significant differences were observed whether respondents were active soldiers or their family members (p = 0.36). Similarly, there were no statistically significant subgroup (race/ethnicity, gender, sponsor rank, or component) differences in mean patient satisfaction, physical health, and mental health scores. In a health equity system of care such as the military health care system, active duty

Managed care: employers' influence on the health care system.

Science.gov (United States)

Corder, K T; Phoon, J; Barter, M

1996-01-01

Health care reform is a complex issue involving many key sectors including providers, consumers, insurers, employers, and the government. System changes must involve all sectors for reform to be effective. Each sector has a responsibility to understand not only its own role in the health care system, but the roles of others as well. The role of business employers is often not apparent to health care providers, especially nurses. Understanding the influence employers have on the health care system is vital if providers want to be proactive change agents ensuring quality care.

Lithuanian on-line periodicals on the World Wide Web

Directory of Open Access Journals (Sweden)

Lina Sarlauskiene

2001-01-01

Full Text Available Deals with Lithuanian full-text electronic periodicals distributed through the World Wide Web. An electronic periodical is usually defined as a regular publication on some particular topic distributed in digital form, chiefly through the Web, but also by electronic mail or digital disk. The author has surveyed 106 publications. Thirty-four are distributed only on the Web, and 72 have printed versions. The number of analysed publications is not very big, but four years of electronic publishing and the variety of periodicals enables us to establish the causes of this phenomenon, the main features of development, and some perspectives. Electronic periodicals were analysed according to their type, purpose, contents, publisher, regularity, language, starting date and place of publication, and other features.

Youth with special health care needs: transition to adult health care services.

Science.gov (United States)

Oswald, Donald P; Gilles, Donna L; Cannady, Mariel S; Wenzel, Donna B; Willis, Janet H; Bodurtha, Joann N

2013-12-01

Transition to adult services for children and youth with special health care needs (CYSHCN) has emerged as an important event in the life course of individuals with disabilities. Issues that interfere with efficient transition to adult health care include the perspectives of stakeholders, age limits on pediatric service, complexity of health conditions, a lack of experienced healthcare professionals in the adult arena, and health care financing for chronic and complex conditions. The purposes of this study were to develop a definition of successful transition and to identify determinants that were associated with a successful transition. The 2007 Survey of Adult Transition and Health dataset was used to select variables to be considered for defining success and for identifying predictors of success. The results showed that a small percentage of young adults who participated in the 2007 survey had experienced a successful transition from their pediatric care.

Strengthening of Oral Health Systems: Oral Health through Primary Health Care

Science.gov (United States)

Petersen, Poul Erik

2014-01-01

Around the globe many people are suffering from oral pain and other problems of the mouth or teeth. This public health problem is growing rapidly in developing countries where oral health services are limited. Significant proportions of people are underserved; insufficient oral health care is either due to low availability and accessibility of oral health care or because oral health care is costly. In all countries, the poor and disadvantaged population groups are heavily affected by a high burden of oral disease compared to well-off people. Promotion of oral health and prevention of oral diseases must be provided through financially fair primary health care and public health intervention. Integrated approaches are the most cost-effective and realistic way to close the gap in oral health between rich and poor. The World Health Organization (WHO) Oral Health Programme will work with the newly established WHO Collaborating Centre, Kuwait University, to strengthen the development of appropriate models for primary oral health care. PMID:24525450

Influence of Rules for Computing Corporate Income Tax on the Accuracy of Financial Statements of Lithuanian Companies

Directory of Open Access Journals (Sweden)

Cernius Gintaras

2016-03-01

Full Text Available Companies in Lithuania have to follow Business Accounting Standards (BAS when preparing their financial statements. Recording financial transactions according to BAS ensures that the information a company shares with potential lenders and investors gives a true and fair view of its business situation. However, the tax law prescribes its own set of accounting rules, which can result in a difference between what a business shows in financial statements and what it reports on its tax returns. This paper examines whether Lithuanian companies predominantly use tax accounting principles that migrate into their financial statements to create an inaccurate picture of business performance. The method of experts’ evaluation was chosen for that purpose. The results indicate that Lithuanian companies tend to heavily rely on accounting principles prescribed in corporate income tax law thus distorting information contained in financial statements. The paper contributes to the scarce literature on this issue of high relevance to both academics and practitioners.

Mothers' health services utilization and health care seeking ...

African Journals Online (AJOL)

Background: data from different studies showed health care behaviour and estimated per capita health care expenditure for the general population, but the specific data for infants at different levels of care are lacking. The objectives of this study were to describe mothers' health service utilization during pregnancy and ...

Hope for health and health care.

Science.gov (United States)

Stempsey, William E

2015-02-01

Virtually all activities of health care are motivated at some level by hope. Patients hope for a cure; for relief from pain; for a return home. Physicians hope to prevent illness in their patients; to make the correct diagnosis when illness presents itself; that their prescribed treatments will be effective. Researchers hope to learn more about the causes of illness; to discover new and more effective treatments; to understand how treatments work. Ultimately, all who work in health care hope to offer their patients hope. In this paper, I offer a brief analysis of hope, considering the definitions of Hobbes, Locke, Hume and Thomas Aquinas. I then differentiate shallow and deep hope and show how hope in health care can remain shallow. Next, I explore what a philosophy of deep hope in health care might look like, drawing important points from Ernst Bloch and Gabriel Marcel. Finally, I suggest some implications of this philosophy of hope for patients, physicians, and researchers.

Collaborative HIV care in primary health care: nurses' views.

Science.gov (United States)

Ngunyulu, R N; Peu, M D; Mulaudzi, F M; Mataboge, M L S; Phiri, S S

2017-12-01

Collaborative HIV care between the nurses and traditional health practitioners is an important strategy to improve health care of people living with HIV. To explore and describe the views of nurses regarding collaborative HIV care in primary healthcare services in the City of Tshwane, South Africa. A qualitative, descriptive design was used to explore and describe the views of nurses who met the study's inclusion criteria. In-depth individual interviews were conducted to collect data from purposively selected nurses. Content analysis was used to analyse data. Two main categories were developed during the data analysis stage. The views of nurses and health system challenges regarding collaborative HIV care. The study findings revealed that there was inadequate collaborative HIV care between the nurses and the traditional health practitioners. It is evident that there is inadequate policy implementation, monitoring and evaluation regarding collaboration in HIV care. The study findings might influence policymakers to consider the importance of collaborative HIV care, and improve the quality of care by strengthening the referral system and follow-up of people living with HIV and AIDS, as a result the health outcomes as implied in the Sustainable Development Goals 2030 might be improved. Training and involvement of traditional health practitioners in the nursing and health policy should be considered to enhance and build a trustworthy working relationship between the nurses and the traditional health practitioners in HIV care. © 2017 International Council of Nurses.

Engaging men in health care.

Science.gov (United States)

Malcher, Greg

2009-03-01

Engaging men in health care involves a multifaceted approach that has as its main principle the recognition that men consume health care differently to women. This article identifies barriers to engaging men in health care and offers potential and existing solutions to overcome these barriers in a range of health care settings. The concept of multiple masculinities recognises that not all men can be engaged via a particular technique or strategy. The perception that men are disinterested in their health is challenged and a range of approaches discussed, both in the community and in health care facilities. In the general practice setting opportunities exist for the engagement of men at the reception desk and waiting room, as well as during the consultation. Use of the workplace in engaging men is discussed. Future activities to build the capacity of health care providers to better engage men are identified and the role of policy and program development is addressed.

Do socio-economic disparities in dental treatment needs exist in Lithuanian adolescents?

Science.gov (United States)

Aleksejuniene, Jolanta; Brukiene, Vilma

2008-01-01

To explore disparities in needs for dental treatment which arise from individual and area-based socio-economic determinants. A cross-sectional study conducted in 22 randomly selected Lithuanian areas. In each of the pre-selected areas, one secondary school was randomly chosen. A total of 885 15-16-year-olds participated. Outcome measures. Dental treatment need was evaluated following the WHO guidelines and aQuantitative Summative Dental Treatment Needs Index (QSDTNI) was used to calculate the total burden of needs. The information about socio-economical determinants was obtained from a structured questionnaire and national statistics database. Individual socio-economic status (SES) measures were: parents' occupation, family structure, family income and affordability to have holiday used as a proxy measure for income. The area-based SES estimates were: unemployment, average household income, educational attainment, natural increase/decrease of population in an area and net migration rate. Data was analyzed by bivariate and multivariate analyses. None of significant bivariate associations between individual socio-economic variables and the QSDTNI were detected. Among area-based variables natural increase/decrease of population in an area and net migration rate were significantly related to the QSDTNI. Two individual and two area-based factors were extracted and introduced into Linear Multiple Regression Analysis (LMR). The LMR model was significant, but only one factor, i.e. area demographics, significantly contributed to this model. There are no clear social disparities in dental treatment needs in Lithuanian adolescents.

The Development of the Model for the Park and Ride System in the Major Lithuanian Cities

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Vytautas Palevičius

2014-10-01

Full Text Available Park and Ride (P&R is the original transport system of public passengers, acting as a traditional supplement of public transport. The system is becoming widely popular in European cities. The central core of this system is composed of parking facilities in the specified parking areas at the approaches to the city with connections to public transport or special buses that allow people reach the city centre. The P&R system is based on a reduction in car density in the city centre as well as on a decrease in traffic noise, air and visual pollution. Furthermore, the P&R system is an economical and time-saving way to travel. This article has been prepared according to structural support provided by the European Union (EU for the purpose of developing the P&R system in five major Lithuanian cities – Vilnius, Kaunas, Klaipeda, Siauliai and Panevezys. Therefore, this paper is aimed at the development and application of the theoretical model of the P&R system to Lithuanian cities according to external good and bad practice.

Impact of Home Health Care on Health Care Resource Utilization Following Hospital Discharge: A Cohort Study.

Science.gov (United States)

Xiao, Roy; Miller, Jacob A; Zafirau, William J; Gorodeski, Eiran Z; Young, James B

2018-04-01

As healthcare costs rise, home health care represents an opportunity to reduce preventable adverse events and costs following hospital discharge. No studies have investigated the utility of home health care within the context of a large and diverse patient population. A retrospective cohort study was conducted between 1/1/2013 and 6/30/2015 at a single tertiary care institution to assess healthcare utilization after discharge with home health care. Control patients discharged with "self-care" were matched by propensity score to home health care patients. The primary outcome was total healthcare costs in the 365-day post-discharge period. Secondary outcomes included follow-up readmission and death. Multivariable linear and Cox proportional hazards regression were used to adjust for covariates. Among 64,541 total patients, 11,266 controls were matched to 6,363 home health care patients across 11 disease-based Institutes. During the 365-day post-discharge period, home health care was associated with a mean unadjusted savings of $15,233 per patient, or $6,433 after adjusting for covariates (p Home health care independently decreased the hazard of follow-up readmission (HR 0.82, p home health care most benefited patients discharged from the Digestive Disease (death HR 0.72, p home health care was associated with significant reduction in healthcare utilization and decreased hazard of readmission and death. These data inform development of value-based care plans. Copyright © 2018 Elsevier Inc. All rights reserved.

Health care reforms.

Science.gov (United States)

Marušič, Dorjan; Prevolnik Rupel, Valentina

2016-09-01

In large systems, such as health care, reforms are underway constantly. The article presents a definition of health care reform and factors that influence its success. The factors being discussed range from knowledgeable personnel, the role of involvement of international experts and all stakeholders in the country, the importance of electoral mandate and governmental support, leadership and clear and transparent communication. The goals set need to be clear, and it is helpful to have good data and analytical support in the process. Despite all debates and experiences, it is impossible to clearly define the best approach to tackle health care reform due to a different configuration of governance structure, political will and state of the economy in a country.

Health promotion in supplementary health care: outsourcing, microregulation and implications for care.

Science.gov (United States)

Silva, Kênia Lara; Sena, Roseni Rosângela; Rodrigues, Andreza Trevenzoli; Araújo, Fernanda Lopes; Belga, Stephanie Marques Moura Franco; Duarte, Elysângela Dittz

2015-01-01

to analyze health promotion programs in the supplementary health care. This was a multiple case study with a qualitative approach whose data were obtained from interviews with coordinators of providers contracted by the corporations of health insurance plans in Belo Horizonte, Minas Gerais. The data were submitted to Critical Discourse Analysis. Home care has been described as the main action in the field of health promotion transferred to the providers, followed by management of patients and cases, and the health education.groups. The existence of health promotion principles is questionable in all programs. Outsourcing is marked by a process with a division between cost and care management. Implications of this process occur within admission and interventions on the needs of the beneficiaries. Statements revealed rationalization of cost, restructuring of work, and reproduction of the dominant logic of capital accumulation by the health insurance companies.

Fodder quality influence on thorough-bred horses’ health and sport skills

OpenAIRE

Babrauskas, Giedrius

2007-01-01

The purpose of this study was: - To investigate jumping sport horses health conditions influence on sport skills; - To investigate blood parameters in Lithuanian jumping sport horses before and after an active training period. Eight healthy horses ranging in age from 6 to 8 with a mean body weight o 607 +/- 86,9 kg were used in experiment. Blood samples were collected from well trained Lithuanian sport horses and tested before and after an intensive period of competition of 2006. Bi...

Organizing emotions in health care.

Science.gov (United States)

Mark, Annabelle

2005-01-01

To introduce the articles in this special issue, discussing emotion in the in health-care organisations. Discusses such topics as what makes health care different, editorial perspectives, how health care has explored emotion so far, and the impact of emotion on patients and the consequences for staff. Health care provides a setting that juxtaposes emotion and rationality, the individual and the body corporate, the formal and the deeply personal, the public and the private, all of which must be understood better if changes in expectations and delivery are to remain coherent. The papers indicate a shared international desire to understand meaning in emotion that is now spreading across organizational process and into all professional roles within health care.

Comparative analysis of features of Polish and Lithuanian Day-ahead electricity market prices

International Nuclear Information System (INIS)

Bobinaite, Viktorija; Juozapaviciene, Aldona; Staniewski, Marcin; Szczepankowski, Piotr

2013-01-01

The goal of this article is to better understand the processes of electricity market price formation in Poland and Lithuania through an analysis of the features (volatility and spikes) of Lithuanian and Polish day-ahead electricity market prices and to assess how acquired electricity price features could affect the achievement of the main goals of the national energy policy. The following indicators have been calculated to determine electricity market price volatility: the oscillation coefficient, the coefficient of variation, an adjusted coefficient of variation, the standard deviation indicator, the daily velocity indicator (based on the overall average price) and the daily velocity indicator (based on the daily average price). Critical values for electricity market price have been calculated to evaluate price spikes. This analysis reveals that electricity market-price volatility is moderate in Poland and high in Lithuania. Electricity price spikes have been an observable phenomenon both in Lithuanian and in Polish day-ahead electricity markets, but they are more common in Lithuania, encompassing 3.15% of the time period analysed in Poland and 4.68% of the time period analysed in Lithuania. Volatile, spiking and increasing electricity prices in day-ahead electricity markets in Lithuania and Poland create preconditions and substantiate the relevance of implementation of the national energy policies and measures. - Highlights: • Moderate and seasonal volatility. • spiking market price and. • stable average price

US health care crisis.

Science.gov (United States)

Cirić, Ivan

2013-01-01

The United States health care is presently challenged by a significant economic crisis. The purpose of this report is to introduce the readers of Medicinski Pregled to the root causes of this crisis and to explain the steps undertaken to reform health care in order to solve the crisis. It is hoped that the information contained in this report will be of value, if only in small measure, to the shaping of health care in Serbia.

?A constant struggle to receive mental health care?: health care professionals? acquired experience of barriers to mental health care services in Rwanda

OpenAIRE

Rugema, Lawrence; Krantz, Gunilla; Mogren, Ingrid; Ntaganira, Joseph; Persson, Margareta

2015-01-01

BACKGROUND: In Rwanda, many people are still mentally affected by the consequences of the genocide and yet mental health care facilities are scarce. While available literature explains the prevalence and consequences of mental disorders, there is lack of knowledge from low-income countries on health care seeking behavior due to common mental disorders. Therefore, this study sought to explore health care professionals' acquired experiences of barriers and facilitators that people with common m...

Type D (distressed) personality and its assessment with the DS14 in Lithuanian patients with coronary artery disease

NARCIS (Netherlands)

Bunevicius, A.; Staniute, M.; Brozaitiene, J.; Stropute, D.; Bunevicius, R.; Denollet, J.

2013-01-01

We examined Type D personality (combination of negative affectivity with social inhibition) and its assessment with the DS14 in 543 Lithuanian coronary patients. Psychometric analyses confirmed the two-factor structure, internal consistency (α = 0.84/α = 0.75), and test–retest reliability (r =

Health Care Utilisation and Attitudes towards Health Care in Subjects Reporting Environmental Annoyance from Electricity and Chemicals

Directory of Open Access Journals (Sweden)

Frida Eek

2009-01-01

Full Text Available Environmentally intolerant persons report decreased self-rated health and daily functioning. However, it remains unclear whether this condition also results in increased health care costs. The aim of this study was to describe the health care consumption and attitudes towards health care in subjects presenting subjective environmental annoyance in relation to the general population, as well as to a group with a well-known disorder as treated hypertension (HT. Methods. Postal questionnaire (n = 13 604 and record linkage with population-based register on health care costs. Results. Despite significantly lower subjective well being and health than both the general population and HT group, the environmentally annoyed subjects had lower health care costs than the hypertension group. In contrast to the hypertension group, the environmentally annoyed subjects expressed more negative attitudes toward the health care than the general population. Conclusions. Despite their impaired subjective health and functional capacity, health care utilisation costs were not much increased for the environmentally annoyed group. This may partly depend on negative attitudes towards the health care in this group.

Health Care Utilisation and Attitudes towards Health Care in Subjects Reporting Environmental Annoyance from Electricity and Chemicals

Science.gov (United States)

Eek, Frida; Merlo, Juan; Gerdtham, Ulf; Lithman, Thor

2009-01-01

Environmentally intolerant persons report decreased self-rated health and daily functioning. However, it remains unclear whether this condition also results in increased health care costs. The aim of this study was to describe the health care consumption and attitudes towards health care in subjects presenting subjective environmental annoyance in relation to the general population, as well as to a group with a well-known disorder as treated hypertension (HT). Methods. Postal questionnaire (n = 13 604) and record linkage with population-based register on health care costs. Results. Despite significantly lower subjective well being and health than both the general population and HT group, the environmentally annoyed subjects had lower health care costs than the hypertension group. In contrast to the hypertension group, the environmentally annoyed subjects expressed more negative attitudes toward the health care than the general population. Conclusions. Despite their impaired subjective health and functional capacity, health care utilisation costs were not much increased for the environmentally annoyed group. This may partly depend on negative attitudes towards the health care in this group. PMID:19936124

Health Care Utilisation and Attitudes towards Health Care in Subjects Reporting Environmental Annoyance from Electricity and Chemicals

International Nuclear Information System (INIS)

Eek, F.; Merlo, J.; Gerdtham, U.; Lithman, T.

2010-01-01

Environmentally intolerant persons report decreased self-rated health and daily functioning. However, it remains unclear whether this condition also results in increased health care costs. The aim of this study was to describe the health care consumption and attitudes towards health care in subjects presenting subjective environmental annoyance in relation to the general population, as well as to a group with a well-known disorder as treated hypertension (HT). Methods. Postal questionnaire (n = 13 604) and record linkage with population-based register on health care costs. Results. Despite significantly lower subjective well being and health than both the general population and HT group, the environmentally annoyed subjects had lower health care costs than the hypertension group. In contrast to the hypertension group, the environmentally annoyed subjects expressed more negative attitudes toward the health care than the general population. Conclusions. Despite their impaired subjective health and functional capacity, health care utilisation costs were not much increased for the environmentally annoyed group. This may partly depend on negative attitudes towards the health care in this group.

Patterns of acute whiplash-associated disorder in the Lithuanian population after road traffic accidents.

Science.gov (United States)

Pajediene, Evelina; Janusauskaite, Jolita; Samusyte, Gintaute; Stasaitis, Kestutis; Petrikonis, Kestutis; Bileviciute-Ljungar, Indre

2015-01-01

To investigate acute whiplash-associated disorder in the Lithuanian population who are unaware of the phenomenon. Controlled cohort study. Seventy-one patients were enrolled from the emergency departments of the Kaunas region of Lithuania following road traffic accidents, examined within 3-14 days after the accident, and compared with 53 matched controls. Clinical neurological examination, including range of motion and motion-evoked pain or stiffness in the neck; spontaneous pain and pain pressure threshold. Questionnaires: Quebec Task Force questionnaire (QTFQ); Disability Rating Index (DRI); Cognitive Failures Questionnaire (CFQ); Hospital Anxiety and Depression Scale (HADS) and health perception. Sixty-six of 71 (93%) patients developed acute symptoms. The most frequent symptoms found after road traffic accidents were neck or shoulder pain; reduced or painful neck movements, including decreased range of motion; multiple subjective symptoms according to QTFQ and significantly reduced pain threshold. Perceived health status was decreased and DRI was increased, while HADS showed a significantly higher risk of developing anxiety. Higher grade whiplash-associated disorder was linked with a greater reduction in range of motion and more prominent neck pain. Road traffic accidents induce whiplash-associated disorder in patients who seek help, but who are unaware of the condition whiplash-associated disorder. Whiplash-associated disorder should be considered and treated as an entity per se.

Health care delivery systems.

NARCIS (Netherlands)

Stevens, F.; Zee, J. van der

2007-01-01

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

[Costs of maternal-infant care in an institutionalized health care system].

Science.gov (United States)

Villarreal Ríos, E; Salinas Martínez, A M; Guzmán Padilla, J E; Garza Elizondo, M E; Tovar Castillo, N H; García Cornejo, M L

1998-01-01

Partial and total maternal and child health care costs were estimated. The study was developed in a Primary Care Health Clinic (PCHC) and a General Hospital (GH) of a social security health care system. Maternal and child health care services, type of activity and frequency utilization during 1995, were defined; cost examination was done separately for the PCHC and the GH. Estimation of fixed cost included departmentalization, determination of inputs, costs, basic services disbursements, and weighing. These data were related to depreciation, labor period and productivity. Estimation of variable costs required the participation of field experts; costs corresponded to those registered in billing records. The fixed cost plus the variable cost determined the unit cost, which multiplied by the of frequency of utilization generated the prenatal care, labor and delivery care, and postnatal care cost. The sum of these three equaled the maternal and child health care cost. The prenatal care cost was $1,205.33, the labor and delivery care cost was $3,313.98, and the postnatal care was $559.91. The total cost of the maternal and child health care corresponded to $5,079.22. Cost information is valuable for the health care personnel for health care planning activities.

Health care reforms

Directory of Open Access Journals (Sweden)

Marušič Dorjan

2016-09-01

Full Text Available In large systems, such as health care, reforms are underway constantly. The article presents a definition of health care reform and factors that influence its success. The factors being discussed range from knowledgeable personnel, the role of involvement of international experts and all stakeholders in the country, the importance of electoral mandate and governmental support, leadership and clear and transparent communication. The goals set need to be clear, and it is helpful to have good data and analytical support in the process. Despite all debates and experiences, it is impossible to clearly define the best approach to tackle health care reform due to a different configuration of governance structure, political will and state of the economy in a country.

Self-reported oral health behavior and attitudes of dental and technology students in Lithuania.

Science.gov (United States)

Pacauskiene, Ingrida M; Smailiene, Dalia; Siudikienė, Jolanta; Savanevskyte, Julija; Nedzelskiene, Irena

2014-01-01

The aim of the present study was to assess self-reported oral health habits, attitudes, lifestyle between the sample groups of preclinical and clinical dental and technology students in Lithuania using the Hiroshima University Dental Behavioral Inventory (HU-DBI), and to evaluate the impact of education on their behavior and self-reported oral health. A sample of 183 dental and 75 technology students at the Lithuanian University of Health Sciences, Medical Academy, Faculty of Odontology, and Kaunas University of Technology completed the Lithuanian version the HU-DBI questionnaire with 11 additional items. The data were analyzed using the "SPSS 19.0 for Windows" software package. The mean HU-DBI score of clinical final-year dentistry students was significantly higher (p=0.001) than the score of the preclinical group (6.81 (1.2) and 5.96 (1.5), respectively). The mean scores of both groups of dental students were significantly (ptechnology group (5.37 (1.8)). Oral health behaviors and knowledge were superior in dental students. Dental education had a significant positive impact on the oral health and behavior improvement. The attitudes of the Lithuanian dental students should be further improved by initiating a comprehensive program that would emphasize the importance of oral hygiene before the clinical program starts.

Children With Special Health Care Needs: Child Health and Functioning Outcomes and Health Care Service Use.

Science.gov (United States)

Caicedo, Carmen

This study describes health, functioning, and health care service use by medically complex technology-dependent children according to condition severity (moderately disabled, severely disabled, and vegetative state). Data were collected monthly for 5 months using the Pediatric Quality of Life Generic Core Module 4.0 Parent-Proxy Report. Health care service use measured the number of routine and acute care office visits (including primary and specialty physicians), emergency department visits, hospitalizations, nursing health care services, special therapies, medications, medical technology devices (MTDs), and assistive devices. Child physical health was different across the condition severity groups. The average age of the children was 10.1 years (SD, 6.2); the average number of medications used was 5.5 (SD, 3.7); the average number of MTDs used was 4.2 (SD, 2.9); and the average number of assistive devices used was 4.3 (SD, 2.7). Severely disabled and vegetative children were similar in age (older) and had a similar number of medications, MTDs, and assistive devices (greater) than moderately disabled children. The advanced practice nurse care coordinator role is necessary for the health and functioning of medically complex, technology-dependent children. Copyright © 2016 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

The ethical self-fashioning of physicians and health care systems in culturally appropriate health care.

Science.gov (United States)

Shaw, Susan J; Armin, Julie

2011-06-01

Diverse advocacy groups have pushed for the recognition of cultural differences in health care as a means to redress inequalities in the U.S., elaborating a form of biocitizenship that draws on evidence of racial and ethnic health disparities to make claims on both the state and health care providers. These efforts led to federal regulations developed by the U.S. Office of Minority Health requiring health care organizations to provide Culturally and Linguistically Appropriate Services. Based on ethnographic research at workshops and conferences, in-depth interviews with cultural competence trainers, and an analysis of postings to a moderated listserv with 2,000 members, we explore cultural competence trainings as a new type of social technology in which health care providers and institutions are urged to engage in ethical self-fashioning to eliminate prejudice and embody the values of cultural relativism. Health care providers are called on to re-orient their practice (such as habits of gaze, touch, and decision-making) and to act on their own subjectivities to develop an orientation toward Others that is "culturally competent." We explore the diverse methods that cultural competence trainings use to foster a health care provider's ability to be self-reflexive, including face-to-face workshops and classes and self-guided on-line modules. We argue that the hybrid formation of culturally appropriate health care is becoming detached from its social justice origins as it becomes rationalized by and more firmly embedded in the operations of the health care marketplace.

What is the health care product?

Science.gov (United States)

France, K R; Grover, R

1992-06-01

Because of the current competitive environment, health care providers (hospitals, HMOs, physicians, and others) are constantly searching for better products and better means for delivering them. The health care product is often loosely defined as a service. The authors develop a more precise definition of the health care product, product line, and product mix. A bundle-of-elements concept is presented for the health care product. These conceptualizations help to address how health care providers can segment their market and position, promote, and price their products. Though the authors focus on hospitals, the concepts and procedures developed are applicable to other health care organizations.

Current employment characteristics and career intentions of Lithuanian dentists.

Science.gov (United States)

Janulyte, Vilija; Aleksejuniene, Jolanta; Puriene, Alina; Peciuliene, Vytaute; Benzian, Habib

2014-12-20

The present survey explored the current employment profile and future career intentions of Lithuanian general dentists and specialists. A census sampling method was employed with data collected by means of a structured questionnaire that inquired about demographics, different employment-related aspects (practice type and location, working hours, perceived lack of patients, etc.), and future career intentions (intent to emigrate, to change profession, or the timing of retirement). The final response rate was 67.6% corresponding to 2,008 respondents. The majority of all dentists work full or part-time in the private dental sector, more than one third of them owns a private practice or rents a dental chair. A minority of dentists works in the public dental sector. According to the survey, 26.6% of general dentists and 39.2% of dental specialists works overtime (> 40 hours per week; P 0.05). The majority (68.9% of general dentists and 65.9% of dental specialists) plans to work after the retirement age (P > 0.05). Emigration as an option for their professional career is being considered by 10.8% of general dentists and 8.3% of dental specialists (P > 0.05). Working either full or part-time in private practices (OR = 4.3) and younger age (≤ 35 years; OR = 2.2) are the two strongest predictors for a perceived insufficient number of patients. One third of dentists in Lithuania work long hours and lack patients. Many dentists practice in multiple locations and plan to retire after the official retirement age. Some dentists and dental specialists plan to emigrate. The perceived shortcomings within the dental care system and workforce planning of dentists need to be addressed.

Optimizing Health Care Environmental Hygiene.

Science.gov (United States)

Carling, Philip C

2016-09-01

This article presents a review and perspectives on aspects of optimizing health care environmental hygiene. The topics covered include the epidemiology of environmental surface contamination, a discussion of cleaning health care patient area surfaces, an overview of disinfecting health care surfaces, an overview of challenges in monitoring cleaning versus cleanliness, a description of an integrated approach to environmental hygiene and hand hygiene as interrelated disciplines, and an overview of the research opportunities and challenges related to health care environmental hygiene. Copyright © 2016 Elsevier Inc. All rights reserved.

Integrated primary health care in Australia

Directory of Open Access Journals (Sweden)

Gawaine Powell Davies

2009-10-01

Full Text Available Introduction: To fulfil its role of coordinating health care, primary health care needs to be well integrated, internally and with other health and related services. In Australia, primary health care services are divided between public and private sectors, are responsible to different levels of government and work under a variety of funding arrangements, with no overarching policy to provide a common frame of reference for their activities. Description of policy: Over the past decade, coordination of service provision has been improved by changes to the funding of private medical and allied health services for chronic conditions, by the development in some states of voluntary networks of services and by local initiatives, although these have had little impact on coordination of planning. Integrated primary health care centres are being established nationally and in some states, but these are too recent for their impact to be assessed. Reforms being considered by the federal government include bringing primary health care under one level of government with a national primary health care policy, establishing regional organisations to coordinate health planning, trialling voluntary registration of patients with general practices and reforming funding systems. If adopted, these could greatly improve integration within primary health care. Discussion: Careful change management and realistic expectations will be needed. Also other challenges remain, in particular the need for developing a more population and community oriented primary health care.

Integrated primary health care in Australia.

Science.gov (United States)

Davies, Gawaine Powell; Perkins, David; McDonald, Julie; Williams, Anna

2009-10-14

To fulfil its role of coordinating health care, primary health care needs to be well integrated, internally and with other health and related services. In Australia, primary health care services are divided between public and private sectors, are responsible to different levels of government and work under a variety of funding arrangements, with no overarching policy to provide a common frame of reference for their activities. Over the past decade, coordination of service provision has been improved by changes to the funding of private medical and allied health services for chronic conditions, by the development in some states of voluntary networks of services and by local initiatives, although these have had little impact on coordination of planning. Integrated primary health care centres are being established nationally and in some states, but these are too recent for their impact to be assessed. Reforms being considered by the federal government include bringing primary health care under one level of government with a national primary health care policy, establishing regional organisations to coordinate health planning, trialling voluntary registration of patients with general practices and reforming funding systems. If adopted, these could greatly improve integration within primary health care. Careful change management and realistic expectations will be needed. Also other challenges remain, in particular the need for developing a more population and community oriented primary health care.

Practices of depression care in home health care: Home health clinician perspectives

Science.gov (United States)

Bao, Yuhua; Eggman, Ashley A.; Richardson, Joshua E.; Sheeran, Thomas; Bruce, Martha L.

2015-01-01

Objective To assess any gaps between published best practices and real-world practices of treating depression in home health care (HHC), and barriers to closing any gaps. Methods A qualitative study based on semi-structured interviews with HHC nurses and administrators from five home health agencies in five states (n=20). Audio-recorded interviews were transcribed and analyzed by a multi-disciplinary team using grounded theory method to identify themes. Results Routine home health nursing care overlapped with all functional areas of depression care. However, there were reported gaps between best practices and real-world practices. Gaps were associated with perceived scope of practice by HHC nurses, knowledge gaps and low self-efficacy in depression treatment, stigma attached to depression, poor quality of antidepressant management in primary care, and poor communication between HHC and primary care. Conclusions Strategies to close gaps between typical and best practices need to enhance HHC clinician knowledge and self-efficacy with depression treatment and improve the quality of antidepressant management and communication with primary care. PMID:26423098

Towards Sustainable Health Care Organizations

Directory of Open Access Journals (Sweden)

Mauro ROMANELLI

2017-09-01

Full Text Available Health care organizations have to develop a sustainable path for creating public value by seeking legitimacy for building and maintaining public trust with patients as social and economic institutions creating value and sustaining both health and wealth for people and communities within society. Health care organizations having at disposal decreasing resources and meeting increasing demands of citizens are following an unsustainable path. Designing sustainable health care systems and organizations is emerging as a strategic goal for developing the wealth of people and communities over time. Building sustainable organizations relies on valuing human resources, designing efficient and effective processes, using technology for better managing the relationships within and outside organizations. Sustainable health care organizations tend to rediscover the importance of human resource management and policies for effectively improving communication with patients and building trust-based relationships. While processes of accreditation contribute to legitimizing effectiveness and quality of health care services and efficient processes, introducing and using new information and communication technologies (ICTs and informatics helps communication leading to restore trust-based relationships between health care institutions and patients for value creation within society.

Association of HFE gene C282Y and H63D mutations with liver cirrhosis in the Lithuanian population

Directory of Open Access Journals (Sweden)

Simonas Juzėnas

2016-01-01

Conclusions: Heterozygous C282Y mutation of the HFE gene was associated with liver cirrhosis in the Lithuanian population. In gender-related analysis, heterozygous C282Y and homozygous H63D mutations were linked to liver cirrhosis in men, not in women.

Adherence and health care costs

Directory of Open Access Journals (Sweden)

Iuga AO

2014-02-01

Full Text Available Aurel O Iuga,1,2 Maura J McGuire3,4 1Johns Hopkins Bloomberg School of Public Health, 2Johns Hopkins University, 3Johns Hopkins Community Physicians, 4Johns Hopkins University School of Medicine, Baltimore, MD, USA Abstract: Medication nonadherence is an important public health consideration, affecting health outcomes and overall health care costs. This review considers the most recent developments in adherence research with a focus on the impact of medication adherence on health care costs in the US health system. We describe the magnitude of the nonadherence problem and related costs, with an extensive discussion of the mechanisms underlying the impact of nonadherence on costs. Specifically, we summarize the impact of nonadherence on health care costs in several chronic diseases, such as diabetes and asthma. A brief analysis of existing research study designs, along with suggestions for future research focus, is provided. Finally, given the ongoing changes in the US health care system, we also address some of the most relevant and current trends in health care, including pharmacist-led medication therapy management and electronic (e-prescribing. Keywords: patient, medication, adherence, compliance, nonadherence, noncompliance, cost

Advancing adolescent health and health services in Saudi Arabia: exploring health-care providers' training, interest, and perceptions of the health-care needs of young people

Directory of Open Access Journals (Sweden)

AlBuhairan FS

2014-09-01

Full Text Available Fadia S AlBuhairan,1–3 Tina M Olsson3,4 1Department of Pediatrics, King Abdulaziz Medical City, Riyadh, Saudi Arabia; 2King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; 3King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; 4School of Social Work, Lund University, Lund, Sweden Background: Adolescent health is regarded as central to global health goals. Investments made in adolescent health and health services protect the improvements witnessed in child health. Though Saudi Arabia has a large adolescent population, adolescent health-care only began to emerge in recent years, yet widespread uptake has been very limited. Health-care providers are key in addressing and providing the necessary health-care services for adolescents, and so this study was conducted with the aim of identifying opportunities for the advancement of knowledge transfer for adolescent health services in Saudi Arabia. Methods: This Web-based, cross-sectional study was carried out at four hospitals in Saudi Arabia. Physicians and nurses were invited to participate in an online survey addressing their contact with adolescent patients, and training, knowledge, and attitudes towards adolescent health-care. Results: A total of 232 professionals participated. The majority (82.3% reported sometimes or always coming into contact with adolescent patients. Less than half (44%, however, had received any sort of training on adolescent health during their undergraduate or postgraduate education, and only 53.9% reported having adequate knowledge about the health-care needs of adolescents. Nurses perceived themselves as having more knowledge in the health-care needs of adolescents and reported feeling more comfortable in communicating with adolescents as compared with physicians. The majority of participants were interested in gaining further skills and knowledge in adolescent health-care and agreed or strongly agreed that adolescents have

[Strengthening primary health care: a strategy to maximize coordination of care].

Science.gov (United States)

de Almeida, Patty Fidelis; Fausto, Márcia Cristina Rodrigues; Giovanella, Lígia

2011-02-01

To describe and analyze the actions developed in four large cities to strengthen the family health strategy (FHS) in Brazil. Case studies were carried out in Aracaju, Belo Horizonte, Florianópolis, and Vitória based on semi-structured interviews with health care managers. In addition, a cross-sectional study was conducted with questionnaires administered to a sample of FHS workers and services users. Actions needed to strengthen primary health care services were identified in all four cities. These include increasing the number of services offered at the primary health care level, removing barriers to access, restructuring primary services as the entry point to the health care system, enhancing problem-solving capacity (diagnostic and therapeutic support and networking between health units to organize the work process, training, and supervision), as well as improving articulation between surveillance and care actions. The cities studied have gained solid experience in the reorganization of the health care model based on a strengthening of health primary care and of the capacity to undertake the role of health care coordinator. However, to make the primary care level the customary entry point and first choice for users, additional actions are required to balance supplier-induced and consumer-driven demands. Consumer driven demand is the biggest challenge for the organization of teamwork processes. Support for and recognition of FHS as a basis for primary health care is still an issue. Initiatives to make FHS better known to the population, health care professionals at all levels, and civil society organizations are still needed.

Reducing Ex-offender Health Disparities through the Affordable Care Act: Fostering Improved Health Care Access and Linkages to Integrated Care

Directory of Open Access Journals (Sweden)

Lacreisha Ejike-King

2014-04-01

Full Text Available Despite steadily declining incarceration rates overall, racial and ethnic minorities, namely African Americans, Latinos, and American Indians and Alaska Natives, continue to be disproportionately represented in the justice system. Ex-offenders commonly reenter communities with pressing health conditions but encounter obstacles to accessing care and remaining in care. The lack of health insurance coverage and medical treatment emerge as the some of the most reported reentry health needs and may contribute to observed health disparities. Linking ex-offenders to care and services upon release increases the likelihood that they will remain in care and practice successful disease management. The Affordable Care Act (ACA offers opportunities to address health disparities experienced by the reentry population that places them at risk for negative health outcomes and recidivism. Coordinated efforts to link ex-offenders with these newly available opportunities may result in a trajectory for positive health and overall well-being as they reintegrate into society.

How to achieve care coordination inside health care organizations

DEFF Research Database (Denmark)

Prætorius, Thim; C. Becker, Markus

2015-01-01

Understanding how health care organizations can achieve care coordination internally is essential because it is difficult to achieve, but essential for high quality and efficient health care delivery. This article offers an answer by providing a synthesis of knowledge about coordination from...

Health Care Reform: a Socialist Vision

Directory of Open Access Journals (Sweden)

Martha Livingston

2010-04-01

Full Text Available At first glance, it doesn't seem as though socialism and health-care reform have a whole lot to do with each other. After all, the most visible "left" position in the current discussion of health-care reform merely advocates for the government to assume the function of national insurer, leaving the delivery of health care - from its often-questionable content to its hierarchical relationships - firmly in place. As such, a single payer, Medicare-for-All insurance program is a modest, even tepid reform. Those of us on the left who have been active in the single payer movement have always seen it as a steppingstone toward health-care justice: until the question of access to care is solved, how do we even begin to address not only health care but also health inequities? How, for example, can working-class Americans, Americans of color, and women demand appropriate, respectful, humane, first-rate care when our ability to access any health-care services at all is so tightly constrained?

Gender disparities in health care.

Science.gov (United States)

Kent, Jennifer A; Patel, Vinisha; Varela, Natalie A

2012-01-01

The existence of disparities in delivery of health care has been the subject of increased empirical study in recent years. Some studies have suggested that disparities between men and women exist in the diagnoses and treatment of health conditions, and as a result measures have been taken to identify these differences. This article uses several examples to illustrate health care gender bias in medicine. These examples include surgery, peripheral artery disease, cardiovascular disease, critical care, and cardiovascular risk factors. Additionally, we discuss reasons why these issues still occur, trends in health care that may address these issues, and the need for acknowledgement of the current system's inequities in order to provide unbiased care for women in the future. © 2012 Mount Sinai School of Medicine.

Gender and communication style in general practice: differences between women's health care and regular health care.

NARCIS (Netherlands)

Brink-Muinen, A. van den; Bensing, J.M.; Kerssens, J.J.

1998-01-01

Objectives: differences were investigated between general practitioners providing women's health care (4 women) and general practitioners providing regular health care (8 women and 8 men). Expectations were formulated on the basis of the principles of women's health care and literature about gender

Health care law versus constitutional law.

Science.gov (United States)

Hall, Mark A

2013-04-01

National Federation of Independent Business v. Sebelius, the Supreme Court's ruling on the Patient Protection and Affordable Care Act, is a landmark decision - both for constitutional law and for health care law and policy. Others will study its implications for constitutional limits on a range of federal powers beyond health care. This article considers to what extent the decision is also about health care law, properly conceived. Under one view, health care law is the subdiscipline that inquires how courts and government actors take account of the special features of medicine that make legal or policy issues especially problematic - rather than regarding health care delivery and finance more generically, like most any other economic or social enterprise. Viewed this way, the opinions from the Court's conservative justices are mainly about general constitutional law principles. In contrast, Justice Ruth Bader Ginsburg's dissenting opinion for the four more liberal justices is just as much about health care law as it is about constitutional law. Her opinion gives detailed attention to the unique features of health care finance and delivery in order to inform her analysis of constitutional precedents and principles. Thus, the Court's multiple opinions give a vivid depiction of the compelling contrasts between communal versus individualistic conceptions of caring for those in need, and between health care and health insurance as ordinary commodities versus ones that merit special economic, social, and legal status.

Quality Improvement in Athletic Health Care.

Science.gov (United States)

Lopes Sauers, Andrea D; Sauers, Eric L; Valier, Alison R Snyder

2017-11-01

  Quality improvement (QI) is a health care concept that ensures patients receive high-quality (safe, timely, effective, efficient, equitable, patient-centered) and affordable care. Despite its importance, the application of QI in athletic health care has been limited.   To describe the need for and define QI in health care, to describe how to measure quality in health care, and to present a QI case in athletic training.   As the athletic training profession continues to grow, a widespread engagement in QI efforts is necessary to establish the value of athletic training services for the patients that we serve. A review of the importance of QI in health care, historical perspectives of QI, tools to drive QI efforts, and examples of common QI initiatives is presented to assist clinicians in better understanding the value of QI for advancing athletic health care and the profession. Clinical and Research Advantages:  By engaging clinicians in strategies to measure outcomes and improve their patient care services, QI practice can help athletic trainers provide high-quality and affordable care to patients.

Discrimination and Delayed Health Care Among Transgender Women and Men: Implications for Improving Medical Education and Health Care Delivery.

Science.gov (United States)

Jaffee, Kim D; Shires, Deirdre A; Stroumsa, Daphna

2016-11-01

The transgender community experiences health care discrimination and approximately 1 in 4 transgender people were denied equal treatment in health care settings. Discrimination is one of the many factors significantly associated with health care utilization and delayed care. We assessed factors associated with delayed medical care due to discrimination among transgender patients, and evaluated the relationship between perceived provider knowledge and delayed care using Anderson's behavioral model of health services utilization. Multivariable logistic regression analysis was used to test whether predisposing, enabling, and health system factors were associated with delaying needed care for transgender women and transgender men. A sample of 3486 transgender participants who took part in the National Transgender Discrimination Survey in 2008 and 2009. Predisposing, enabling, and health system environment factors, and delayed needed health care. Overall, 30.8% of transgender participants delayed or did not seek needed health care due to discrimination. Respondents who had to teach health care providers about transgender people were 4 times more likely to delay needed health care due to discrimination. Transgender patients who need to teach their providers about transgender people are significantly more likely to postpone or not seek needed care. Systemic changes in provider education and training, along with health care system adaptations to ensure appropriate, safe, and respectful care, are necessary to close the knowledge and treatment gaps and prevent delayed care with its ensuing long-term health implications.

Health care and equity in India.

Science.gov (United States)

Balarajan, Y; Selvaraj, S; Subramanian, S V

2011-02-05

In India, despite improvements in access to health care, inequalities are related to socioeconomic status, geography, and gender, and are compounded by high out-of-pocket expenditures, with more than three-quarters of the increasing financial burden of health care being met by households. Health-care expenditures exacerbate poverty, with about 39 million additional people falling into poverty every year as a result of such expenditures. We identify key challenges for the achievement of equity in service provision, and equity in financing and financial risk protection in India. These challenges include an imbalance in resource allocation, inadequate physical access to high-quality health services and human resources for health, high out-of-pocket health expenditures, inflation in health spending, and behavioural factors that affect the demand for appropriate health care. Use of equity metrics in monitoring, assessment, and strategic planning; investment in development of a rigorous knowledge base of health-systems research; development of a refined equity-focused process of deliberative decision making in health reform; and redefinition of the specific responsibilities and accountabilities of key actors are needed to try to achieve equity in health care in India. The implementation of these principles with strengthened public health and primary-care services will help to ensure a more equitable health care for India's population. Copyright © 2011 Elsevier Ltd. All rights reserved.

Lithuanian medical tourism cluster: conditions and background for functioning

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Korol A. N.

2017-10-01

Full Text Available as the global economy develops, more and more attention is paid to the creation of tourist clusters, which are extremely important for the economy and national competitiveness. This article analyzes the cluster of medical tourism in Lithuania, and explores the conditions for its successful functioning. The creation of the medical tourism cluster is highly influenced by a number of factors: the regulation of tourist and medical services, the level of entrepreneurial activity, human resources, the experience of partnership. In addition, the article analyzes the structure of the medical tourism cluster, determines the prerequisites for the functioning of the Lithuanian medical tourism cluster, including a wide range of services, European standards for the provision of medical services, high qualification of specialists, etc. When writing the article, the methods of systematic and logical analysis of scientific literature were used.

Employment preferences of Lithuanian MA graduates in economic studies

Directory of Open Access Journals (Sweden)

Vaitiekus Novikevičius

2009-12-01

Full Text Available People may demonstrate preferences for different alternatives when choosing a workplace, for example: wages, career opportunities or workplace location. It is therefore important to determine which of the alternatives provides the maximum performance for the respondents. For this purpose, the authors have carried out extensive research of utility functions, originated theoretical models and / or employed practically. Unfortunately, there has been a lack of such research in Lithuania. The paper aims to examine the preferences and financial incentives based on the utility aspect Lithuanian master’s graduates in economic studies, including financial incentives, when they choose a workplace. The paper formulates the definition of the utility functions and the analysis its types. Moreover, it analyzes the utility functions of the MA graduates in economic studies from four universities, distinguishes their preferences and major financial incentives which give them the maximum utility.

Health care of youth aging out of foster care.

Science.gov (United States)

2012-12-01

Youth transitioning out of foster care face significant medical and mental health care needs. Unfortunately, these youth rarely receive the services they need because of lack of health insurance. Through many policies and programs, the federal government has taken steps to support older youth in foster care and those aging out. The Fostering Connections to Success and Increasing Adoptions Act of 2008 (Pub L No. 110-354) requires states to work with youth to develop a transition plan that addresses issues such as health insurance. In addition, beginning in 2014, the Patient Protection and Affordable Care Act of 2010 (Pub L No. 111-148) makes youth aging out of foster care eligible for Medicaid coverage until age 26 years, regardless of income. Pediatricians can support youth aging out of foster care by working collaboratively with the child welfare agency in their state to ensure that the ongoing health needs of transitioning youth are met.

The Impact of Health Insurance on Health Care Provision in ...

African Journals Online (AJOL)

This study assesses the impact of the NHIS scheme in promoting access to health care. It identifies a need for all stakeholders to engage in the active promotion of awareness on health insurance as option of health care provisioning. It argues that health insurance can make health care more accessible to a wider segment ...

What Contributes Most to High Health Care Costs? Health Care Spending in High Resource Patients.

Science.gov (United States)

Pritchard, Daryl; Petrilla, Allison; Hallinan, Shawn; Taylor, Donald H; Schabert, Vernon F; Dubois, Robert W

2016-02-01

U.S. health care spending nearly doubled in the decade from 2000-2010. Although the pace of increase has moderated recently, the rate of growth of health care costs is expected to be higher than the growth in the economy for the near future. Previous studies have estimated that 5% of patients account for half of all health care costs, while the top 1% of spenders account for over 27% of costs. The distribution of health care expenditures by type of service and the prevalence of particular health conditions for these patients is not clear, and is likely to differ from the overall population. To examine health care spending patterns and what contributes to costs for the top 5% of managed health care users based on total expenditures. This retrospective observational study employed a large administrative claims database analysis of health care claims of managed care enrollees across the full age and care spectrum. Direct health care expenditures were compared during calendar year 2011 by place of service (outpatient, inpatient, and pharmacy), payer type (commercially insured, Medicare Advantage, and Medicaid managed care), and therapy area between the full population and high resource patients (HRP). The mean total expenditure per HRP during calendar year 2011 was $43,104 versus $3,955 per patient for the full population. Treatment of back disorders and osteoarthritis contributed the largest share of expenditures in both HRP and the full study population, while chronic renal failure, heart disease, and some oncology treatments accounted for disproportionately higher expenditures in HRP. The share of overall expenditures attributed to inpatient services was significantly higher for HRP (40.0%) compared with the full population (24.6%), while the share of expenditures attributed to pharmacy (HRP = 18.1%, full = 21.4%) and outpatient services (HRP = 41.9%, full = 54.1%) was reduced. This pattern was observed across payer type. While the use of physician

Process integration and waste heat recovery in Lithuanian and Danish industry. Final report phase 1

Energy Technology Data Exchange (ETDEWEB)

NONE

1998-08-01

The present document forms the Final Report for the first phase of the project `Process Integration and Waste Heat Recovery in Lithuanian and Danish Industry`. The project is carried out in the period 1995-1998 in a co-operation between the COWI offices in Lyngby and Vilnius, The Technical University of Denmark (Institute for Energetics), Kaunas University of Technology (CIPAI) and Vilnius Technical University, financed by The Danish Ministry of Energy`s EFP-95-programme, Lithuanian Energy Agency as well as the participants. The first phase of the project has comprised the establishment of the CIPAI centre (Centre for Industrial Process Analysis and Integration) at Kaunas University of Technology, training and knowledge transfer as well as elaboration of 6 industrial case-studies within the area of `Process Integration and waste Heat Recovery`. The second phase of the project has comprised R and D activities in this area in order to present general conclusions from the project as well as to present new and improved methods and tools for PI-analysis. The aim of the Final Report for the first phase of the project is to summarise project activities and the achieved results from case-studies and from the operation of the CIPAI-centre in general. (au)

Challenges in mental health care in the Family Health Strategy

Directory of Open Access Journals (Sweden)

Consuelo Helena Aires de Freitas

2011-06-01

Full Text Available Objective: To discuss the practice of mental health care performed by healthcare professionals from the Family Health Strategy in Fortaleza-CE, Brazil. Methods: This is a critical and reflective study conducted in six Basic Health Units in Fortaleza-Ce. The study subjects were 12 health workers of the following professions: doctor, nurse, community health agents and technical and/or nursing assistant. Semi-structured interviews, systematic observationand questionnaire were used for data collection. The empirical analysis was based on an understanding of the discourses through critical hermeneutics. Results: It was evident that the mental health services are developed by some health workers in the ESF, such as, matrix support, relational technologies, home visits and community group therapy. However, there is still deficiency in training/coaching by most professionals in primary care, due to anenduring model of pathological or curative health care. Conclusion: Mental health care is still occasionally held by some workers in primary care. However, some progresses are already present as matrix support, relational technologies in health care, home visits andcommunity therapy.

Health Care Performance Indicators for Health Information Systems.

Science.gov (United States)

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

2016-01-01

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

Attending Unintended Transformations of Health Care Infrastructure

DEFF Research Database (Denmark)

Wentzer, Helle; Bygholm, Ann

2007-01-01

Introduction: Western health care is under pressure from growing demands on quality and efficiency. The development and implementation of information technology, IT is a key mean of health care authorities to improve on health care infrastructure. Theory and methods: Against a background of theor......Introduction: Western health care is under pressure from growing demands on quality and efficiency. The development and implementation of information technology, IT is a key mean of health care authorities to improve on health care infrastructure. Theory and methods: Against a background...

The Oral Health Care Manager in a Patient-Centered Health Facility.

Science.gov (United States)

Theile, Cheryl Westphal; Strauss, Shiela M; Northridge, Mary Evelyn; Birenz, Shirley

2016-06-01

The dental hygienist team member has an opportunity to coordinate care within an interprofessional practice as an oral health care manager. Although dental hygienists are currently practicing within interprofessional teams in settings such as pediatric offices, hospitals, nursing homes, schools, and federally qualified health centers, they often still assume traditional responsibilities rather than practicing to the full extent of their training and licenses. This article explains the opportunity for the dental hygiene professional to embrace patient-centered care as an oral health care manager who can facilitate integration of oral and primary care in a variety of health care settings. Based on an innovative model of collaboration between a college of dentistry and a college of nursing, an idea emerged among several faculty members for a new management method for realizing continuity and coordination of comprehensive patient care. Involved faculty members began working on the development of an approach to interprofessional practice with the dental hygienist serving as an oral health care manager who would address both oral health care and a patient's related primary care issues through appropriate referrals and follow-up. This approach is explained in this article, along with the results of several pilot studies that begin to evaluate the feasibility of a dental hygienist as an oral health care manager. A health care provider with management skills and leadership qualities is required to coordinate the interprofessional provision of comprehensive health care. The dental hygienist has the opportunity to lead closer integration of oral and primary care as an oral health care manager, by coordinating the team of providers needed to implement comprehensive, patient-centered care. Copyright © 2016 Elsevier Inc. All rights reserved.

Diaspora, disease, and health care.

Science.gov (United States)

Wick, Jeannette Y; Zanni, Guido R

2007-03-01

When groups of people relocate from their homelands to other nations, especially if the movement is involuntary, minority populations are created in the countries that receive them. The issues related to these diaspora and diasporic communities--any groups that have been dispersed outside their traditional homelands--are financial, social, historical, political, or religious. In health care, issues include heritable diseases, cultural barriers, patients' health care beliefs, and unique disease presentations. In long-term care, many residents and health care providers have relocated to the United States from other countries.

Have out-of-pocket health care payments risen under free health care policy? The case of Sri Lanka.

Science.gov (United States)

Pallegedara, Asankha; Grimm, Michael

2018-04-26

Compared to its neighbors, Sri Lanka performs well in terms of health. Health care is provided for free in the public sector, yet households' out-of-pocket health expenditures are steadily increasing. We explore whether this increase can be explained by supply shortages and insufficient public health care financing or whether it is rather the result of an income-induced demand for supplementary and higher quality services from the private sector. We focus on total health care expenditures and health care expenditures for specific services such as expenses on private outpatient treatments and expenses on laboratory and other diagnostic services. Overall, we find little indication that limited supply of public health care per se pushes patients into the private sector. Yet income is identified as one key driver of rising health care expenditures, ie, as households get richer, they spend an increasing amount on private services suggesting a dissatisfaction with the quality offered by the public sector. Hence, quality improvements in the public sector seem to be necessary to ensure sustainability of the public health care sector. If the rich and the middle class increasingly opt out of public health care, the willingness to pay taxes to finance the free health care policy will certainly shrink. Copyright © 2018 The Authors. The International Journal of Health Planning and Management published by John Wiley & Sons Ltd.

Health system challenges to integration of mental health delivery in primary care in Kenya--perspectives of primary care health workers.

Science.gov (United States)

Jenkins, Rachel; Othieno, Caleb; Okeyo, Stephen; Aruwa, Julyan; Kingora, James; Jenkins, Ben

2013-09-30

Health system weaknesses in Africa are broadly well known, constraining progress on reducing the burden of both communicable and non-communicable disease (Afr Health Monitor, Special issue, 2011, 14-24), and the key challenges in leadership, governance, health workforce, medical products, vaccines and technologies, information, finance and service delivery have been well described (Int Arch Med, 2008, 1:27). This paper uses focus group methodology to explore health worker perspectives on the challenges posed to integration of mental health into primary care by generic health system weakness. Two ninety minute focus groups were conducted in Nyanza province, a poor agricultural region of Kenya, with 20 health workers drawn from a randomised controlled trial to evaluate the impact of a mental health training programme for primary care, 10 from the intervention group clinics where staff had received the training programme, and 10 health workers from the control group where staff had not received the training). These focus group discussions suggested that there are a number of generic health system weaknesses in Kenya which impact on the ability of health workers to care for clients with mental health problems and to implement new skills acquired during a mental health continuing professional development training programmes. These weaknesses include the medicine supply, health management information system, district level supervision to primary care clinics, the lack of attention to mental health in the national health sector targets, and especially its absence in district level targets, which results in the exclusion of mental health from such district level supervision as exists, and the lack of awareness in the district management team about mental health. The lack of mental health coverage included in HIV training courses experienced by the health workers was also striking, as was the intensive focus during district supervision on HIV to the detriment of other

Self-publishing of Lithuanian cultural periodicals in Soviet and contemporary times

Directory of Open Access Journals (Sweden)

Asta Urbanaviciute

2015-07-01

Full Text Available The aim of this article is to analyse self-publishing trends of Lithuanian cultural periodicals focusing on the historical and contemporary contexts. The article provides an overview of the reasons for historical cultural periodical self-published texts, known as samizdats, to appear, as well as their publishing and circulation trends in Lithuania. It also analyses what contemporary cultural self-publishing is: whether it is a completely independent, logical consequence of the digital age, which emerged under favourable circumstances, or if it can be characterized as having something in common with the past experiences. The most active years of the periodical underground press publishing in Soviet Lithuanian self-publishing development were between 1975 and 1981. Self-published texts ideologically diverged into three main directions: religious, civic, and cultural-artistic. A total of 22 publications were being published for a longer or shorter period of time. While analysing contemporary cultural self-publishing topics, the report focuses only on online cultural texts, irrespective of the printed ones. Survey method was used to find out how much and in what aspect modern Internet users perceive historical periodical self-publishing, and how and in what aspect they value modern cultural self-published texts. The results show that 18-35-year-old respondents have not acquired the skills necessary to analyse samizdat publishing. They associate the word self-publishing with digital texts only, which due to favourable conditions spread easily through social networks and blogs. In the era of advancing computer technologies and the Internet, every person who has the time and desire may become a developer, an author, or at least a disseminator of information: this tradition is becoming more and more topical and quite frequently – an almost self-evident phenomenon.

Health care entrepreneurship: financing innovation.

Science.gov (United States)

Grazier, Kyle L; Metzler, Bridget

2006-01-01

Entrepreneurship is often described as the ability to create new ventures from new or existing concepts, ideas and visions. There has been significant entrepreneurial response to the changes in the scientific and social underpinnings of health care services delivery. However, a growing portion of the economic development driving health care industry expansion is threatened further by longstanding use of financing models that are suboptimal for health care ventures. The delayed pace of entrepreneurial activity in this industry is in part a response to the general economy and markets, but also due to the lack of capital for new health care ventures. The recent dearth of entrepreneurial activities in the health services sector may also due to failure to consider new approaches to partnerships and strategic ventures, despite their mutually beneficial organizational and financing potential. As capital becomes more scarce for innovators, it is imperative that those with new and creative ideas for health and health care improvement consider techniques for capital acquisition that have been successful in other industries and at similar stages of development. The capital and added expertise can allow entrepreneurs to leverage resources, dampen business fluctuations, and strengthen long term prospects.

Private sector in public health care systems

OpenAIRE

Matějusová, Lenka

2008-01-01

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

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

NARCIS (Netherlands)

H. Zhang (Hao)

2017-01-01

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

Behavioral Health and Health Care Reform Models: Patient-Centered Medical Home, Health Home, and Accountable Care Organization

OpenAIRE

Bao, Yuhua; Casalino, Lawrence P.; Pincus, Harold Alan

2013-01-01

Discussions of health care delivery and payment reforms have largely been silent about how behavioral health could be incorporated into reform initiatives. This paper draws attention to four patient populations defined by the severity of their behavioral health conditions and insurance status. It discusses the potentials and limitations of three prominent models promoted by the Affordable Care Act to serve populations with behavioral health conditions: the Patient Centered Medical Home, the H...

Rationalising health care in india : Challenges & strategies

Directory of Open Access Journals (Sweden)

K I Mathai

2014-01-01

Full Text Available An overview of health care delivery in India is essential, if we are to plan and to improve health care delivery and the indices of health in the coming decades. The health sector in India is a mix of private and government services. While some health care indices appear dismal, several others, including life expectancy are heartening. A balance between regulation and free enterprise is possibly the best option. In this paper we provide a glimpse of health and health related statistics & a n overview of the public health care delivery systems. In the end, we offer suggestion on rationalisation of health care delivery to provide maximum services for the majority of our population within the budget of an optimal health care system outlay

Health federalism: the role of health care professionals in Nepal.

Science.gov (United States)

Dulal, R K

2009-01-01

Nepal has entered from its unitary system into a new "Federal Democratic Republic State". The current constitution presents basic health care services as a fundamental right. The Ministry for Health and Population has been providing resources to meet health demands, but managers are wrestling to meet these demands. Persistent disparities between rural and urban and across regions resulted inferior health outcomes, e.g., life expectancy in an urban district like Bhaktapur is 71 years, whereas in the rural district of Mugu it is 44 years. The poor health and poor access to health care in the past systems prompted people to seek a different model. Ultimately, all political parties except one have agreed on federalism. The exact number of federal states that are going to be created is unknown. In federalism, all federated states have to assume certain relationships between the locality, the region, and the nation that apply not only in politics but in health care too. Managing changes in health care organization during the transitional period and after restructuring the unitary Nepal into federal states should be carefully planned. In case, if new system also fails to deliver necessary health care services, the possibility of igniting of dissatisfaction, public unrest and even disintegration cannot be ignored. In order to outline a structure and give life to a health care system under federalism, health care professionals need to engage themselves seriously.

Health care need

DEFF Research Database (Denmark)

Hasman, Andreas; Hope, Tony; Østerdal, Lars Peter

2006-01-01

The argument that scarce health care resources should be distributed so that patients in 'need' are given priority for treatment is rarely contested. In this paper, we argue that if need is to play a significant role in distributive decisions it is crucial that what is meant by need can be precis......The argument that scarce health care resources should be distributed so that patients in 'need' are given priority for treatment is rarely contested. In this paper, we argue that if need is to play a significant role in distributive decisions it is crucial that what is meant by need can...... be precisely articulated. Following a discussion of the general features of health care need, we propose three principal interpretations of need, each of which focuses on separate intuitions. Although this account may not be a completely exhaustive reflection of what people mean when they refer to need...

Health care utilization

DEFF Research Database (Denmark)

Jacobsen, Christian Bøtcher; Andersen, Lotte Bøgh; Serritzlew, Søren

An important task in governing health services is to control costs. The literatures on both costcontainment and supplier induced demand focus on the effects of economic incentives on health care costs, but insights from these literatures have never been integrated. This paper asks how economic cost...... containment measures affect the utilization of health services, and how these measures interact with the number of patients per provider. Based on very valid register data, this is investigated for 9.556 Danish physiotherapists between 2001 and 2008. We find that higher (relative) fees for a given service...... make health professionals provide more of this service to each patient, but that lower user payment (unexpectedly) does not necessarily mean higher total cost or a stronger association between the number of patients per supplier and the health care utilization. This implies that incentives...

Solidarity as a national health care strategy.

Science.gov (United States)

West-Oram, Peter

2018-05-02

The Trump Administration's recent attempts to repeal the Affordable Care Act have reignited long-running debates surrounding the nature of justice in health care provision, the extent of our obligations to others, and the most effective ways of funding and delivering quality health care. In this article, I respond to arguments that individualist systems of health care provision deliver higher-quality health care and promote liberty more effectively than the cooperative, solidaristic approaches that characterize health care provision in most wealthy countries apart from the United States. I argue that these claims are mistaken and suggest one way of rejecting the implied criticisms of solidaristic practices in health care provision they represent. This defence of solidarity is phrased in terms of the advantages solidaristic approaches to health care provision have over individualist alternatives in promoting certain important personal liberties, and delivering high-quality, affordable health care. © 2018 John Wiley & Sons Ltd.

The Future of Home Health Care

Science.gov (United States)

Landers, Steven; Madigan, Elizabeth; Leff, Bruce; Rosati, Robert J.; McCann, Barbara A.; Hornbake, Rodney; MacMillan, Richard; Jones, Kate; Bowles, Kathryn; Dowding, Dawn; Lee, Teresa; Moorhead, Tracey; Rodriguez, Sally; Breese, Erica

2016-01-01

The Future of Home Health project sought to support transformation of home health and home-based care to meet the needs of patients in the evolving U.S. health care system. Interviews with key thought leaders and stakeholders resulted in key themes about the future of home health care. By synthesizing this qualitative research, a literature review, case studies, and the themes from a 2014 Institute of Medicine and National Research Council workshop on “The Future of Home Health Care,” the authors articulate a vision for home-based care and recommend a bold framework for the Medicare-certified home health agency of the future. The authors also identify challenges and recommendations for achievement of this framework. PMID:27746670

Health care expenditure for hospital-based delivery care in Lao PDR

Directory of Open Access Journals (Sweden)

Douangvichit Daovieng

2012-01-01

Full Text Available Abstract Background Delivery by a skilled birth attendant (SBA in a hospital is advocated to improve maternal health; however, hospital expenses for delivery care services are a concern for women and their families, particularly for women who pay out-of-pocket. Although health insurance is now implemented in Lao PDR, it is not universal throughout the country. The objectives of this study are to estimate the total health care expenses for vaginal delivery and caesarean section, to determine the association between health insurance and family income with health care expenditure and assess the effect of health insurance from the perspectives of the women and the skilled birth attendants (SBAs in Lao PDR. Methods A cross-sectional study was carried out in two provincial hospitals in Lao PDR, from June to October 2010. Face to face interviews of 581 women who gave birth in hospital and 27 SBAs was carried out. Both medical and non-medical expenses were considered. A linear regression model was used to assess influencing factors on health care expenditure and trends of medical and non-medical expenditure by monthly family income stratified by mode of delivery were assessed. Results Of 581 women, 25% had health care insurance. Health care expenses for delivery care services were significantly higher for caesarean section (270 USD than for vaginal delivery (59 USD. After adjusting for the effect of hospital, family income was significantly associated with all types of expenditure in caesarean section, while it was associated with non-medical and total expenditures in vaginal delivery. Both delivering women and health providers thought that health insurance increased the utilisation of delivery care. Conclusions Substantially higher delivery care expenses were incurred for caesarean section compared to vaginal delivery. Three-fourths of the women who were not insured needed to be responsible for their own health care payment. Women who had higher family

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.

Health Literacy and Communication Quality in Health Care Organizations

Science.gov (United States)

Wynia, Matthew K.; Osborn, Chandra Y.

2011-01-01

The relationship between limited health literacy and poor health may be due to poor communication quality within health care delivery organizations. We explored the relationship between health literacy status and receiving patient-centered communication in clinics and hospitals serving communication-vulnerable patient populations. Thirteen health care organizations nationwide distributed a survey to 5,929 patients. All patients completed seven items assessing patient-centered communication. One third also completed three items assessing health literacy. The majority of patients had self-reported health literacy challenges, reporting problems learning about their medical condition because of difficulty understanding written information (53%), a lack of confidence in completing medical forms by themselves (61%), and needing someone to help them read hospital/clinic materials (57%). Logistic regression models showed that, after adjustment for patient demographic characteristics and health care organization type, patients with limited health literacy were 28–79% less likely than those with adequate health literacy to report their health care organization “always” provides patient-centered communication across seven communication items. Using a scaled composite of these items, limited health literacy remained associated with lower reported communication quality. These results suggest that improving communication quality in health care organizations might help to address the challenges facing patients with limited health literacy. They also highlight that efforts to address the needs of patients with limited health literacy should be sensitive to the range of communication challenges confronting these patients and their caregivers. PMID:20845197

Planning for health care transitions: results from the 2005-2006 National Survey of Children With Special Health Care Needs.

Science.gov (United States)

Lotstein, Debra S; Ghandour, Reem; Cash, Amanda; McGuire, Elizabeth; Strickland, Bonnie; Newacheck, Paul

2009-01-01

Many youth with special health care needs have difficulties transferring to adult medical care. To address this, the Maternal and Child Health Bureau has made receipt of transition services a core performance outcome for community-based systems of care for youth with special health care needs. In this article we describe the results for the transition core outcome from the 2005-2006 National Survey of Children With Special Health Care Needs. We also describe changes in the measurement strategy for this outcome since the first National Survey of Children With Special Health Care Needs in 2001. In the nationally representative, cross-sectional 2005-2006 National Survey of Children With Special Health Care Needs, parent or guardian respondents of 18198 youth with special health care needs (aged 12-17) were asked if they have had discussions with their child's health care providers about (1) future adult providers, (2) future adult health care needs, (3) changes in health insurance, and (4) encouraging their child to take responsibility for his or her care. All 4 components had to be met for the youth to meet the overall transition core outcome. Those who had not had transition discussions reported if such discussions would have been helpful. Overall, 41% of youth with special health care needs met the core performance outcome for transition. Forty-two percent had discussed shifting care to an adult provider, 62% discussed their child's adult health care needs, and 34% discussed upcoming changes in health insurance. Most (78%) respondents said that providers usually or always encourage their child to take responsibility for his or her health. Non-Hispanic black or Hispanic race/ethnicity, lower income level, not speaking English, and not having a medical home reduced the odds of meeting the transition core outcome. Current performance on the transition core outcome leaves much room for improvement. Many parents feel that having transition-related discussions with their

The Impact of the Conflict in Ukraine on Lithuanian Security Development

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Kojala Linas

2015-12-01

Full Text Available After regaining independence in 1990, Lithuania chose a strategic path to integrate into Western organizations, with clear priorities for the European Union and NATO, the biggest military alliance in the world. In Russia, such direction was regarded as a threat to its influence in the post-Soviet area. Hence the article seeks to provide an overview of Lithuania’s security policy, with specific emphasis on the role of Russia, in the recent quarter century. The aim is to distinguish key priorities for Lithuania and assess their practical implementation. Furthermore, the paper seeks to analyse the impact of the war in Ukraine, both on Lithuanian and regional security as well as the development of key security priorities.

[Intercultural health care policy from the perspective of health care providers and Mapuche clients].

Science.gov (United States)

Alarcón, Ana María; Astudillo, Paula; Barrios, Sara; Rivas, Edith

2004-09-01

Intercultural health is becoming an emergent topic in the design of health care programs for Mapuche people of Chile. This process faces important challenges such as the scarce theoretical support about the meaning of intercultural health and their practical consequences for providers and clients. To explore the perception in providers and Mapuche clients about intercultural health. A survey performed in 11 counties with the highest concentration of Mapuche people, of the IX region of Chile. The perception about the development of a new health policy specially designed for Mapuche patients was surveyed in 399 Mapuche patients and 64 providers of primary health care centers. Mapuche clients considered, as the main regional challenges, the indifference and discrimination of health care teams towards Mapuche patients, aggravated by the indifference of authorities. Providers considered that the main problem was a lack of knowledge about Mapuche culture and skills to deal with this ethnic group. Patients and providers agreed on the need to use Mapuche dialect in health care attentions, to coordinate actions with traditional healers and to accept ethnical therapeutic practices. There is scarce agreement between providers and Mapuche clients about the need for an special intercultural health policy, its contents, and the regional conditions for its implementation and development.

Promoting oral health care among people living in residential aged care facilities: Perceptions of care staff.

Science.gov (United States)

Villarosa, Amy R; Clark, Sally; Villarosa, Ariana C; Patterson Norrie, Tiffany; Macdonald, Susan; Anlezark, Jennifer; Srinivas, Ravi; George, Ajesh

2018-04-23

This study aimed to look at the practices and perspectives of residential aged care facility (RACF) care staff regarding the provision of oral health care in RACFs. Emphasis has been placed on the provision of adequate oral health care in RACFs through the Better Oral Health in Residential Aged Care programme. Endorsed by the Australian government, this programme provided oral health education and training for aged care staff. However, recent evidence suggests that nearly five years after the implementation of this programme, the provision of oral care in RACFs in NSW remains inadequate. This project utilised an exploratory qualitative design which involved a focus group with 12 RACF care staff. Participants were asked to discuss the current oral health practices in their facility, and their perceived barriers to providing oral health care. The key findings demonstrated current oral health practices and challenges among care staff. Most care staff had received oral health training and demonstrated positive attitudes towards providing dental care. However, some participants identified that ongoing and regular training was necessary to inform practice and raise awareness among residents. Organisational constraints and access to dental services also limited provision of dental care while a lack of standardised guidelines created confusion in defining their role as oral healthcare providers in the RACF. This study highlighted the need for research and strategies that focus on capacity building care staff in oral health care and improving access of aged care residents to dental services. © 2018 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.

Self-care as a health resource of elders

DEFF Research Database (Denmark)

Høy, Bente; Wagner, Lis; Hall, Elisabeth O.C.

2007-01-01

into self-care as a significant health resource of elders with different health status. It suggests that an elder's self-care ability is determined by the interaction of various sub-resources and conditions and emphasizes the constantly evolving nature of self-care. The framework may be of use in clinical......AIM: To review the literature related to self-care and health promotion for elders and to develop an understanding of self-care as a health resource. BACKGROUND: Self-care may improve health and prevent illness and disabilities in elders. Although studies of self-care are numerous, the significance...... of the concept as a health resource for elders lacks clarity. Before 1989, research focused principally on medical self-care at the expense of health care, and self-care was seen more as supplementary to professional health care rather than as a health-promoting approach in health care. METHOD...

COMMUNITY HEALTH & PRIMARY HEALTH CARE

African Journals Online (AJOL)

adedamla

Background: The well-being of women and children is one of the major determinants ... The Sample for the study were women recruited from 11 primary health care ... respondents educational level and knowledge of preconception care (X =24.76, ... single adult or married couple) are in an optimal state .... The major site for.

Integrated occupational health care at sea

DEFF Research Database (Denmark)

Jensen, Olaf Chresten

2011-01-01

exposures during life at sea and work place health promotion. SEAHEALTH and some of the shipping companies have already added workplace health promotion to occupational health care programs. The purpose of this article is to reinforce this trend by adding some international perspectives and by providing......Workplace Health Promotion is the combined efforts of employers, employees and society to improve the health and well-being of people at work. Integrated maritime health care can be defined as the total maritime health care function that includes the prevention of health risks from harmful...

[The ethics of health care organization].

Science.gov (United States)

Goic, Alejandro

2004-03-01

Health care organization is not only a technical issue. Ethics gives meaning to the medical profession's declared intent of preserving the health and life of the people while honoring their intelligence, dignity and intimacy. It also induces physicians to apply their knowledge, intellect and skills for the benefit of the patient. In a health care system, it is important that people have insurance coverage for health contingencies and that the quality of the services provided be satisfactory. People tend to judge the medical profession according to the experience they have in their personal encounter with physicians, health care workers, hospitals and clinics. Society and its political leaders must decide upon the particular model that will ensure the right of citizens to a satisfactory health care. Any health care organization not founded on humanitarian and ethical values is doomed tofailure. The strict adherence of physicians to Hippocratic values and to the norms of good clinical practice as well as to an altruistic cooperative attitude will improve the efficiency of the health care sector and reduce its costs. It is incumbent upon society to generate the conditions where by the ethical roots of medical care can be brought to bear upon the workings of the health care system. Every country must strive to provide not only technically efficient medical services, but also the social mechanisms that make possible a humanitarian interaction between professionals and patients where kindness and respect prevail.

Primary care and behavioral health practice size: the challenge for health care reform.

Science.gov (United States)

Bauer, Mark S; Leader, Deane; Un, Hyong; Lai, Zongshan; Kilbourne, Amy M

2012-10-01

We investigated the size profile of US primary care and behavioral health physician practices since size may impact the ability to institute care management processes (CMPs) that can enhance care quality. We utilized 2009 claims data from a nationwide commercial insurer to estimate practice size by linking providers by tax identification number. We determined the proportion of primary care physicians, psychiatrists, and behavioral health providers practicing in venues of >20 providers per practice (the lower bound for current CMP practice surveys). Among primary care physicians (n=350,350), only 2.1% of practices consisted of >20 providers. Among behavioral health practitioners (n=146,992) and psychiatrists (n=44,449), 1.3% and 1.0% of practices, respectively, had >20 providers. Sensitivity analysis excluding single-physician practices as "secondary" confirmed findings, with primary care and psychiatrist practices of >20 providers comprising, respectively, only 19.4% and 8.8% of practices (difference: Pestimate practice census for a high-complexity, high-cost behavioral health condition; only 1.3-18 patients per practice had claims for this condition. The tax identification number method for estimating practice size has strengths and limitations that complement those of survey methods. The proportion of practices below the lower bound of prior CMP studies is substantial, and care models and policies will need to address the needs of such practices and their patients. Achieving a critical mass of patients for disorder-specific CMPs will require coordination across multiple small practices.

Changing trends in health care tourism.

Science.gov (United States)

Karuppan, Corinne M; Karuppan, Muthu

2010-01-01

Despite much coverage in the popular press, only anecdotal evidence is available on medical tourists. At first sight, they seemed confined to small and narrowly defined consumer segments: individuals seeking bargains in cosmetic surgery or uninsured and financially distressed individuals in desperate need of medical care. The study reported in this article is the first empirical investigation of the medical tourism consumer market. It provides the demographic profile, motivations, and value perceptions of health care consumers who traveled abroad specifically to receive medical care. The findings suggest a much broader market of educated and savvy health care consumers than previously thought. In the backdrop of the health care reform, the article concludes with implications for health care providers.

Investments and costs of oral health care for Family Health Care

Directory of Open Access Journals (Sweden)

Márcia Stefânia Ribeiro Macêdo

2016-01-01

Full Text Available ABSTRACT OBJECTIVE To estimate the investments to implement and operational costs of a type I Oral Health Care Team in the Family Health Care Strategy. METHODS This is an economic assessment study, for analyzing the investments and operational costs of an oral health care team in the city of Salvador, BA, Northeastern Brazil. The amount worth of investments for its implementation was obtained by summing up the investments in civil projects and shared facilities, in equipments, furniture, and instruments. Regarding the operational costs, the 2009-2012 time series was analyzed and the month of December 2012 was adopted for assessing the monetary values in effect. The costs were classified as direct variable costs (consumables and direct fixed costs (salaries, maintenance, equipment depreciation, instruments, furniture, and facilities, besides the indirect fixed costs (cleaning, security, energy, and water. The Ministry of Health’s share in funding was also calculated, and the factors that influence cost behavior were described. RESULTS The investment to implement a type I Oral Health Care Team was R$29,864.00 (US$15,236.76. The operational costs of a type I Oral Health Care Team were around R$95,434.00 (US$48,690.82 a year. The Ministry of Health’s financial incentives for investments accounted for 41.8% of the implementation investments, whereas the municipality contributed with a 59.2% share of the total. Regarding operational costs, the Ministry of Health contributed with 33.1% of the total, whereas the municipality, with 66.9%. Concerning the operational costs, the element of heaviest weight was salaries, which accounted for 84.7%. CONCLUSIONS Problems with the regularity in the supply of inputs and maintenance of equipment greatly influence the composition of costs, besides reducing the supply of services to the target population, which results in the service probably being inefficient. States are suggested to partake in funding

Investments and costs of oral health care for Family Health Care

Science.gov (United States)

Macêdo, Márcia Stefânia Ribeiro; Chaves, Sônia Cristina Lima; Fernandes, Antônio Luis de Carvalho

2016-01-01

ABSTRACT OBJECTIVE To estimate the investments to implement and operational costs of a type I Oral Health Care Team in the Family Health Care Strategy. METHODS This is an economic assessment study, for analyzing the investments and operational costs of an oral health care team in the city of Salvador, BA, Northeastern Brazil. The amount worth of investments for its implementation was obtained by summing up the investments in civil projects and shared facilities, in equipments, furniture, and instruments. Regarding the operational costs, the 2009-2012 time series was analyzed and the month of December 2012 was adopted for assessing the monetary values in effect. The costs were classified as direct variable costs (consumables) and direct fixed costs (salaries, maintenance, equipment depreciation, instruments, furniture, and facilities), besides the indirect fixed costs (cleaning, security, energy, and water). The Ministry of Health’s share in funding was also calculated, and the factors that influence cost behavior were described. RESULTS The investment to implement a type I Oral Health Care Team was R$29,864.00 (US$15,236.76). The operational costs of a type I Oral Health Care Team were around R$95,434.00 (US$48,690.82) a year. The Ministry of Health’s financial incentives for investments accounted for 41.8% of the implementation investments, whereas the municipality contributed with a 59.2% share of the total. Regarding operational costs, the Ministry of Health contributed with 33.1% of the total, whereas the municipality, with 66.9%. Concerning the operational costs, the element of heaviest weight was salaries, which accounted for 84.7%. CONCLUSIONS Problems with the regularity in the supply of inputs and maintenance of equipment greatly influence the composition of costs, besides reducing the supply of services to the target population, which results in the service probably being inefficient. States are suggested to partake in funding, especially to cover the

Changing the Care Process: A New Concept in Iranian Rural Health Care

Directory of Open Access Journals (Sweden)

Abbas Abbaszadeh, RN, BSCN, PhD

2013-03-01

Conclusion: The findings of this study indicate that the process of health care in Iranian rural society is changing rapidly with community health workers encountering new challenges. There is diminished efficiency in responding to the changing care process in Iran's rural society. Considering this change in process of care, therefore, the health care system should respond to these new challenges by establishing new health care models.

EVALUATION OF HEALTH CARE QUALITY

Directory of Open Access Journals (Sweden)

Zlatko Fras

2002-12-01

Full Text Available Background. It is possible to evaluate quality characteristics of different aspects of health care by many different measures. For these purposes, in various countries all over the world authorised institutions and/or agencies developed number of methodological accessories, criteria and tools for selection of more or less appropriately and optimally defined criteria and indicators of quality clinical performance.Conclusions. Recently we have started with activities for gradual introduction of systematic monitoring, assessment and improvement of quality of health care in Slovenia as well. One of the key prerequisites for selection of valid, practicable, efficient and reliable quality indicators is the establishment of continuous and methodologically appropriate system of development and implementation of evidence-based clinical practice guidelines. We started this process within the framework of national Health Sector Management Project, where all potential key stakeholders from health care sector participated. Also the project on Quality in Health Care in Slovenia, started, leaded and performed by the Medical Chamber of Slovenia, represents one of the important parallel starting steps towards assurance of reliable data on development/establishment of appropriate set of quality indicators and standards of health care in our country.

Lower Costs, Better Care- Reforming Our Health Care Delivery

Data.gov (United States)

U.S. Department of Health & Human Services — The Affordable Care Act includes tools to improve the quality of health care that can also lower costs for taxpayers and patients. This means avoiding costly...

Health promotion in connection to the health care students

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S. Kyuchukova

2017-09-01

Full Text Available The activities of health promotion for the students in health care specialties is organized and managed by the teacher process. During the training communication skills are acquired. It is the time for preparing students for work in counseling and patient education, collecting and providing health information - promotive function in the process of care (1. We assumed that these opportunities could be used in our work with children deprived of parental care. We set a goal to explore experiences, attitudes and ideas about students’ participation in health care in health promotion in the community of children and individuals. The study found that students are aware of the social importance of the knowledge acquired during the training and are convinced of the need to support adolescents to develop a responsible attitude towards their own health.

Czechoslovakia's changing health care system.

Science.gov (United States)

Raffel, M W; Raffel, N K

1992-01-01

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

The Child Health Care System in Italy.

Science.gov (United States)

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

2016-10-01

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

Attending unintended transformations of health care infrastructure

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Helle Wentzer

2007-11-01

Full Text Available Introduction: Western health care is under pressure from growing demands on quality and efficiency. The development and implementation of information technology, IT is a key mean of health care authorities to improve on health care infrastructure. Theory and methods: Against a background of theories on human-computer interaction and IT-mediated communication, different empirical studies of IT implementation in health care are analyzed. The outcome is an analytical discernment between different relations of communication and levels of interaction with IT in health care infrastructure. These relations and levels are synthesized into a framework for identifying tensions and potential problems in the mediation of health care with the IT system. These problems are also known as unexpected adverse consequences, UACs, from IT implementation into clinical health care practices. Results: This paper develops a conceptual framework for addressing transformations of communication and workflow in health care as a result of implementing IT. Conclusion and discussion: The purpose of the conceptual framework is to support the attention to and continuous screening for errors and unintended consequences of IT implementation into health care practices and outcomes.

The Music Repertoire of the Society of Jesus in the Polish-Lithuanian Commonwealth (1565–1773

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Jeż Tomasz

2016-12-01

Full Text Available The paper presents the research project coordinated by the University of Warsaw and financed by the Minister of Science and Higher Education as part of the “Tradition 1a” module of the National Programme for the Development of Humanities. The main task of this research project is the documentation of the Jesuit music repertory produced and disseminated on the territory of the Polish-Lithuanian Commonwealth.

Sustainable Development of Lithuanian Seacoast Recreational Objects

Directory of Open Access Journals (Sweden)

Jonas Abromas

2011-04-01

Full Text Available Recreational architecture is a branch of architectural activity whose main object is formation of recreational spaces (territories, buildings, complexes and equipment. The goal of recreational architecture is to create optimal (comfortable, lovely and realizable environment for all recreation types and forms. This goal is realized by projects which are based on scientific research and recommendations. This activity needs more than casual work and living environment. It needs special space and equipment: territory, water area, buildings, and rooms. Everything can be called recreational environment. Recreational environment can be of various dimensional scales: enormous seaside or lake areas intended for recreation, resorts, recreational institution complexes and many single buildings, beaches, forest parks, pools. Recreational environment is possible not only out of town but in town as well. Beginning of recreational architecture is observed in antique cultures, but as a separate specific architectural activity branch it rapidly began to spread in last century first half and in Lithuania – in the last four decades. In this work, analysis of evaluating recreational architecture is made seeking to reveal recreational architecture evaluating criteria and their use .Article in Lithuanian

The Dynamics of Lithuanian-Polish Strategic Partnership

Directory of Open Access Journals (Sweden)

Pukšto Andžej

2014-12-01

Full Text Available The paper aims at identifying relations between the events which influence Lithuanian-Polish strategic cooperation, defining principal aspects of cooperation dynamics, and analysing recent challenges in relations between Lithuania and Poland. For the purpose of analysis the following objectives have been set: 1 to analyse the development of strategic partnership and political dialogue in bilateral relations; 2 to evaluate the importance of security, defence policy, and economic projects in cooperation between the states; 3 to assess the aspect of ethnic minorities in the context of bilateral relations. The authors of the paper seek to review the principal internal and external factors which affect bilateral cooperation between Lithuania and Poland. The following methods of analysis are used in the paper: public statements made by officials, document analysis and discourse formed by the media. The key areas of analysis are the development of political dialogue, strategic cooperation, security and defence policy, economic and energy cooperation, and questions of ethnic minorities in bilateral relations. Presently in the field there is a lack of thorough investigation of similarities and differences of strategic cooperation between Lithuania and Poland.

Child Health Care Services in Austria.

Science.gov (United States)

Kerbl, Reinhold; Ziniel, Georg; Winkler, Petra; Habl, Claudia; Püspök, Rudolf; Waldhauser, Franz

2016-10-01

We describe child health care in Austria, a small country in Central Europe with a population of about 9 million inhabitants of whom approximately 1.7 million are children and adolescents under the age of 20 years. For children and adolescents, few health care indicators are available. Pediatric and adolescent health provision, such as overall health provision, follows a complex system with responsibilities shared by the Ministry of Health, 19 social insurance funds, provinces, and other key players. Several institutions are affiliated with or cooperate with the Ministry of Health to assure quality control. The Austrian public health care system is financed through a combination of income-based social insurance payments and taxes. Pediatric primary health care in Austria involves the services of general pediatricians and general practitioners. Secondary care is mostly provided by the 43 children's hospitals; tertiary care is (particularly) provided in 4 state university hospitals and 1 private university hospital. The training program of residents takes 6 years and is completed by a final examination. Every year, this training program is completed by about 60 residents. Copyright © 2016 Elsevier Inc. All rights reserved.

Adolescent Health Care in School-Based Health Centers. Position Statement

Science.gov (United States)

National Assembly on School-Based Health Care, 2008

2008-01-01

School-based health centers (SBHCs) are considered one of the most effective strategies for delivering preventive care, including reproductive and mental health care services, to adolescents--a population long considered difficult to reach. National Assembly on School-Based Health Care (NASBHC) recommends practices and policies to assure…

Health Literacy and Access to Care

Science.gov (United States)

Janke, Alex

2016-01-01

Despite well-documented links between low health literacy, low rates of health insurance coverage, and poor health outcomes, there has been almost no research on the relationship between low health literacy and self-reported access to care. This study analyzed a large, nationally representative sample of community-dwelling adults ages 50 and older to estimate the relationship between low health literacy and self-reported difficulty obtaining care. We found that individuals with low health literacy were significantly more likely than individuals with adequate health literacy to delay or forego needed care or to report difficulty finding a provider, even after controlling for other factors including health insurance coverage, employment, race/ethnicity, poverty, and general cognitive function. They were also more likely to lack a usual source of care, although this result was only marginally significant after controlling for other factors. The results show that in addition to any obstacles that low health literacy creates within the context of the clinical encounter, low health literacy also reduces the probability that people get in the door of the health care system in a timely way. PMID:27043757

Health insurance and health care in India: a supply-demand perspective

OpenAIRE

Perianayagam, Arokiasamy; Goli, Srinivas

2013-01-01

India’s health care and health financing provision is characterized by too little Government spending on health, meager health insurance coverage, declining public health care use contrasted by highest levels of private out-of-pocket health spending in the world. To understand the interconnectedness of these disturbing outcomes, this paper envisions a theoretical framework of health insurance and health care revisits the existing health insurance schemes and assesses the health insurance cove...

Health Care Provider Value Chain

OpenAIRE

Kawczynski , Lukasz; Taisch , Marco

2009-01-01

International audience; In every society there is a need for an efficient health care system. This paper aims to propose a value definition and a value chain model within the health care. In order to define value patients and experts were surveyed. The proposed definition offers a complex way of looking at the value within the health care sector. The proposal of the value chain model is anticipated with a value stream mapping activities and experts interviews. Proposed model offers consistent...

Use, misuse and non-use of health care assistants: understanding the work of health care assistants in a hospital setting.

Science.gov (United States)

Spilsbury, Karen; Meyer, Julienne

2004-11-01

This study is concerned with understanding the work of non-registered nurses (health care assistants) in a UK hospital setting. There are increasing numbers of health care assistants employed by the National Health Service in the UK to support registered nurses providing nursing care. However, little is known about the make-up of the health care assistant workforce and the changing nature of their role. This study addresses some of these gaps in the research-based literature. A single case study design using mixed methods (survey, interviews, participant observations, focus groups and documents) was used to generate an in-depth account of health care assistants' work in one organization. The study is built upon what health care assistants say they do, compared with what they actually do in practice. It explores how and whether the work of health care assistants is adequately supervised, tensions between the work of health care assistants and registered nurses and the subsequent effects on teamwork and patient care. There are policy expectations associated with the work of health care assistants. However, this study reveals significant deviations from these goals. The workplace arena and the negotiations between health care assistants and registered nurses that take place within it, actively shape the health care assistants' work. Findings suggest dynamic patterns of use, misuse and non-use of the health care assistants as a resource to patient care. The changing roles of registered nurses have direct implications for the roles of health care assistants: as registered nurses take on extra duties and responsibilities they are conceding some of their role to health care assistants. This has implications for nurse managers. The competence of health care assistants to carry out nursing work needs to be reassessed and there also needs to be ongoing monitoring and supervision of their work to maximize, and further develop, their contribution to patient care and to ensure

Health care: economic impact of caring for geriatric patients.

Science.gov (United States)

Rich, Preston B; Adams, Sasha D

2015-02-01

National health care expenditures constitute a continuously expanding component of the US economy. Health care resources are distributed unequally among the population, and geriatric patients are disproportionately represented. Characterizing this group of individuals that accounts for the largest percentage of US health spending may facilitate the introduction of targeted interventions in key high-impact areas. Changing demographics, an increasing incidence of chronic disease and progressive disability, rapid technological advances, and systemic market failures in the health care sector combine to drive cost. A multidisciplinary approach will become increasingly necessary to balance the delicate relationship between our constrained supply and increasing demand. Copyright © 2015 Elsevier Inc. All rights reserved.

Digital health care: where health care, information technology, and the Internet converge.

Science.gov (United States)

Frank, S R; Williams, J R; Veiel, E L

2000-01-01

The digital health care industry applies information technologies to facilitate communications, commerce, transactions, business problem solving, and enhanced decision making for one or more groups that supply, consume, or finance health care services and products. The variation among companies is significant, but each one attempts to leverage information technology to drive sustainable evolutionary change. In an overview of the industry, a framework is provided to understand the maze of business plans.

Health care consumerism movement takes a step forward.

Science.gov (United States)

Thompson, Michael; Cutler, Charles M

2010-01-01

One of the contributing factors to both the increase in health care costs and the backlash to managed care was the lack of consumer awareness of the cost of health care service, the effect of health care costs on profits and wages, and the need to engage consumers more actively as consumers in health care decisions. This article reviews the birth of the health care consumerism movement and identifies gaps in health care consumerism today. The authors reveal some of the keys to building a sustainable health care consumerism framework, which involves enlisting consumers as well as other stakeholders.

Health care in China: improvement, challenges, and reform.

Science.gov (United States)

Wang, Chen; Rao, Keqin; Wu, Sinan; Liu, Qian

2013-02-01

Over the past 2 decades, significant progress has been made in improving the health-care system and people's health conditions in China. Following rapid economic growth and social development, China's health-care system is facing new challenges, such as increased health-care demands and expenditure, inefficient use of health-care resources, unsatisfying implementation of disease management guidelines, and inadequate health-care insurance. Facing these challenges, the Chinese government carried out a national health-care reform in 2009. A series of policies were developed and implemented to improve the health-care insurance system, the medical care system, the public health service system, the pharmaceutical supply system, and the health-care institution management system in China. Although these measures have shown promising results, further efforts are needed to achieve the ultimate goal of providing affordable and high-quality care for both urban and rural residents in China. This article not only covers the improvement, challenges, and reform of health care in general in China, but also highlights the status of respiratory medicine-related issues.

Functioning of primary health care in opinion of managers of primary health care units.

Science.gov (United States)

Bojar, I; Wdowiak, L; Kwiatosz-Muc, M

2006-01-01

The aim of the research is to get to know opinions of primary health care managers concerning working of primary health care and concerning quality of medical services offered by family doctors out-patient clinics. The research among managers of primary health care units took place in all out-patient clinics in Lublin province. Research instrument was survey questionnaire of authors own construction. Results were statistically analyzed. From 460 surveys sent, 108 questionnaires were accepted to analysis. Majority of managers of out-patient clinics of primary health care is satisfied with the way and the quality of work of employed staff. In opinion of 71.3% of managers access to family doctor services is very good. Availability of primary health care services is better estimated by managers of not public units. The occupied local provide comfortable work for the staff in opinion of 78.5% of surveyed managers of out-patient clinics. Managers estimate the level of their services as very good (37.96%) and good (37.96%) comparing to other such a subjects present in the market. Internal program of improving quality is run in 22% of out-patient clinics, which were investigated. Managers of primary health care units assess the quality of their services as good and very good. They estimate positively the comfort and politeness in serving patients as well as technical status of equipment and the lodging. They assess availability of their services as very good. Large group of managers of family doctors practices recognizes neighborhood practices as a competitors.

COMMUNITY MEDICINE & PRIMARY HEALTH CARE

African Journals Online (AJOL)

Client Satisfaction with Antenatal Care Services in Primary Health Care. Centres in Sabon ... important information about how well clinicians and the population of women within child bearing. 8 ..... model. Health and Quality of Life outcomes.

Promoting coordination in Norwegian health care

Directory of Open Access Journals (Sweden)

Tor I. Romøren

2011-10-01

Full Text Available   Introduction: The Norwegian health care system is well organized within its two main sectors - primary health and long term care on the one hand, and hospitals and specialist services on the other. However, the relation between them lacks mediating structures.Policy practice: Enhancing coordination between primary and secondary health care has been central in Norwegian health care policy the last decade. In 2003 a committee was appointed to identify coordination problems and proposed a lot of practical and organisational recommendations. It relied on an approach challenging primary and secondary health care in shared geographical regions to take action. However, these proposals were not implemented. In 2008 a new Minister of Health and Care worked out plans under the key term "Coordination Reform". These reform plans superseded and expanded the previous policy initiatives concerning cooperation, but represented also a shift in focus to a regulative and centralised strategy, including new health legislation, structural reforms and use of economic incentives that are now about to be implemented.Discussion: The article analyses the perspectives and proposals of the previous and the recent reform initiatives in Norway and discusses them in relation to integrated care measures implemented in Denmark and Sweden.

Nigerian health care: A quick appraisal

Directory of Open Access Journals (Sweden)

Yau Zakari Lawal

2017-01-01

Full Text Available Qualitative health care is a fundamental right of all citizens of a given country. How this health care is delivered depends significantly on the economy, dedication, and quality of the health-care providers and the political will of the government of the country. Health care may be public run or organized by private health-care providers. We can also have an intercalated program where there is public–private partnership. Whichever way this basic fundamental human right is delivered, sustainability, affordability, and accessibility are vital to its success. The Nigerian health-care delivery can be broadly classified into two; the hitherto existing traditional medicine and the modern orthodox medicine which came to our shores with the arrival of the European colonialists. The traditional system is still patronized by most Nigerians and is known by different linguistic terminologies such as the “Wanzami” or Barber in Hausa and the “Babalawo” in Yoruba language. Traditional birth attendants also exist in all communities in Nigeria complemented by herbalist and spiritualists of different shades and callings. It is our aim to give a brief account of our observations on the Nigerian health-care system with a view to correcting the challenges by the government and the public in general.

Consumer Attitudes toward Health and Health Care: A Differential Perspective.

Science.gov (United States)

Gould, Stephen J.

1988-01-01

Questionnaires returned by 343 out of 350 subjects measured health attitudes and health status. Results suggest that some consumers take a more scientific approach to health care and prevention. Demographic factors, health status, and health consciousness are partial predictors of consumer attitudes and approach to health care. (SK)

Care for children with special health care needs in a managed care system: a patient satisfaction survey.

Science.gov (United States)

Flynn, J M; Bravo, C J; Reyes, O

2001-09-01

In 1994 the government of Puerto Rico adopted a capitated managed health care system for the medically indigent. The new law has been implemented in most municipalities. A survey of children with special health care needs treated at a tertiary pediatric center under the capitated managed care system and the prior non-capitated system was analyzed using the Consumer Assessments of Health Plan Survey (CHAPS) instrument. One third of the patients who were under the new capitated managed care system were not satisfied with the medial care they were receiving. The parents of children with multidisciplinary conditions found it much more difficult to access care at the tertiary center. It took parents two years to learn to navigate within the capitated managed care system. Studies to measure outcome and health quality of children with special health care needs in capitated managed health care programs must be developed to learn how the potential benefits of managed care can be maximized and the potential harms minimized. The purpose of this study was to analyze the accessibility and satisfaction of caretakers of children with special health care needs under a capitated managed health care system.

The future of health insurance for children with special health care needs.

Science.gov (United States)

Newacheck, Paul W; Houtrow, Amy J; Romm, Diane L; Kuhlthau, Karen A; Bloom, Sheila R; Van Cleave, Jeanne M; Perrin, James M

2009-05-01

Because of their elevated need for services, health insurance is particularly important for children with special health care needs. In this article we assess how well the current system is meeting the insurance needs of children with special health care needs and how emerging trends in health insurance may affect their well-being. We begin with a review of the evidence on the impact of health insurance on the health care experiences of children with special health care needs based on the peer-reviewed literature. We then assess how well the current system meets the needs of these children by using data from 2 editions of the National Survey of Children With Special Health Care Needs. Finally, we present an analysis of recent developments and emerging trends in the health insurance marketplace that may affect this population. Although a high proportion of children with special health care needs have insurance at any point in time, nearly 40% are either uninsured at least part of the year or have coverage that is inadequate. Recent expansions in public coverage, although offset in part by a contraction in employer-based coverage, have led to modest but significant reductions in the number of uninsured children with special health care needs. Emerging insurance products, including consumer-directed health plans, may expose children with special health care needs and their families to greater financial risks. Health insurance coverage has the potential to secure access to needed care and improve the quality of life for these children while protecting their families from financially burdensome health care expenses. Continued vigilance and advocacy for children and youth with special health care needs are needed to ensure that these children have access to adequate coverage and that they fare well under health care reform.

COMMUNITY HEALTH & PRIMARY HEALTH CARE

African Journals Online (AJOL)

adedamla

enrol in an insurance scheme feeling that they need more information on health insurance and the willingness to enrol in a ... and utilize the benefits of different types of health insurance services. Conclusion: The findings ..... improvements in access and quality of care, and the ... the 'rising tide' of and information technology.

Occupational Health for Health Care Providers

Science.gov (United States)

Health care workers are exposed to many job hazards. These can include Infections Needle injuries Back injuries ... prevention practices. They can reduce your risk of health problems. Use protective equipment, follow infection control guidelines, ...

eHealth and quality in health care: implementation time

NARCIS (Netherlands)

Ossebaard, Hans Cornelis; van Gemert-Pijnen, Julia E.W.C.

2016-01-01

The use of information and communication technologies in health and health care could improve healthcare quality in many ways. Today's evidence base demonstrates the (cost-)effectiveness of online education, self-management support and tele-monitoring in several domains of health and care. While new

Women's self-perception and self-care practice: implications for health care delivery.

Science.gov (United States)

Mendias, E P; Clark, M C; Guevara, E B

2001-01-01

Mexican American women experience unique health care needs related to integration of Mexican and American cultures. To learn how to better promote self-care practices and service utilization in women of Mexican origin living in Texas, researchers used a qualitative approach to interview a convenience sample of 11 low-income women attending a health clinic. Researchers collected narrative data about the women's perceptions of health, wellness, and self-care. Using the matrix approach described by Miles and Huberman, we organized findings around women's roles, including participants' descriptions of themselves, their health and wellness awareness, self-care practices for health/illness and wellness/nonwellness, barriers to self-care, origin of self-care practices, and perceptions of life control. Implications for health planning and service delivery are presented.

Disabling health care? Medicaid managed care and people with disabilities in America

DEFF Research Database (Denmark)

Hiranandani, Vanmala Sunder

2011-01-01

Medicaid, America's largest government-funded health insurance program, plays a pivotal role in providing health services to eight million adults with disabilities. Since the mid-1990s, many Medicaid programs have aggressively introduced managed care, which reconfigures service delivery using...... business principles. Most states have insufficient experience in developing managed care plans for Medicaid beneficiaries with disabilities. Middle-aged adults with physical disabilities present their own constellation of health care issues that is not readily appreciated in health and social services....... The purpose of the study was to understand their experiences in accessing physical health care services and to ascertain the effects of managed care on their health and well-being. This study found beneficiaries encounter numerous barriers in accessing preventative, treatment, and acute care services. Overall...

The role of Lithuanian TSO in view of changing nuclear situation in Lithuania

International Nuclear Information System (INIS)

Uspuras, E.

2010-01-01

At present, the Technical and scientific Support Organisations (TSOs) are gaining increased importance by providing the technical and scientific basis for decisions and activities regarding nuclear and radiation safety. In lithuania, after Lithuania declared its independence, the technical support organisations in Lithuania grows and develops into institution, capable to perform all necessary safety analyses for Ignalina NPP. However, the preparation for the construction of new nuclear power plant showed that Lithuania lacks the nuclear energy specialists. This paper presents information about the creation and growing up of Lithuanian TSOs, the works performed at present days and the needs for nearest future. (author)

Health care in rural areas.

Science.gov (United States)

Nath, L M

1994-02-01

In India, although the health care system infrastructure is extensive, the people often regard government facilities as family planning (FP) centers instead of primary health care centers. This problem has been compounded by the separation of health care and FP at all stages, even down to the storage of the same medication in two different locations depending upon whether it is to be used for "health" or for "FP." In rural areas where the government centers are particularly desolate, the community has chosen to erect its own health care system of private practitioners of all sorts and qualifications. Even in rural areas where a comprehensive health service is provided, with each household visited regularly by health workers, and where this service has resulted in a lowering of the crude death rate from 14.6 to 7 and the maternal mortality rate from 4.7 to 0.5/1000, people depend upon practitioners of various types. Upon analysis, it was discovered that the reason for using this multiplicity of practitioners had nothing to do with the level of satisfaction with the government service or with the accessibility of the services. Rather, when ill, the people make a diagnosis and then go to the proper place for treatment. If, for instance, they believe their malady was caused by the evil eye, they consult a magico-religious practitioner. These various types of practitioners flourish in areas with the best primary health care because they fulfill a need not met by the primary health care staff. If government agencies work with the local practitioners and afford them the proper respect, their skills can be upgraded in selected areas and the whole community will benefit.

National Health-Care Reform

Science.gov (United States)

2009-03-24

and pre/ post partum care during delivery. America should select measures that reflect the health-care goals of the nation. As an example, the Healthy...accidents (8) More than 50% of patients with diabetes, hypertension, tobacco addiction, hyperlipidemia, congestive heart failure, asthma, depression ...reflect the cumulative efforts of different types of individual care. For example, infant mortality is a reflection of pre-natal care, post - natal care

Care of children with disabilities in Primary Health Care

Directory of Open Access Journals (Sweden)

Thaís Giudice Schultz

2016-07-01

Full Text Available Objective: This article describes an experience report that aimed to present perceptions on the care of children with disabilities in the Family Health Strategy (FHS, showing its limits and potentials based on the experience of participation in the program ‘PET-Saúde’. Method: Data were collected from field notes which recorded the monitoring of the care process offered to children with disabilities by the FHS teams. The study was conducted in a health facility in the city of Rio de Janeiro for one year. Results: Content analysis results listed the two main themes that composed the issues of concern for child care in this experience: the coordination of health care and the family and community orientation as the core for child care in the FHS. Conclusion: Despite the weakness in compliance with these categories, which are principles and fundamentals of the FHS, this is a privileged space with regard to care practices for children with disabilities.

Using appreciative inquiry to transform health care.

Science.gov (United States)

Trajkovski, Suza; Schmied, Virginia; Vickers, Margaret; Jackson, Debra

2013-08-01

Amid tremendous changes in contemporary health care stimulated by shifts in social, economic and political environments, health care managers are challenged to provide new structures and processes to continually improve health service delivery. The general public and the media are becoming less tolerant of poor levels of health care, and health care professionals need to be involved and supported to bring about positive change in health care. Appreciative inquiry (AI) is a philosophy and method for promoting transformational change, shifting from a traditional problem-based orientation to a more strength-based approach to change, that focuses on affirmation, appreciation and positive dialog. This paper discusses how an innovative participatory approach such as AI may be used to promote workforce engagement and organizational learning, and facilitate positive organizational change in a health care context.

Discrimination against older women in health care.

Science.gov (United States)

Belgrave, L L

1993-01-01

Growing awareness of apparent gaps in health care received by women and men raises concern over possible discrimination. This literature review examines this issue for elderly women, whose health care is obtained in a system that also may be permeated with age discrimination. Physicians tend to spend more time with women and older patients, suggesting that discrimination may not be an issue in the physician-patient relationship or may work in favor of older women. However, this may simply reflect elderly women's poorer health. Gender and age disparities in medical treatments received provide a more compelling argument that the health care system is a source of discrimination against older women, who are less likely than others to receive available treatments for cardiac, renal, and other conditions. The history of medical treatment of menopause suggests that stereotypes of older women have been advantageous for segments of the health care system. Finally, in addition to discrimination that has its source within the health care system itself, societal-wide inequities, particularly economic, are extremely detrimental to older women's health care. As we respond to the health care crisis, we must be alert to the potential to rectify those structures and tendencies that can lead to discrimination against women and the aged. Health care reform presents a unique opportunity to ensure health care equity.

Care Preferences Among Middle-Aged and Older Adults With Chronic Disease in Europe: Individual Health Care Needs and National Health Care Infrastructure.

Science.gov (United States)

Mair, Christine A; Quiñones, Ana R; Pasha, Maha A

2016-08-01

The purpose of this study is to expand knowledge of care options for aging populations cross-nationally by examining key individual-level and nation-level predictors of European middle-aged and older adults' preferences for care. Drawing on data from the Survey of Health, Ageing and Retirement in Europe and the Organisation for Economic Co-operation and Development, we analyze old age care preferences of a sample of 6,469 adults aged 50 and older with chronic disease in 14 nations. Using multilevel modeling, we analyze associations between individual-level health care needs and nation-level health care infrastructure and preference for family-based (vs. state-based) personal care. We find that middle-aged and older adults with chronic disease whose health limits their ability to perform paid work, who did not receive personal care from informal sources, and who live in nations with generous long-term care funding are less likely to prefer family-based care and more likely to prefer state-based care. We discuss these findings in light of financial risks in later life and the future role of specialized health support programs, such as long-term care. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Boundaries and e-health implementation in health and social care

Directory of Open Access Journals (Sweden)

King Gerry

2012-09-01

Full Text Available Abstract Background The major problem facing health and social care systems globally today is the growing challenge of an elderly population with complex health and social care needs. A longstanding challenge to the provision of high quality, effectively coordinated care for those with complex needs has been the historical separation of health and social care. Access to timely and accurate data about patients and their treatments has the potential to deliver better care at less cost. Methods To explore the way in which structural, professional and geographical boundaries have affected e-health implementation in health and social care, through an empirical study of the implementation of an electronic version of Single Shared Assessment (SSA in Scotland, using three retrospective, qualitative case studies in three different health board locations. Results Progress in effectively sharing electronic data had been slow and uneven. One cause was the presence of established structural boundaries, which lead to competing priorities, incompatible IT systems and infrastructure, and poor cooperation. A second cause was the presence of established professional boundaries, which affect staffs’ understanding and acceptance of data sharing and their information requirements. Geographical boundaries featured but less prominently and contrasting perspectives were found with regard to issues such as co-location of health and social care professionals. Conclusions To provide holistic care to those with complex health and social care needs, it is essential that we develop integrated approaches to care delivery. Successful integration needs practices such as good project management and governance, ensuring system interoperability, leadership, good training and support, together with clear efforts to improve working relations across professional boundaries and communication of a clear project vision. This study shows that while technological developments make

Health care needs and use of health care services among newly arrived Syrian refugees: a cross-sectional study.

Science.gov (United States)

Oda, Anna; Tuck, Andrew; Agic, Branka; Hynie, Michaela; Roche, Brenda; McKenzie, Kwame

2017-05-03

Canada welcomed 33 723 Syrian refugees between November 2015 and November 2016. This paper reports the results of a rapid assessment of health care needs and use of health care services among newly arrived Syrian refugees in Toronto. A cross-sectional study was conducted in Toronto among Syrian refugees aged 18 years or more who had been in Canada for 12 months or less. Participants were recruited initially through distribution of flyers in hotels and through direct referrals and communication with community and settlement agency partners, and then through snowball sampling. We collected sociodemographic information and data on self-perceived physical health and mental health, unmet health care needs and use of health care services. A total of 400 Syrian refugees (221 women [55.2%] and 179 men [44.8%]) were enrolled. Of the 400, 209 (52.2%) were privately sponsored refugees, 177 (44.2%) were government-assisted refugees, and 12 (3.0%) were refugees under the Blended Visa Office-Referred Program. They reported high levels of self-perceived physical and mental health. Over 90% of the sample saw a doctor in their first year in Canada, and 79.8% had a family doctor they saw regularly. However, almost half (49.0%) of the respondents reported unmet health care needs, with the 3 most common reasons reported being long wait times, costs associated with services and lack of time to seek health care services. Many factors may explain our respondents' high levels of self-perceived physical and mental health during the first year of resettlement, including initial resettlement support and eligibility for health care under the Interim Federal Health Program. However, newly arrived Syrian refugees report unmet health care needs, which necessitates more comprehensive care and management beyond the initial resettlement support. Copyright 2017, Joule Inc. or its licensors.

Health care agreements as a tool for coordinating health and social services

DEFF Research Database (Denmark)

Rudkjøbing, Andreas; Strandberg-Larsen, Martin; Vrangbaek, Karsten

2014-01-01

of general practitioners (n = 700/853). RESULTS: The health care agreements were considered more useful for coordinating care than the previous health plans. The power relationship between the regional and municipal authorities in drawing up the agreements was described as more equal. Familiarity......INTRODUCTION: In 2007, a substantial reform changed the administrative boundaries of the Danish health care system and introduced health care agreements to be signed between municipal and regional authorities. To assess the health care agreements as a tool for coordinating health and social...... with the agreements among general practitioners was higher, as was the perceived influence of the health care agreements on their work. DISCUSSION: Health care agreements with specific content and with regular follow-up and systematic mechanisms for organising feedback between collaborative partners exemplify...

[Calculation of workers' health care costs].

Science.gov (United States)

Rydlewska-Liszkowska, Izabela

2006-01-01

In different health care systems, there are different schemes of organization and principles of financing activities aimed at ensuring the working population health and safety. Regardless of the scheme and the range of health care provided, economists strive for rationalization of costs (including their reduction). This applies to both employers who include workers' health care costs into indirect costs of the market product manufacture and health care institutions, which provide health care services. In practice, new methods of setting costs of workers' health care facilitate regular cost control, acquisition of detailed information about costs, and better adjustment of information to planning and control needs in individual health care institutions. For economic institutions and institutions specialized in workers' health care, a traditional cost-effect calculation focused on setting costs of individual products (services) is useful only if costs are relatively low and the output of simple products is not very high. But when products form aggregates of numerous actions like those involved in occupational medicine services, the method of activity based costing (ABC), representing the process approach, is much more useful. According to this approach costs are attributed to the product according to resources used during different activities involved in its production. The calculation of costs proceeds through allocation of all direct costs for specific processes in a given institution. Indirect costs are settled on the basis of resources used during the implementation of individual tasks involved in the process of making a new product. In this method, so called map of processes/actions consisted in the manufactured product and their interrelations are of particular importance. Advancements in the cost-effect for the management of health care institutions depend on their managerial needs. Current trends in this regard primarily depend on treating all cost reference

Corruption in health-care systems and its effect on cancer care in Africa.

Science.gov (United States)

Mostert, Saskia; Njuguna, Festus; Olbara, Gilbert; Sindano, Solomon; Sitaresmi, Mei Neni; Supriyadi, Eddy; Kaspers, Gertjan

2015-08-01

At the government, hospital, and health-care provider level, corruption plays a major role in health-care systems in Africa. The returns on health investments of international financial institutions, health organisations, and donors might be very low when mismanagement and dysfunctional structures of health-care systems are not addressed. More funding might even aggravate corruption. We discuss corruption and its effects on cancer care within the African health-care system in a sociocultural context. The contribution of high-income countries in stimulating corruption is also described. Corrupt African governments cannot be expected to take the initiative to eradicate corruption. Therefore, international financial institutions, health organisations, and financial donors should use their power to demand policy reforms of health-care systems in Africa troubled by the issue of corruption. These modifications will ameliorate the access and quality of cancer care for patients across the continent, and ultimately improve the outcome of health care to all patients. Copyright © 2015 Elsevier Ltd. All rights reserved.

The Healthy People 2010 outcomes for the care of children with special health care needs: an effective national policy for meeting mental health care needs?

Science.gov (United States)

Spears, Amanda P

2010-05-01

To assess the effectiveness of the Maternal and Child Health Bureau's (MCHB) Six Core Outcomes for children with special health care needs (CSHCN) as indicators in measuring the degree to which mental health care needs are met. This study analyzes data from the 2001 National Survey of Children with Special Health Care Needs for 9,748 CSHCN who needed mental health care. Bivariate and logistic analyses were employed to investigate the impact of the MCHB's Six Core Outcomes on the probability of having an unmet need for mental health services. Of the 2.3 million CSHCN in the U.S. who needed mental health care in 2001, almost one-fifth did not receive all of the mental health services that they needed. Ultimately, eight Outcomes and sub-categories of Outcomes were considered. Sixty-one percent of CSHCN with a need for mental health care had care that fulfills six of the eight considered Outcomes. Logistic analysis indicates that individual fulfillment of each of the Core Outcomes and fulfillment of additional Outcomes have a significant association with reducing the probability of having an unmet mental health care need for CSHCN. This study is the first attempt to apply the Six Core Outcomes to meeting the needs for mental health care among CSHCN. Estimates of unmet need for mental health care suggest that efforts can be made to improve access for CSHCN. The initial estimates generated by this study indicate that the MCHB Outcomes are important in meeting children's mental health needs and are important indicators for informing MCHB policy.

Adult care transitioning for adolescents with special health care needs: a pivotal role for family centered care.

Science.gov (United States)

Duke, Naomi N; Scal, Peter B

2011-01-01

To examine the relationship between having a usual source of care, family centered care, and transition counseling for adolescents with special health care needs. Data are from 18,198 parents/guardians, of youth aged 12-17 years, who participated in the 2005-2006 National Survey of Children With Special Health Care Needs. Linear and logistic regression models were used to define relationships between parent report of identification of a usual place and provider of medical care for their child and counseling on four transition issues: transfer to adult providers, review of future health needs, maintaining health insurance in adulthood, and youth taking responsibility for care. The direct mediating effect of family centered care was evaluated. Youth having a usual source of care (vs. not) were more likely to receive counseling on future health needs (47.4 vs. 33.6%, P needs (56.3 vs. 39.6%, P needs and 94.9% of the effect of a usual source of care on encouragement to take responsibility for care. Study findings support the development of health care delivery models focusing on family centered care to the same degree as other health care access issues.

Professional values, technology and future health care: The view of health care professionals in The Netherlands

NARCIS (Netherlands)

M.E. Nieboer; A.M. van Hout; Joost van Hoof; Sil Aarts; Eveline Wouters

2014-01-01

Perceptions and values of care professionals are critical in successfully implementing technology in health care. The aim of this study was threefold: (1) to explore the main values of health care professionals, (2) to investigate the perceived influence of the technologies regarding these values,

Health care technology as a policy issue

NARCIS (Netherlands)

Banta, H.D.

1994-01-01

Health care technology has become an increasingly visible issue in many countries, primarily because of the rising costs of health care. In addition, many questions concerning quality of care are being raised. Health care technology assessment has been seen as an aid in addressing questions

Health care and equity in India

Science.gov (United States)

Balarajan, Yarlini; Selvaraj, S; Subramanian, S V

2011-01-01

India’s health system faces the ongoing challenge of responding to the needs of the most disadvantaged members of Indian society. Despite progress in improving access to health care, inequalities by socioeconomic status, geography and gender continue to persist. This is compounded by high out-of-pocket expenditures, with the rising financial burden of health care falling overwhelming on private households, which account for more than three-quarter of health spending in India. Health expenditures are responsible for more than half of Indian households falling into poverty; the impact of this has been increasing pushing around 39 million Indians into poverty each year. In this paper, we identify key challenges to equity in service delivery, and equity in financing and financial risk protection in India. These include imbalanced resource allocation, limited physical access to quality health services and inadequate human resources for health; high out-of-pocket health expenditures, health spending inflation, and behavioral factors that affect the demand for appropriate health care. Complementing other paper in this Series, we argue for the application of certain principles in the pursuit of equity in health care in India. These are the adoption of equity metrics in monitoring, evaluation and strategic planning, investment in developing a rigorous knowledge-base of health systems research; development of more equity-focused process of deliberative decision-making in health reform, and redefinition of the specific responsibilities and accountabilities of key actors. The implementation of these principles, together with strengthening of public health and primary care services, provide an approach for ensuring more equitable health care for India’s population. PMID:21227492

Ethical thinking and discrimination in health care

Directory of Open Access Journals (Sweden)

Aleksander Mlinšek

2012-02-01

Full Text Available RQ: Personal excellence of nursing focusing on self-transcendence and achievements is crucial for achieving excellence in health care. The question is whether there is unequal treatment of patients despite high ethical standards placed in health care.Purpose: Professional nurses code is a guide in assessing their ethical performance. People are different amongst each other, but have the same rights in the health system, which should be provided by health care services. The need to overcome inequalities has become a cornerstone of excellence in health care.Method: A small quantitative survey of nurses was conducted in one of the departments in a Slovenian hospital. To analyse the results, we used frequency statistics, Spearman's rank correlation test and chi-square test. Results: Providers of health care services are aware of the importance of ethics in its formation. Professional Code is relatively well known; 8.4 % of the respondents were not sure if they clearly define the principles of respect for equality. Discrimination, caused by providers of health care, is of a less extent. Ethical awareness among health care providers does not affect identification with the profession. The education level ofnursing personnel and the perception of discrimination based on religious affiliation influenced one another. Education has no influence on the perception of discrimination based on other circumstances.Organization: Health care organizations should integrate hygieneethical thinking among its strategic goals. Quality is not only quantifying the data. Personal excellence of health care providers, which is difficult to measure, is the basic building block of organizational excellence and patient satisfaction.Originality: There are not many research studies on perceptionsof discrimination in health care. The article raises the sensitive issue that we should talk more about.Limitations: The survey was conducted on a small sample size. Further research

Cross-cultural barriers to health care.

Science.gov (United States)

Vidaeff, Alex C; Kerrigan, Anthony J; Monga, Manju

2015-01-01

Culturally sensitive health care represents a real ethical and practical need in a Western healthcare system increasingly serving a multiethnic society. This review focuses on cross-cultural barriers to health care and incongruent aspects from a cultural perspective in the provision of health care. To overcome difficulties in culturally dissimilar interactions and eventually remove cross-cultural barriers to health care, a culturally sensitive physician considers his or her own identity, values, and beliefs; recognizes the similarities and differences among cultures; understands what those similarities and differences mean; and is able to bridge the differences to accomplish clear and effective communication.

Conscientious objection in health care

Directory of Open Access Journals (Sweden)

Kuře Josef

2016-12-01

Full Text Available The paper deals with conscientious objection in health care, addressing the problems of scope, verification and limitation of such refusal, paying attention to ideological agendas hidden behind the right of conscience where the claimed refusal can cause harm or where such a claim is an attempt to impose certain moral values on society or an excuse for not providing health care. The nature of conscientious objection will be investigated and an ethical analysis of conscientious objection will be conducted. Finally some suggestions for health care policy will be proposed.

Dual Loyalty in Prison Health Care

Science.gov (United States)

Stöver, Heino; Wolff, Hans

2012-01-01

Despite the dissemination of principles of medical ethics in prisons, formulated and advocated by numerous international organizations, health care professionals in prisons all over the world continue to infringe these principles because of perceived or real dual loyalty to patients and prison authorities. Health care professionals and nonmedical prison staff need greater awareness of and training in medical ethics and prisoner human rights. All parties should accept integration of prison health services with public health services. Health care workers in prison should act exclusively as caregivers, and medical tasks required by the prosecution, court, or security system should be carried out by medical professionals not involved in the care of prisoners. PMID:22390510

Islamic Cultures: Health Care Beliefs and Practices.

Science.gov (United States)

Kemp, Charles

1996-01-01

Presents an overview of Islamic health care beliefs and practices, noting health-related social and spiritual issues, fundamental beliefs and themes in Islam, health care beliefs and practices common among Muslims, and health-affecting social roles among Muslims. Cultural, religious, and social barriers to health care and ways to reduce them are…

High and rising health care costs.

Science.gov (United States)

Ginsburg, Paul B

2008-10-01

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

[Managed care. Its impact on health care in the USA, especially on anesthesia and intensive care].

Science.gov (United States)

Bauer, M; Bach, A

1998-06-01

Managed care, i.e., the integration of health insurance and delivery of care under the direction of one organization, is gaining importance in the USA health market. The initial effects consisted of a decrease in insurance premiums, a very attractive feature for employers. Managed care promises to contain expenditures for health care. Given the shrinking public resources in Germany, managed care seems attractive for the German health system, too. In this review the development of managed care, the principal elements, forms of organisation and practical tools are outlined. The regulation of the delivery of care by means of controlling and financial incentives threatens the autonomy of physicians: the physician must act as a "double agent", caring for the interest for the individual patient and being restricted by the contract with the managed care organisation. Cost containment by managed care was achieved by reducing the fees for physicians and hospitals (and partly by restricting care for patients). Only a fraction of this cost reduction was handed over to the enrollee or employer, and most of the money was returned with profit to the shareholders of the managed care organisations. The preeminent role of primary care physicians as gatekeepers of the health network led to a reduced demand for specialist services in general and for university hospitals and anesthesiologists in particular. The paradigm of managed care, i.e., to guide the patient and the care giver through the health care system in order to achieve cost-effective and high quality care, seems very attractive. The stress on cost minimization by any means in the daily practice of managed care makes it doubtful if managed care should be an option for the German health system, in particular because there are a number of restrictions on it in German law.

Health care financing and the sustainability of health systems.

Science.gov (United States)

Liaropoulos, Lycourgos; Goranitis, Ilias

2015-09-15

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

Health care engineering management.

Science.gov (United States)

Jarzembski, W B

1980-01-01

Today, health care engineering management is merely a concept of dreamers, with most engineering decisions in health care being made by nonengineers. It is the purpose of this paper to present a rationale for an integrated hospital engineering group, and to acquaint the clinical engineer with some of the salient features of management concepts. Included are general management concepts, organization, personnel management, and hospital engineering systems.

Health Care Services

Science.gov (United States)

Misuse and Addiction Prevention Finance & Management Services Health Care Services Juvenile Justice , 2017 Warning - A phone number that was once used for the Denali KidCare program is now being used to ask people for their credit card number in order to win a prize. The phone number related to this

Solid health care waste management status at health care centers in the West Bank - Palestinian Territory

International Nuclear Information System (INIS)

Al-Khatib, Issam A.; Sato, Chikashi

2009-01-01

Health care waste is considered a major public health hazard. The objective of this study was to assess health care waste management (HCWM) practices currently employed at health care centers (HCCs) in the West Bank - Palestinian Territory. Survey data on solid health care waste (SHCW) were analyzed for generated quantities, collection, separation, treatment, transportation, and final disposal. Estimated 4720.7 m 3 (288.1 tons) of SHCW are generated monthly by the HCCs in the West Bank. This study concluded that: (i) current HCWM practices do not meet HCWM standards recommended by the World Health Organization (WHO) or adapted by developed countries, and (ii) immediate attention should be directed towards improvement of HCWM facilities and development of effective legislation. To improve the HCWM in the West Bank, a national policy should be implemented, comprising a comprehensive plan of action and providing environmentally sound and reliable technological measures.

Health Care Employee Perceptions of Patient-Centered Care: A Photovoice Project

Science.gov (United States)

Balbale, Salva Najib; Turcios, Stephanie; LaVela, Sherri L.

2015-01-01

Given the importance of health care employees in the delivery of patient-centered care, understanding their unique perspective is essential for quality improvement. The purpose of this study was to use photovoice to evaluate perceptions and experiences around patient-centered care among Veterans Affairs (VA) health care employees. We asked participants to take photographs of salient features in their environment related to patient-centered care. We used the photographs to facilitate dialogue during follow-up interviews. Twelve VA health care employees across two VA sites participated in the project. Although most participants felt satisfied with their work environment and experiences at the VA, several areas for improvement were identified. These included a need for more employee health and wellness initiatives and a need for enhanced opportunities for training and professional growth. Application of photovoice enabled us to learn about employees' unique perspectives around patient-centered care while engaging them in an evaluation of care delivery. PMID:25274626

Teaching Health Care in Introductory Economics

Science.gov (United States)

Cutler, David M.

2017-01-01

Health care is one of the economy's biggest industries, so it is natural that the health care industry should play some role in the teaching of introductory economics. There are many ways that health care can appear in such a context: in the teaching of microeconomics, as a macroeconomic issue, to learn about social welfare, and even to learn how…

Health-enabling technologies for pervasive health care: on services and ICT architecture paradigms.

Science.gov (United States)

Haux, Reinhold; Howe, Jurgen; Marschollek, Michael; Plischke, Maik; Wolf, Klaus-Hendrik

2008-06-01

Progress in information and communication technologies (ICT) is providing new opportunities for pervasive health care services in aging societies. To identify starting points of health-enabling technologies for pervasive health care. To describe typical services of and contemporary ICT architecture paradigms for pervasive health care. Summarizing outcomes of literature analyses and results from own research projects in this field. Basic functions for pervasive health care with respect to home care comprise emergency detection and alarm, disease management, as well as health status feedback and advice. These functions are complemented by optional (non-health care) functions. Four major paradigms for contemporary ICT architectures are person-centered ICT architectures, home-centered ICT architectures, telehealth service-centered ICT architectures and health care institution-centered ICT architectures. Health-enabling technologies may lead to both new ways of living and new ways of health care. Both ways are interwoven. This has to be considered for appropriate ICT architectures of sensor-enhanced health information systems. IMIA, the International Medical Informatics Association, may be an appropriate forum for interdisciplinary research exchange on health-enabling technologies for pervasive health care.

Self-care as a health resource of elders

DEFF Research Database (Denmark)

Høy, Bente; Wagner, Lis; Hall, Elisabeth O.C.

2007-01-01

into self-care as a significant health resource of elders with different health status. It suggests that an elder's self-care ability is determined by the interaction of various sub-resources and conditions and emphasizes the constantly evolving nature of self-care. The framework may be of use in clinical...... practice, policy-making and research into health care of frail or robust elders.......AIM: To review the literature related to self-care and health promotion for elders and to develop an understanding of self-care as a health resource. BACKGROUND: Self-care may improve health and prevent illness and disabilities in elders. Although studies of self-care are numerous, the significance...

Insurance + Access ≠ Health Care: Typology of Barriers to Health Care Access for Low-Income Families

Science.gov (United States)

DeVoe, Jennifer E.; Baez, Alia; Angier, Heather; Krois, Lisa; Edlund, Christine; Carney, Patricia A.

2007-01-01

PURPOSE Public health insurance programs have expanded coverage for the poor, and family physicians provide essential services to these vulnerable populations. Despite these efforts, many Americans do not have access to basic medical care. This study was designed to identify barriers faced by low-income parents when accessing health care for their children and how insurance status affects their reporting of these barriers. METHODS A mixed methods analysis was undertaken using 722 responses to an open-ended question on a health care access survey instrument that asked low-income Oregon families, “Is there anything else you would like to tell us?” Themes were identified using immersion/crystallization techniques. Pertinent demographic attributes were used to conduct matrix coded queries. RESULTS Families reported 3 major barriers: lack of insurance coverage, poor access to services, and unaffordable costs. Disproportionate reporting of these themes was most notable based on insurance status. A higher percentage of uninsured parents (87%) reported experiencing difficulties obtaining insurance coverage compared with 40% of those with insurance. Few of the uninsured expressed concerns about access to services or health care costs (19%). Access concerns were the most common among publicly insured families, and costs were more often mentioned by families with private insurance. Families made a clear distinction between insurance and access, and having one or both elements did not assure care. Our analyses uncovered a 3-part typology of barriers to health care for low-income families. CONCLUSIONS Barriers to health care can be insurmountable for low-income families, even those with insurance coverage. Patients who do not seek care in a family medicine clinic are not necessarily getting their care elsewhere. PMID:18025488

Health Care System Measures to Advance Preconception Wellness: Consensus Recommendations of the Clinical Workgroup of the National Preconception Health and Health Care Initiative.

Science.gov (United States)

Frayne, Daniel J; Verbiest, Sarah; Chelmow, David; Clarke, Heather; Dunlop, Anne; Hosmer, Jennifer; Menard, M Kathryn; Moos, Merry-K; Ramos, Diana; Stuebe, Alison; Zephyrin, Laurie

2016-05-01

Preconception wellness reflects a woman's overall health before conception as a strategy to affect health outcomes for the woman, the fetus, and the infant. Preconception wellness is challenging to measure because it attempts to capture health status before a pregnancy, which may be affected by many different service points within a health care system. The Clinical Workgroup of the National Preconception Health and Health Care Initiative proposes nine core measures that can be assessed at initiation of prenatal care to index a woman's preconception wellness. A two-stage web-based modified Delphi survey and a face-to-face meeting of key opinion leaders in women's reproductive health resulted in identifying seven criteria used to determine the core measures. The Workgroup reached unanimous agreement on an aggregate of nine preconception wellness measures to serve as a surrogate but feasible assessment of quality preconception care within the larger health community. These include indicators for: 1) pregnancy intention, 2) access to care, 3) preconception multivitamin with folic acid use, 4) tobacco avoidance, 5) absence of uncontrolled depression, 6) healthy weight, 7) absence of sexually transmitted infections, 8) optimal glycemic control in women with pregestational diabetes, and 9) teratogenic medication avoidance. The focus of the proposed measures is to quantify the effect of health care systems on advancing preconception wellness. The Workgroup recommends that health care systems adopt these nine preconception wellness measures as a metric to monitor performance of preconception care practice. Over time, monitoring these baseline measures will establish benchmarks and allow for comparison within and among regions, health care systems, and communities to drive improvements.

The Quiet Health Care Revolution.

Science.gov (United States)

Herzlinger, Regina

1994-01-01

Discusses how entrepreneurs have helped reduce costs in health care and examines the major changes in the health care system that are simultaneously lowering costs and increasing quality. The author then explains how current reform proposals might affect these entrepreneurial innovations. (GLR)

The carbon footprint of Australian health care.

Science.gov (United States)

Malik, Arunima; Lenzen, Manfred; McAlister, Scott; McGain, Forbes

2018-01-01

Carbon footprints stemming from health care have been found to be variable, from 3% of the total national CO 2 equivalent (CO 2 e) emissions in England to 10% of the national CO 2 e emissions in the USA. We aimed to measure the carbon footprint of Australia's health-care system. We did an observational economic input-output lifecycle assessment of Australia's health-care system. All expenditure data were obtained from the 15 sectors of the Australian Institute of Health and Welfare for the financial year 2014-15. The Australian Industrial Ecology Virtual Laboratory (IELab) data were used to obtain CO 2 e emissions per AUS$ spent on health care. In 2014-15 Australia spent $161·6 billion on health care that led to CO 2 e emissions of about 35 772 (68% CI 25 398-46 146) kilotonnes. Australia's total CO 2 e emissions in 2014-15 were 494 930 kilotonnes, thus health care represented 35 772 (7%) of 494 930 kilotonnes total CO 2 e emissions in Australia. The five most important sectors within health care in decreasing order of total CO 2 e emissions were: public hospitals (12 295 [34%] of 35 772 kilotonnes CO 2 e), private hospitals (3635 kilotonnes [10%]), other medications (3347 kilotonnes [9%]), benefit-paid drugs (3257 kilotonnes [9%]), and capital expenditure for buildings (2776 kilotonnes [8%]). The carbon footprint attributed to health care was 7% of Australia's total; with hospitals and pharmaceuticals the major contributors. We quantified Australian carbon footprint attributed to health care and identified health-care sectors that could be ameliorated. Our results suggest the need for carbon-efficient procedures, including greater public health measures, to lower the impact of health-care services on the environment. None. Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.

[An experience of collaboration between primary health care and mental health care in La Ribera Department of Health (Valencia, Spain)].

Science.gov (United States)

Morera-Llorca, Miquel; Romeu-Climent, José Enrique; Lera-Calatayud, Guillem; Folch-Marín, Blanca; Palop-Larrea, Vicente; Vidal-Rubio, Sonia

2014-01-01

Despite the high prevalence of mental health problems among patients attending primary care, diagnosis and treatment of these disorders remain inadequate. Sound training of primary care physicians in how to manage mental health problems is needed to reduce the health, economic and social impact associated with these disorders. Among other elements, there is a need for cooperation between primary care physicians and mental health services. Distinct models are available for such collaboration. In 2006, our health department started a collaboration between these two levels of heath care, using a liaison model. Delays until the first specialist visit were reduced and satisfaction among health professionals increased, although these results should be interpreted with caution. Evidence has recently accumulated on the usefulness of the collaborative model, but evaluation of this model and extrapolation of its results are complex. We intend to evaluate our model more thoroughly, similar to other projects in our environment. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

Health care policy and community pharmacy: implications for the New Zealand primary health care sector.

Science.gov (United States)

Scahill, Shane; Harrison, Jeff; Carswell, Peter; Shaw, John

2010-06-25

The aim of our paper is to expose the challenges primary health care reform is exerting on community pharmacy and other groups. Our paper is underpinned by the notion that a broad understanding of the issues facing pharmacy will help facilitate engagement by pharmacy and stakeholders in primary care. New models of remuneration are required to deliver policy expectations. Equally important is redefining the place of community pharmacy, outlining the roles that are mooted and contributions that can be made by community pharmacy. Consistent with international policy shifts, New Zealand primary health care policy outlines broad directives which community pharmacy must respond to. Policymakers are calling for greater integration and collaboration, a shift from product to patient-centred care; a greater population health focus and the provision of enhanced cognitive services. To successfully implement policy, community pharmacists must change the way they think and act. Community pharmacy must improve relationships with other primary care providers, District Health Boards (DHBs) and Primary Health Organisations (PHOs). There is a requirement for DHBs to realign funding models which increase integration and remove the requirement to sell products in pharmacy in order to deliver services. There needs to be a willingness for pharmacy to adopt a user pays policy. General practitioners (GPs) and practice nurses (PNs) need to be aware of the training and skills that pharmacists have, and to understand what pharmacists can offer that benefits their patients and ultimately general practice. There is also a need for GPs and PNs to realise the fiscal and professional challenges community pharmacy is facing in its attempt to improve pharmacy services and in working more collaboratively within primary care. Meanwhile, community pharmacists need to embrace new approaches to practice and drive a clearly defined agenda of renewal in order to meet the needs of health funders, patients

Health and Disability: Partnerships in Health Care

Science.gov (United States)

Tracy, Jane; McDonald, Rachael

2015-01-01

Background: Despite awareness of the health inequalities experienced by people with intellectual disability, their health status remains poor. Inequalities in health outcomes are manifest in higher morbidity and rates of premature death. Contributing factors include the barriers encountered in accessing and receiving high-quality health care.…

Curing a meagre health care system by lean methods--translating 'chains of care' in the Swedish health care sector.

Science.gov (United States)

Trägårdh, Björn; Lindberg, Kajsa

2004-01-01

The purpose of this article is to discuss what happens when work embedded in a 'meagre' organizational context is changed by lean production-related methods. The article is based on studies of seven lean production-inspired projects in the Swedish health care sector, a sector already poor due to organizational slack. The projects were directed to develop 'health care chains', an organizational concept regarded as a way to rationalize health care organizations as well as to develop them, i.e. increase productivity, quality from a customer perspective and quality of working conditions. The article analyses the projects from an interpretative perspective and discusses how modem management models with ambitions to concurrently rationalize and develop organizations--e.g. lean production and health care chains--are used in a 'meagre' organizational field. As an outcome, a model is presented that explores what is beyond simple imitations and unique translations of ideas when a new concept is implemented in local organizations.

Transforming health care delivery through consumer engagement, health data transparency, and patient-generated health information.

Science.gov (United States)

Sands, D Z; Wald, J S

2014-08-15

Address current topics in consumer health informatics. Literature review. Current health care delivery systems need to be more effective in the management of chronic conditions as the population turns older and experiences escalating chronic illness that threatens to consume more health care resources than countries can afford. Most health care systems are positioned poorly to accommodate this. Meanwhile, the availability of ever more powerful and cheaper information and communication technology, both for professionals and consumers, has raised the capacity to gather and process information, communicate more effectively, and monitor the quality of care processes. Adapting health care systems to serve current and future needs requires new streams of data to enable better self-management, improve shared decision making, and provide more virtual care. Changes in reimbursement for health care services, increased adoption of relevant technologies, patient engagement, and calls for data transparency raise the importance of patient-generated health information, remote monitoring, non-visit based care, and other innovative care approaches that foster more frequent contact with patients and better management of chronic conditions.

FastStats: Home Health Care

Science.gov (United States)

... this? Submit What's this? Submit Button NCHS Home Home Health Care Recommend on Facebook Tweet Share Compartir Data are ... National Study of Long-Term Care Providers Nursing Home Care Residential Care Communities Centers for Medicare and Medicaid ...

Competence of health care providers on care of newborns at birth in ...

African Journals Online (AJOL)

Introduction: This is an observational study which was carried out at a level one health facility in Yaoundé from June to July 2009. The aim was to evaluate the competence of health care providers towards newborns' care at birth. Methods: Ten health care providers took care of three hundred and thirty-five pregnant women ...

Parity for mental health and substance abuse care under managed care.

Science.gov (United States)

Frank, Richard G.; McGuire, Thomas G.

1998-12-01

BACKGROUND: Parity in insurance coverage for mental health and substance abuse has been a key goal of mental health and substance abuse care advocates in the United States during most of the past 20 years. The push for parity began during the era of indemnity insurance and fee for service payment when benefit design was the main rationing device in health care. The central economic argument for enacting legislation aimed at regulating the insurance benefit was to address market failure stemming from adverse selection. The case against parity was based on inefficiency related to moral hazard. Empirical analyses provided evidence that ambulatory mental health services were considerably more responsive to the terms of insurance than were ambulatory medical services. AIMS: Our goal in this research is to reexamine the economics of parity in the light of recent changes in the delivery of health care in the United States. Specifically managed care has fundamentally altered the way in which health services are rationed. Benefit design is now only one mechanism among many that are used to allocate health care resources and control costs. We examine the implication of these changes for policies aimed at achieving parity in insurance coverage. METHOD: We develop a theoretical approach to characterizing rationing under managed care. We then analyze the traditional efficiency concerns in insurance, adverse selection and moral hazard in the context of policy aimed at regulating health and mental health benefits under private insurance. RESULTS: We show that since managed care controls costs and utilization in new ways parity in benefit design no longer implies equal access to and quality of mental health and substance abuse care. Because costs are controlled by management under managed care and not primarily by out of pocket prices paid by consumers, demand response recedes as an efficiency argument against parity. At the same time parity in benefit design may accomplish less

Journal of Community Medicine and Primary Health Care

African Journals Online (AJOL)

Journal of Community Medicine and Primary Health Care. ... environmental health, clinical care, health planning and management, health policy, health ... non-communicable diseases within the Primary Health Care system in the Federal ... Assessment of occupational hazards, health problems and safety practices of petrol ...

Community health workers and health care delivery: evaluation of a women's reproductive health care project in a developing country.

Science.gov (United States)

Wajid, Abdul; White, Franklin; Karim, Mehtab S

2013-01-01

As part of the mid-term evaluation of a Women's Health Care Project, a study was conducted to compare the utilization of maternal and neonatal health (MNH) services in two areas with different levels of service in Punjab, Pakistan. A cross-sectional survey was conducted to interview Married Women of Reproductive Age (MWRA). Information was collected on MWRA knowledge regarding danger signs during pregnancy, delivery, postnatal periods, and MNH care seeking behavior. After comparing MNH service utilization, the two areas were compared using a logistic regression model, to identify the association of different factors with the intervention after controlling for socio-demographic, economic factors and distance of the MWRA residence to a health care facility. The demographic characteristics of women in the two areas were similar, although socioeconomic status as indicated by level of education and better household amenities, was higher in the intervention area. Consequently, on univariate analysis, utilization of MNH services: antenatal care, TT vaccination, institutional delivery and use of modern contraceptives were higher in the intervention than control area. Nonetheless, multivariable analysis controlling for confounders such as socioeconomic status revealed that utilization of antenatal care services at health centers and TT vaccination during pregnancy are significantly associated with the intervention. Our findings suggest positive changes in health care seeking behavior of women and families with respect to MNH. Some aspects of care still require attention, such as knowledge about danger signs and neonatal care, especially umbilical cord care. Despite overall success achieved so far in response to the Millennium Development Goals, over the past two decades decreases in maternal mortality are far from the 2015 target. This report identifies some of the key factors to improving MNH and serves as an interim measure of a national and global challenge that remains

Community health workers and health care delivery: evaluation of a women's reproductive health care project in a developing country.

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Abdul Wajid

Full Text Available BACKGROUND: As part of the mid-term evaluation of a Women's Health Care Project, a study was conducted to compare the utilization of maternal and neonatal health (MNH services in two areas with different levels of service in Punjab, Pakistan. METHODS: A cross-sectional survey was conducted to interview Married Women of Reproductive Age (MWRA. Information was collected on MWRA knowledge regarding danger signs during pregnancy, delivery, postnatal periods, and MNH care seeking behavior. After comparing MNH service utilization, the two areas were compared using a logistic regression model, to identify the association of different factors with the intervention after controlling for socio-demographic, economic factors and distance of the MWRA residence to a health care facility. RESULTS: The demographic characteristics of women in the two areas were similar, although socioeconomic status as indicated by level of education and better household amenities, was higher in the intervention area. Consequently, on univariate analysis, utilization of MNH services: antenatal care, TT vaccination, institutional delivery and use of modern contraceptives were higher in the intervention than control area. Nonetheless, multivariable analysis controlling for confounders such as socioeconomic status revealed that utilization of antenatal care services at health centers and TT vaccination during pregnancy are significantly associated with the intervention. CONCLUSIONS: Our findings suggest positive changes in health care seeking behavior of women and families with respect to MNH. Some aspects of care still require attention, such as knowledge about danger signs and neonatal care, especially umbilical cord care. Despite overall success achieved so far in response to the Millennium Development Goals, over the past two decades decreases in maternal mortality are far from the 2015 target. This report identifies some of the key factors to improving MNH and serves as an

Corporate moral responsibility in health care.

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Wilmot, S

2000-01-01

The question of corporate moral responsibility--of whether it makes sense to hold an organisation corporately morally responsible for its actions, rather than holding responsible the individuals who contributed to that action--has been debated over a number of years in the business ethics literature. However, it has had little attention in the world of health care ethics. Health care in the United Kingdom (UK) is becoming an increasingly corporate responsibility, so the issue is increasingly relevant in the health care context, and it is worth considering whether the specific nature of health care raises special questions around corporate moral responsibility. For instance, corporate responsibility has usually been considered in the context of private corporations, and the organisations of health care in the UK are mainly state bodies. However, there is enough similarity in relevant respects between state organisations and private corporations, for the question of corporate responsibility to be equally applicable. Also, health care is characterised by professions with their own systems of ethical regulation. However, this feature does not seriously diminish the importance of the corporate responsibility issue, and the importance of the latter is enhanced by recent developments. But there is one major area of difference. Health care, as an activity with an intrinsically moral goal, differs importantly from commercial activities that are essentially amoral, in that it narrows the range of opportunities for corporate wrongdoing, and also makes such organisations more difficult to punish.

Health Care Access Among Deaf People.

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Kuenburg, Alexa; Fellinger, Paul; Fellinger, Johannes

2016-01-01

Access to health care without barriers is a clearly defined right of people with disabilities as stated by the UN Convention on the Rights of People with Disabilities. The present study reviews literature from 2000 to 2015 on access to health care for deaf people and reveals significant challenges in communication with health providers and gaps in global health knowledge for deaf people including those with even higher risk of marginalization. Examples of approaches to improve access to health care, such as providing powerful and visually accessible communication through the use of sign language, the implementation of important communication technologies, and cultural awareness trainings for health professionals are discussed. Programs that raise health knowledge in Deaf communities and models of primary health care centers for deaf people are also presented. Published documents can empower deaf people to realize their right to enjoy the highest attainable standard of health. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Use of Mental Health Care and Unmet Needs for Health Care Among Lesbian and Bisexual Chinese-, Korean-, and Vietnamese-American Women.

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Hahm, Hyeouk Chris; Lee, Jieha; Chiao, Christine; Valentine, Anne; Lê Cook, Benjamin

2016-12-01

This study examined associations between sexual orientation of Asian-American women and receipt of mental health care and unmet need for health care. Computer-assisted self-interviews were conducted with 701 unmarried Chinese-, Korean-, and Vietnamese-American women ages 18 to 35. Multivariate regression models examined whether lesbian and bisexual participants differed from exclusively heterosexual participants in use of mental health care and unmet need for health care. After the analyses controlled for mental health status and other covariates, lesbian and bisexual women were more likely than exclusively heterosexual women to have received any past-year mental health services and reported a greater unmet need for health care. Sexual-minority women were no more likely to have received minimally adequate care. Given the high rates of mental health problems among Asian-American sexual-minority women, efforts are needed to identify and overcome barriers to receipt of adequate mental health care and minimize unmet health care needs.

Congenital Heart Disease: Guidelines of Care for Children with Special Health Care Needs.

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Minnesota State Dept. of Health, Minneapolis. Services for Children with Handicaps.

These guidelines were written to help families coordinate the health care that may be needed by a child with congenital heart disease. The booklet begins with general information about congenital heart disease. It then discusses the goals of health care, the health care team, the importance of periodic health care, and record keeping procedures.…

Evaluation of Student Care Process in Urban and Rural Health Care Centers and Health House in Tabriz Using Tracer Methodology

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Neda Kabiri

2015-08-01

Full Text Available Background and Objectives : Tracer methodology is a novel evaluation method which its purpose is to provide an accurate assessment of systems and processes for the delivery of care, treatment, and services at a health care organization. This study aimed to assess student care process in Tabriz using Tracer methodology. Material and Methods : This cross-sectional study was conducted in autumn 1391. Population study consisted of all the students who were covered by Tabriz health care center and study sample included an urban health care center, a rural health care center, a health house, and two schools in urban and rural areas which were selected by simple sampling method. Also, all the complicated and problematic processes were chosen to be assessed. Data were collected by interviewing, observing, and surveying documents and were compared with current standards. Results : The results of this study declared the percentage of points that each target group gained from tracer evaluation in student care process was 77% in health house, 90% in rural health care center and 83% in urban health care center. Findings indicated that documentation was the main weak point. Conclusion : According to the results of this study, student care process is sufficient; despite the fact that there are some deficiencies in caring process, as it may be improved through appropriate strategies. Furthermore, tracer methodology seems to be a proper method to evaluate various levels of health care system. ​

Health care delivery in Malaysia: changes, challenges and champions

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Thomas, Susan; Beh, LooSee; Nordin, Rusli Bin

2011-01-01

Since 1957, there has been major reorganization of health care services in Malaysia. This article assesses the changes and challenges in health care delivery in Malaysia and how the management in health care processes has evolved over the years including equitable health care and health care financing. The health care service in Malaysia is changing towards wellness service as opposed to illness service. The Malaysian Ministry of Health (MOH), being the main provider of health services, may need to manage and mobilize better health care services by providing better health care financing mechanisms. It is recommended that partnership between public and private sectors with the extension of traditional medicine complementing western medicine in medical therapy continues in the delivery of health care. PMID:28299064

Predictors of Adolescent Health Care Utilization

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Vingilis, Evelyn; Wade, Terrance; Seeley, Jane

2007-01-01

This study, using Andersen's health care utilization model, examined how predisposing characteristics, enabling resources, need, personal health practices, and psychological factors influence health care utilization using a nationally representative, longitudinal sample of Canadian adolescents. Second, this study examined whether this process…

World Health Organization Public Health Model: A Roadmap for Palliative Care Development.

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Callaway, Mary V; Connor, Stephen R; Foley, Kathleen M

2018-02-01

The Open Society Foundation's International Palliative Care Initiative (IPCI) began to support palliative care development in Central and Eastern Europe and the Former Soviet Union in 1999. Twenty-five country representatives were invited to discuss the need for palliative care in their countries and to identify key areas that should be addressed to improve the care of adults and children with life-limiting illnesses. As a public health concern, progress in palliative care requires integration into health policy, education and training of health care professionals, availability of essential pain relieving medications, and health care services. IPCI created the Palliative Care Roadmap to serve as a model for government and/or nongovernment organizations to use to frame the necessary elements and steps for palliative care integration. The roadmap includes the creation of multiple Ministry of Health-approved working groups to address: palliative care inclusion in national health policy, legislation, and finance; availability of essential palliative care medications, especially oral opioids; education and training of health care professionals; and the implementation of palliative care services at home or in inpatient settings for adults and children. Each working group is tasked with developing a pathway with multiple signposts as indicators of progress made. The roadmap may be entered at different signposts depending upon the state of palliative care development in the country. The progress of the working groups often takes place simultaneously but at variable rates. Based on our experience, the IPCI Roadmap is one possible framework for palliative care development in resource constrained countries but requires both health care professional engagement and political will for progress to be made. Copyright © 2017. Published by Elsevier Inc.

Consumer subjectivity and U.S. health care reform.

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West, Emily

2014-01-01

Health care consumerism is an important frame in U.S. health care policy, especially in recent media and policy discourse about federal health care reform. This article reports on qualitative fieldwork with health care users to find out how people interpret and make sense of the identity of "health care consumer." It proposes that while the term consumer is normally understood as a descriptive label for users who purchase health care and insurance services, it should actually be understood as a metaphor, carrying with it a host of associations that shape U.S. health care policy debates in particular ways. Based on interviews with 36 people, patient was the dominant term people used to describe themselves, but consumer was the second most popular. Informants interpreted the health care consumer as being informed, proactive, and having choices, but there were also "semiotic traps," or difficult-to-resolve tensions for this identity. The discourse of consumerism functions in part as code for individual responsibility, and therefore as a classed moral discourse, with implications for U.S. health care policy.

Transition care for children with special health care needs.

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Davis, Alaina M; Brown, Rebekah F; Taylor, Julie Lounds; Epstein, Richard A; McPheeters, Melissa L

2014-11-01

Approximately 750,000 children in the United States with special health care needs will transition from pediatric to adult care annually. Fewer than half receive adequate transition care. We had conversations with key informants representing clinicians who provide transition care, pediatric and adult providers of services for individuals with special health care needs, policy experts, and researchers; searched online sources for information about currently available programs and resources; and conducted a literature search to identify research on the effectiveness of transition programs. We identified 25 studies evaluating transition care programs. Most (n = 8) were conducted in populations with diabetes, with a smaller literature (n = 5) on transplant patients. We identified an additional 12 studies on a range of conditions, with no more than 2 studies on the same condition. Common components of care included use of a transition coordinator, a special clinic for young adults in transition, and provision of educational materials. The issue of how to provide transition care for children with special health care needs warrants further attention. Research needs are wide ranging, including both substantive and methodologic concerns. Although there is widespread agreement on the need for adequate transition programs, there is no accepted way to measure transition success. It will be essential to establish consistent goals to build an adequate body of literature to affect practice. Copyright © 2014 by the American Academy of Pediatrics.

The importance of health information technology in care coordination and transitional care.

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Cipriano, Pamela F; Bowles, Kathryn; Dailey, Maureen; Dykes, Patricia; Lamb, Gerri; Naylor, Mary

2013-01-01

Care coordination and transitional care services are strategically important for achieving the priorities of better care, better health, and reduced costs embodied in the National Strategy for Quality Improvement in Health Care (National Quality Strategy [NQS]). Some of the most vulnerable times in a person’s care occur with changes in condition as well as movement within and between settings of care. The American Academy of Nursing (AAN) believes it is essential to facilitate the coordination of care and transitions by using health information technology (HIT) to collect, share, and analyze data that communicate patient-centered information among patients, families, and care providers across communities. HIT makes information accessible, actionable, timely, customizable, and portable. Rapid access to information also creates efficiencies in care by eliminating redundancies and illuminating health history and prior care. The adoption of electronic health records (EHRs) and information systems can enable care coordination to be more effective but only when a number of essential elements are addressed to reflect the team-based nature of care coordination as well as a focus on the individual’s needs and preferences. To that end, the AAN offers a set of recommendations to guide the development of the infrastructure, standards, content, and measures for electronically enabled care coordination and transitions in care as well as research needed to build the evidence base to assess outcomes of the associated interventions.

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

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Malmivaara, Antti

2016-01-01

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

Cognitive systems engineering in health care

CERN Document Server

Bisantz, Ann M; Fairbanks, Rollin J

2014-01-01

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

Primary health care in India.

Science.gov (United States)

Deodhar, N S

1982-03-01

Concurrently with the development of the general health services infrastructure in India, serveral special health programs were instituted at the national level to provide a massive and concentrated assault on the major public health problems of malaria, smallpox, cholera, trachoma, tuberculosis, leprosy, filariasis, and the rapid population growth. These vertical programs were expected to reduce the heavy morbidity and mortality within the shortest possible time to where they were no longer major public health problems. The impact was variable. Major steps toward providing integrated health care were taken during the first 5-year plan. Emphasis was on the provision of a packet of inttegrated health, family planning, and nutrition services to the vulnerable groups, i.e., children, pregnant women, and nursing mothers. To rectify past shortcomings ssuch as the failures of the national health programs, ineffective coordination in the nutrition programs, and slow rate of development as a result of interdependence of different sectors, it was necessary to improve the health infrastructure and to launch a frontal attack on poverty. The Multipurpose Health Workers Scheme was planned to rationalize the organization and use of available manpower to reduce the area and population covered by each of the field staff in order to reduce travel time and to make services more effective and more satisfactory. Each multipurpose health worker was entrusted with the task of providing comprehensive health care to about 5000 people. Communicable diseases were the main public health problems, and many specific control/eradication programs were launched. the immunization programs against common childhood diseases have not taken deep roots and coverage continues to be poor. The adoption of the Western model of medical services has resulted in emphasis on "cure" rather than on "care". Another problem is maldistribution of the facilities. Overemphasis on medical education has resulted in the

Rural migration and health care

DEFF Research Database (Denmark)

Svendsen, Gunnar Lind Haase; Jensen, Marit Vatn

This literature study focuses on possible links between access to health services and migration in rural areas. Why do people move to or from rural areas or why do they stay? What determines where people settle? And, in this context, do local health care services play an important or minor role......, or no role at all? First, the paper reports on key findings from rural migration studies, in order to shed light on two migration trends: urbanization and counter-urbanization. Then we take a closer look on settlement preferences in rural areas, including the impact of health care facilities. Finally, we end...... up with a more deepgoing review of the relatively small number of studies, which explicitly deal with settlement preferences related to access to health care....

Primary health care in Canada: systems in motion.

Science.gov (United States)

Hutchison, Brian; Levesque, Jean-Frederic; Strumpf, Erin; Coyle, Natalie

2011-06-01

During the 1980s and 1990s, innovations in the organization, funding, and delivery of primary health care in Canada were at the periphery of the system rather than at its core. In the early 2000s, a new policy environment emerged. This policy analysis examines primary health care reform efforts in Canada during the last decade, drawing on descriptive information from published and gray literature and from a series of semistructured interviews with informed observers of primary health care in Canada. Primary health care in Canada has entered a period of potentially transformative change. Key initiatives include support for interprofessional primary health care teams, group practices and networks, patient enrollment with a primary care provider, financial incentives and blended-payment schemes, development of primary health care governance mechanisms, expansion of the primary health care provider pool, implementation of electronic medical records, and quality improvement training and support. Canada's experience suggests that primary health care transformation can be achieved voluntarily in a pluralistic system of private health care delivery, given strong government and professional leadership working in concert. © 2011 Milbank Memorial Fund. Published by Wiley Periodicals Inc.